Deficiency of Energy and Nutrient and Gender Differences among Chinese Adults: China Nutrition and Health Survey (2015-2017).

Half of Chinese adults face the double burden of overweight/obesity and micronutrient deficiencies, and nearly 40% of them are severely overweight/obese or have micronutrient deficiencies. This study used the data from China Nutrition and Health Survey (CNHS) from 2015 to 2017 to estimate the prevalence of inadequate dietary micronutrient intake (including vitamin A, vitamin B1, vitamin B2, vitamin C, cCalcium, iron and sodium) in Chinese adults and further determine the differences in micronutrient intake by gender, age and BMI. A total of 61,768 subjects were included in this study, of which 33,262 (54%) were female. The intake of energy and all macronutrients decreased with age, and the intake was higher in men than in women. Inadequate energy intake occurs in adults of all ages. In terms of nutrient intake, women had a higher rate of insufficient carbohydrate intake than men in all age groups. Inadequate protein intake was more common in women aged 18-49 years (60.9%) than in men. Compared with women, men had a higher rate of vitamin B2 intake. Insufficient vitamin B3 intake was more common in women aged 18-49 years (35.6%), men aged 65-79 years (39.7%) and men aged 80 years and above (47.9%). In all age groups, insufficient vitamin C intake is higher in women than in men-up to 85.8 percent in women aged 80 years old and above. Compared with men in the same age group, insufficient intake of calcium and iron is more obvious in women. Women have significantly higher rates of inadequate intake of calcium, iron and sodium than men. In the analysis of correlations between BMI or demographic data and micronutrient intakes, the likelihood of micronutrient intakes being insufficient was higher in the central and western regions in all age groups compared to the eastern regions. The risk of insufficient micronutrient intake was higher in obese men and women aged 18-49 years and 50-64 years. Underweight and overweight women in the 65-79 age group were more likely to have inadequate micronutrient intake. Obese women over 80 years of age were less likely to have inadequate micronutrient intake. No significant difference was found between urban and rural areas for each age group.

[Energy and macronutrients intake of the elderly aged 75 years and above in China in 2015].

OBJECTIVE: To analyze the intake of energy and macronutrients in the elderly aged 75 years and above in China. METHODS: The data was sourced from the China National Chronic Non-communicable Disease and Nutrition Surveillance, which adopted a multi-stage stratified clustered random sampling method and selected 298 monitoring points from 31 provinces across the country to carry out chronic non-communicable disease and nutrition surveillance of Chinese adults. The condiments weighting method and 3-day 24-hour dietary review method were used to collect dietary data for residents. Based on the dietary survey result of 3368 elderly people aged 75 years and above in the surveillance, the intake of energy and macro nutrients of elderly people was analyzed. RESULTS: Among the elderly aged 75 years and above included in the analysis, there were 1727 males and 1641 females, 1511 people in urban areas and 1857 people in rural areas, 1956 people aged 75-79, 1412 people aged ≥ 80. The average energy intake of the elderly aged 75 years and above in China was(1601.0±473.4)kcal, and the average intakes of carbohydrate, protein and fat were(219.6±76.6)g, (48.2±18.6)g and(60.2±31.5)g, respectively. The energy supply ratios of carbohydrate, protein and fat were 54.9%, 12.0% and 33.1% respectively. The carbohydrate intake and its energy supply ratio of the urban elderly((200.0±74.0)g and 51.8%) were significantly lower than those of the rural elderly((235.5±75.0) and 57.4%), while the protein intake and its energy supply ratio((50.2±18.9)g and 13.0%), fat intake and its energy supply ratio((61.2±30.2)g and 35.2%)of the urban elderly were significantly higher than those of the rural elderly((46.5±18.2)g and 11.2% for protein, and(59.4±32.5)g and 31.4% for fat). According to Chinese dietary reference intake standard, only 28.1% of the elderly aged 75 and above reached the recommended value of energy, 71.9% of the elderly did not take enough energy, the proportion of insufficient protein intake was 72.2%, 68.5% in urban areas and 75.2% in rural areas, the proportion of people with fat to energy ratio more than 30% was 58.5%, 65.3% in urban areas and 52.9% in rural areas. CONCLUSION: The energy intake of the elderly aged 75 years and above in China was insufficient, the protein intake was low, the fat to energy ratio was too high, and the dietary structure was unreasonable.

[Screen time among Chinese primary and middle school students from 2016 to 2017].

OBJECTIVE: To get a better knowledge of the current situation of screen time among primary and secondary school students in all provinces of China from 2016 to 2017. METHODS: Data was from the China National Nutrition and Health Surveillance of Children and Lactating Women(2016-2017).275 monitoring points were selected from 31 provinces of China by multi-stage stratified cluster random sampling. A total of 280 primary and secondary school students from 2 primary schools, 2 junior middle schools and 1 senior high school were randomly selected from each monitoring point to complete the survey.73629 primary and secondary school students(except grade 9 and grade 12) were included in this study. RESULTS: From 2016 to 2017, the average daily screen time of Chinese primary and secondary school students was(1.65±1.54) hours, M(P25, P75) was 1.29(0.58, 2.21) h. In terms of provinces, the average daily electronic screen time of primary and secondary school students in Beijing, Tianjin, Jilin, Fujian, Guangdong and Hainan is more than 2 hours. In terms of rural and urban areas, the screen time of students in Beijing's rural and urban areas, Tianjin's rural areas, Hebei's urban areas, Liaoning's rural areas, Jilin's rural areas, Fujian's urban areas, Guangdong's urban areas, Guangxi's urban areas, Hainan's rural and urban areas, and Xinjiang's urban areas all exceeds 2 hours/day. Besides, screen times of rural primary and secondary school students in Beijing(Z=2.62, P<0.01), Tianjin(Z=5.94, P<0.01), Liaoning(Z=11.56, P<0.01), Jilin(Z=-7.59, P<0.01), Shanghai(Z=3.19, P<0.01), Jiangsu(Z=12.00, P<0.01), Zhejiang(Z=-4.80, P<0.01), Anhui(Z=-4.67, P<0.01), Jiangxi(Z=-3.29, P=0.01), and Sichuan(Z=-4.53, P<0.01) are longer than that of urban students. CONCLUSION: There are urban-rural differences in the average daily electronic screen time and different types of electronic screen time of primary and secondary school students in China's provinces from 2016 to 2017.

Comparison of data-driven identified hypertension-protective dietary patterns among Chinese adults: based on a nationwide study.

PURPOSE: Diet pattern (DP) is a key modifiable and cost-effective factor in hypertension (HTN) management. The current study aimed to identify and compare the hypertension-protective DPs among Chinese adults. METHODS: 52,648 participants aged over 18 years were included from China Nutrition and Health Surveillance (CNHS) 2015-2017. Reduced rank regression (RRR) and partial least square regression (PLS) was applied to identify the DPs. Multivariable-adjusted logistic regression was used to assess the association between the DPs and HTN. RESULTS: DPs derived by RRR and PLS were both featured by higher consumption of fresh vegetables and fruits, mushrooms and edible fungi, seaweeds, soybeans and related products, mixed legumes, dairy products, fresh eggs, and lower of refined grain consumption. Compared to the lowest quintile, participants in the highest quintile had lower odds of HTN (RRR-DP: OR = 0.77, 95% CI = 0.72-0.83; PLS-DP: OR = 0.76, 95% CI = 0.71-0.82; all p < 0.0001). Simplified DP scores were observed the same protective tendencies (Simplified RRR-DP: OR = 0.81, 95% CI = 0.75-0.87; Simplified PLS-DP: OR = 0.79, 95% CI = 0.74-0.85; all p < 0.0001) and showed effective extrapolation in subgroups defined by gender, age, location, lifestyle, and different metabolic conditions. CONCLUSIONS: The identified DPs had high conformity with East Asian dietary habits, and significantly negative associations with HTN among Chinese adults. The simplified DP technique also indicated the potential for improving the extrapolation of the results of DP analysis related to HTN.

The impact of green credits on high-quality energy development: evidence from China.

The implementation of green credits has become an important engine for China's high-quality energy development (HQED). On the basis of constructing an index of HQED and the panel data of thirty provinces in China from 2008 to 2019, this study empirically investigated the effects of green credits on HQED and the action mechanisms behind it in a multi-dimensional manner using a panel fixed-effects model, mediating-effects model, and spatial Durbin model. The results indicated that green credits had significantly contributed to China's HQED, and that conclusion still held true after a series of robustness tests were conducted. It was found that industrial structures and human capital were important channels through which green credits influenced China's HQED. Moreover, the spatial spillover effects of green credits on HQED were also confirmed. Finally, in terms of temporal heterogeneity, the positive effects of green credits on HQED were found to have increased significantly after 2012. Also, in terms of regional heterogeneity, this study observed that the positive influence of green credits on HQED was more significantly in central and western China than in eastern China, and in southern China than in northern China. The results obtained in this research investigation will potentially provide some important insights for energy planners and policymakers to further the understanding of the drivers of HQED, and the corresponding transmission mechanisms and regional differences.

Weight-Control Behaviors and Dietary Intake in Chinese Adults: An Analysis of Three National Surveys (2002-2015).

Weight control through dietary management is becoming increasingly common worldwide. This study aimed to evaluate and compare the dietary intake and diet quality between Chinese adults with and without weight-control behaviors. Data were collected from the China National Nutrition Survey 2002, 2012, and 2015. Dietary intake was assessed using a combination of 24 h dietary recall of three consecutive days and a weighing method. Diet quality was calculated based on China healthy diet index (CHDI). A total of 167,355 subjects were included, of which 11,906 (8.0%) adults reported attempting to control weight within the past 12 months. Participants with weight control had lower daily total energy intake, as well as lower percentages of energy from carbohydrates, low-quality carbohydrates, and plant protein, but higher percentages of energy from protein, fat, high-quality carbohydrates, animal protein, saturated fatty acids, and monounsaturated fatty acids than those without weight control. Additionally, the CHDI score in the weight-control group was higher than those without (53.40 vs. 48.79, p < 0.001). Fewer than 40% of participants in both groups met the requirement for all specific food groups. Chinese adults who reported weight-control behaviors had an energy-restricted diet characterized by reduced carbohydrate intake and overall higher diet quality compared with those without dietary-control behaviors. However, both groups had significant room for improvement in meeting dietary recommendations.

Self-Reported Dietary Management Behaviors and Dietary Intake among Chinese Adults with Diabetes: A Population-Based Study.

Few studies have analyzed the implementation of dietary management in Chinese adults with diabetes. Thus, we assessed and compared dietary intake and diet quality between diabetic patients with and without dietary management behaviors (DPDM vs. NDPDM), and evaluated the adherence to dietary guidelines in both groups of patients. The data were obtained from the 2002, 2010-2013, and 2015 China National Nutrition Survey. A total of 69,583, 67,177, and 96,631 subjects participated in the 2002, 2010-2013, and 2015 survey rounds, respectively. The dietary intake data were measured using 3-day 24 h dietary recalls and weighed records of household condiments. The China Healthy Diet Index (CHDI) was used to evaluate diet quality. The study included 6229 patients with diabetes, of which 78% had dietary management behaviors. The diabetic patients with dietary management behaviors showed higher percentages of energy from high-quality carbohydrates, animal protein, saturated fatty acids, and unsaturated fatty acids and lower percentages from low-quality carbohydrates and plant protein than NDPDM. The diabetic patients with dietary management behaviors also had lower intakes of cereals and tubers and higher intakes of vegetables than NDPDM. The total CHDI score of DPDM was higher than NDPDM (56.3 ± 12.7 vs. 54.1 ± 12.3). The proportion of DPDM meeting the recommended intake for different food items ranged from 3.3% to 42.8% and from 3.0% to 39.2% in NDPDM. The diabetic patients with dietary management behaviors showed better adherence to dietary guidelines and higher diet quality scores than NDPDM, while the overall adherence was poor in both groups of patients. Our findings suggested that measures are needed to promote and refine dietary management behaviors, which can help to improve disease management in diabetic patients.

Dietary Fat Intake among Chinese Adults and Their Relationships with Blood Lipids: Findings from China Nutrition and Health Surveillance and Comparison with the PURE Study.

Dietary fat intake in the Chinese population has increased. The PURE (prospective urban rural epidemiology) study concluded the potential advantage of total fat and saturated fats (SFA) over carbohydrates on blood lipids with the inaccurate assessment of dietary fats. We investigated the dietary fat profile among 48,315 participants (aged 30−70 years, national representative) from the China Nutrition and Health Surveillance (2015−2017), determined the relationship of various fats with blood lipid biomarkers in the selected 39,115 participants, and compared the results with the PURE study. Dietary fat intake was calculated by using 3 days of 24 h recalls and food inventory. Serum lipid biomarkers were assessed at morning fasting state by health professionals. Plant fats (21.5% of total energy (TE)) dominated in total fat intake (69.5 g/day, 35.6% TE), with monounsaturated fats (MUFA) in the largest (13.8% TE) portion and plant oils as the major source (43.7%). Two thirds of the population consumed more than 30% TE from dietary fats and nearly half more than 35%, while 26.4% of them exceeded 10% TE from SFA. Total fat was positively associated with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), but also high-density lipoprotein cholesterol (HDL-c), and negatively with triglyceride (TG)-to-HDL-c ratio (TGHDL) (all p-trend < 0.05). Replacing total fat with carbohydrate yielded adverse changes in most biomarkers (higher LDL-c, TG, and TGHDL, lower HDL-c, all p < 0.05) when total fat was low (<34.9% TE). Regardless of fat intake level, replacing plant fat or polyunsaturated fats (PUFA) with carbohydrate yielded the most adverse changes (higher TC, LDL-c, TG, TC-to-HDL-c ratio (TCHDL), and TGHDL, but lower HDL-c, all p < 0.01), while replacing animal fat/SFA with plant fat/PUFA yielded the most favorable changes (lower all biomarkers, all p < 0.01). The results suggested a less harmful effect of carbohydrate on blood lipids when total fat was high, and more beneficial effect of unsaturated fats, than the PURE. In conclusion, dietary fat intake in Chinese adults had reached quite a high level, but with a different profile from Western populations. Replacement of SFA (animal fat) with PUFA (plant fat) could most effectively improve blood lipids, while replacement with carbohydrate could slightly benefit only when total fat was high. The present results may be more applicable to the Chinese population than the PURE study.

Usual Intake of Micronutrients and Prevalence of Inadequate Intake among Chinese Adults: Data from CNHS 2015-2017.

Previous studies have used the traditional average-value method to calculate the usual dietary intake of a population, but the results may be biased due to the measurement errors. The aim of this study was to provide an assessment of the usual micronutrient intake and estimate the prevalence of inadequate intake among Chinese adults. Data from the Chinese Nutrition and Health Surveillance 2015−2017 as well as a total of 72,231 subjects aged 18 years and older were included in the analysis. The 24 h recall method combined with the condiment weighing method were used for three consecutive days to collect daily food and condiments intake. The daily intake of 16 micronutrients was calculated based on the Chinese Food Component Tables. The National Cancer Institute (NCI) method was used to estimate the usual intake of micronutrients, and the prevalence of inadequate intake was estimated using the estimated average requirement (EAR) cut-point method. The results showed that, except for sodium, copper, iron (only for males), vitamin E, and phosphorus, the usual intake of micronutrients in Chinese adults was low, and the prevalence of inadequate intake ranged from 38.67 to 97.63%. The prevalence of inadequate calcium and riboflavin intake was more than 90%, and the proportion of individuals with a usual intake of thiamine, vitamin A, potassium, and selenium below EAR also reached 80%. Manganese, magnesium, vitamin C, and zinc were potentially deficient micronutrients, with the prevalence of inadequate intake ranging from 38.67% to 77.09%. However, usual sodium intake was extremely high with an average of 5139.61 mg/day, and only a quarter of Chinese adults were below the World Health Organization (WHO) recommended value. For most micronutrients, the usual dietary intake declined with age and the prevalence of inadequate intake increased with age. Except for zinc, vitamin A, and B-vitamins, the prevalence of micronutrient deficiencies was higher in females than in males in the same age group (p < 0.05). Therefore, Chinese adults do not receive enough micronutrients. Effective nutrition supplementary strategies and measures are needed to address these problems.

The Association of Dietary Magnesium and Prediabetes in Childbearing Chinese Women: Results from China Nutrition and Health Surveillance (2015-2017).

Although several studies have shown the relationship between magnesium and diabetes, there are few studies regarding the association between magnesium status and prediabetes. This study aimed to examine the association between dietary magnesium intake and the risk of prediabetes in childbearing Chinese women (18−44 years). A total of 1981 participants without diabetes were randomly selected from China Nutrition and Health Surveillance (CNHS) in 2015 by considering the regional types and monitoring points, including 1420 normal fasting glucose (NFG) people and 561 prediabetes cases. The Food Frequency Questionnaire (FFQ) and inductively coupled plasma mass spectrometry (ICP-MS) measured dietary and plasma magnesium. The results of this study showed that dietary magnesium intake was inversely associated with fasting plasma glucose. For every 100 mg of magnesium intake, there was a 0.052 mmol/L (95% CI 0.019, 0.085) reduction in fasting plasma glucose (p = 0.002). Compared with the lowest intake quartile (<350.10 mg/day), the third and fourth quartiles (≥405.41 mg/day) reduced the odds risk of prediabetes (OR = 0.63, 95% CI 0.46, 0.88, p = 0.020) by approximately 37%. The dose-response curves for the association between magnesium intake and prediabetes followed an L shape. The odds ratio of prediabetes decreased significantly with increasing dietary Mg intake at less than 410 mg/day, and then the curve leveled off or slightly increased. This study found a negative association between dietary magnesium intake and prediabetes in childbearing Chinese women. The risk of prediabetes was reduced with increasing dietary magnesium intake, and the threshold value was 410 mg/day. This suggests that childbearing women also need to pay attention to their magnesium status.

The Prevalence of Hyperuricemia and Its Correlates among Adults in China: Results from CNHS 2015-2017.

This study aimed to investigate the prevalence of hyperuricemia (HUA) and associated risk factors in Chinese adults aged 18 to 59 years. All the data were collected from the China Nutrition and Health Surveillance during the period 2015-2017, which adopted a stratified, multistage, random sampling method on a national scale. A total of 52,627 participants aged 18 years or older were included in this study. The definition of hyperuricemia was 420 µmol/L for male and 360 µmol/L for female. The Rao-Scott chi-square test was used to compare the differences in prevalence between or among the subgroups. A weighted two-level multivariate survey-logistic regression was used to detect the correlations between HUA and demographic, physical, lifestyle and metabolic factors. The total prevalence of HUA was 15.1%, and that was higher in male, current smokers, higher BMI and less physical activities subgroups, and also in noninfectious chronic diseases (NCDs) subgroups. The subgroups of non-vegetarian diet, insufficient vegetable intakes and excessive red meat and alcohol intakes had significantly higher HUA prevalence. After introducing all the variables in the survey-logistic regression, gender, age, BMI, physically active, hypertension, diabetes mellitus, bean and nut intake, vegetable intake, red meat intake, alcohol consumption and vegetarian were associated with HUA. Among the significant variables, age and physical active served as a protective factor, and BMI showed to be a risk factor for HUA. Hypertension and dyslipidemia could increase the risk for HUA, while diabetes mellitus was shown a negative association with it. For dietary factors, vegetarian diet, sufficient beans and nuts and vegetables intake could lower the risk of HUA, but more alcohol could increase the risk of HUA. Dietary factor played a key role in HUA. It suggested that the intervention of dietary factor should receive more attention to ameliorate the high prevalence of HUA in China.

Geographic Variations in Dietary Patterns and Their Associations with Overweight/Obesity and Hypertension in China: Findings from China Nutrition and Health Surveillance (2015-2017).

Regional dietetic cultures were indicated in China, but how dietary patterns geographically varied across China is unknown. Few studies systematically investigated the association of dietary patterns with overweight/obesity and hypertension and the potential mechanism with a national sample. This study included 34,040 adults aged 45 years and older from China Nutrition and Health Surveillance (2015−2017), who had complete outcome data, reliable intakes of calorie and cooking oils, unchanged diet habits, and without diagnosed cancer or cardiovascular disease. Outcomes were overweight/obesity and hypertension. By using the Gaussian finite mixture models, four dietary patterns were identified­common rice-based dietary pattern (CRB), prudent diversified dietary pattern (PD), northern wheat-based dietary pattern (NWB), and southern rice-based dietary pattern (SRB). Geographic variations in dietary patterns were depicted by age−sex standardized proportions of each pattern across 31 provinces in China. We assessed the association of these dietary patterns with outcomes and calculated the proportion mediated (PM) by overweight/obesity in the association of the dietary patterns with hypertension. Evident geographic disparities in dietary patterns across 31 provinces were observed. With CRB as reference group and covariates adjusted, the NWB had higher odds of being overweight/obese (odds ratio (OR) = 1.44, 95% confidence interval (CI): 1.36−1.52, p < 0.001) and hypertension (OR = 1.07, 95%CI: 1.01−1.14, p < 0.001, PM = 43.2%), while the SRB and the PD had lower odds of being overweight/obese (ORs = 0.84 and 0.92, 95%CIs: 0.79−0.89 and 0.85−0.99, p < 0.001 for both) and hypertension (ORs = 0.93 and 0.87, 95%CIs: 0.87−0.98 and 0.80−0.94, p = 0.038 for SRB and p < 0.001 for PD, PMs = 27.8% and 9.9%). The highest risk of overweight/obesity in the NWB presented in relatively higher carbohydrate intake (about 60% of energy) and relatively low fat intake (about 20% of energy). The different trends in the association of protein intake with overweight/obesity among dietary patterns were related to differences in animal food sources. In conclusion, the geographic distribution disparities of dietary patterns illustrate the existence of external environment factors and underscore the need for geographic-targeted dietary actions. Optimization of the overall dietary pattern is the key to the management of overweight/obesity and hypertension in China, with the emphasis on reducing low-quality carbohydrate intake, particularly for people with the typical northern diet, and selection of animal foods, particularly for people with the typical southern diet.

[Status of dietary micronutrient intakes among the children of 12-17 years old in China from 2016 to 2017].

OBJECTIVE: To analyze the status of dietary micronutrient in takes among the children of 12-17 years old in China from 2016 to 2017. METHODS: Multistage stratified random sampling method was used to collect data in 275 monitoring sites of the China National Nutrition and Health Survey of Chinese children and lactating mothers in 31 provinces of China from 2016 to 2017. Three consecutive 24-hour recalls method wasused to collect the information of food intake, and household or school canteen edible oil and condiments weighing were adopted. The dietary micronutrient were analyzed based on theChina Food Composition table. RESULTS: The average daily intakes of vitamin A(retinol activity equivalents), vitamin B_1(thiamine), vitamin B_2(riboflavin), vitamin C(ascorbic acid), calcium, iron, zinc and sodium were 356.8 µ g, 0.8 mg, 0.8 mg, 60.5 mg, 342.8 mg, 19.2 mg, 9.8 mg and 5 230.4 mg, respectively. The proportion ofdaily average intakes of vitamin A, vitamin B_1, vitamin B_2, vitamin C and calcium lower than 60% of the recommended value were 74.3%, 59.4%, 57.7%, 62.6% and 93.0%, respectively. The proportion of daily intake of iron and zinc reaching 80% of the recommended value were 73.8% and 64.8%, respectively. The proportion of daily average intake of sodium exceeded the appropriate intake by 94.4%. The average daily intakes of micronutrients increased with age among the children of 12-17 years old. There were differences of daily intake of vitamin A in gender, urban and rural areas(P<0.05), there was difference of vitamin C in urban and rural areas(P<0.01), there were differences of daily intake of vitamin B_1, vitamin B_2, calcium, iron and zinc in age, gender, urban and rural areas(P<0.01), there were differences in the average daily intake of sodium in age, gender(P<0.01). CONCLUSION: The average daily dietary of iron and zinc intakes in the diet were basically enough in most children of 12-17 years old in China, that of sodium was too much, and that of some micronutrients was insufficient.

[Current situation of screen time among Chinese primary and middle school students from 2016 to 2017].

OBJECTIVE: To analyze and describe the status and characteristics of using electronic screens of primary and middle school students in China from 2016 to 2017. METHODS: From 2016 to 2017, 275 monitoring points were selected from 31 provinces in China, and 280 primary and middle school students were selected from each monitoring point to complete the survey. Using the suggestion from "Healthy China Initiative(2019-2030)"of which the screen time of primary and middle school students should be less than one hour per day as the standard. RESULTS: A total of 74 314 primary and secondary school students(except grade 9 and grade 12) were included in this study. Among them, there were 37 147 boys(50.0%) and 37 167 girls(50.0%); 44 612 pupils(60.0%), 14 858 junior school students(20.0%), and 14 844 senior high school students(20.0%); 38 995(52.5%) rural students and 35 319(47.5%) urban students; 53 287 boarding students(71.7%) and 20 537 day students(27.6%). From 2016 to 2017, the average daily screen time of Chinese primary school students was 1.45 hours, M(P25, P75) was 1.14(0.57, 1.93) h. That of junior high school students was 1.92 hours, M(P25, P75) was 1.43(0.71, 2.48) h. That of senior high school students was 2.37 hours, M(P25, P75) was 1.71(0.90, 3.02) h. The average daily screen time qualified rates of primary school, junior high and senior high school students were 46.1%, 37.1% and 27.7%, respectively. From 2016 to 2017, the most used electronic screen products of primary school students in China were TV/videos(62%), followed by mobile phones(21%). Junior high school students spent 38% and 37% of the total time watching TV/videos and playing mobile phones, respectively. High school students spend the longest time using mobile phones(49%) of the total time, followed by watching TV/videos(26%). CONCLUSION: With the increasing of grade, screen time became longer, and screen time qualified rate dropped. Moreover, the most used electronic screens were mobile phones and TV/videos.

Dietary Micronutrient Status and Relation between Micronutrient Intakes and Overweight and Obesity among Non-Pregnant and Non-Lactating Women Aged 18 to 49 in China.

Women between the ages of 18 and 49 are women of reproductive age, for whom physical health and nutritional status are closely related to successful pregnancy, good pregnancy outcomes and the nurturing of the next generation. Overweight and obesity have become important nutrition and health problems of women aged 18−49 years in China. In social life, non-pregnant and non-lactating Chinese women aged 18−49 are the most vulnerable and neglected group. At present, there are no research data on their dietary micronutrient intake, and the relationship between dietary micronutrient intake and overweight and obesity in China. However, non-pregnant and non-lactating women aged 18−49 are the best window of opportunity to implement strategies, correct nutrition and improve physical health. It remains to be explored whether their overweight and obesity are related to inadequate dietary micronutrient intake. The aim of this study was to evaluate dietary micronutrient intake in non-pregnant and non-lactating Chinese women aged 18−49 years, and to analyze the relationship between dietary micronutrient intake and overweight and obesity. Data were obtained from 2015 China Adult Chronic Disease and Nutrition Surveillance (CACDNS 2015). In CACDNS 2015, 12,872 women aged 18 to 49 years (excluding pregnant women and lactating mothers) were surveyed for a three-day 24 h dietary recall and a three-day household weighing of edible oil and condiments. The average daily dietary intake of micronutrients was calculated according to the Chinese food composition table. In 2015, the median intake of vitamin A, vitamin B1, vitamin B2, vitamin C and folate in non-pregnant and non-lactating women aged 18−49 years in China was 267.0 µg RE/day, 0.7 mg/day, 0.6 mg/day, 63.5 mg/day and 121.0 µg/day, respectively. The median mean intake of vitamin A, niacin, calcium and zinc in overweight/obese group was lower than that in non-overweight/obese group, and the difference was statistically significant (p < 0.05). Multivariate Logistic regression analysis showed that vitamin A intake (Q3 vs. Q1: OR = 0.785, 95% CI: 0.702~0.878; Q4 vs. Q1: OR = 0.766, 95% CI: 0.679~0.865), niacin intake (Q2 vs. Q1: OR = 0.801, 95% CI: 0.715−0.898; Q3 vs. Q1: OR = 0.632, 95% CI: 0.554~0.721; Q4 vs. Q1: OR = 0.662, 95% CI: 0.568~0.772), Zinc intake (Q4 vs. Q1: OR = 0.786, 95% CI: 0.662~0.932) were a protective factor for overweight/obesity in women, while vitamin B2 intake (Q2 vs. Q1: OR = 1.256, 95% CI: 1.120~1.408; Q3 vs. Q1: OR = 1.416, 95% CI: 1.240~1.617; Q4 vs. Q1: OR = 1.515, 95% CI: 1.293−1.776), vitamin E intake (Q2 vs. Q1: OR = 1.114, 95% CI: 1.006−0.235; Q3 vs. Q1: OR = 1.162, 95% CI: 1.048~0.288; Q4 vs. Q1: OR = 1.234, 95% CI: 1.112−1.371) was a risk factor for overweight/obesity in females. The intakes of most dietary micronutrients in non-pregnant and non-lactating women aged 18−49 in China were low. The intakes of dietary vitamin A, niacin and zinc were negatively correlated with the risk of overweight/obesity, while the intakes of vitamin B2 and vitamin E were positively correlated with the risk of overweight/obesity.

Consumption of Milk and Dairy Products Among Junior High and Senior High School Students - China, 2016-2017.

What is already known about this topic?: Chinese dietary guidelines recommend an intake of milk and dairy products to be closely related to human health. Although the production capacity of dairy in China is strong, the per capita consumption of dairy products is not high. What is added by this report?: This report showed that the consumption rate of milk and dairy products of junior high and senior high school students in China was 82.5% from 2016 to 2017. Only 44.1% of them consumed milk and dairy products every day. Only 20.4% of these students reached intake levels recommended by the Dietary guidelines for Chinese residents (2016). What are the implications for public health practice?: Milk and dairy products are a key food group in a healthy dietary pattern. To cultivate a healthy eating habit of including dairy for children and adolescents, the government, suppliers, schools, and parents need to cooperate together.

[Eating out behavior of residents aged 6 and above in China from 2015 to 2017].

OBJECTIVE: To analyze the eating out behavior of Chinese residents aged 6 and above from 2015 to 2017. METHODS: Using the data of eating out behavior in the past week from China Nutrition and Health Surveillance(2015-2017), after data cleaning, a total of 150 682 subjects were included in this study, including 80 703 in 2015 and 69 979 in 2016-2017. The percentage of cases were used to describe the eating behaviors of different characteristics of the population, Chi-square test was used to comparative analysis. RESULTS: From 2015 to 2017, proportions of eating out for all the three meals was 46.3% of Chinese residents aged 6 and above in the past week, that of were 69.7%, 84.6%, 33.2%, 19.8% and 9.1% of Chinese residents aged 6 to 11, 12 to 17, 18 to 44, 45 to 59 and 60 and above, respectively. The proportion of urban and rural residents eating out in the past week were 52.8% and 41.2%, respectively, the difference was statistically significant(P<0.05). The proportion of male and female residents eating out in the past week were 49.6% and 43.1%, respectively, the difference was statistically significant(P<0.05). Proportions of eating out for breakfast, lunch and dinner were 31.4%, 37.2% and 21.4% respectively of Chinese residents, that of were 17.3%, 29.1% and 15.1% of Chinese residents eating breakfast, lunch and dinner in work/school canteens. CONCLUSION: Children aged 6 to 17 years old are the key groups for eating out. Among adults aged 18 and above, residents aged 18 to 44 have the highest proportion of eating out. Proportions of eating out for lunch is the highest and the main eating-out place is the canteen for Chinese residents.

Intake of Vitamin A, Thiamine, Riboflavin, Vitamin C, and Niacin Among Children Aged 6-11 Years Old - China, 2016-2017.

WHAT IS ALREADY KNOWN ON THIS TOPIC?: Insufficient intake of vitamins is one of the major nutritional problems in children aged 6-11 years old in China, and the problem is particularly severe for rural populations. WHAT IS ADDED BY THIS REPORT?: Among children aged 6-11 years old in 2016-2017, the average intakes of vitamin A, thiamine, riboflavin, vitamin C, and niacin were 336.37 µgRAE/d, 0.7 mg/d, 0.7 mg/d, 51.5 mg/d, and 11.4 mg/d, respectively. The proportions of vitamin intakes reaching recommended nutrient intakes of the 5 nutrients were 18.2%, 13.8%, 14.95%, 24.6%, and 51.3%, respectively. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Imbalance of nutritional conditions among different regions and populations in China should be seriously prioritized in nutritional improvement. Systematic measures including government policy, economy improvement, education, behavior intervention, and food resource safety should be applied.

Beverage Consumption of Children and Adolescents Aged 6-17 Years - China, 2016-2017.

WHAT IS ALREADY KNOWN ON THIS TOPIC?: Beverage consumption has become a problematic dietary behavior in children and adolescents. Excessive drinking of beverages, especially sugary beverages, can increase the risk of chronic diseases such as obesity, dental cavities, and diabetes. WHAT IS ADDED BY THIS REPORT?: This report revealed the beverage consumption rate was higher in males, in urban areas, and adolescents aged 12-17 years. The top three beverages by consumption rate were carbonated beverages (33.2%), milk-containing beverages (25.0%), and non-100% fruit and vegetable beverages (23.5%). Children and adolescents in China consumed beverages at a primary frequency rate of 1-3 times/week. Among children and adolescents aged 6-17 years who consumed beverages, the average amount was 193.8 g/d, and was higher in males (210.6 g/d), those in urban areas (204.7 g/d), and adolescents aged 12-17 years (259.0 g/d). WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Children and adolescents are key periods of life to develop healthy dietary behaviors for individuals. The consumption of beverages by Chinese children and adolescents has shown to increase year over year. Parents, schools, and governments need to prioritize promoting health consumption of beverasges.

Cooking Oil and Salt Intakes Among Children Aged 6-17 Years - China, 2016-2017.

What is already known on this topic? High-level intakes of both cooking oil and salt are issues of concern in China as they can lead to an increased risk of chronic diseases later in life. Reducing intakes of cooking oil and salt should be prioritized in children. What is added by this report? Among children aged 6-17 years in China in 2016-2017, the median intake of cooking oil and salt were 27.7 and 6.1 g/d, respectively. The percentages of children with intake of cooking oil and salt that exceeded the recommended guidelines were 50.4% and 67.8%, respectively. What are the implications for public health practice? Understanding the consumption levels of cooking oil and salt among children aged 6-17 years in China is vital for reducing associated health effects later in life. This study provided scientific evidence to recommend policymakers formulate effective policies to reduce intake of cooking oil and salt for the target population.