- Associated Press - Thursday, September 15, 2011

BEIJING (AP) - During a recent weekday lunch, middle-aged Wu Zhixin had a plate of shredded pork noodles glistening with oil and washed it down with a paper cup of vodka-like alcohol. Then she lit a cigarette.

“No smoking,” a waitress called out. Wu nodded, but finished her Double Happiness brand cigarette before stubbing it out on the tiled floor.

Scenes like this are typical and illustrate the challenges China faces in tackling the explosion of chronic diseases such as heart disease and cancer, two top killers here.

“I smoke because I work in sales and it helps me cope with the stress of meeting targets,” said Wu, a slightly overweight woman who smiles warmly but has stained teeth. “I know it is bad for me and I’m trying to quit, but I’m still very healthy now, and I’m optimistic about my future.”

Newly prosperous, China is facing a very changed health picture from a generation ago when it was still largely poor and agrarian _ and the diseases plaguing Chinese have changed too.

Heart disease, cancer, and respiratory disease have replaced hepatitis, diarrhea and malaria as desk work replaces farming, cars replace bicycles, and smoking remains stubbornly popular.

Chronic diseases account for more than 80 percent of deaths, in China, or nearly 8 million in 2008, according to the World Health Organization. The epidemic comes as the United Nations’ General Assembly holds a high-level meeting on non-communicable diseases in New York next week.

Compared to the United States, China has three times the death rate from respiratory diseases like emphysema. By another measure, Chinese are healthier, with only a quarter of the population overweight, compared to two-thirds of Americans.

Chronic diseases are costly. The World Bank estimated in a July report that reducing the death rate of cardiovascular disease _ conditions that cause heart attacks and strokes _ by just 1 percent a year over three decades could generate an economic value equivalent to 68 percent of China’s GDP last year, or about $10.7 trillion.

China’s breakneck economic development over the past 30 years has pulled hundreds of millions out of poverty and moved many people into cities. But a broken health care system and inadequate state insurance mean getting treated for serious diseases can impoverish many families. Unhealthy diets and sedentary lifestyles have helped accelerate an explosion in chronic diseases.

Lu Nanxu, 28, a programmer at an IT services company in Beijing, knows he needs to exercise and eat less to shed some of the 215 pounds (98 kilograms) on his 1.7-meter (5-foot-8-inch)-tall frame that categorizes him as obese, but he doesn’t.

“I have plenty of time to exercise, but I’m too lazy,” he said with a sheepish grin at a Japanese fast food joint. “When I finish work, I prefer to go home and surf the Internet or watch movies on my computer.”

Lu said he used to be a competitive ice-skater when he was growing up in Harbin, a city in frigid northeastern China, but as an adult, he stopped exercising.

“It’s not only exercise, but I would have to control my eating and that can be very difficult,” he said as he polished off a dinner of braised thinly sliced, fatty beef and fried chicken with rice and steamed vegetables, a side of mashed potatoes, and a soft drink.

A high-salt diet is also a major problem in China. Experts believe high blood pressure is the leading preventable risk factor tied to stroke and heart attack. On average, the Chinese consume twice as much salt as the recommended maximum set by the WHO, according to the organization’s food safety expert in Geneva, Dr. Peter Ben Embarek.

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