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Nutrition transition and related health challenges over decades in China

European Journal of Clinical Nutrition volume 75, pages 247–252 (2021)Cite this article

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Abstract

Since the Opening of China, the country’s economy has continuously and rapidly improved. Various economic, educational, and health policies have been implemented to shape the development of society, which may have greatly affected the Chinese diet and related malnutrition issues. The objective of the present review was to comprehensively review long-term trends in dietary intakes, nutrition status, and subsequent health challenges among Chinese adults. The data sources were mainly the 1982, 1992, 2002, and 2010–2012 China National Nutrition Surveys (CNNS) and reports and the 1989–2015 China Health and Nutrition Survey (CHNS). Over decades, there have been significant changes in the dietary structure of Chinese adults, characterized as decreased intake of cereals and vegetables and increased intake of animal foods with pork dominating. Intakes of eggs, fish, and dairy has reminded at a low level, with only a small increase over time. Consumption of cooking oil and salt was substantively far above the recommendations. A great proportion of fat-to-energy intake and “hidden hunger” was still prominent. Despite nutrition deficiency, there have been some modest improvements in related diseases, but overweight and obesity has become a prominent issue, with the prevalence in adults increasing from 16.4% and 3.6% in 1982 to 30.1% and 11.9% in 2012, respectively. In conclusion, this review sheds light on some salient problems with nutrition and malnutrition status in China, especially the dual challenges of undernutrition and overnutrition. Dynamic monitoring of nutritional characteristics in China should be strengthened, and effective strategies to improve nutrition need to be targeted at the national, societal, family, and individual levels.

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Fig. 1: Trends of animal-food consumption in China.
Fig. 2: Trend in percentage of energy intake from carbohydrate, protein, and fat among Chinese by CNNS survey cycle from 1982 to 2012.
Fig. 3: The prevalence of overweight and obesity among chinese adults, from 1992 to 2012.

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References

  1. Ying F, Ping W, Rongxue J. Urbanization level in the transitional stage of China and provincial economic growth: An empirical study. Proc - Int Conf Manag Serv Sci, MASS. 2009. https://doi.org/10.1109/ICMSS.2009.5302741.

  2. Lenchuk EB. Course on new industrialization: a global trend of economic development. Stud Russian Economic Dev. 2016;27:332–40.

    Article  Google Scholar 

  3. Jones-Smith JC, Popkin BM. Understanding community context and adult health changes in China: development of an urbanicity scale. Soc Sci Med. 2010;71:1436–46.

    Article  Google Scholar 

  4. Popkin BM, Du S, Zhai F, Zhang B. Cohort profile: the China Health and Nutrition Surveye monitoring and understanding socio-economic and health change in China, 1989–2011. Int J Epidemiol. 2010;39:1435–40.

    Article  Google Scholar 

  5. FAO, WHO. Rome declaration on nutrition;[EB/OL] 2014 [cited 2019 November 22]. http://www.fao.org/3/a-ml542e.pdf.

  6. Campbell TC, Parpia B, Chen J. Diet, lifestyle, and the etiology of coronary artery disease: the Cornell China study. Am J Cardiol. 1998;82(10B):18T–21T.

    Article  CAS  Google Scholar 

  7. He Y, Li Y, Yang X, Hemler EC, Fang Y, Zhao L, et al. The dietary transition and its association with cardiometabolic mortality among Chinese adults, 1982–2012: a cross-sectional population-based study. Lancet Diabetes Endocrinol. 2019;7:540–8.

    Article  Google Scholar 

  8. Batis C, Sotres-Alvarez D, Gordon-Larsen P, Mendez MA, Adair L, Popkin B. Longitudinal analysis of dietary patterns in Chinese adults from 1991 to 2009. Br J Nutr. 2014;111:1441–51.

    Article  CAS  Google Scholar 

  9. Adair LS, Gordon-Larsen P, Du SF, Zhang B, Popkin BM. The emergence of cardiometabolic disease risk in Chinese children and adults: consequences of changes in diet, physical activity and obesity. Obes Rev. 2014;15(Suppl 1):49–59.

    Article  Google Scholar 

  10. Baraldi LG, Martinez Steele E, Canella DS, Monteiro CA. Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study. BMJ Open. 2018;8:e020574–e.

    Article  Google Scholar 

  11. Gui ZH, Zhu YN, Cai L, Sun FH, Ma YH, Jing J, et al. Sugar-sweetened beverage consumption and risks of obesity and hypertension in Chinese Children and Adolescents: a national cross-sectional analysis. Nutrients. 2017;9:1302.

  12. Wang Z, Zhang B, Zhai F, Wang H, Zhang J, Du W, et al. Fatty and lean red meat consumption in China: differential association with Chinese abdominal obesity. Nutr, Metab, cardiovascular Dis. 2014;24:869–76.

    Article  CAS  Google Scholar 

  13. Institute of health Ccfpm. Summary of the 1982 national nutrition survey. Beijing: Institute of health, Chinese center for preventive medicine; 1985.

    Google Scholar 

  14. Longde W. Chinese nutrition and health status survey reports: 2002 comprehensive report. Beijing: People’s Medical Publishing House; 2005.

    Google Scholar 

  15. Ge K. The dietary and nutritional status of Chinese population(1992 National Nutrition Survey). Beijing: People’s Medical Publishing House; 1996.

    Google Scholar 

  16. Liyun Z, Guansheng M, Jianhua P, Jian Z, Dongmei Y, Yuna H, et al. Scheme of the 2010-2012 Chinese nutrition and health surveillance. Chin J Prev Med. 2016;50:204–7.

    Google Scholar 

  17. Xiaoguang Y, Lingzhi K, Fengying Z, Guansheng M, Shuigao J. Scheme of the 2002 Chinese nutrition and health survey. Chin J Epidemiol. 2005;26:471–4.

    Google Scholar 

  18. Society CN. Chinese Dietary Guideline, 2016th ed. Beijing, China: People’s Health Publishing House; 2016.

  19. Jile C, Yu W. Chinese nutrition and health status survey report: 2010–2013 comprehensive report. Beijing: Peking University Medical Press; 2016.

    Google Scholar 

  20. Su C, Zhang B, Wang H, Wenwen D. The status and trend of cereal consumption among Chinese adults in nine provinces (municipality) from 1989–2006. Chin J Pre Med. 2011;45:798–801.

    Google Scholar 

  21. Yingting X, Chang S, Yifei O, Bing Z. Trends of vegetables and fruits consumption among Chinese adults aged 18 to 44 years old from 1991 to 2011. Chin J Epidemiol. 2015;36:232–6.

    Google Scholar 

  22. Zhihong W, Bing Z, Huijun W, Yiping Z, Chang S, Jiguo Z, et al. Status of meat consumption patterns of the residents aged 18-59 in 15 provinces (autonomous regions and municipalities) of China in 2015. J Hyg Res. 2019;48:1–8. (In Chinese).

    Google Scholar 

  23. Su C, Wang ZH, Jia XF, Du W, Zhang B, Ding GQ. AN analysis on marine food consumption amoNG CHINESE adults aged 18 to 59 years old in 15 provinces in 2015. Acta Nutrimenta Sin. 2018;40:23–6.

    Google Scholar 

  24. Hongru J, Ji Z, Chang S, Jiguo Z, Bing Z, Huijun W. Cooking oil and salt consumption among chinese adults aged 18–59 years in 2015. Acta Nutrimenta Sin. 2018;40:27–31.

    Google Scholar 

  25. Yecheng Y, Weiyan G, Chao S, Yan Z, Yanning M, Fan Y, et al. Out of home eating behavior analysis of chinese adult residents, 2010-2012. Acta Nutrimenta Sin. 2019;41:10–4.

    Google Scholar 

  26. Todd JE. Changes in consumption of food away from home and intakes of energy and other nutrients among US working-age adults, 2005-2014. Public health Nutr. 2017;20:3238–46.

    Article  Google Scholar 

  27. Wang Z, Xiang X, Li X, He Y, Yang Y. Survey on diet and nutrition intake for customers from out-home eating in Beijing. Wei Sheng Yan Jiu. 2015;44:232–6. 41

    PubMed  Google Scholar 

  28. Jiguo Z, Zizi L, Feifei H, Fengying Z, Huijun W, Bing Z. Survey on the consumption of pre-packaged foods among urban adult residents in China. Acta Nutrimenta Sin. 2015;37:404–8.

    Google Scholar 

  29. WHO. Nutriton [cited 2019 November 20]. https://www.who.int/pmnch/topics/part_publications/KS18-high.pdf.

  30. Huang Q, Wang L, Zhang B, Wang H, Wang Z. Secular trends in dietary micronutrient intakes and demographic characteristics of adults in nine provinces (autonomous regions) of China from 1991 to 2015. J Environ Occup Med. 2019;36:410–7.

    Google Scholar 

  31. Guansheng M, Zhaohui C, Yanping L, Xiaoqi H, Jingzhong W, Xiaoguang Y. The survey about the use of dietary supplements by CHINESE adults. Acta Nutrimenta Sinica. 2006;28:8–10.

    Google Scholar 

  32. Monda KL, Gordon-Larsen P, Stevens J, Popkin BM. China’s transition: the effect of rapid urbanization on adult occupational physical activity. Soc Sci Med. 2007;64:858–70.

    Article  Google Scholar 

  33. Zhai Y, Fang HY, Yu WT, Wang JZ, Yu DM, Zhao LY, et al. Epidemiological characteristics of waist circumference and abdominal obesity among Chinese adults in 2010–2012. Zhonghua Yu Fang Yi Xue Za Zhi [Chinese J Prev Med]. 2017;51:506–12.

    CAS  Google Scholar 

  34. Xi B, Liang Y, He T, Reilly KH, Hu Y, Wang Q, et al. Secular trends in the prevalence of general and abdominal obesity among Chinese adults, 1993–2009. Obes Rev. 2012;13:287–96.

    Article  CAS  Google Scholar 

  35. PRC NHaFPCot. Report on the status of nutrition and chronic diseases of Chinese residents (2015). Beijing: People’s medical publishing house; 2015.

    Google Scholar 

  36. Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, et al. Status of hypertension in China: results from the china hypertension survey, 2012–2015. Circulation 2018;137:2344–56.

    Article  Google Scholar 

  37. Lewington S, Lacey B, Clarke R, Guo Y, Kong XL, Yang L, et al. The burden of hypertension and associated risk for cardiovascular mortality in China. Jama Intern Med. 2016;176:524–32.

    Article  Google Scholar 

  38. Liu M, Liu SW, Wang LJ, Bai YM, Zeng XY, Guo HB, et al. Burden of diabetes, hyperglycaemia in China from to 2016: findings from the 1990 to 2016, global burden of disease study. Diabetes Metab. 2019;45:286–93.

    Article  CAS  Google Scholar 

  39. Federation ID. Cartographer IDF diabetes atlas 8th ed. Brussels, Belgium: International Diabetes Federation;2017.

  40. Wang L, Gao P, Zhang M, Huang Z, Zhang D, Deng Q, et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013. Jama. 2017;317:2515–23.

  41. Diseases NCfC. Report on cardiovascular diseases in China (2018). Beijing: Encuclopedia of China Publishing House; 2018.

    Google Scholar 

  42. Global Nutrition Report. From promise to impact: ending malnutrition by 2030; 2016 [cited 2019 November 25]. https://globalnutritionreport.org/reports/2016-global-nutrition-report/.

  43. The CPC Central Committee and the State Council. The outline of the “Healthy China 2030” Program. Beijing: Xinhua News Agency; 2016 [cited 2019 November 20]. http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.

  44. General Office of the State Council. The National Nutrition Plan (2017–2030); Beijing, 2017 [cited 2019 November 20]. http://www.gov.cn/zhengce/content/2017-07/13/content_5210134.htm.

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  1. These authors contributed equally: Lina Huang, Zhihong Wang

Authors and Affiliations

  1. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China

    Lina Huang, Zhihong Wang, Huijun Wang, Liyun Zhao, Hongru Jiang, Bing Zhang & Gangqiang Ding

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  1. Lina Huang
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Huang, L., Wang, Z., Wang, H. et al. Nutrition transition and related health challenges over decades in China. Eur J Clin Nutr 75, 247–252 (2021). https://doi.org/10.1038/s41430-020-0674-8

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