Environmental, Dietary, and Behavioral Factors Distinguish Chinese Adults with High Waist-to-Height Ratio with and without Inflammation

The environmental and behavioral risk factors associated with central obesity and/or inflammation in populations exposed to both obesogenic and pathogenic environments remain unclear. We tested which of the characteristics distinguished 3 risk groups--high waist-to-height ratio (WHtR; >0.5) without inflammation [high-sensitivity C-reactive protein (hs-CRP) 40% less likely to have high physical activity than the healthy referent group. Men with high WHtR with inflammation had higher odds of infectious symptoms than those with high WHtR without inflammation (OR: 1.73; 95% CI: 1.15, 2.61). Women with high WHtR without inflammation were less likely to have high household sanitation (44%) or perform high levels of physical activity (24%) and were 34% more likely to consume more fiber than the healthy referent group. Women with high WHtR and inflammation were more likely than those with high WHtR without inflammation to have infectious symptoms (OR: 1.45; 95% CI: 1.01, 2.07) and less likely to have higher fiber intake (OR: 0.77; 95% CI: 0.60,1.00) or physical activity (OR: 0.55; 95% CI: 0.41, 0.73). These results document different underlying pathogenic and obesogenic risk factors for visceral adiposity with and without inflammation in Chinese adults, suggesting that context-specific approaches may be needed to prevent and treat inflammation.