What is the clinical evidence from this study?

Study design: Cohort. Population: Obesity and metabolic health (n=118639). Intervention: Observation (2014-2024). Primary outcome: Overall obesity prevalence.

What question did this study set out to answer?

The study aims to analyze long-term trends in obesity and metabolic health among middle-aged and older adults in China.

May 14, 2026Open Access

Decadal Trends in Obesity and Metabolic Health Phenotypes among Middle-Aged and Older Adults in China (2014–2024): Insights from the KARE Cohort Study

Key Result

Over a 10-year period, overall obesity prevalence among middle-aged and older adults in China rose from 38.43% to 44.01%, and abdominal obesity increased from 42.91% to 54.64%.

Key Points

The study aims to analyze long-term trends in obesity and metabolic health among middle-aged and older adults in China.
Utilized the Kunshan Ageing Research with E-health cohort (KARE) for data analysis from 2014 to 2024, with participant numbers ranging from 69,880 to 118,639.
Performed longitudinal analysis of individual BMI transitions among 40,335 to 42,601 participants.
Measured anthropometric data professionally to assess obesity prevalence and transitions over a decade.
Obesity prevalence among middle-aged/older adults rose significantly from 38.43% to 44.01%.
Metabolically unhealthy overweight/obesity predominated, with 52.34% changing their BMI category over the decade.
Abdominal obesity increased from 42.91% to 54.64%, particularly affecting women, while significant percentages of individuals transitioned between metabolic health categories.

Study Design

Type

Cohort (n=118,639)

Structured PICO

Population

Middle-aged and older adults in China from the Kunshan Ageing Research with E-health (KARE) cohort (repeated cross-sections n=69,880-118,639; longitudinal analysis n=40,335-42,601)

Outcome

Trends in obesity prevalence, abdominal obesity, and metabolic health phenotypes over 10 yearssurrogate

The prevalence of overall and abdominal obesity, as well as metabolically unhealthy phenotypes, has increased markedly among middle-aged and older adults in China over the past decade.

Main Result

Absolute Event Rate: 44.01% vs 38.43%

Abstract

Background and AimChina faces dual challenges of ageing and obesity, yet long-term cohort evidence on obesity trajectories in midlife and older adulthood remains limited. Methods and ResultsUtilizing the Kunshan Ageing Research with E-health cohort, we analyzed 2014-2024 obesity trends using professionally measured anthropometrics (repeated cross-sections, n=69,880-118,639) and individual transition patterns (longitudinal analysis, n=40,335-42,601).Over ten years, overall obesity prevalence among middle-aged/older adults rose significantly from 38.43% to 44.01%.Abdominal obesity surged from 42.91% to 54.64%.Metabolically unhealthy overweight/obesity (MUO) consistently predominated (>50%), yet metabolically healthy overweight/obesity (MHO) prevalence also increased markedly (13.18% to 19.10%).Longitudinally, 52.34% changed BMI category.Individuals with overweight progressed to obesity at 38.32%, while only 4.80% of those with obesity achieved normal weight.Abdominal obesity proved persistent, especially in women (59.46% maintained).Metabolically, 48.00% of MHO transitioned to MUO; 20.00% of metabolically unhealthy normal weight (MONW) individuals regained metabolic health. ConclusionsObesity burden has risen markedly, with faster increases in men and high rates in older women.Because overweight appeared more modifiable than established obesity, midlife may be a key period for prevention, while combined monitoring of BMI, waist circumference, and metabolic markers in older adults may help identify high-risk individuals.

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