New Chinese dietary guidelines: healthy eating patterns and food-based dietary recommendations.

BACKGROUND AND OBJECTIVES: The Chinese Dietary Guidelines (CDGs) were first released to the public in 1989 by the Chinese Nutrition Society (CNS). In 2016, the Ministry of Health commissioned the CNS to revise and publish new CDGs. METHODS AND STUDY DESIGN: The CNS convened an expert committee of leaders in the fields of nutrition, epidemiology, public health, preventive medicine, and food science. The CDGs were revised according to the World Health Organization Handbook for Guideline Development procedures. The expert committee recommended key inclusions for the CDGs on the basis of the current status of public health and priority health challenges affecting the Chinese population, as well as the quality of scientific evidence. RESULTS: The CDGs (2016) provide six key dietary recommendations for the general Chinese population aged 2 years and above. In addition to a newly revised Chinese Food Guide Pagoda, both the Chinese Food Guide Plate and Chinese Food Guide Abacus are newly created pictorial models in the CDGs (2016); the Chinese Food Guide Abacus is specifically designed for children. Seven additional dietary guidelines targeting specific populations are included; these guidelines emphasize the different physiological and nutritional requirements of particular populations, including dietary guidelines for vegetarians for the first time. CONCLUSIONS: The CDGs (2016) is an official document published by the National Health Commission of China. Its content highlights the current status of public health and offers advice to address health concerns faced by the Chinese population. The CDGs (2016) have been widely disseminated and accepted in the Chinese population; the National Nutrition Week is a major national event in which the CDG are used as its core to increase public awareness towards a healthy diet and lifestyle.

[Trend in meat consumption patterns among Chinese children in nine provinces(autonomous region) aged 6 to 17 years between 1991 and 2011].

OBJECTIVE: To examine the trend in meat consumption patterns between 1991 and 2011 in Chinese children in nine provinces(autonomous region) aged 6 to 17 years. METHODS: A multistage, random cluster sampling process was used to investigate 2720, 2702, 2525, 2405, 1509, 1238, 1085, and 936 children and adolescents aged 6-17 years in 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011 respectively in 9 provinces (autonomous region) in China. Their consecutive 3 d 24 h dietary recall data were analyzed to compare meat intake pattern in children and adolescents with different characteristics and different years. RESULTS: The consumption rate increased from 60.9% (1657/2720) in 1991 to 87.2% (816/936) in 2011 for livestock meat (χ(2) = 458.23, P < 0.01), from 9.4% (257/2720) to 33.3% (312/936) for poultry (χ(2) = 446.07, P < 0.01) and from 27.3% (743/2720) to 40.6% (380/936) for seafood (χ(2) = 89.89, P < 0.01). The median of total meat intake increased from 47.4 g/d in 1991 to 100.0 g/d in 2011 (χ(2) = 516.77, P < 0.01), poultry intake from 33.3 g/d to 60.0 g/d (χ(2) = 420.13, P < 0.01), pork intake from 26.7 g/d to 50.0 g/d (χ(2) = 380.50, P < 0.01). The percentage of children whose livestock meat and poultry intakes higher than the recommended amount increased from 32.9% (896/2720) in 1991 to 59.8% (560/936) in 2011 (χ(2) = 392.97, P < 0.01); the percentage of children whose seafood intakes meeting the recommended amount increased from 6.9% (187/2720) in 1991 to 8.8% (82/936) in 2011 (χ(2) = 21.52, P < 0.01). The consumption rates of livestock meat in urban and rural children increased from 81.2% (536/660) and 54.4% (1121/2060) in 1991 to 94.7% (234/247) (χ(2) = 38.34, P < 0.01) and 84.5% (582/689) (χ(2) = 429.26, P < 0.01) in 2011. The intakes of livestock meat in rural children increased from 16.7 g/d in 1991 to 56.7 g/d in 2011 (χ(2) = 472.46, P < 0.01). CONCLUSION: The overall pattern of meat consumption in Chinese children in nine provinces(autonomous region) was unreasonable between 1991 and 2011. There was a significant improvement in meat consumption in rural children over time.

[Trend in vegetable and fruit intake among Chinese children and adolescents aged 6 to 17 years from 1991 to 2009 and related socio-demographic factors].

OBJECTIVE: To analyze the long-term shifts in fruit and vegetable intakes in Chinese children and adolescents between 1991 and 2009 and related impact from socio-economic factors on such dynamics. METHODS: Data was from the seven waves of the China Health and Nutrition Survey. 12 596 children and adolescents aged 6 to 17 years with full data of 3-day-24-hour dietary recall, together with related demographic and socioeconomic factors were chosen as the study subjects. RESULTS: The consumption rates of fruits and vegetables showed an significant increasing trend, from 58.3% in 1991 to 82.4%, on dark-color vegetables(χ(2) = 213.2, P < 0.01), from 94.4% to 96.9% on light-color vegetable(χ(2) = 11.6, P < 0.0001)and from 12.6% to 45.4% for fruits(χ(2) = 571.2, P < 0.0001)in 2009. The median intake of total vegetables decreased from 250.0 g/d in 1991 to 225.8 g/d in 2009(χ(2) = 72.4, P < 0.0001) and the light-color vegetable decreased by 36.6 g/d. However, among the corresponding consumers, the fruit intake increased about 50.0 g/d (χ(2) = 104.2, P < 0.01)and the dark-color vegetable intake decreased about 40.0 g/d (χ(2) = 92.8, P < 0.0001 ). The proportion of children who reached the minimum intake of vegetable(300 g/d)recommended by Dietary Guidelines for Chinese 2007 decreased from 38.9% in 1991 to 26.8% in 2011 and the proportion of children who had met the minimum intake(200 g/d)increased from 2.0% to 13.9% . 25.1% of the children consumed dark-color vegetables more than half of the total vegetable intake. Schooling of the mother and family income had important impact on fruit consumption of the children. CONCLUSION: Rates on fruit and vegetable consumption showed an increasing trend among Chinese children and adolescents over the past 20 years. However, the vegetable intake significantly decreased and the fruit intake increased slightly. Chinese Children posed a greater risk on insufficient intake on both vegetables and fruits. Comprehensive and effective programs should be taken to increase vegetable and fruit intakes in order to improve the nutritional status of children.

[Trend in dietary calcium intake among Chinese children and adolescents aged 4 to 17 years in nine provinces from 1991 to 2009].

OBJECTIVE: To understand the daily calcium intake, food sources and the trends among Chinese children and adolescents aged 4 to 17 years from 1991 to 2009. METHODS: Consecutive 3-day-24-hour dietary recall data from the seven waves of the China Health and Nutrition Survey(CHNS)was used to describe the status and trends of daily calcium intake and related food sources. RESULTS: Between 1991 and 2009, the daily intake of calcium in Chinese children and adolescents showed an increasing trend. In 2009, the average intakes of calcium in Chinese boys and girls were 311.2 mg/d and 294.6 mg/d, respectively. 81.5%-87.6% of boys and 87.0%-91.0% of girls had their calcium intakes less than half of the recommended amount of adequate intakes. Only 0.2%-0.8% of boys and 0.1%-0.8% of girls had their calcium intakes equal or higher than the recommended amount of adequate intakes. The sources of dietary calcium were mainly from vegetables, legumes, cereals and milk products for Chinese children and adolescents, accounting for more than 70% of the average daily intakes. CONCLUSION: During the past two decades, the dietary calcium intake of Chinese children and adolescents still remained at lower level, suggesting that the optimal food sources of calcium were under-consumed.

[Study on the multilevel and longitudinal association between red meat consumption and changes in body mass index, body weight and risk of incident overweight among Chinese adults].

OBJECTIVE: To examine the longitudinal association between red meat consumption and changes in body mass index(BMI), body weight and overweight risk in Chinese adults. METHODS: Data from the open, prospective cohort study 'China Health and Nutrition Survey' (CHNS), 18 006 adults(47.5% males)were chosen as the study subjects who participated in at least one wave of survey between 1991 and 2009. Three-level(community-individual-measure occasion) mixed effect modeling was performed to investigate the effect of red meat consumption on BMI, body weight changes and risk of overweight. The average daily red meat intake was assessed using consecutive 3 d 24 h recalls. RESULTS: In general, participants with higher red meat intake appeared to be those with younger age, higher personal income and higher education level, lower physical activities, higher total energy intake, smokers and alcohol drinkers. 3-level mixed-effects linear regression models showed that red meat intake was positively associated with changes in BMI and body weight. Compared to those who consumed no red meat, men and women in the highest quartile of red meat intake showed an increase of 0.17(95% CI:0.08-0.26, P < 0.0001)and 0.12 kg/m(2) (95%CI:0.02-0.22, P < 0.05) on BMI and increase of 596 g (95%CI:329-864, P < 0.0001) and 400 g (95%CI:164-636, P < 0.0001) on body weight, respectively, after adjustment for potential confounders (age, income, education, smoking, alcohol, physical activity level, community urbanization index and total energy intake). After adjustment for above confounders and baseline BMI, results from the 3-level mixed effect logistic model indicated that the odds ratios of being overweight in males and females who had the highest quartile of red meat intake were 1.21 (95%CI:1.01-1.46, P < 0.05)and 1.18(95% CI:1.01-1.37, P < 0.05) in comparison with non-consumers of red meat, respectively. CONCLUSION: Higher red meat intake was associated with increased BMI and body weight, as well as increased overweight risk.

[Dietary patterns of Chinese adults in nine provinces].

OBJECTIVE: To examine and characterize the dietary patterns of Chinese adults in nine provinces. METHODS: The subjects were selected from the 'China Health and Nutrition Survey' within age group of 18 - 70 years old in 2009. 24-hour dietary recall method for 3 consecutive days was used to collect information on food intake. RESULTS: Major dietary patterns of Chinese adults in nine provinces were labeled "rice/pork" in both men and women while "fruit/egg", "beef, mutton/poultry"and "ethnic food/legumes" in men and "fruit/milk", "tubers/grains" in women. Urban or rural life style and related characteristics of the population showed an influence on the dietary pattern (men: ß = -0.153 24, -0.153 24, 0.376 62, 0.148 10, P < 0.01; women: ß = -0.139 43, 0.222 00, -0.308 36, P < 0.01). CONCLUSION: The dietary patterns of Chinese adults varied by sex and "Rice/Pork" had been the typical dietary pattern among the Chinese adults.

[The impact of socioeconomic status on the prevalence of hypertension among adults in 9 provinces of China, 1991-2009].

OBJECTIVE: To investigate the trends of hypertension prevalence among Chinese adults from 1991 to 2009. To analysis the effects of socioeconomic status (SES) on hypertension rate. METHODS: This study was based on the data of China Health and Nutrition Survey which was conducted in 1991, 1993, 1997, 2000, 2004, 2006 and 2009. Adult subjects aged 18 to 74 years old in each round were included. Statistical method of single factor and multi-factor analysis was used. RESULTS: During the eighteen-year follow up, from 1991 to 2009, the crude rate increased from 14.6% to 28.7%, and the adjusted rate by age increased from 14.6% to 32.2% among males. The crude rate increased from 12.0% to 24.6% , and age adjusted rate from 12.0% to 24.9% among females. Hypertension prevalence was highest among the male group with highest SES score at 1991, 1993, 1997, 2000 and 2004. However, the lowest SES score with highest hypertension prevalence was found among the male group at 2006 and 2009. From 1997, the hypertension prevalence of female with highest SES score was lowest, and the group with lowest SES score was highest hypertension prevalence in female group from 1993. Negative association was found between SES score and female hypertension prevalence by the logistic regression analysis. No association was found between SES score and male hypertension prevalence. CONCLUSION: The prevalence of hypertension among Chinese adults had a continual increase with age during the period from 1991 to 2009. Negative association was existed between SES and hypertension prevalence for female. However, further study should be conducted between SES and male hypertension prevalence.

[Trends in dietary protein intake among Chinese children and adolescent between 1991 and 2009].

OBJECTIVE: To examine dietary protein intake and its trend between 1991 and 2009 among Chinese children and adolescents aged 6 to 17 years. METHODS: Consecutive 3 d-24 hr Dietary Recall and household income data of 14 053 children from the seven waves of the China Health and Nutrition Survey (CHNS), 1991, 1993, 1997, 2000, 2004, 2006 and 2009 were used to describe long-term changes in dietary protein intake, percentage energy, and food sources. RESULTS: The median of dietary protein intake of Chinese children and adolescents decreased from 60.0 g/d in 1991 to 52.6 g/d in 2009 (χ² = 109.0, P < 0.01). The dietary protein intake among children in rural areas and in low-income households decreased 8.8 g/d (χ² = 74.8, P < 0.01) and 9.8 g/d (χ² = 100.5, P < 0.01) respectively. The percentage of total energy intake from protein was 11.3%-13.0%. The percentage of protein intake equal or higher than Recommended Nutrient Intake of protein decreased from 29.5% in 1991 to 19.2% in 2009 (χ² = 259.6, P < 0.01). Furthermore, the proportion of high-quality dietary protein increased rapidly. The percentage of animal protein increased from 12.3% in 1991 to 32.2% in 2009 (χ² = 750.3, P < 0.01), while no big increase in soybean protein (lower than 5.0%). CONCLUSION: There is a decreasing trend in dietary protein intake among Chinese children from 1991 to 2009. The high-quality protein intake was improved but we should be concerned about the high proportion of animal protein. The children living in low-income households and in rural areas may be at risk of inadequate dietary protein.

[Trend on vitamin C intake among Chinese population aged 50 - 79 years in 9 provinces, from 1991 to 2009].

OBJECTIVE: To analyze the trend of dietary vitamin C intake and its food sources among Chinese population aged 50-79 years old in 9 provinces, from 1991 to 2009. METHODS: Data on twenty-four-hour dietary recall from China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, 2006 and 2009) was used to identify the trends in vitamin C intake among Chinese population aged 50-79 years old. RESULTS: Totally, 24,321 adults were assessed among 7 round surveys, including 11,739 males (48.3%) and 12,582 females (51.7%). From 1991 to 2009, the intake of vitamin C was reduced by 12.1 mg and 11.8 mg in rural male and female respectively; and the intake of vitamin C increased by 8.7 mg and 10.2 mg in urban males and females, respectively. Intake of vitamin C from the dark-color vegetables decreased by 15.1 mg and 13.9 mg in rural males and females, and it was increased first then decreased in both urban males and females. Vitamin C from the light-color vegetables kept stable during the 18 years. The intake of vitamin C in the southern residents aged 50-79 year-olds was significantly higher than that of the northern residents (except for 1997). The proportion that vitamin C intake reached to Chinese RNI were 19.8%-30.4% (urban males), 31.1%-43.9% (rural males), 15.9%-24.9% (urban females), and 26.4%-38.1% (rural females) respectively. CONCLUSION: The present study indicated that the changing of vitamin C intake was different between urban and rural residents aged 50-79. The amount of vitamin C intake between urban and rural residents was gradually getting closer. However, the intake of vegetables and fruit was not sufficiency.

[Trend in dietary calcium intake among Chinese elderly aged 50 years and over in nine provinces, from 1991 to 2009].

OBJECTIVE: To understand the daily calcium intake and the dietary sources, as well as its trends from 1991 to 2009 in Chinese elderly aged 50 years and over. METHODS: Consecutive 3 d-24 hr Dietary Recall Data from the seven waves of the China Health and Nutrition Survey (CHNS) was used to describe the status and trends of daily calcium intake and its food sources. RESULTS: Between 1991 and 2009, the daily intake of calcium in the Chinese elderly showed an increasing trend. In 2009, the average intakes of calcium in Chinese elderly men and women were 400.2 mg/day and 352.7 mg/day, respectively. 72.0% - 82.2% of males and 78.8% - 88.0% of females had their calcium intake less than half of the recommended amount of adequate intakes, but only 0.4% - 3.9% of males and 0.4% - 3.0% of females had their calcium intake equal or higher than the recommended amount of intakes. The sources of dietary calcium were mainly from vegetables, legumes, and cereals for the Chinese elderly, accounting for more than 70% of the average daily intakes. CONCLUSION: During the past twenty years, the average daily calcium intake of the Chinese elderly still remained at low level while the optimal calcium sources as milk and legumes, were under-consumed.

[Trend of energy intake among Chinese children and adolescents in nine provinces from 1989 to 2009].

OBJECTIVE: To examine the trends of energy intake among Chinese children and adolescents in nine provinces from 1989 to 2009. METHOD: Stratified multi-stage cluster sampling method was used to recruit 488, 2807, 2802, 2580, 2520, 1604, 1305 and 1159 children and adolescents aged 6 - 17 years in each year of 1989, 1991, 1993, 1997, 2000, 2004, 2006 and 2009 in 9 provinces. The descriptive analyses were carried out for three days 24-h dietary recall data to compare energy intake by year and demographic characteristics. RESULTS: The median of dietary energy intake among Chinese children and adolescents aged 6 - 17 years in 1989, 1991, 1993, 1997, 2000, 2004, 2006 and 2009 were 6645.7, 8314.8, 7849.3, 8115.0, 7970.5, 7598.0, 7345.0 and 7051.9 kJ/d (χ(2) = 239.75, P < 0.01), respectively. In 2009, children and adolescents from city (7820.4 kJ/d) and county (7356.0 kJ/d) consumed more energy than that from suburb (7168.2 kJ/d) and village (6863.5 kJ/d) (χ(2) = 8.00, P < 0.05). Cereal was the main food source of energy intake. In 2009, the percentage of energy intake from cereal was 44.0%, 45.6%, 52.9% and 61.0% (χ(2) = 36.75, P < 0.01)for city, suburb, county and village respectively. The percentage of population with > 30% of energy intake from dietary fat increased yearly and that with more than 60% of energy from carbohydrate decreased, from 25.4% (124/488) and 54.1% (264/488) in 1989 to 58.1% (637/1159) and 15.9% (184/1159) (χ(2) values were 811.24, 919.35 respectively;both P values < 0.05) in 2009. The percentage of children and adolescents whose energy intake was more than 80% recommended nutrient intake (RNI) declined from 60.2% (294/488) in 1989 to 47.8% (554/1159) in 2009(χ(2) = 227.66, P < 0.05). CONCLUSION: The current study demonstrated that energy intake of Chinese children and adolescents increased at early stage and then declined in the recent years. Average energy intake was higher in city and county than suburb and village.

[Trend in dietary vitamin C intake among Chinese children and adolescents between 1991 and 2009].

OBJECTIVE: To examine status and trend in dietary vitamin C intake between 1991 and 2009 in Chinese children and adolescents aged 6 to 17 years. METHODS: A stratified multistage, random cluster sampling process was used to investigate 2716, 2691, 2507, 2358, 1490, 1218 and 1073 children and adolescents aged 6 - 17 years in 1991, 1993, 1997, 2000, 2004, 2006 and 2009 respectively in 9 provinces. Their consecutive 3 d 24 h dietary recall data were analyzed to compare vitamin C intake in children and adolescents with different characteristics and different years. RESULTS: The median of dietary vitamin C intake in Chinese children and adolescents decreased from 69.7 mg/d in 1991 to 53.4 mg/d in 2009 (χ(2) = 188.1, P < 0.01). Vitamin C intake of rural children and adolescents decreased from 73.7 mg/d in 1991 to 52.5 mg/d in 2009 (χ(2) = 96.7, P < 0.01); vitamin C intake of children and adolescents in the low-income household decreased from 74.3 mg/d in 1991 to 47.5 mg/d in 2009 (χ(2) = 172.9, P < 0.01). The percentage of children and adolescents whose vitamin C intake equal or higher than recommended nutrient intake of vitamin C decreased from 35.9% (974/2716) in 1991 to 18.5% (198/1073) in 2009 (χ(2) = 284.7, P < 0.01). CONCLUSION: There was a decreased trend in dietary vitamin C in Chinese children and adolescents during the past two decades. The children and adolescents of low-income household in rural areas may pose a higher risk of inadequate vitamin C intake.

[Current status and trends of both dietary fat and cholesterol intake among Chinese children and adolescents aged 7 to 17 years old in 9 provinces of China, from 1991 to 2009].

OBJECTIVE: To study the current status and trends of fat and cholesterol intake among Chinese children and adolescents in 9 provinces from 1991 to 2009, so as to provide evidence on dietary guidance. METHODS: Data was collected in 1991, 1993, 1997, 2000, 2004, 2006 and 2009 from the China Health and Nutrition Survey. Sample would include 7 - 17 years old healthy children and adolescents with a complete 3-day 24-hour-dietary data. Figures on the intake of fat, cholesterol, mean percentage of energy from fat and food source of fat per capita were calculated and compared with the Chinese Dietary Reference Intakes (DRIs). RESULTS: Data showed that, in 1991 - 2009, the dietary fats, mean percentage of energy from total fat and intake of cholesterol had an increasing trend in the population of 9 provinces and were 65.8 g/d, 240.0 mg/d and 32.0% respectively, in 2009. The percentage of population whose mean energy coming from total fat and reached 57.0% in 2009. CONCLUSION: The dietary structure of children and adolescents in Chinese 9 provinces had changed significantly. 57.0% of the studied subjects had more than 30% increase of their fat intake exceeding the Chinese DRIs. It was necessary to provide children and adolescent with basic knowledge on nutrition, in order to properly control the intake of food rich in fat and cholesterol.

[The status and trend of cereal consumption among Chinese adults in nine provinces (municipality) from 1989 to 2006].

OBJECTIVE: To explore the status and trend of cereal consumption among Chinese adults aged 18 to 59 years in nine provinces (municipality) from 1989 to 2006. METHODS: The survey data were collected by consecutive 3 d 24 h dietary recall method in 1989, 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey Project. The subjects aged 18-59 years with complete information on dietary survey were included. The sample number of the subjects were 5978, 7566, 7492, 7738, 8439, 7484 and 7157 in the 7 round surveys from 1989 to 2006, respectively. The trends of their cereal consuming rate and daily intake were analyzed by year, gender, age and regions. RESULTS: The cereal intake of 18 - 59 years old Chinese adults in 9 provinces (municipality) decreased from 522.3 g/d in 1989 to 431.9 g/d in 2006 (χ(2) = 2421.76, P < 0.01). The cereal intake of males decreased from 545.6 g/d in 1989 to 471.6 g/d in 2006 (χ(2) = 861.21, P < 0.01) and females decreased from 500.3 g/d in 1989 to 395.5 g/d in 2006 (χ(2) = 1844.13, P < 0.01). Compared with 1989, the average cereal consumption were reduced to 104.8, 134.4, 103.3 and 98.2 g in the suburban, female, 18 to 29 years old age group and level of education for college and above separately in 2006. The rice consuming rate among 18 - 59 year-old residents increased from 79.9% (4776/5978) in 1989 to 87.3% (6248/7157) (Z = 18.45, P < 0.01) in 2006, the wheat consuming rate increased from 63.3% (3784/5978) in 1989 to 80.2% (5740/7157) (Z = 27.28, P < 0.01) in 2006. CONCLUSION: The present study indicated that there was a decreasing trend of cereal intake among Chinese adults aged 18 - 59 years in 9 provinces (municipality). In the stratified groups, cereal intake in groups of female, suburb, aged 18 - 59 years and higher educational level decreased significantly.

[Milk consumption and its changing trend of Chinese adult aged 18 - 44 in nine provinces (autonomous region) from 1991 to 2006].

OBJECTIVE: To investigate the age, gender and region specified milk consumption and its changing trends of Chinese 18 - 44 years old adults in 9 provinces (autonomous region) from 1991 to 2006. METHODS: The data of 18 - 44 aged old adults investigated in Chinese Health and Nutrition Survey from 1991 to 2006 in 9 provinces (autonomous region) were utilized. The numbers of the subjects selected in 1991, 1993, 1997, 2000, 2004 and 2006 were 5593, 5491, 5334, 4188 and 3908, respectively. Changes of the percentage of milk consumption, average intake of daily milk and dietary calcium intake were analyzed across different groups of gender, income levels, and areas. RESULTS: There was an increasing trend in the percentage of milk consumption and daily intake of milk from 1991 to 2006. The average percentage of Chinese adult milk consumption went up from 2.2% (123/5593) in 1991 to 7.6% (297/3908) in 2006 (Z = -22.16, P < 0.01). Specifically, urban adult and rural adult showed significant increase in the percentages from 9.7% (80/823) to 23.7% (112/472) (Z = -12.81, P < 0.01) and 0.1% (2/2937) to 1.8% (36/1987) (Z = -9.21, P < 0.01) respectively. Percentages of adult who ever drank milk at top income level and bottom income level increased from 4.7% (95/2006) to 14.6% (200/1373) (Z = -17.36, P < 0.01) and from 0.1% (2/1748) to 2.4% (28/1171) (Z = -9.58, P < 0.01), respectively. Meanwhile, the average daily intake of milk increased from (3.6 ± 24.6) g/d in 1991 to (11.8 ± 51.4) g/d in 2006 (F = 67.07, P < 0.01). The daily milk consumption among top income level adults and bottom income level adults increased from (8.5 ± 50.9) g/d to (23.1 ± 71.5) g/d and from (0.2 ± 6.5) g/d to (3.3 ± 23.5) g/d (F = 13.90, P < 0.01), respectively. From 1991 to 2006, milk consumers significantly promoted their percentage of achieving the Chinese dietary reference intake on calcium (800 mg/d) from 6.5% (8/123) to 12.8% (38/297) (Z = -1.67, P < 0.05), whereas this percentage increased from 1.6% (38/5470) to 3.6% (130/3611) among milk non-consumers (Z = -5.66, P < 0.01). CONCLUSION: Chinese adult milk intake still remains in quite low level, and the situation of milk consumption among rural adults requires further promotion.

[The status of dietary sodium intake of Chinese population in nine provinces (autonomous region) from 1991 to 2006].

OBJECTIVE: To analyze the status of dietary sodium intake of 18 - 65 years old Chinese people in nine provinces (autonomous region) in 1991 and 2006. METHODS: In 1991 and 2006, China Health and Nutrition Survey was carried out in nine provinces, including Liaoning, Heilongjiang, Shandong, Jiangsu, Henan, Hunan, Hubei, Guangxi and Guizhou, Subjects were selected by multi-stage stratified cluster random sampling method from 18 - 65 years old people and 8235 subjects in 1991 and 7788 subjects in 2006. Sodium intake analysis was conducted across gender, regions and rural(urban) residences. RESULTS: On average, sodium intake decreased from (6750.6 ± 3771.5) mg/d in 1991 to (4949.7 ± 2829.4) mg/d in 2006 (Z = -35.5, P < 0.01) among the 18 - 65 years old people. In 1991 and 2006, the main sources of dietary sodium were salt, soy sauce and vegetable. In 1991, the proportion were 79.6% ((5375.6 ± 3532) mg/d), 8.7% ((586.7 ± 721.7) mg/d) and 7.5% ((506.9 ± 906.1) mg/d), respectively. In 2006, the proportion were 71.5% ((3539.8 ± 2545) mg/d), 8.3% ((410.7 ± 547.9) mg/d) and 6.2% ((304.6 ± 610.7) mg/d), respectively. CONCLUSIONS: Among 18 - 65 years old residents, sodium intake in 2006 was significantly lower than that in 1991, but still far beyond the 2200 mg/d of adequate intake level (2200 mg/d). The major source of sodium intake in Chinese diet was condiments.

[Milk consumption and effects on dietary nutrients and growth status among Chinese children in nine provinces (autonomous region) from 1991 to 2006].

OBJECTIVE: To investigate milk consumption and effects on dietary nutrients and growth status among 7 - 17 years-old Chinese children in 9 provinces (autonomous region) from 1991 to 2006. METHODS: Data was collected in 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey, and 11 691 subjects aged 7 to 17 years old were included. The subjects were divided into the following groups according to milk consumption per day, 0 (no milk drinking), 1 - 99, 100 - 199, 200 - 299 and ≥ 300 g/d. Variables from different years were compared, such as milk categories, energy, protein, calcium intake, body mass index (BMI), as well as that dietary nutrients, height and weight among different milk consumption groups. RESULTS: From 1991 to 2006, milk drinking rate and milk consumption among Chinese children had great improvement: milk drinking rate reached to 14.1% (161/1145) in 2006, while that was 3.0% (73/2441) in 1991; milk consumption reached to (26.7 ± 85.0) g/d in 2006, which was 6.8 times of that in 1991 (3.9 ± 31.9) g/d (χ(2) = 474.5, P < 0.01). BMI increased from (17.3 ± 2.9) kg/m(2) in 1991 to (18.5 ± 6.0) kg/m(2) in 2006 (χ(2) = 123.5, P < 0.01). Meanwhile, energy intake decreased from (8653.3 ± 2789.2) kJ/d in 1991 to (8058.3 ± 2866.6) kJ/d in 2006 (χ(2) = 72.6, P < 0.01); protein intake decreased from (63.0 ± 22.8) g/d in 1991 to (57.3 ± 23.1) g/d in 2006 (χ(2) = 71.9, P < 0.01). Average height of 0 (no milk drinking), 1 - 99, 100 - 199, 200 - 299 and ≥ 300 g/d groups were (142.9 ± 16.9), (146.9 ± 18.8), (147.6 ± 16.2), (148.8 ± 16.0), (149.9 ± 15.3) cm, respectively (χ(2) = 29.4, P < 0.01); average weight were (37.1 ± 13.2), (40.3 ± 13.9), (41.3 ± 16.9), (41.7 ± 14.6), (41.4 ± 12.2) kg, respectively (χ(2) = 25.7, P < 0.01). CONCLUSION: In the period of 1991 to 2006, milk drinking rate and milk consumption has improved greatly. Main nutrient intake, height and weight increased with milk consumption.

[Trends of the dietary fiber intake among Chinese aged 18 - 45 in nine provinces (autonomous region) from 1989 to 2006].

OBJECTIVE: To analyze the status and trend of dietary fiber intake and its food sources among Chinese residents aged 18 - 45 years old in 9 provinces (autonomous region), from 1989 to 2006. METHODS: Twenty-four-hour dietary recall data of three consecutive days from China Health and Nutrition Survey (1989, 1991, 1993, 1997, 2000, 2004 and 2006) were used. And the 18 - 45 years old subjects with complete information on dietary survey were included. The sample size of these 7 surveys were 5597, 5596, 5323, 5485, 5308, 4144 and 3889, respectively. The trends of dietary fiber intake and food sources by time and sex were studied. RESULTS: From 1989 to 2000, the total of daily dietary fiber intake of 18 - 45 years old healthy residents decreased from 15.1 g/d to 11.6 g/d, insoluble dietary fiber intake decreased from 22.6 g/d to 17.8 g/d. In villages, from 1989 to 2000, the insoluble dietary fiber intake decreased 5.1 g/d in males and 5.2 g/d in females(13.2, 11.8 g in 2000, respectively;18.3, 17.0 g in 1989, respectively). In 2006, the insoluble dietary intake was 12.6 g/d in males and 11.2 g/d in females in villages. In cities, from 1989 to 2006, the insoluble dietary fiber intake was 9.4 - 11.8 g/d in males and 8.3 - 10.8 g/d in females. The total dietary fiber intake was 15.7 - 17.6 g/d in males and 13.5 - 16.4 g/d in females. The difference of insoluble and total dietary fiber intake between city and village was decreasing. In 2006, 70.6% (8.4/11.9) insoluble dietary fiber came from vegetables ((4.1 ± 3.1) g/d), wheat flour and its products ((2.6 ± 3.6) g/d), rice and its products ((1.7 ± 1.3) g/d). CONCLUSION: Dietary fiber intake among Chinese aged 18 - 45 in 9 provinces (autonomous region) decreased from 1989 to 2006. Vegetables, wheat flour, rice and their products were the major food sources of insoluble dietary fiber.

[Status and trend of alcohol consumption among adults in nine provinces (antonomous region) of China from 1993 to 2006].

OBJECTIVE: To understand the status and trend of alcohol consumption among adult people living in 9 provinces (autonomous region) of China from 1993 to 2006. METHODS: The data was collected at the China Health and Nutrition Survey in 1993, 1997, 2000, 2004 and 2006, the subjects with complete drinking data of adult residents were involved. The sample of subjects were 7994, 8625, 9283, 9780 and 9746 among 5 round surveys respectively. Alcohol intake, drinking frequency, drinking type, drinking amount and trends of changing was analyzed. RESULTS: The average drinking rates were 60.2% (13 201/21 919) and 9.7% (2269/23 509) among male and female respectively. The average alcohol intake was (32.2 ± 35.6) g in male and (14.0 ± 19.4) g in female drinkers. Male drinkers with primary and secondary schools or below education had the lowest level of drinking rate, which was 59.7% (985/1651), 58.7% (941/1604), 57.0% (889/1560), 55.4% (885/1599) and 53.1% (812/1529) in the 5 round surveys respectively. However, the average daily alcohol intake was the highest, which was (31.1 ± 38.2) g, (39.8 ± 42.1) g, (38.9 ± 41.3) g and (38.4 ± 43.3) g at 1997, 2000, 2004, 2006 respectively. The male drinkers with college or above education had the lowest alcohol intake, which was (21.9 ± 24.5) g, (28.8 ± 30.9) g, (24.6 ± 22.0) g and (25.0 ± 26.4) g in 1997, 2000, 2004 and 2006 respectively. Female drinkers with college or above education had the highest drinking rate, which was 21.0% (13/62), 24.5% (26/106), 16.6% (27/163), 19.7% (38/193) and 18.8% (46/245) at 5 round surveys respectively. But their average daily alcohol intake was lowest, which was (4.7 ± 3.3) g, (12.5 ± 31.9) g, (9.9 ± 18.7) g and (8.2 ± 8.5) g at 1997, 2000, 2004, 2006 respectively. And the average daily alcohol intake was the highest among female drinkers with primary and secondary schools or below education, which was (13.4 ± 16.9) g, (16.3 ± 22.4) g, (19.9 ± 26.1) g and (16.4 ± 18.0) g respectively. According to the regional distribution, the highest drinking rate of female drinker was occurred at urban female, which was 17.4% (110/631), 19.9% (147/740), 17.4% (129/741), 14.4% (117/814) and 11.3% (88/781) at 5 round surveys. Drinking every day was most popular in male drinkers, the proportion was 32.6% (3533/10 844). Drinking 1 to 2 times per week, 1 to 2 times per month, no more than 1 time per month was most popular in female drinkers, the proportion was 23.0% (410/1786), 24.6% (440/1786) and 21.2% (379/1786) respectively. Male drinkers liked liquor more (drinking rate was 81.8%, 8875/10 844). The wine drinking rate of female (22.3%, 399/1786) is far higher than that of male's (9.0%, 976/10 844) (χ(2) = 280.4, P < 0.01). The daily alcohol intake equal to or greater than 25 g of male drinkers was 42.0% (4058/9654), and the daily alcohol intake equal to or greater than 15 g of female drinkers was 25.3% (349/1378). CONCLUSION: The drinking rate of adults among 9 provinces (autonomous region) was higher than that of national average level. The drinking rate and the average alcohol consumption among male and female was significantly different. Same differences was observed among education level and different regions.

[Food consumption trend of Chinese adults in nine provinces (autonomous region) from 1989 to 2006].

OBJECTIVE: To analyze the trends of food consumption among Chinese residents aged from 18 to 59 years old in 9 provinces (autonomous region) from 1989 to 2006. METHODS: The paper was based on data collected in 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey of Chinese residents of 24 h in three consecutive day dietary recall data. The healthy residents aged 18 - 59 years with twenty-four-hour dietary recall data were selected as study subjects. The sample sizes of these seven surveys were 5766, 7296, 7019, 7599, 8143, 7168 and 6827, respectively. The trends of their food consumption in each year were analyzed through Kruskal-wallis method. RESULTS: The intake of cereals decreased significantly from (528.5 ± 192.9) g/d in 1989 to (427.7 ± 173.8) g/d in 2006 (χ(2) = 2833.13, P < 0.01). The minor variation of soybean food intake was observed. The average intake was (22.3 ± 39.4) g/d in 1989 and (18.9 ± 30.5) g/d in 2006 which was still at a low level. The trend of vegetables intake showed a small decrease. It was (374.5 ± 205.9) g/d in males and (346.4 ± 187.6) g/d in females in 2006, respectively. Both quantity and rate of fruits consumption showed an increase trend. Its consumption rate reached at 22.5% (741/3296) in males and 27.7% (1004/3619) in females in 2006, respectively. The average intake increased from (122.4 ± 126.9) g/d in 1989 to (228.5 ± 267.3) g/d in 2006 (χ(2) = 539.66, P < 0.01). At the same time, the daily intake of meat and egg showed a large increase, the average meat intake increased from (97.0 ± 111.5) g/d in males and (80.2 ± 97.0) g/d in females in 1989 to (141.5 ± 125.2) g/d in males and (118.4 ± 111.8) g/d in females in 2006, respectively. The oil consumption showed a significant increase. The average intake increased from (30.4 ± 37.9) g/d in 1989 to (42.8 ± 32.3) g/d in 2006 (χ(2) = 1646.94, P < 0.01). CONCLUSIONS: There have been noticeable changes in the Chinese dietary pattern in the past 17 years. Some changes would be helpful for nutritional improvement in Chinese people, but it also caused some adverse effects on health because of improper food consumption.