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BEIJING (Reuters) - Evening exercise classes at the Nirvana fitness centre in Beijing are in high demand these days as young professionals whose mothers once counted ration cards seek to stay svelte despite lavish lunches.
China has gone from famine to feast in a generation and the health consequences for its citizens are only just beginning to be felt.
"Before there was nothing fun or interesting to eat, but now with GDP so high people no longer worry about basic necessities like food or clothes," said Yang Bin, a trainer at Nirvana, as he rushed to a class.
The government of the world's most populous country is in the unenviable position of having to deal with rural areas so poor that malnutrition is still a threat, while at the same time formulate health policies for well-to-do urbanites battling the bulge.
"On the one hand, a massive rural population still has low income and low caloric intake compared with urban populations where there is high caloric intake and rising weight," said Matthew Crabbe, of research firm Access Asia.
"China is more like a set of regions, not one country, in that respect."
And it's not just how much the country's citizens are eating, but what products are going into their shopping baskets that has many concerned.
James Watson, an anthropologist at Harvard University who has studied food cultures in Asia, points to rising dairy consumption in a country where cheese and butter were not traditionally eaten as a major culprit in diet-related illnesses.
Over the last two decades, Chinese have begun to eat more and more dairy, though lactose intolerance and limited refrigeration networks mean milk consumption still lags far behind the West.
"I'm personally convinced that that has as much or more to do with the obesity or health problems that are emerging as the usual scapegoat of fast food," said Watson.
"There's a big change in terms of taste when people want ice-cream throughout their lives," he said. Ice-cream and chocolates are also becoming popular among China's expanding middle class.
While malnutrition is still a problem in inland provinces that have been left out of the economic boom, the country also faces over nutrition and a rise in attendant chronic diseases.
In 2002, some 200 million Chinese adults were considered overweight by national standards and another 60 million were obese, more than double 1992 levels, according to a report published by the Asian Development Bank.
As a result, China is facing the dual challenge of malnutrition and over nutrition, and simultaneously dealing with communicable diseases common to poor countries and chronic diseases, such as diabetes, associated with the higher fat diets of the developed world.
"The PRC is thus at a critical juncture," warned the 2005 ADB report, 'Strengthening Public Nutrition Planning and Policy in the People's Republic of China'.
"The combination of deep poverty in the past and rapid socioeconomic transitions together pose a 'time bomb' that threatens to disrupt, if not derail, continued socioeconomic development," the report said.
Rates of breast cancer used to be five times lower in China than in the United States, but already in Chinese cities the gap is narrowing, as consumption of fatty foods rises, said Yibin Kang, a molecular biologist at Princeton University.
"When you see a change in diet and living standards it will take 20 years to manifest itself in cancer patterns," said Kang.
The average Chinese still eats about half the amount of meat a year as the average American -- about 110 pounds (50 kg) versus 269 pounds (122 kg) -- according to a paper by Daryll E. Ray, of the University of Tennessee's Agricultural Policy Analysis Center.
Traditionally, citizens of the two nations eat roughly the same amount of pork, while Chinese eat far less chicken and beef.
But these patterns are changing as pork prices in China hit record highs due to shortages, a result of disease among pigs and a growing reluctance among farmers to breed pigs.
China's per capita poultry consumption is likely to triple in the next five years as high pork prices trigger a shift, according to recent estimates by Qingdao Chia Tai Co. Ltd, a unit of the world's second-largest poultry producer.
Harvard's Watson estimates that beef consumption will also rise as people become wealthier.
"As people have money they'll pay for it, regardless of the price. It's the status," he said.
In a country where the older generation still remembers famine and deprivation, there is a tendency to shower children with love by giving them as much food as well as the richest foods possible regardless of the long-term health consequences.
"People still remember the poverty, so the fact that they can eat well now means they do. There's the concept that you should live the good life while it lasts," said Crabbe, of Access Asia.
Editing by Megan Goldin