Twenty-Five-Year Trends in Dietary Patterns among Chinese Adults from 1991 to 2015.
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ABSTRACT:
SUBMITTER: Zhang J
PROVIDER: S-EPMC8072541 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:In the present study, we aimed to identify the changes or stability in the structure of dietary patterns and tracking, trends and factors related to the adherence to these dietary patterns in China from 1991 to 2009. We analysed dietary data collected during seven waves of the China Health and Nutrition Survey and included 9253 adults with complete dietary data for three or more waves. Dietary intake assessment was carried out over a 3 d period with 24 h recalls and a household food inventory. Using factor analysis in each wave, we found that the structure of the two dietary patterns identified remained stable over the studied period. The traditional southern dietary pattern was characterised by high intakes of rice, fresh leafy vegetables, low-fat red meat, pork, organ meats, poultry and fish/seafood and low intakes of wheat flour and maize/coarse grains and the modern high-wheat dietary pattern was characterised by high intakes of wheat buns/breads, cakes/cookies/pastries, deep-fried wheat, nuts/seeds, starchy root/tuber products, fruits, eggs/egg products, soya milk, animal-based milk and instant noodles/frozen dumplings. Temporal tracking (maintenance of a relative position over time) was higher for the traditional southern dietary pattern, whereas adherence to the modern high-wheat dietary pattern had an upward trend over time. Higher income, education and urbanicity levels were positively associated with both the dietary patterns, but the association became weaker in the later years. These results suggest that even in the context of rapid economic changes in China, the way people chose to combine their foods remained relatively stable. However, the increasing popularity of the modern high-wheat dietary pattern, a pattern associated with several energy-dense foods, is a cause of concern.
| S-EPMC3966951 | biostudies-other
Project description:Background: Little information is available on the trends in severe pediatric obesity in China. Therefore, we aimed to examine the trends in overweight, obesity, and severe obesity in Chinese children from 1991 to 2015. Methods: Overall, 17,004 children aged 6-17 years were included in this study, which was based on the China Health and Nutrition Survey 1991-2015. We defined overweight [BMI ≥85th percentile], obesity (BMI ≥95th percentile), and severe obesity (BMI ≥120% of the 95th percentile, or 35 kg/m2) according to the U.S. Centers for Disease Control and Prevention Growth Charts. Controlling for age, sex, and region, we performed multivariate analyses to assess secular trends in the prevalence of overweight, obesity, and severe obesity in the pediatric population. Results: During 1991-2015, the prevalence of overweight increased from 4.6% to 21.1%, of obesity from 1.4% to 10.1%, and of severe obesity from 0.2% to 4.0% (relative increases of 358.7%, 621.4% and 1900.0% in overweight, obesity, and severe obesity, respectively). We observed a significant positive trend in the prevalence of overweight, obesity, and severe obesity in the pediatric population [odds ratios (95% confidence intervals): 1.23 (1.21, 1.26), 1.30 (1.26, 1.34), and 1.52 (1.41, 1.63), respectively; all ps < 0.001]. These results did not differ significantly between subgroups of sex, age, and region, or when Chinese national reference standards were used. Conclusion: The prevalence of childhood overweight, obesity, and particularly severe obesity in China increased significantly from 1991 to 2015.
| S-EPMC7262639 | biostudies-literature
Project description:BACKGROUND AND OBJECTIVES:To examine temporal trends in dietary energy, fat, carbohydrate, protein, sodium and potassium intake of Chinese adolescents aged 12 - 17 years by sex and urbanicity, using data from the China Health and Nutrition Survey. METHODS AND STUDY DESIGN:Individual level, consecutive 3 - day 24-hour recalls were analyzed from survey years 1991 (n=504), 2000 (n=665), and 2011 (n=267) from nine provinces representing a range of geography, economic development, and health indicators in China. Linear multivariable regression models were conducted to predict mean intakes of energy, macronutrients, sodium, and potassium. Models were adjusted for age, per capita income, parental education, region, and family size. RESULTS:From 1991 to 2011, total energy consumption decreased among both sexes and all urbanicity groups (p<0.05). Sodium intake decreased in all sex and urbanicity groups except the high urbanicity group, which was the only group to show significant change in potassium intake (p<0.05). Sodium-potassium ratios decreased overall and across both sexes (p<0.05). However, the major observed shift was a structural change from carbohydrates to fat and protein. Both sexes showed decrease in carbohydrate-derived energy (p<0.05). Proportion of fat-derived energy increased in female adolescents. Proportion of protein-derived energy increased in male adolescents, as well as in the low and high urbanicity groups (p<0.01). CONCLUSIONS:This suggests Chinese adolescents are transitioning to a low carbohydrate diet. Urbanicity appears to play a role in sodium, potassium and protein intake. Improvements of sodiumpotassium ratios are primarily due to decreased sodium intake and require further reduction efforts.
| S-EPMC6298787 | biostudies-literature
Project description:Studies on fat intake and obesity have been inconclusive. This study examined the associations between dietary fat intake and body weight and the risk of overweight and obesity in China. We used data from 23,859 adults aged 20-60 years who participated in the China Health and Nutrition Survey, an ongoing open-cohort study, from 1991 to 2015. We collected detailed dietary data by conducting three 24-h dietary recalls and weighing foods and condiments in household inventories. We examined the associations between fat intake and body weight, body mass index (BMI), and the risk of overweight and obesity with random-effects linear or logistic regression models for panel data. The Chinese population's fat intake, percentage of energy intake from fat, and prevalence of high-fat diets (energy intake from fat > 30%) increased from 68.5 g per day (g/d), 23.1%, and 22.4%, respectively, in 1991 to 79.3 g/d, 35.6%, and 67.2%, respectively, in 2015. The prevalence of overweight and obesity increased from 12.3% to 37.3% during the same period. Fat intake, percentage of energy intake from fat, and a high-fat diet were positively associated with body weight, BMI, and the risk of overweight and obesity in both sexes (p < 0.001) after adjustment for nonfat energy intake, physical activity, and socioeconomic status. Increased fat intake and high-fat diets were associated with increased body weight, BMI, and risk of overweight and obesity. These findings could have a significant impact on Chinese policies and interventions to control overweight and obesity.
| S-EPMC7694029 | biostudies-literature
Project description:Until recently, few studies have reported the secular trend and associated factors of hypertension severities and phenotypes in China. In this study, the authors aimed to assess the trend in the prevalence of hypertension according to severity and phenotype in Chinese adults from 1991 to 2015 and to explore potential cardiometabolic factors. From the China Health and Nutrition Survey (CHNS), the authors included 164 682 records of adults (≥18 years). The prevalence of hypertension by severity (stage 1 and stage 2 hypertension) and by phenotype (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], and systolic-diastolic hypertension [SDH]), during 1991-2015 was explored. The potential effects of demographic, socioeconomic, geographic, and cardiometabolic factors on hypertension severities and phenotypes were assessed by multivariable logistic regression. During 1991-2015, the overall prevalence of hypertension increased dramatically from 15.7% to 23.3%. For stage 1 and stage 2 hypertension, the age-standardized prevalence increased from 10.1% to 15.6% and from 5.5% to 7.4%, respectively. For ISH and SDH, the age-standardized prevalence rates rose from 3.6% to 6.4% and from 6.9% to 10.4%, respectively. Advanced age and medium/high urbanization were positively associated factors, whereas females, higher educational attainments, and residing in Southern China were negatively associated factors. Additionally, general obesity, central obesity, diabetes, and elevated triglyceride levels were linked to ISH, IDH, and SDH. The present study documents an increasing trend in the prevalence of hypertension, including different severities and phenotypes, among Chinese adults over more than two decades. Efforts for the prevention and management of hypertension are in urgent need in China.
| S-EPMC8678778 | biostudies-literature
Project description:IntroductionThe prevalence of obesity in Chinese adults increased from 1991 to 2000; however, recent changes in this trend are unclear. This study aims to estimate the current prevalence of obesity and to assess trends in obesity and BMI distribution in Chinese adults from 1991 through 2011.MethodsHeight and weight measurements of 12,249 Chinese adults from the 2011 China Health and Nutrition Survey were analyzed (in 2013) together with China Health and Nutrition Survey data for 1991-2009. Obesity was defined as BMI≥28.0 kg/m(2) based on the Working Group on Obesity in China criteria.ResultsIn the 2011 survey, the age-adjusted mean BMI was 23.8 (95% CI=23.7, 23.9) for men and 23.4 (95% CI=23.2, 23.5) for women. The age-adjusted prevalence of obesity was 11.3% (95% CI=10.8%, 11.9%) overall, 11.8% (95% CI=10.8%, 12.6%) among men, and 11.0% (95% CI=10.3%, 11.8%) among women. Estimates of age-adjusted obesity prevalence among the Chinese population were significantly lower than those of the U.S. population (all p<0.05). Over the 20-year period, the prevalence of obesity increased from 2.88% to 11.8% among men (age-adjusted annual change in OR=1.08, 95% CI=1.07, 1.09, p<0.001) and from 4.55% to 11.0% among women (OR=1.05, 95% CI=1.05, 1.06, p<0.001). Similar significant findings were observed for both men and women based on WHO recommendations.ConclusionsThe prevalence of obesity among both Chinese men and women increased significantly from 1991 through 2011, particularly among men.
| S-EPMC4615397 | biostudies-literature
Project description:We examined 13-year trends in dietary patterns, using data from the National Health and Nutrition Survey, Japan 2003?2015. In repeated, independent cross-sectional studies, dietary intake was assessed with a one-day weighed dietary record in 88,527 Japanese adults aged ?20 years. Using principal component analysis based on the daily consumption of 31 food groups, we identified three dietary patterns, the "plant food and fish", "bread and dairy", and "animal food and oil" patterns. In the whole sample, the "plant food and fish" pattern score decreased while the "bread and dairy" and "animal food and oil" pattern scores increased. The decreasing trends in the "plant food and fish" pattern were observed in all subgroups considered. The increasing trends in the "bread and dairy" pattern were similar across sexes and by current smoking status. However, in terms of age, occupation, and weight status, the increasing trends were only evident in particular subgroups (i.e., age 50?64 and ?65 years; security/transportation/labor occupation and nonworker; and normal weight and overweight participants). For the "animal food and oil" pattern, the increasing trends were observed in all subgroups, except for the youngest age group (20?34 years old). This study suggests continuous Westernization of the Japanese diet.
| S-EPMC6115850 | biostudies-other
Project description:BackgroundThe China Dietary Guidelines Index (CDGI) is a diet quality evaluation index that can present the overall diet quality and is comparable between individuals. The aim of this study was to revise CDGI for Chinese adults according to the Chinese Dietary Guidelines 2016 (CDG-2016), evaluate adherence to recommended diets between 1991 and 2015, and analyze the trend, variation, and determinants of diet quality.MethodsFood, cooking oil, and condiment intakes were estimated based on twenty-four-hour dietary recalls over three consecutive days and the household weighing method. Based on the food and nutrients recommendations for people with different energy requirements in CDG-2016, CDGI was revised as China Dietary Guidelines Index (2019)-Adults (CDGI(2019)-A) by equal weight continuity scoring. Three-level random intercept-slope growth models were applied to analyze the trend, variation, and determinants at both the community and individual levels.ResultsCDGI(2019)-A, the sum of fourteen component scores with a range of 0-110 points, increased significantly from 38.2 in 1991 to 47.3 in 2015. Components with a score of less than half were milk (91.6%), fruits (72.0%), nuts (82.5%), other cereals and beans (82.6%), and seafood (77.7%). Between-individual accounted for 25.6% of the total score variation, of which 87.4% derived from the community level. CDGI(2019)-A score displayed a positive association with being female, having higher education, having higher income, living in an urban area, and knowing the CDG-2016 recommendations. The impact of income and awareness of CDG-2016 varied significantly across communities.ConclusionsAlthough quality of diet has been improving in China, overall quality remains poor, primarily because of inadequate intake of milk and dairy products, nuts, fruits, other cereals and miscellaneous beans, and seafood. Intervention at the community level may improve diet quality more efficiently than at the individual level, and the most effective intervention should be selected in different communities according to local conditions.
| S-EPMC6849297 | biostudies-literature
Project description:It is essential to understand the impact of different dietary pattern trajectories on health over time. Therefore, we aimed to explore the long-term trajectories of dietary patterns among Chinese adults and examine the prospective association between different trajectory groups and the risk of overweight/obesity. The sample was 9299 adults aged 18 years or older from the China Health and Nutrition Survey (CHNS) between 1991 and 2018. We used factor analysis to identify dietary patterns and group-based trajectory modeling to identify dietary pattern trajectories. Three trajectories of a southern pattern and a modern pattern and four trajectories of a meat pattern were identified. Participants who followed the highest initial score and a slight decrease trajectory (OR = 1.63; 95% CI: 1.04, 2.54) of the meat dietary pattern were positively associated with risk of overweight/obesity when compared with the lowest initial score trajectory. The southern dietary pattern and the modern dietary pattern trajectories of participants in Group 2 (OR = 0.64; 95% CI: 0.51, 0.81; OR = 0.76; 95% CI: 0.63, 0.91) and Group 3 (OR = 0.71; 95% CI: 0.54, 0.91; OR = 0.64; 95% CI: 0.44, 0.90) were associated with lower risk of overweight/obesity when compared with Group 1. We observed that dietary pattern trajectories have different associations with overweight/obesity among Chinese adults.
| S-EPMC8401187 | biostudies-literature
Project description:BackgroundThe effect of the overall diet quality on cardiometabolic diseases has been well studied in the Western population. However, evidence is still in need regarding dietary patterns depicting unique Chinese dietary habits and their associations with cardiometabolic diseases.MethodsA prospective cohort recruited around 0.5 million Chinese residents aged 30-79 years from 10 diverse survey sites during 2004-08. Dietary patterns were obtained using factor analysis based on the habitual consumption of 12 food groups collected at baseline. Among 477,465 eligible participants free of prior heart disease, stroke and cancer, linkages to multiple registries and health insurance database recorded 137,715 cardiovascular diseases (CVD) and 17,412 diabetes cases (among 451,846 non-diabetic participants) until 31 December 2017. Adjusted hazard ratios (HRs) were estimated to compare the risks of cardiometabolic diseases across quintiles of dietary pattern scores using the Cox regression.ResultsTwo dietary patterns were derived: the traditional northern pattern, characterised by wheat, other staples, egg and dairy products; and the modern pattern, featured with fresh fruit, meat, poultry, fish, dairy products and soybean. Adherence to either dietary pattern was associated with lower risks of major cardiometabolic diseases in a dose-response relationship way. After multivariate adjustment, participants adhering to the traditional northern pattern the most had an 8% (95%CI: 5-11%) lower risk of CVD in comparison with those adhering the least. Corresponding risk reductions were 12% (11-32%) for haemorrhagic stroke (HS), 14% (8-19%) for ischaemic stroke (IS), and 15% (6-24%) for diabetes, respectively. When comparing extreme quintiles of the modern pattern, the adjusted HR of HS was 0.67 (95%CI: 0.59-0.77). Corresponding HRs were 0.89 (0.86-0.92) for CVD, 0.88 (0.77-0.99) for MCE, 0.85 (0.80-0.89) for IS, and 0.89 (0.81, 0.97) for diabetes.ConclusionAmong Chinese adults, both traditional northern and modern dietary patterns were associated with lower risks of cardiovascular disease and diabetes beyond other risk factors.
| S-EPMC8418004 | biostudies-literature