Nutrition Transition with Accelerating Urbanization? Empirical Evidence from Rural China

Status and Associated Factors of Breakfast Consumption Among Chinese Residents: A National Cross-Sectional Study

While the importance of breakfast for human health is widely acknowledged, there is limited understanding of the factors influencing breakfast habits among Chinese residents. We conducted a nationwide cross-sectional survey between June 20 and August 31, 2022, analyzing weekly breakfast frequency, food categories, and associated factors to daily breakfast consumption using multivariable logistic regression, with subgroup analyses by gender and residence (urban or rural). Among 21,875 participants, 41.0% reported non-daily breakfast consumption. Common breakfast items included staples like rice, wheat, and corn (70.5%), eggs (56.2%), dairy products (42.0%), and soy drinks (36.8%), while less frequently consumed items included meat products (26.3%), potatoes (23.4%), fresh vegetables and fruits (20.2%), and pickled vegetables (18.2%). Behavioral factors such as sleeping 6-7 h and abstaining from smoking and sugar-sweetened beverages, along with health factors like better quality of life, family health, and higher self-efficacy, were positively associated with daily breakfast consumption. Depression was negatively associated. Sociodemographic factors including female gender, living in southern China, and having children were positively associated, whereas rural residency, higher education levels, being a student or unemployed, and living alone were negatively associated. Subgroup analyses revealed pronounced variations in breakfast habits by residence (urban vs. rural) but fewer differences by gender. Non-daily breakfast consumption is prevalent among Chinese residents, with multiple sociodemographic, behavioral, and health factors influencing this behavior. Region- and gender-specific strategies are essential to promote healthy breakfast habits, address disparities, and encourage healthier breakfast practices across diverse subgroups.

Changes in eye axis length and corneal curvature in central China from the perspective of birth year

OBJECTIVES

To explore the changes in eye structures over time in the Chinese population from the perspective of birth year.

METHODS

We collected measurement data of intraocular lens Master from patients who underwent intraocular lens Master biometry for a routine cataract or refractive examination (ametropia and presbyopia) between April 2012 and October 2023, then screened them. Selected patients were divided into ten groups of 10 years each according to their year of birth (called birth decades). Birth-year-dependent changes in axial length and corneal curvature were compared between the groups.

RESULTS

The average axial length increased from 23.52 mm to 25.95 mm, and the corneal curvature dropped from 44.20 D to 43.33 D in patients born in before-1930 and 1990s. The proportion of short average axial length and steep corneal curvature decreased, whereas the proportion of long average axial length increased with the birth decade. The proportion of patients with corneal curvature < 40 D was 4.18% in 1970s, 5.73% in 1980s, and 3.38% in 1990s, which were significantly higher than those of other age groups. The average axial length of the eyes among primary school students was 23.96 mm, and among college students, it was 25.86 mm.

CONCLUSIONS

Overall, with the birth decade, average axial length increased and corneal curvature decreased. There were generational differences in ocular biological parameters, changes in the eye might affect the incidence of eye diseases such as glaucoma and fundus diseases, which in turn might lead to changes in the spectrum of eye diseases.

Anemia and food insecurity: the nutritional struggles of pregnant women in Lebanon amid unprecedented crises

BACKGROUND

Pregnant women require specific dietary intake to optimize fetal development and support mother's health. The ongoing crises in Lebanon: the economic crisis, the COVID-19 pandemic, and the Beirut port explosion, limited the population's overall ability to consume a well-balanced diet, preventing adequate consumption of fresh, whole food and possibly disrupting people's eating habits, notably for pregnant women. Given the vulnerability of pregnant women to malnutrition and diseases during those times, research on the nutrition status and intake of pregnant women is urgently needed to inform targeted policies and programs. This study explores nutritional status (malnutrition and anemia), food insecurity, and diet quality, and associated factors in Lebanese adult pregnant women residing in Lebanon.

METHODS

A cross sectional study was conducted on a representative sample of 500 adult Lebanese pregnant women who were in different pregnancy trimesters, between March and October 2023. Collected data included sociodemographic and medical characteristics, anthropometrics, serum hemoglobin, food security status, and diet quality using validated tools.

RESULTS

A total of 38.6% of the participants had anemia, with more than half (53.8%) reporting not taking iron supplements. Food insecurity prevalence was 14.6% based on the "Food Insecurity Experience Scale" and 22.6% based on the "Arab Family Food Security Scale". Although most women in the sample (79.2%) had a high minimum dietary diversity (MDD-W) score and an acceptable household dietary diversity, however; around 38% and 81.6% of them had low adherence to the Mediterranean Diet (MD) and the USDA dietary guidelines, respectively. Being in the second (aOR: 1.77) or third (aOR:1.88) pregnancy trimesters increased the likelihoods of anemia; while being employed (aOR: 0.46) and having a higher household income (aOR: 0.639) decreased the likelihood of maternal anemia. Living in a crowded household (aOR: 0.072) decreased the odds of high MDD-W, while being employed (aOR: 2.88), being food secure (aOR: 1.76) and living in the North and Akkar (aOR: 2.44) or South and Nabatieh (aOR: 2.06) increased the odds of high MDD-W. Being food secure (aOR: 1.87) increased the likelihood of fair to very good MD adherence, while having a higher household income (aOR: 0.57) decreased adherence to MD. A higher household income (aOR: 0.57) decreased the adherence to USDA dietary guidelines.

CONCLUSION

Anemia, compounded by low levels of iron supplementation and low adherence to healthy diets, warrant immediate public action given the detrimental effects they have on pregnancy outcomes. National comprehensive nutrition policies and interventions are thus needed to enhance adherence to healthy diets and the overall health of pregnant women. This also requires improving the food security situation of Lebanese pregnant women, as our findings showed that food security increases the odds of dietary diversity and adherence to the MD.

A Systematic Review of Contemporary Challenges and Debates on Chinese Food Security: Integrating Priorities, Trade-Offs, and Policy Pathways

Although food security has been a long-standing focus of research and policy in China, significant gaps remain in synthesizing evolving debates across multiple disciplines such as agriculture, economics, environmental science, and politics. This systematic review provides an interdisciplinary analysis of five key areas shaping contemporary discourses on Chinese food security: (1) balancing self-sufficiency with trade dependence; (2) reconciling agricultural intensification with environmental sustainability; (3) addressing urbanization's impact on small-scale agriculture transformation; (4) enhancing resilience to climate change through targeted investments and policies; and (5) improving food safety standards to meet growing consumer concerns. This review harnesses insights from global academic databases-including Web of Science, Scopus, and Google Scholar-to map interdisciplinary debates on Chinese food security, synthesizing peer-reviewed studies and policy reports from 2010 to 2024. Drawing upon empirical evidence from recent studies, this review highlights critical tensions, such as those between economic growth priorities and ecological preservation, and explores pathways for sustainable development within China's unique socio-political context. The findings underscore that robust food security strategies must integrate diverse perspectives while adapting to emerging challenges such as climate change impacts and shifting consumer demands. To ensure sustainable outcomes, future policies should prioritize inclusivity by incorporating insights from ongoing research agendas across disciplines. This review can be used as a benchmark for the advancement of research agendas focused on developing sustainable solutions to the complex challenges of food security in China and beyond.

Global, regional, and national burden of liver cancer due to non-alcoholic steatohepatitis and non-alcoholic fatty liver disease, 1990-2021: a multi-model trend analysis and forecasting study

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) and its advanced form, non-alcoholic steatohepatitis (NASH), significantly contribute to the increasing incidence of liver cancer due to NASH (NALC), emphasizing the urgent need to address the associated global health burden.

METHODS

Using the Global Burden of Disease 2021 dataset, we analyzed the incidence, mortality, and disability-adjusted life year (DALY) rates of NALC and NAFLD from 1990 to 2021 across 204 countries. The Joinpoint model, age-period-cohort modeling, decomposition analysis, and frontier analysis were used to assess trends, identify contributing factors, and evaluate health inequities. Projections for future incidence were made using Nordpred and Bayesian age-period-cohort models.

RESULTS

The global incidence and mortality rates of NALC have increased significantly. Incidence rose from 14,413.92 cases (95% CI 11,470.95-17,854.24) in 1990 to 42,291.37 (95% CI 34,032.64-51,129.45) in 2021. This trend was particularly evident in low-middle SDI countries, while high SDI countries exhibited declining mortality rates despite rising incidence. Population growth was a primary driver of the increased burden in most regions. Projections suggest that NALC incidence may reach 43,525.53 (95% CI 14,169.28-72,881.77) by 2039, particularly among the elderly, highlighting the serious future risks associated with NALC globally.

CONCLUSION

The findings highlight the growing global burden of NALC driven by NAFLD, especially in low- to middle-income regions. Targeted interventions, alongside a deeper understanding and better resource allocation, are essential to mitigate the rising incidence and address the health disparities associated with this expanding public health challenge.

The promotion of ultra-processed foods in modern retail food outlets in rural and urban areas in Kenya

OBJECTIVE

To assess the availability and marketing of ultra-processed foods (UPF) in modern retail food outlets (supermarkets and minimarts) in Kenya and associated factors.

DESIGN

This cross-sectional study was conducted in Kenya from August 2021 to October 2021. Variables included the geographic location and the socio-economic status (SES) levels, the food items displayed for sale and advertised in the stores, and locations in the stores such as the entrance.

SETTING

Three counties in Kenya (Nairobi - urban, Mombasa - coastal tourist and Baringo - rural). Each county was stratified into high and low SES using national poverty indices.

PARTICIPANTS

Food outlets that offered a self-service, had at least one checkout and had a minimum of two stocked aisles were assessed.

RESULTS

Of 115 outlets assessed, UPF occupied 33 % of the cumulative shelf space. UPF were the most advertised foods (60 %) and constituted 40 % of foods available for sale. The most commonly used promotional characters were cartoon characters (18 %). UPF were significantly more available for sale in Mombasa (urban) compared to Baringo (rural) (adjusted prevalence rate ratios (APRR): 1·13, 95 % CI 1·00, 1·26, P = 0·005). UPF advertisements were significantly higher in Mombasa ((APRR): 2·18: 1·26, 3·79, P = 0·005) compared to Baringo and Nairobi counties. There was a significantly higher rate of advertisement of UPF in larger outlets ((APRR): 1·68: 1·06, 2·67 P = 0·001) compared to smaller outlets.

CONCLUSIONS

The high marketing and availability of UPF in modern retail outlets in Kenya calls for policies regulating unhealthy food advertisements in different settings in the country.

The Interplay of Dietary Habits, Economic Factors, and Globalization: Assessing the Role of Institutional Quality

BACKGROUND

Dietary habits are pivotal for population health and well-being, yet remain a pressing global issue, particularly in Sub-Saharan Africa (SSA), where economic instability and institutional challenges exacerbate dietary problems. Despite extensive research, there is a notable gap in the literature regarding the direct and interactive effects of institutional quality and inflationary shocks on dietary habits.

METHODS

This study delves into these complex interplays across 44 SSA nations from 2002 to 2022. Employing an innovative entropy method (EM) and the generalized autoregressive conditional heteroskedasticity (GARCH) modeling, the study introduces an inclusive institutional quality index and an inflationary shock predictor as crucial determinants of dietary habits in the literature.

RESULTS

The results from the panel-corrected standard error (PCSE) method and feasible generalized least squares (FGLS) model reveal that per capita GDP, school enrollment rate, government expenditures, globalization index, and urbanization are positively associated with population dietary habits, while inflationary shock, food insecurity, and unemployment rate exert negative influences. Notably, institutional quality acts as a catalyst, amplifying the positive effects of the former group and absorbing the negative impacts of the latter on population dietary habits. Additionally, a dynamic panel causality analysis confirms a bidirectional causality nexus between population dietary habits and all variables, except for inflationary shocks, which demonstrate a unidirectional causality link.

CONCLUSIONS

These findings carry significant policy implications, underscoring the complex dynamics between institutional quality, inflationary shocks, and dietary habits in the region. The bidirectional causality highlights the need for holistic interventions that address economic, social, and institutional factors simultaneously. Moreover, the unidirectional causality of inflationary shocks on dietary habits suggests that stabilizing inflation is critical to protecting dietary habits. These results provide critical insights for policymakers to design targeted interventions aimed at improving nutrition, bolstering institutional frameworks, and ensuring public health resilience in the face of economic and social shocks.

Double burden of malnutrition among women and children in Zimbabwe: a pooled logistic regression and Oaxaca-Blinder decomposition analysis

Background

The double burden of malnutrition (DBM) is a public health issue characterised by the coexistence of undernutrition and overnutrition within the same population, household, or individual. Undernutrition, manifesting as stunting, wasting, or being underweight, results from insufficient nutrient intake while overnutrition, manifesting as overweight or obesity, results from excessive caloric intake, poor diet quality, and sedentary lifestyles. This dual burden poses significant challenges for health systems due to lost productivity and increased healthcare expenditure.

Methods

This study utilised data from the Demographic and Health Surveys (DHS) conducted in Zimbabwe for 2010-2011 and 2015, which provided information on women's and children's health and nutritional status, household characteristics, and socio-economic status. Pooled logistic regression was used to analyse the association between various sociodemographic factors and DBM among women and children. The Oaxaca-Blinder decomposition method explored differences in DBM between 2010-2011 and 2015.

Results

The average age of mothers was approximately 31 years, and children's ages averaged around 32 months. From 2010 to 2015, there was a notable socio-economic improvement, with a decrease in the percentage of mothers in the poorest quartile from 20 to 16% and an increase in the richest quartile from 22 to 23%. The study found a slight decrease in overall household DBM among women from 34% in 2010 to 32% in 2015, while DBM among children increased from 12 to 14%. Pooled logistic regression analysis indicated that children in rural areas had statistically significantly higher odds of experiencing DBM than their urban counterparts. The Oaxaca-Blinder decomposition showed that changes in residence status significantly impacted the increase in DBM among children. At the same time, the coefficient effect accounted for most of the unexplained differences in DBM among women.

Conclusion

The growing DBM among women and children in Zimbabwe is significantly influenced by changes in residence status. The findings highlight the need for targeted public health interventions to address urban-rural disparities and emphasise the importance of considering socio-economic, environmental, and behavioural factors. Context-specific public health strategies, aligned with WHO's Double Duty Actions, are essential to improve the nutritional health of Zimbabwe's population.

Preliminary Insights on Barriers to and Facilitators of Healthy Eating for Rural Residents Emerging from Extreme Poverty: A Qualitative Study in Dafang, China

The purpose of this study was to examine the dietary views and practices and to identify associated barriers to and facilitators of healthy eating of rural residents emerging from poverty in the context of rapid socio-economic development. A qualitative design with semi-structured interviews was utilized to collect detailed insights into the dietary behaviors of 22 rural residents from 10 villages in Fengshan town, Dafang county, Guizhou province, China. Thematic analysis was applied to interpret the interview data, guided by the socio-ecological model. Four themes were identified: traditional eating patterns, factors influencing food choice, limited knowledge of healthy diet, and lack of nutritional guidance. Barriers to healthy eating included traditional but unhealthy foods, limited nutritional knowledge, inadequate understanding of nutritional requirements, overwhelming nutritional information, and limited professional guidance. Facilitators encompassed healthy traditional eating patterns, household composition, home gardening, preference for traditional bean and soy products, improved food supply and availability owing to poverty alleviation efforts, and being open to receiving professional dietary guidance. As a preliminary investigation into the dietary views and practices of this population, the study highlights a significant gap in the nutritional knowledge and guidance available to rural residents in China, emphasizing the need for comprehensive strategies that address the complex socio-ecological factors influencing dietary behaviors.

Empirical analysis of spatial heterogeneity in the development of China's National Fitness Plan

PURPOSE

The National Fitness Plan (NFP) is a vital initiative aimed at realizing Healthy China 2030. This study assessed spatial heterogeneity in the NFP development and the socioeconomic factors contributing to this inequality.

METHODS

Data from 31 administrative regions in 2021 were analyzed using four NFP development metrics. Spatial autocorrelation was evaluated using global Moran's I, followed by global and local regression models for non-random spatial patterns.

RESULTS

National physical fitness exhibited significant clustering (z = 5.403), notably a high-high cluster in East China. The global regression model identified three socioeconomic factors in the geographically weighted regression model: per capita disposable income and the number of public buses positively affected national physical fitness, while general public budget expenditure had a negative impact.

CONCLUSIONS

Persistent unequal NFP development is projected due to income disparities in economically backward regions. To promote the NFP effectively, a cost-efficient strategy includes creating 15-minute fitness circles, especially by establishing public sports facilities in Western China communities. These findings inform policy priorities for advancing the NFP towards Healthy China 2030.

Can Non-farm Employment Improve Dietary Diversity of Left-Behind Family Members in Rural China?

Rural residents in China are still at risk of malnutrition, and increasing dietary diversity is crucial to improving their health. This study empirically analyzed the impact of non-farm employment on the dietary diversity of rural left-behind family members based on the China Land Economy Survey (CLES) 2020-2021 panel data at the farm and village levels. Dietary diversity was measured using the dietary diversity score (DDS) and the Chinese Food Guide Pagoda Score (CFGPS). The empirical results show that non-farm employment significantly enhances the dietary diversity of rural left-behind household members, including animal food diversity and plant food diversity. This result verifies the altruism phenomenon of non-farm employment in family diet. Mechanism analysis shows that non-farm employment enhances the dietary diversity of rural left-behind family members by increasing the level of family income, Internet accessibility, and family education. Heterogeneity analysis shows that non-farm employment does not enhance the dietary diversity of rural empty nesters and even has a negative impact. This reminds us that the nutritional health of rural empty nesters needs attention in the context of rapid urbanization and aging.

The effects of trade liberalization on inequality in nutrition intake: empirical evidence from Indian districts

BACKGROUND

Despite the positive impact of trade liberalization on food availability in India, severe inequality in nutrition consumption at the district level persists. Empirical evidence on the relationship between trade liberalization and nutrition consumption inequality often offers a country-level perspective and generates disputed outcomes. The study aimed to explore the effects of trade liberalization on inequality in nutrition consumption at the district level in India and to examine the heterogeneity of the impact on different nutrition consumption.

METHODS

Our study employed the Gini Index to measure nutrition consumption inequality of 2 macronutrients and 5 micronutrients at the district level in India during 2009-2011, utilizing the comprehensive FAO/WHO individual food consumption data. The import tariff was adopted as a proxy for trade liberalization, as its externally imposed nature facilitates a causal interpretation. We further identified the direct causal relationship between food trade liberalization and inequality in nutrition consumption using a fixed effects model.

RESULTS

The results show that more than 50% of the individuals in the survey districts did not meet the dietary standards for both macronutrients and micronutrients. Food trade liberalization hindered the improvement of inequality in nutrition consumption. As import tariffs were reduced by 1%, the inequality in intake of calories, zinc, vitamin B1, and vitamin B2 increased significantly by 0.45, 0.56, 0.48, and 0.66, respectively, which might be related to food market performance. The results also highlight the positive role of the gender gap, female-headed households, and caste culture on inequality in nutrition consumption in India.

CONCLUSIONS

To ease the shock of liberalization and minimize its inequality effects, complementary measures should be adopted, such as improving food logistic conditions in poor areas, and nutrition relief schemes.

The effect of Internet use on nutritional intake and health outcomes: new evidence from rural China

Introduction

Internet use is changing nutritional intake and health outcomes, but the results are mixed, and less attention is given to the rural developing regions. Based on the China Health and Nutrition Survey (CHNS) data from 2004 to 2015, this study seeks to better understand the effect of Internet use on nutritional intake and health outcomes.

Methods

An instrumental variable estimation is used to address endogeneity problem.

Results

The results show that Internet use improves the dietary knowledge of rural residents, and thus has a positive impact on dietary quality, such as healthy eating index (HEI) and dietary diversity score (DDS). The higher the dietary quality, the better the nutritional health status. However, results also show that Internet use increases the risk of overweight, and obesity among rural Chinese residents. Because Internet use has significantly reduced the physical activity of rural residents in China. Interestingly, we also find that the Internet increases the risk of chronic diseases such as diabetes and high blood pressure, but there is a positive causal relationship between Internet use and the self-assessment score of health.

Discussion

Our findings suggest that there may be a serious lack of awareness of the health risks of chronic diseases among Chinese rural residents. Therefore, policymakers are suggested to consider the possible negative effects when promoting digital development.

Health first, convenience second: Caregiver perspectives of commercially produced complementary foods in five Southeast Asian capital cities

Caregivers in low- and middle-income countries increasingly feed commercially produced complementary foods (CPCF) to older infants and young children-shaped by factors including industry promotion. The dynamics of CPCF consumption and caregiver knowledge, attitudes and behaviours regarding complementary feeding practices are poorly understood in these settings. We examined how caregiver knowledge/attitudes/behaviours about CPCF shape the feeding of older infants and young children in the capital cities of five countries in Southeast Asia (Bangkok, Hanoi, Jakarta, Kuala Lumpur, Manila). An online, web-based, cross-sectional panel survey was conducted among mothers of a child aged 6-23 months. One hundred participants were included in each of the five capital cities. Questionnaires were undertaken in the official language of each city. Data were analysed in Stata (version 17.0), using χ2 tests to examine difference between variables of interest. All mothers purchased CPCF for their youngest child aged 6-23 months at the time of survey. CPCF were commonly fed to children at least once per day, and in many of the five cities at most or every feeding. While factors such as convenience and affordability influenced CPCF purchase, mothers primarily purchased CPCF for nutritional reasons. The most common source of feeding information was health care professionals, followed by social media. CPCF are ubiquitous in the diets of older infants and young children of educated middle-upper socioeconomic status mothers in capital cities of Southeast Asia, with perceived healthiness a key driver in selecting CPCF. A strong governmental regulatory response to industry marketing/promotion will be critical to addressing CPCF appropriateness, including health and nutritional claim use.

Global trends indicate increasing consumption of dietary sodium and fiber in middle-income countries: A study of 30-year global macrotrends

According to the Global Burden of Disease Study, 3 million deaths were attributable to high sodium intake and low intake of whole grains. With the rapid evolution of the food industry, we hypothesize that dietary intake of sodium has increased and that dietary intake of whole grains or fibers has decreased because of easier access to highly processed food. Country-level data on dietary factors and country income levels from 1990 to 2018 were collected from 3 public databases. The trend of dietary intake was modeled using the linear mixed model accounting for random effects of individual countries. The country-level differences in dietary factors between males and females were calculated, and the trends were also modeled accounting for the random effects of countries. Both males and females consumed increasing amounts of dietary sodium from 1990 to 2018 in high-income, middle- to high-, middle-, and low-income countries. Dietary fiber intake increased in low-to-middle, middle-, and middle-to-high income countries for both men and women over the past 3 decades. Men tend to consume more sodium and less fiber and whole grains in their diets than women, the trend of which is statistically significant in middle-income countries. Over the past 3 decades, the macrotrend of dietary sodium has increased around the globe. To reduce the sodium intake level, nutrition policy should emphasize sodium reduction, especially in high-income, middle- to high-income, middle-income, and low-income countries.

Does urbanisation lead to unhealthy diets? Longitudinal evidence from Indonesia

Urbanization is generally believed to contribute to dietary patterns that increase the risk of non-communicable disease (NCD). However, empirical evidence using nuanced measures of urbanization and longitudinal data is limited. This study examines the link between urbanization and dietary patterns in Indonesia, the largest country in Southeast Asia, between 2000 and 2015. Results show that urbanisation is associated with dietary patterns conducive to increased NCD risk-for example, high in soft drinks and ultra-processed foods-but also with higher consumption of healthier foods such as vegetables and fish. Results highlight important non-linearities and draw attention to the need to refrain from generalizations about the effect of urbanization on nutritional health.

Food Intake and Food Selection Following Physical Relocation: A Scoping Review

Objectives: To synthesize the current available evidence on the changes in food intake and food selection after physical relocation in non-refugee populations. Methods: The inclusion criteria were studies with a measurement of food selection and/or food intake in non-refugee populations where physical relocation had occurred with self-reported or objective assessment of the neighbourhood physical environment before and after relocation. Databases searched included MEDLINE, EMBASE, CINAHL and SCOPUS from 1946 to August 2022. Results: A total of four articles met the inclusion criteria. Overall, these studies gave longitudinal (n = 2) and cross-sectional (n = 2) evidence to suggest that moving to an urban neighbourhood with more convenience stores, cafés and restaurants around the home was associated with an increase in unhealthy food intake in adult populations. Additional factors such as income, vehicle access, cost, availability and perceptions of the local food environment played a role in shaping food selection and food intake. Conclusion: Four internal migration studies were found. The limited evidence base calls for more research. Future studies should include children and apply appropriate research designs to account for neighbourhood self-selection and concurrent life events. International migration studies should include assessment of neighbourhood physical environments pre- and post-relocation.

The Association between Methionine Intake and Diabetes in Chinese Adults-Results from the China Health and Nutrition Survey

This study aimed to evaluate the association between methionine intake and diabetes prevalence in Chinese adults and explore whether the association was source-specific. Data from 12,849 adults aged ≥20 years old were used from the China Health and Nutrition Survey during 1997-2011. Diabetes was diagnosed as self-reported and/or when blood tests results met the diagnostic criteria. A 3-day, 24-h recall was used to assess different sources of methionine. Multivariable mixed linear regression was used to examine the associations. Across the quartiles of total methionine intake, the odds ratio (ORs, 95% CI) of diabetes were 1.00, 1.49 (1.21 to 1.82), 1.72 (1.37 to 2.15), and 2.53 (1.97 to 3.23). In the subgroup analysis, similar trends were observed in both animal and plant methionine. There was a significant interaction between urbanization and diabetes. The positive association was only significant in those who lived in low or medium urbanization areas. The ORs (95% CI) were 1.00, 1.27 (0.85 to 1.88), 1.56 (1.01 to 2.39), and 1.79 (1.09 to 2.95) for medium urbanization, respectively. No interaction was identified when stratified by different methionine sources. In conclusion, methionine intake was positively associated with diabetes independent of food source, and it was modified by urbanization levels.

Effects of Intergenerational Care Behavior on Residents' Nutrition Intake-Descriptive Statistical Analysis of Rural China Survey 2010-2014

Nutritional status plays an indispensable role in enhancing human capital and preventing the return to poverty. In the context of the three-child policy and the aging society in China, intergenerational care will inevitably become a core component of family support. Thus, this paper evaluates the impacts of intergenerational care behavior on nutritional intake in Chinese rural residents from the perspective of household consumption. The study's data is from the China Family Panel Studies (CFPS) (2010-2014), and, the fixed effect model and analyses are applied to achieve the study's objective. The results reveal that rural residents with intergenerational family care behavior have significantly higher food diversity. Thus, Chinese rural residents with intergenerational care consumed 22.4% more food. A possible mechanism is that intergenerational care improves young mothers' labor participation and income, thus optimizing their dietary structure. Moreover, there was heterogeneity concerning the nutrition intake among rural residents in different geographic and family net income groups. Finally, the robust check is consistent with the baseline regression results. In summary, governments should fully affirm the elderly contribution to families to give full play to the elderly family benefit maximization.

Shrinking Working-Age Population and Food Demand: Evidence from Rural China

China is facing a rapidly aging population, and the proportion of the working-age population (WAP) is showing a decreasing trend. In this study, we use a two-stage budgeting quadratic almost-ideal demand system framework to estimate the distribution of food demand elasticity under different proportions of the WAP in rural China. The results show that the income elasticities of rural residents' demand for fruits and vegetables, animal products, oils and fats, and grains were 0.73, 0.65, 0.55, and 0.48, respectively. Additionally, the income elasticity of rural residents tended to increase as the household proportion of the WAP decreased. These results can provide a deeper understanding of the food consumption patterns of rural residents in China, and could be used in general or partial equilibrium models to forecast food supply and demand.

China is implementing the national nutrition plan of action

With the transformation of Chinese economic and social structure, the social determinants of nutrition have undergone significant changes, which have a great influence on the dietary patterns and nutrition status of its population. The transition in the structure of nutrition intake in China can be characterized by a rapid trend in food accessibility, affordability, and diversity. However, challenges, such as the triple burden of malnutrition (undernourishment, micronutrient deficiencies, and obesity), still seriously threaten the population's health. To approach the targets for the “Healthy China 2030,” the General Office of the State Council of the People's Republic of China issued the National Nutrition Plan of Action (2017–2030), which specifies multi-sectoral transdisciplinary measures to improve population nutrition status. In our study, we recognized the role of the National Nutrition Plan of China in responding to the call for the Sustainable Development Goals (SDGs). Under the global- and country-level targets, this paper presented six primary intervention measures specified in the National Nutrition Plan of Action in China, highlighting the importance of collaborative actions for participants in all sectors.

A Comparison between Dietary Consumption Status and Healthy Dietary Pattern among Adults Aged 55 and Older in China

The nutrition and health of middle-aged and elderly people is crucial to the long-term development of a country. The present study aimed to analyze the dietary consumption status in Chinese adults by using baseline and follow-up data from the community-based Cohort Study on Nervous System Diseases between 2018−2020 and selecting those aged 55 and older (n = 23,296). Dividing 65 food items into 17 subgroups on the basis of a valid semi-quantitative food frequency questionnaire, we analyze the consumption amount and consumption rate of foods in relation to wave and sociodemographic factors by employing the Wilcoxon rank sum test, Kruskal−Wallis analysis, the Chi-squared test, and the Cochran−Armitage trend test and evaluate food intake status using the Chinese Dietary Guidelines Recommendations (2022). Compared to 2018, the median daily intake of livestock meat, poultry, and eggs increased in 2020 (p < 0.05), while the median daily intake of wheat, other cereals, tubers, legumes, fruits, and fish and seafood decreased (p < 0.05). The proportion of subjects with excessive intake of grain, livestock and poultry, and eggs was 46.3%, 36.6%, and 26.6%, respectively, while the proportion of subjects with insufficient intake of whole grains and mixed beans, tubers, legumes, dairy products, fruits, vegetables, and fish and seafood were 98.4%, 80.3%, 74.0%, 94.6%, 94.3%, 75.8%, and 86.5%, respectively, and more than 50% of subjects were non-consumers of dairy products, nuts, and whole grains and mixed beans. In conclusion, the problem of unhealthy dietary structure is prominent among adults aged 55 and older in China; insufficient or excessive intakes of various types of foods are common; and excessive consumption of edible oil and salt remains a serious problem.

Changing Dietary Habits: The Impact of Urbanization and Rising Socio-Economic Status in Families from Burkina Faso in Sub-Saharan Africa

(1) Background: Sub-Saharan Africa is experiencing the fastest urbanization worldwide. People in rural areas still have a traditional and rural lifestyle, whereas the Westernization of diet and lifestyle is already evident in urban areas. This study describes dietary habits of families in Burkina Faso living at different levels of urbanization. (2) Methods: Data on lifestyle, socio-economic conditions, health status and anthropometry were collected from 30 families living in rural villages, a small town and the capital city. A food frequency questionnaire and a 24 h recall diary were used to estimate dietary habits and macronutrients intake. (3) Results: The urban cohort showed a more diversified diet, with a higher intake of animal protein and, especially in children, a higher consumption of simple sugars. Fiber intake was significantly higher in the rural and semi-urbanized cohorts. As expected, overweight and obesity gradually increased with the level of urbanization. In semi-urbanized and urban families, we observed coexistence of under- and over-nutrition, whereas in rural families, a portion of children were wasted and stunted, and adults were underweight. (4) Conclusions: These three cohorts represent a model of the effect on diet of rural-to-urban migration. Rural diet and traditional habits are replaced by a Western-oriented diet when families move to urbanized areas. This dietary transition and increased socio-economic status in newly developing urban areas have a major impact on disease epidemiology, resembling the past evolution in Western countries.

Thirty-Year Urbanization Trajectories and Obesity in Modernizing China

The effects of long-term urbanization changes in obesity are unclear. Data were obtained from the China Health and Nutrition Survey (CHNS) 1989-2018. A multidimensional urbanicity index was used to define the urbanization level for communities. Group-based trajectory modeling was used to identify distinct urbanization change trajectories. Gender-stratified multilevel models were used to investigate the association between urbanization trajectories and weight/BMI, through the PROC MIXED procedure, as well as the risk of being overweight + obesity (OO)/obesity (OB), through the PROC GLIMMIX procedure. A total of three patterns of the trajectory of change in urbanization were identified in 304 communities (with 1862 measurements). A total of 25.8% of communities had a low initial urbanization level and continuous increase (termed "LU"), 22.2% of communities had a low-middle initial urbanization level and constant increase (termed "LMU"), and 52.0% of communities had a middle-high initial urbanization and significant increase before 2009, followed by a stable platform since then (termed "MHU"). During the 30 follow-up years, a total of 69490 visits, contributed by 16768 adult participants, were included in the analysis. In the period, weight and BMI were observed in an increasing trend in all urbanization trajectory groups, among both men and women. Compared with LU, men living in MHU were related to higher weight, BMI, and an increased risk of OO (OR: 1.46, 95%CI: 1.26 to 1.69). No significant associations were found between urbanization trajectories and OB risk in men. Among women, the associations between urbanization and all obesity indicators became insignificant after controlling the covariates. Obesity indicators increased along with urbanization in the past thirty years in China. However, the differences among urbanization trajectories narrowed over time. More urbanized features were only significantly associated with a higher risk of obesity indicators in Chinese men. The effects of urbanization on obesity among women were buffered.

Internet Access and Nutritional Intake: Evidence from Rural China

Over the past 4 decades, China has experienced a nutritional transition and has developed the largest population of internet users. In this study, we evaluated the impacts of internet access on the nutritional intake in Chinese rural residents. An IV-Probit-based propensity score matching method was used to determine the impact of internet access on nutritional intake. The data were collected from 10,042 rural households in six Chinese provinces. The results reveal that rural residents with internet access have significantly higher energy, protein, and fat intake than those without. Chinese rural residents with internet access consumed 1.35% (28.62 kcal), 5.02% (2.61 g), and 4.33% (3.30 g) more energy, protein, and fat, respectively. There was heterogeneity in regard to the intake of energy, protein, and fat among those in different income groups. Moreover, non-staple food consumption is the main channel through which internet access affects nutritional intake. The results demonstrate that the local population uses the internet to improve their nutritional status. Further studies are required to investigate the impact of internet use on food consumed away from home and micronutrient intake.