Childhood Obesity Common In Both New York and Shanghai Interview with:
May May Leung Ph.D.

Hunter College School of Urban Public Health,
City University of New York School of Public Health
New York, NY

MedicalResearch: What is the background for this study?

Dr. Leung: Shanghai and New York City are two urban centers that play a key role in the global economy. However, both cities are facing elevated rates and inequitable distributions of childhood obesity. Given the role that obesity plays in the etiology of chronic diseases, this epidemic calls for interurban learning to better understand some of its diet-related determinants. In turn, this paper attempts to explore how culture, history and politics have influenced the rates and distributions of childhood obesity in Shanghai and New York City, to inform public health officials as to what approaches could be taken to address the epidemic in ‘world cities’.

MedicalResearch: What are the main findings?

Dr. Leung: Our paper found that Shanghai and New York City face similar, yet unique challenges to the childhood obesity epidemic. Both cities have combined rates of childhood obesity and overweight that are higher than their national averages. Childhood obesity first appeared in Shanghai in 1985 and continues to rise, though the rise is disproportionately greater in high- and middle-income populations and younger boys, with increasing concern in the growing minority and migrant population. In New York City, childhood obesity appeared 25 years earlier and is gradually decreasing, but at the cost of growing inequities; this epidemic is increasingly more prevalent among low-income populations, especially in black and Hispanic adolescents.

China’s economic growth has resulted in dietary behaviors consistent with other countries undergoing a nutrition transition, which include increased consumption of animal products and edible oils. Chinese children’s diets now resemble that of American children’s in the mid-1990s. Meanwhile, American youth are now consuming large amounts of carbohydrates and simple sugars. Changing dietary behaviors in both cities further stem from other influences such as shifts in food distribution chains, media and marketing of unhealthy foods, and gender and cultural values.

As the diet-related determinants of childhood obesity are complex and multi-factorial, responses to address this epidemic should be equally complex, which include multi-sectoral approaches with action at the individual, family, community, municipal, national and global levels. Shanghai and New York City have strong municipal governments committed to taking action, but both face challenges in establishing comprehensive and sustainable programs that reach all sectors of the population.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Leung: This paper highlighted some of the diet-related social and behavioral determinants of childhood obesity in Shanghai and New York City and identified possible programs and policies that each city could adopt to address inequalities in childhood obesity prevalence. Laying this groundwork was fundamental for understanding how cultural, historical and political differences shaped the distribution of the epidemic in these cities.

Future research should consider examining the implementation and impact of existing municipal responses to the childhood obesity epidemic in Shanghai and New York City. Summarizing existing initiatives will help to better understand how these programs and policies are shaped and how unique governance structures of Shanghai and New York City may have influenced their adoption and impact. Such information could help to inform the development of future program and policy initiatives with increased potential public health impact.


Diet-related determinants of childhood obesity in urban settings: a comparison between Shanghai and New York

M.M. Leung, H. Fu, A. Agaronov, N. Freudenberg
Public Health Available online 2 April 2015 Interview with:, & Alexandre Faisal-Cury, MD, PhD (2015). Childhood Obesity Common In Both New York and Shanghai 


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