'You don't tend to see fat families. You tend to see the fat kid,' with figures for Beijing last year revealing that a quarter of 12-year-old children were obese.
Childhood obesity on the rise in China
BEIJING // Sitting in a McDonald's in central Beijing, Tan Shisheng admitted that the food his young daughter eats is not always very healthy.
But Mr Tan, the product manager for a food company, said his two-and-a-half-year-old child is so headstrong that he and his wife feel they have little choice but to give in and go to fast-food restaurants for meals.
"When she sees the capital letter 'M', she goes almost crazy about McDonald's. We have no choice. She likes to have chips and ketchup," said Mr Tan, 40, as his wife, Li Xiaofang, fed a chip to the little girl, Tan Panpan.
"So far, we don't worry about it as she's not fat at all. Maybe in the next few years, when she's a bit older, we'll be more concerned."
While Tan Panpan is for the moment a picture of health, the same cannot be said of many children in China.
Figures for Beijing last year published in state media showed that 25.6 per cent of 12-year-old children were obese. There is even a problem among the under fives, 17 per cent of whom are obese and therefore five times as likely to be overweight in later childhood.
"You don't tend to see fat families. You tend to see the fat kid. The little emperor is fat. He's having McDonald's, and no one ever says no to him when he wants his Coca-Cola and biscuits. In the next generation we may see fat mums and dads with their kids," said Paul French, co-author of a book published last year called Fat China, and publishing and marketing director of the Shanghai research agency Access Asia.
As China has urbanised, with last year's census finding that 49.7 per cent of the country's population now lives in towns and cities, more adults and children experience the sedentary lifestyles that cause people to become overweight.
For youngsters, time playing outside has been replaced by hours spent in front of a computer, while adults, instead of toiling in the fields, now experience the physically undemanding existence of the office worker, ticket attendant or street vendors.
Diets have changed too: the Chinese have enthusiastically embraced fast food to the extent that KFC has 3,700 restaurants across the country.
Concerns over the cleanliness of many traditional restaurants partly explains why people visit Western fast-food chains, said Yang Yang, 21, a Beijing-based student originally from central China's Henan province.
"People find these restaurants enjoyable. They are nicer inside, that's why they're becoming more popular," he said.
Christine Chan, an assistant professor in the Department of Psychological Studies at the Hong Kong Institute of Education whose research deals with obesity among children, said there had been a dramatic shift in eating patterns in just a decade.
"They've gone from starving to overeating. All these fast food restaurants, takeaway shops and ready-eat meals ... people are eating the wrong food," she said.
"It's easier to buy ready-eat meals and on the other hand, they have no time to cook at home. That's why [obesity] is rising rapidly in China and Hong Kong."
There are sometimes limited opportunities for children to get exercise at school, partly because some parents do not appreciate the importance of physical activity. Grandparents will commonly carry the schoolbag of their grandson or granddaughter.
"They're supposed to do one hour of physical activity [at school each day], but the parents complain, 'Why are the kids doing one hour of sport? - that's not going to get them into Harvard,'" Mr French said.
As well as encouraging more exercise, improvements in food labelling are needed to help people make better choices on what they eat, Dr Chan said.
Yet even with such initiatives, the picture remains bleak because an estimated 15 million rural dwellers are still moving to the cities annually and experiencing the increases in income and dietary changes that China's well-off coastal regions have gone through.
"For these rapidly developing areas, obesity will still grow fast if the government's focus is on economic growth and not on people's quality of life," Dr Chan said.
Medical conditions caused by obesity, such as Type 2 diabetes, are likely to become more common. Already 92 million Chinese have diabetes and a further 150 million are at risk of developing it.
"Over the coming 10 years there will be a huge medical burden from these kinds of obesity-related diseases in China as well as Hong Kong," Dr Chan said.
This is a particular concern given the limitations of China's healthcare system, Mr French said.
With the government seemingly reluctant to push healthy eating and exercise messages on the public, he said the problem was likely to grow.
"It's inevitable. No one has an answer to this," he said.