Relationship between nutrient-related dietary pattern and mild cognitive impairment in middle-aged and elderly people in 15 provinces of China / 中华流行病学杂志

Objective: To explore the relationship between nutrient-related dietary pattern and mild cognitive impairment (MCI) in middle-aged and elderly people. Methods: A total of 6 444 middle-aged and elderly people aged ≥55 years were selected in 2018 China Health and Nutrition Survey. MCI was evaluated by Mini-Mental State Examination, and the intakes of various foods were obtained by consecutive 3-day 24-hour dietary survey and weighing method. The intakes of various nutrients and total dietary energy were calculated based on the food composition table. Demographic and social information, lifestyle and health status of the respondents were obtained through questionnaire survey and physical measurements. In this study, vitamin C, vitamin E, zinc, iron, copper and selenium were selected as dependent variables. Nutrient-related dietary patterns were extracted by reduced rank regression method, and the relationship between dietary patterns and MCI was analyzed by multivariate logistic regression model. Results: Six dietary patterns were extracted in this study, and dietary pattern 1 with the highest explanatory degree was selected for subsequent analysis. Dietary pattern 1 was characterized by higher intakes of legume products, vegetables, fruits, nuts, pork, aquatic products and plant oil. Multivariate logistic regression analysis showed that the risk of MCI was lower in Q4 dietary score group than in Q1 dietary score group (OR=0.69, 95%CI: 0.49-0.98) in the 55-64 age group. In people with sleep duration of 8 hours per day, the risk of MCI was reduced in Q2, Q3 and Q4 dietary score groups compared with the Q1 dietary score group, with OR values of 0.68 (95%CI: 0.51-0.92), 0.67 (95%CI: 0.49-0.92) and 0.65 (95%CI: 0.45-0.92), respectively. Interaction analysis showed that the risk for MCI increased in those aged 65-74 years and ≥75 years compared with those aged 55-64 years in Q1 dietary score group. However, the risk for MCI decreased in both age groups as dietary pattern scores increased. Compared with those with sleep duration less or more than 8 hours per day in Q1 dietary score group, those with sleep duration of 8 hours per day in Q2 and Q3 dietary score groups had a reduced risk for MCI. Conclusion: Dietary patterns with higher intakes of legume products, vegetables, fruits, nuts, pork, aquatic products, and plant oil are negatively associated with MCI in people aged 55-64 years and those who slept 8 hours per day, and may reduce the risk of MCI with aging.

Association of Red Meat Usual Intake with Serum Ferritin and the Risk of Metabolic Syndrome in Chinese Adults: A Longitudinal Study from the China Health and Nutrition Survey / 生物医学与环境科学（英文）

Objective@#The present study aimed to investigate the association of red meat usual intake with metabolic syndrome (MetS), and explore the contribution of red meat usual intake to serum ferritin.@*Methods@#Based on the data from the longitudinal China Health and Nutrition Survey (CHNS), 2,797 healthy adults aged 18-75 years without hypertension, diabetes, and MetS were selected in 2009 as subjects and follow-up studies were carried out till 2015. We used the National Cancer Institute (NCI) method to estimate the usual intake of foods. Multivariable logistic regressions were performed to evaluate the association between red meat usual intake and the risk of MetS. Quantile regression analysis was used to study the relationship between red meat consumption and serum ferritin levels.@*Results@#After adjusting for potential confounders, red meat, and fresh red meat were positively associated with the risk of MetS ( = 1.41, 95% : 1.05-1.90 and = 1.37, 95% : 1.02-1.85, respectively). These relationships showed increasing trend ( < 0.05). The level of serum ferritin increased significantly with the number of MetS components ( < 0.05). The quantile regression analysis showed that red meat and fresh red meat usual intake had a significant positive association with serum ferritin levels across the entire conditional serum ferritin distribution ( < 0.05). Processed red meat did not exhibit a similar association.@*Conclusion@#Higher red meat usual intake was associated with an increased risk of MetS and elevated serum ferritin levels.

A Scan of Obesogenic Environments and a Spatial Inference of Obesity Prevalence in Chinese Children and Adolescents: Based on the Chinese Health and Nutrition Survey 2011 Data / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To identify the characteristics of Chinese obesogenic environments at a provincial level, infer a spatial distribution map of obesity prevalence in 31 provinces, and provide a foundation for development of policy to reduce obesity in children and adolescents.</p><p><b>METHODS</b>After scanning obesity data on subjects aged 7-17 years from 12 provinces in the China Health and Nutrition Survey 2011 and environmental data on 31 provinces from the China Statistical Yearbook 2011 and other sources, we selected 12 predictors. We used the 12 surveyed provinces as a training sample to fit an analytical model with partial least squares regression and prioritized the 12 predictors using variable importance in projection. We also fitted a predictive model with Bayesian analysis.</p><p><b>RESULTS</b>We identified characteristics of obesogenic environments. We fitted the predictive model with a deviance information criterion of 61.96 and with statistically significant (P < 0.05) parameter estimates of intercept [95% confidence interval (CI): 329.10, 963.11], log(oil) (CI: 13.11, 20.30), log(GDP) (CI: 3.05, 6.93), log(media) (CI: -234.95, -89.61), and log(washing-machine) (CI: 0.92, 5.07). The total inferred average obesity prevalence among those aged 7-17 was 9.69% in 31 Chinese provinces in 2011. We also found obvious clustering in occurrences of obesity in northern and eastern provinces in the predicted map.</p><p><b>CONCLUSION</b>Given complexity of obesity in children and adolescents, concerted efforts are needed to reduce consumption of edible oils, increase consumption of vegetables, and strengthen nutrition, health, and physical activity education in Chinese schools. The northern and eastern regions are the key areas requiring intervention.</p>

Dietary patterns of Chinese adults in nine provinces / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine and characterize the dietary patterns of Chinese adults in nine provinces.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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: β = -0.153 24, -0.153 24, 0.376 62, 0.148 10, P < 0.01; women: β = -0.139 43, 0.222 00, -0.308 36, P < 0.01).</p><p><b>CONCLUSION</b>The dietary patterns of Chinese adults varied by sex and "Rice/Pork" had been the typical dietary pattern among the Chinese adults.</p>

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 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the longitudinal association between red meat consumption and changes in body mass index(BMI), body weight and overweight risk in Chinese adults.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>Higher red meat intake was associated with increased BMI and body weight, as well as increased overweight risk.</p>

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 / 中华流行病学杂志

<p><b>OBJECTIVE</b>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.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>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.</p>

Trend in dietary calcium intake among Chinese children and adolescents aged 4 to 17 years in nine provinces from 1991 to 2009 / 中华流行病学杂志

<p><b>OBJECTIVE</b>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.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>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.</p>

Situation on 'eating out' and its related risk factors among 1013 Chinese adults in 3 provinces / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the characteristics of 'eating out' behavior among Chinese adults and to explore it related risk factors.</p><p><b>METHODS</b>Data in the present study was from the China Health and Nutrition Study(CHNS), including those from Liaoning, Henan and Hunan as sample provinces. 2 cities and 2 counties from each province and 2 urban communities and 2 suburban communities from each city plus communities from 1 township and 3 villages from each county were chosen. A final 1013 Chinese adults aged 18 to 59 years old who participated in the 2011 CHNS with complete individual information and were available in the present study period were involved in the study. 'Eating out behavior' was estimated through face-to-face interview on the items as:frequency, cost, ways of transportation and distance between restaurants, eating at fast food restaurants/Chinese full service restaurants/Chinese fast food restaurants/mobile food carts/cafes/canteens or other restaurants during the last week. Information on the amount of food intake was collected through three '24 h recalls'. We described the eating out behaviors by types of restaurants they had gone to and comparing eating out eaters and non-eating out eaters for a set of nutritional indicators in order to explore the risk factors related to 'eating out' behaviors.</p><p><b>RESULTS</b>'Eating out' was defined as individuals who consumed at least once in restaurants per week. In all the 1013 adults, 51.72% from urban and 39.14% from rural were defined as having 'eating out' experiences. Proportions of eating out in western fast food restaurants, Chinese full service restaurants, Chinese fast food restaurants, mobile food carts, cafes, canteens and other restaurants were 1.68%, 23.49%, 12.93%, 10.37%, 1.09%, 10.07% and 4.34%, respectively. Energy, Ca, Fe and Zn intake were substantially higher among eaters eating at Chinese full service restaurants than those who had not,Energy, protein, fibers, Ca and Zn intake were higher among canteens eaters than those who did not. Age, gender, education, income and residential areas were associated with eating out behaviors.</p><p><b>CONCLUSION</b>Eating out is a significant nutritional issue among Chinese adults. Education related to nutrition should be taken into account to guide healthy food choices for adults who eat out.</p>

Trend in meat consumption patterns among Chinese children in nine provinces(autonomous region) aged 6 to 17 years between 1991 and 2011 / 中华预防医学杂志

<p><b>OBJECTIVE</b>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.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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).</p><p><b>CONCLUSION</b>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.</p>

Trend on vitamin C intake among Chinese population aged 50-79 years in 9 provinces, from 1991 to 2009 / 中华流行病学杂志

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 / 中华流行病学杂志

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.

Trends in dietary protein intake among Chinese children and adolescent between 1991 and 2009 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To examine dietary protein intake and its trend between 1991 and 2009 among Chinese children and adolescents aged 6 to 17 years.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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%).</p><p><b>CONCLUSION</b>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.</p>

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 / 中华流行病学杂志

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 320％ 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.

Trend in dietary vitamin C intake among Chinese children and adolescents between 1991 and 2009 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To examine status and trend in dietary vitamin C intake between 1991 and 2009 in Chinese children and adolescents aged 6 to 17 years.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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).</p><p><b>CONCLUSION</b>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.</p>

Trend of energy intake among Chinese children and adolescents in nine provinces from 1989 to 2009 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To examine the trends of energy intake among Chinese children and adolescents in nine provinces from 1989 to 2009.</p><p><b>METHOD</b>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.</p><p><b>RESULTS</b>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).</p><p><b>CONCLUSION</b>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.</p>

The status and trend of cereal consumption among Chinese adults in nine provinces (municipality) from 1989 to 2006 / 中华预防医学杂志

<p><b>OBJECTIVE</b>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.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>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.</p>

Status of anemia among children under 5 years of age in the economically less developed rural areas from the 6 western provinces of China, in 2009 / 中华流行病学杂志

Objective To analyze the status of anemia among children under 5 years of age in the economically less developed rural areas from 6 western provinces of China in 2009. Methods 8141 study subjects were from the program-‘Study on Appropriate Technology of Children Under-nutrition Improvement in Poor Rural Areas'. Results In 2009, the prevalence of anemia among children under 5 years of age in the above said rural areas from 6 western provinces was 24.1％. The prevalence of anemia among male children was much higher than that among female children. The peak of anemia prevalence( 38.5％ ) was among children of 6-11 months. The prevalence of anemia decreased along with the increase of age. Conclusion Results from the study demonstrated that anemia among the preschool children was a public health problem in poor rural areas of western China, Improving the knowledge on reasonable feeding seemed a better way for the prevention and control of anemia plus providing complementary nutrients sprinkle to the affected children.

Analysis on the status of vitamin A deficiency among children under 5 years old in poor rural areas of 6 Western Chinese provinces in 2009 / 中华流行病学杂志

Objective To analyze the status of vitamin A deficiency among children under 5 years old in poor rural areas of 6 Western Chinese provinces in 2009.Methods The study subjects involved 2091 children from a program-'Appropriate measurements in improving children under-nutrition in poor rural areas'.Results In 2009,prevalence of vitamin A deficiency among children under 5 years old from the poor rural areas of 6 western Chinese provinces was 20.2％,with boys as 20.6％ and girls as 19.7％.Prevalence rates of vitamin A deficiency among children under 5 years old in the highest and lowest areas were seen in Gansu(25.5％)and Guangxi(12.2％)provinces,respectively.The peak of vitamin A deficiency prevalence fell in the 6-11 months age group.The prevalence of vitamin A deficiency declined along with the increase of age.Conclusion Results from this study demonstrated that vitamin A deficiency among children under 5 years old appeared to be a serious public health problem in the poor rural areas of 6 Western Chinese provinces.Education on reasonable ways of feeding and provision of complementary nutrients to children with vitamin A deficiency,should be the key points in the prevention and control programs on this problem.

Food consumption trend of Chinese adults in nine provinces (autonomous region) from 1989 to 2006 / 中华预防医学杂志

<p><b>OBJECTIVE</b>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.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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).</p><p><b>CONCLUSIONS</b>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.</p>

Trends of the dietary fiber intake among Chinese aged 18 - 45 in nine provinces (autonomous region) from 1989 to 2006 / 中华预防医学杂志

<p><b>OBJECTIVE</b>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.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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).</p><p><b>CONCLUSION</b>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.</p>