Moderate Intake of Lean Red Meat was Associated with Lower Risk of Elevated Blood Pressure in Chinese Women: Results from the China Health and Nutrition Survey, 1991-2015.

This study aimed to examine longitudinal associations between fatty and lean, fresh red meat intake and blood pressure (BP) in Chinese adults. The data were from nine waves of the China Health and Nutrition Survey (1991-2015), a longitudinal, open cohort study. The surveys were conducted in 303 urban and rural communities of 15 provinces in China. Collected by consecutive three-day 24-h dietary recalls combined with household weighing for foods or only condiments, the diet exposure of interest was daily red meat intake and its subtypes (fatty versus lean) defined by 10-g fat content per 100 g. The main outcome was systolic blood pressure (SBP), diastolic blood pressure (DBP) and risk of elevated BP defined as having a mean of SBP ≥ 135 mmHg, DBP ≥ 85 mmHg, or taking antihypertensive medication. Three-level mixed-effect regressions showed women had SBP increases of 2.19 mmHg (95% CI: 1.07, 4.46) from a higher intake of total fresh red meat, 2.42 mmHg (95% CI: 1.18, 4.94) from a higher intake of fatty, fresh red meat, as well as 0.48 mmHg (95% CI: 0.26, 0.88) from a higher intake of lean, fresh red meat in the top tertile versus bottom one when adjusted for potential confounders. After adjusting for survey years, women with the highest tertile of lean, fresh red meat intake had a 32% lower risk of elevated BP (OR 0.68, 95%CI:0.48, 0.96) as compared with those with the first tertile (non-consumer). Fatty and lean, fresh red meat intakes were differentially associated with BP among Chinese adults. Further research is required to elicit the potential mechanism on gender-specific differential association of fatty versus lean, fresh red meat with BP.

[Effect of dietary cholesterol intake on stroke incidence among Chinese adults: evidence from China Health and Nutrition Survey].

OBJECTIVE: To examine the longitudinal association between dietary cholesterol intake and stroke incidence in Chinese adults. METHODS: The data were from 5833 non-stroke participants aged 30-98 in 1997 and more than one repeated measurements in the following five waves (2000, 2004, 2006, 2009 and 2011) of the China Health and Nutrition Survey. 5805 participants were included eventually after removing those with abnormal dietary cholesternul intake. Dietary cholesterol and energy intake was assessed with 3 d - 24 h dietary recalls in all the waves. Self-reported hypertension, diabetes mellitus, alcohol drinking, smoking, and standardized measurement of waist circumstance were collected also. Time-dependent Cox proportional hazard regression models were constructed to estimate relative risks (RR) with 95% confidence intervals (CI). RESULTS: During the mean 11. 3 years follow-up, 198 stroke events of 5805 participants were ascertained. The quintiles dietary cholesterol intake were 70.0, 146.9, 218.3, 297.8 and 425.9 mg/d. After adjusted for potential confounders, the time-dependent cholesterol intake, baseline cholesterol intake and the mean cholesterol intake during 1997-2011 were insignificantly associated with stroke. The relative risks and 95% confidence intervals were 1. 000 (0.999 - 1.001), 1.000 (0.999 - 1.001 ) and 0.999 (0.998 - 1.001) respectively. The cholesterol intake quintiles were insignificantly associated with stroke incidence. The relative risks and 95% confidence intervals versus lowest quintile were 0.812 (0.504 - 1.310), 0.644 (0.389 - 1.066) 0.913 (0.576 - 1.446) and 0.692 (0.416 - 1.152) respectively. CONCLUSION: Effect of dietary cholesterol intake on stroke incidence might was insignificant in Chinese adults.

Association between dietary patterns and blood lipid profiles among Chinese women.

OBJECTIVE: The present study aimed to identify dietary patterns and explore their associations with blood lipid profiles among Chinese women. DESIGN: In a cross-sectional study, we identified dietary patterns using principal component analysis of data from three consecutive 24 h dietary recalls. The China Health and Nutrition Survey (CHNS) collected blood samples in the morning after an overnight fast and measured total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C) and TAG. SETTING: Data were from the 2009 wave of the CHNS. SUBJECTS: We studied 2468 women aged 18-80 years from the CHNS. RESULTS: We identified three dietary patterns: traditional southern (high intakes of rice, pork and vegetables), snack (high intakes of fruits, eggs and cakes) and Western (high intakes of poultry, fast foods and milk). The traditional southern pattern was inversely associated with HDL-C (ß=-0·68; 95 % CI -1·22, -0·14; P<0·05). The snack pattern was significantly associated with higher TAG (ß=4·14; 95 % CI 0·44, 7·84; P<0·05). The Western pattern was positively associated with TC (ß=2·52; 95 % CI 1·03, 4·02; P<0·01) and LDL-C (ß=2·26; 95 % CI 0·86, 3·66; P<0·01). CONCLUSIONS: We identified three dietary patterns that are significantly associated with blood lipid profiles. This information is important for developing interventions and policies addressing dyslipidaemia prevention among Chinese women.

Influence of proximities to food establishments on body mass index among children in China.

BACKGROUND AND OBJECTIVES: Over the past two decades, food environment has changed, and the obesity and overweight rates have increased dramatically in China. Previous studies have suggested an association between food environment and obesity, while most studies were based on the data from developed countries, and few were conducted in developing countries. METHODS AND STUDY DESIGN: The current study evaluated the influence of food establishments (distance to and types of grocery store, free market, restaurant, and food stall) on body mass index (BMI) in 348 children aged 6-17 years, surveyed in the 2009 and 2011 China Health and Nutrition Survey in nine provinces. Food establishments were assessed using geographic information system (GIS) data. Weight and height of children were directly measured. RESULTS: Our longitudinal analysis suggested boys in the 2nd quartile of the proximity to the nearest grocery store had higher BMI (by 1.6 kg/m2, 95% CI, 0.07 to 3.24) as compared to those in the 1st quartile, while girls in higher quartiles had lower BMI (-1.78 kg/m2, 95% CI: -3.38 to - 0.18, 2nd quartile; -1.62 kg/m2, 95%: -3.22 to -0.01, 3rd quartile) as compared to those in the 1st quartile. Boys and girls in the 2nd quartile of the proximity to the nearest Chinese restaurant had lower BMI (-1.69 kg/m2, 95% CI: - 3.27 to -0.12; -1.76 kg/m2, 95% CI: -3.26, -0.27, respectively) as compared to those in the 1st quartile. CONCLUSIONS: Food environment may affect children's BMI in China, while the association is inconsistent with previous studies. Further research is needed.

[Pre-packaged foods' nutritional ingredients analysis among 706 adult residents in cities in China].

OBJECTIVE: To analyze the nutritional ingredients of daily consumed pre-packaged foods in Chinese adult residents. METHODS: From October to December 2013, the nutrition labels of pre-packaged foods consumed in continuous 7 days by 706 adult residents were collected by multi-stage stratified cluster random sampling in 18 communities with 360 households in 9 cities in China including Beijing, Shanghai, Chongqing, Shenyang, Haerbin,Jinan,Zhengzhou, Changsha and Nanning. The contents of energy, protein, fat, carbohydrate, sodium and the percentages of low-fat and low-sodium foods were compared among 7 different kinds of foods including baked foods, convenient foods, leisure foods, puffed foods, milk, beverages and seasonings. RESULTS: 871 kinds of pre-packaged foods were collected. The median (min, max) of energy contents of puffed foods, baked foods and leisure foods were 2 155(1 638-2 785) kJ/100 g, 1 980 (582-2 639) kJ/100 g, 1 575 (353-3 015) kJ/100 g respectively. The median (min, max) of fat contents of puffed foods, baked foods and leisure foods were 30.0 (5.0-40.9) g/100 g, 20.5 (0.3-40.5) g/100 g, 15.1 (0-71.4) g/100 g respectively. The contents of carbohydrate of baked foods, convenient foods and puffed foods were high relatively, the medians (min, max) of which were 58.1(19.8-82.5), 56.5(0-90.7), and 56.1(42.6-75.8)g/100 g respectively. The sodium content of seasoning was the highest, which was 2 177 (20-12 000) mg/100 g. The protein content of beverage was the lowest, which was 0.4(0-17.8)g/100 ml. CONCLUSION: The energy and fat contents of puffed foods, baked foods and leisure foods were high. The carbohydrate contents of baked foods, convenient foods and puffed foods were high relatively. The sodium content of seasonings was high. The protein contents of beverages were low.

Dietary patterns and their associations with childhood obesity in China.

Dietary patterns represent the combined effects of foods, and illustrate efficaciously the impact of diet on health outcomes. Some findings of previous studies have limited applicability to Chinese children due to cultural factors. The present study was designed to identify dietary patterns and determine their relationships with obesity among Chinese children and adolescents. Data collected from 1282 children and adolescents aged 7-17 years from the 2011 China Health and Nutrition Survey (CHNS) were used. Dietary patterns were identified using factor analysis of data from three consecutive 24-h dietary recalls. Weight and height were measured following standard methods, and BMI was calculated. Three dietary patterns were identified: modern (high intakes of milk, fast foods and eggs), traditional north (high intakes of wheat, tubers and other cereals) and traditional south (high intakes of vegetables, rice and pork). After adjusting for some confounders and total energy intake, subjects in the highest quartiles of the modern and traditional north patterns were found to have significantly greater risk of obesity (OR 3·10, 95 % CI 1·52, 6·32, and OR 2·42, 95 % CI 1·34, 4·39, respectively). In conclusion, the modern dietary pattern and the traditional north dietary pattern were associated with higher risk of obesity. Promoting healthier eating patterns could help prevent obesity in Chinese children.

[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.

Joint Association of Dietary Pattern and Physical Activity Level with Cardiovascular Disease Risk Factors among Chinese Men: A Cross-Sectional Study.

The purpose of this cross-sectional study was to investigate the joint associations of physical activity level (PAL) and dietary patterns in relation to cardiovascular disease (CVD) risk factors among Chinese men. The study population consisted of 13 511 Chinese males aged 18-59 years from the 2002 China National Nutrition and Health Survey. Based on dietary data collected by a food frequency questionnaire, four dietary patterns were identified and labeled as "Green Water" (high consumption of rice, vegetables, seafood, pork, and poultry), "Yellow Earth" (high consumption of wheat flour products and starchy tubers), "New Affluent" (high consumption of animal sourced foods and soybean products), and "Western Adopter" (high consumption of animal sourced foods, cakes, and soft drinks). From the information collected by a 1-year physical activity questionnaire, PAL was calculated and classified into 4 categories: sedentary, low active, active, and very active. As compared with their counterparts from the New Affluent pattern, participants who followed the Green Water pattern had a lower likelihood of abdominal obesity (AO; 50.2%), hypertension (HT; 37.9%), hyperglycemia (HG; 41.5%), elevated triglyceride (ETG; 14.5%), low HDL (LHDL; 39.8%), and metabolic syndrome (MS; 51.9%). When compared to sedentary participants, the odds ratio of participants with very active PAL was 0.62 for AO, 0.85 for HT, 0.71 for HG, 0.76 for ETG, 0.74 for LHDL, and 0.58 for MS. Individuals who followed both very active PAL and the Green Water pattern had a lower likelihood of CVD risk factors (AO: 65.8%, HT: 39.1%, HG: 57.4%, ETG: 35.4%, LHDL: 56.1%, and MS: 75.0%), compared to their counterparts who followed both sedentary PAL and the New Affluent pattern. In addition, adherence to both healthy dietary pattern and very active PAL presented a remarkable potential for CVD risk factor prevention.

[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.

[Status and trend of fat and cholesterol intake among Chinese middle and old aged residents in 9 provinces from 1991 to 2009].

OBJECTIVE: To study the status and trend of fat and cholesterol intake among Chinese middle and old aged residents in 9 provinces from 1991 to 2009, and provide the basic reference material for the revision of Chinese DRIs. METHOD: The data were collected in 1991, 1993, 1997, 2000, 2004, 2006 and 2009 from China Health and Nutrition Survey. The sample was 50 years old and over of health male and female residents and the intake of fat, cholesterol and mean percentage of energy from fat was calculated and compared with Chinese DRIs. RESULTS: The results 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 surveyed population of 9 provinces, and in 2009, the results was 81.9 g/d, 270.8 mg/d and 31.8% in male, and was 70.4 g/d, 238.5 mg/d and 32.2% in female respectively. The percentage of population whose mean percentage of energy from total fat exceed 30% and intake of cholesterol exceed 300 mg/d increased significantly, and in 2009, the results was 54.7% and 35.8% in male, and was 56.9% and 29.8% in female respectively. CONCLUSION: The dietary structure of middle and old aged residents in Chinese 9 provinces had changed significantly, and the percentage of energy from total fat and intake of cholesterol had closed or exceeded the Chinese DRIs. So the intake of food that is rich in fat and cholesterol should be controlled.

[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.

[Feeding status of children under 2 years old in poor rural areas of western China in 2009].

OBJECTIVE: To analyze feeding status of children under 2 years old in the poor rural areas of western China in 2009. METHODS: The study subjects were 2933 from the program of 'Study on appropriate technology of children under-nutrition improvement in poor rural areas'. RESULTS: In 2009, the rate of almost exclusive breast-feeding of children under 6 months in poor rural areas of western China was 38.3%, the time of giving complementary food was the 5th month and the weaning time was the 10th month. CONCLUSION: The study demonstrated that it is unreasonable of feeding status in poor rural areas of western China.

[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.

[Intergenerational differences on the nutritional status and lifestyle of Chinese residents].

OBJECTIVE: To study the diversities on nutritional status and lifestyle of adult Chinese residents born in different years. METHOD: The data of healthy adult residents born in the 1960s and 1980s were selected from the CHNS 1993 and 2009. Information on physical examination, nutrient intake and lifestyle factors were used as indicators to evaluate the nutritional status of residents; data was analyzed by SAS and STATA software. RESULTS: (1) Weight, height, BMI, waist circumference, hip circumference, waist-hip ratio, skin fold thickness, overweight/obesity, hypertension rate of residents born in the 1980s were all significantly higher than residents born in the 1960s. (2) Dietary fats intake, percentage of energy contributed from total fat, cholesterol intake, calcium intake and the rate of energy and cholesterol intake exceeding the Chinese dietary reference intakes (Chinese DRIs) of residents born in the 1980s were all significantly higher than residents born in the 1960s, however, the energy intake,carbohydrate intake, salt intake, vitamin B1 intake, vitamin C intake, the energy contributed from carbohydrates and the rate of vitamin B1 intake and vitamin C intake exceeding the Chinese DRIs of residents born in the 1980s were all significantly lower in residents born in the 1960s. (3) The smoking rates, rates of drinking tea and the percentage of population engaged in medium or vigorous physical activity of residents born in the 1980s were all significantly lower than residents born in the 1960s. CONCLUSION: The diversity of nutritional status and lifestyle in different generations could not be ignored, and the phenomenon of increased prevalence of nutrition-related non-communicable diseases (NR-NCDs) of residents born in 1980s should be concerned.

[Effect of nutritional status in childhood on health status in adulthood].

OBJECTIVE: To investigate the effect of nutritional status in childhood on health status in adulthood. METHODS: Data were collected from the China Health and Nutrition Survey in 1991, 1993, 1997, 2001, 2004 and 2006, and the subjects were older than 2 and no more than 18 year-old at the Survey in 1991 and remained in the same cohort with completed records through all six surveys. Mixed effect linear model was used to study the trajectory of BMI. Proportional hazards model was used to study the hazard risk of hypertension in adulthood. RESULTS: Generally, the thinness or overweight-obesity status in childhood followed a same trend till adulthood. Nutritional status in childhood and the educational level of their parents appeared to be related to risk factors of hypertension in adulthood. The hazard ratio of not developing hypertension for additional 1 gram of protein intake per day in male subjects was 0.991, and which for additional 1 kcal of energy intake per day in female subjects was 0.9997. CONCLUSION: The nutritional health status in childhood keeps the same trajectory till adulthood.

[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.