Fat China: How Expanding Waistlines are Changing a Nation by Paul French and Matthew Crabbe Anthem Press HK$298 'Obesity is a bullet that the Chinese government, society and their healthcare system cannot dodge.' So reads the conclusion of Fat China, which looks at one aspect of the 'economic miracle' that had previously escaped attention. Authors Paul French and Matthew Crabbe are co-founders of Access Asia, a Shanghai-based company specialising in analysis of China's consumer and lifestyle sectors, especially food, beverage and retail. The book grew out of a study the company undertook for CLSA Emerging Markets on the growing rates of obesity on the mainland. Their findings are startling. In October 2004, the Ministry of Health announced 22.8 per cent of adults were overweight and a further 7.1 per cent - 60 million people - clinically obese. These are increases of 39 per cent and 97 per cent respectively from 1992. The book estimates that by 2020, 29.3 per cent of the population will be overweight and 15.9 per cent obese. Wang Longde, deputy health minister in 2004, said: 'Lifestyles, eating habits and the healthcare system have changed and so have diseases and health rates. Chronic diseases do not only affect health, they undermine the working strength of society.' The shape of the nation has changed in a way unprecedented in its history. From 1959 to 1961, between 30 million and 40 million died of hunger, and food rationing continued until the 1980s. But in the past 30 years, the average child has become 3kg heavier than in 1980. The average waist size of an urban male is 76.2cm, compared to 63.5cm in 1985, with those in the 40-50 age group rising by 7.9cm to 82.6cm. The chest circumference of the average urban female is 84cm, an increase of 1cm since 1992. Fat China explains the changes in diet, lifestyle and society that have caused this transformation. While in rich countries obesity is mainly a problem for the poor, in China it is a problem of the urban middle class. It is they who have eagerly embraced the lifestyle, fast food and culture of the West. In the 80s, urban Chinese went to work on foot or by bicycle. Now they sit in crowded buses or subways and, increasingly, in cars. In 'socialist China', work was relaxed, with time for sports, tai chi and walking to the wet market to buy fresh produce. Now, people work for hours in front of computers; their only break is to go outside for a smoke. In the 'socialist' days, everyone ate at the work canteen or at home; public restaurants were few and expensive. Now, nearly half of white-collar women in Beijing and Guangzhou do not cook at home after work and 10 per cent say they don't cook at all. Instead, they go to the enormous variety of food outlets now available, many offering Western cuisine. The growth in sales of Western food is astonishing. Between 2003 and 2009, sales of ice cream rose 132 per cent, chilled ready meals 131 per cent, cakes and sweet biscuits 124 per cent and chocolate 78 per cent. Average consumption of sugar is 10kg a year, 82 per cent more than in 2001, and is expected to rise to 15kg in 2012. Between 2001 and 2007, sales of carbonated soft drinks rose 105 per cent. 'As diet has changed in China, it is children's diets that have changed the most. Older Chinese may be able to afford more, but they do not always want fast food or Western food or snacks. Children do - their metabolisms tell that as well as peer group pressure, doting parents and advertisers,' the authors write. Opportunities to work off the weight have diminished. City residents work long hours, with a commute of one to two hours a day. Public space for exercise is limited, even in schools, where the emphasis is on academic achievements. Fat China also describes the impact of obesity on the creaking healthcare system. The strength of this book is the wealth of its research, which charts the changes in the diet and lifestyle of Chinese people over the past 30 years. This research is of great value to the companies, Chinese and foreign, that aim to sell to this market and need to keep pace with its rapid changes. For the general reader, it offers an explanation of what they see everywhere in China: the podgy child with his doting grandparents in tow, the queues outside Pizza Hut and KFC outlets, and the dating couple having their picture taken with a smiling Ronald MacDonald.