Search Results (269)

Background/Objectives: Intergenerational care plays a significant role in shaping household dietary quality and human capital development in China. Influenced by the legacy of the one-child policy, the care provided in these families often prioritizes child-focused practices. This study examines how intergenerational care influences schoolchildren’s sugar-sweetened beverage (SSB) consumption. Methods: This study utilizes data from the 2014–2015 China Education Panel Survey (CEPS) to investigate the impact of intergenerational care on schoolchildren’s dietary behaviors, with a focus on sugar-sweetened beverage (SSB) consumption. We apply both ordinary least squares (OLS) regression and the ordered logit model to estimate the impacts, and we use the instrumental variables approach to address potential endogeneity. Results: Schoolchildren from only-child families report greater SSB consumption, while those from multi-child families consume less. Intergenerational care is linked to more digital media exposure, more pocket money, and less parental supervision. These findings withstand rigorous validation through multiple robustness checks, including sample restriction strategies and propensity score matching (PSM) analysis. The effect is especially pronounced among boys, schoolchildren from families with higher parental education levels, and schoolchildren attending schools without formal nutrition education programs. Conclusions: The result indicates that intergenerational care significantly increases SSB consumption among schoolchildren from only-child families. Community nutrition and school health education programs can reduce schoolchildren’s SSB consumption, thereby lowering risks of obesity and other public health concerns. Full article

Background High-sensitivity C-reactive protein (hs-CRP) is a protein that indicates inflammation and the risk of cardiovascular diseases. The intake of dietary amino acids can influence immune and inflammatory reactions. However, studies on the relationship between dietary amino acids and hs-CRP, especially in children, remain scarce. Methods This cross-sectional study analyzed data from the Nutrition and China Children and Lactating Women Nutrition and Health Survey (2016–2019), focusing on 3514 children (724 with elevated hs-CRP ≥ 3 mg/L and 2790 with normal levels). Dietary information was gathered via a food frequency questionnaire, and hs-CRP levels were obtained from blood samples. Boruta algorithm and propensity scores were used to select and match dietary factors and sample sizes. Machine learning (ML) algorithms and logistic regression models assessed the link between amino acid intake and elevated hs-CRP risk, adjusting for age, sex, BMI, and lifestyle factors. Results The odds ratios (ORs) for elevated hs-CRP were significant for several amino acids, including Ile, Leu, Lys, Ser, Cys, Tyr, His, Pro, SAA, and AAA, with values ranging from 1.10 to 2.07. The LightGBM algorithm was the most effective in predicting elevated hs-CRP risk, achieving an AUC of 0.927. Tyrosine, methionine, cysteine, and proline were identified as important features by SHAP analysis and logistic regression. The intake of Ser, Cys, Tyr, and Pro showed a linear increase in the risk of elevated hs-CRP, especially in individuals with low protein intake and normal weight (p < 0.1). Conclusions Intake of amino acids like Ser, Cys, Tyr, and Pro significantly impacts hs-CRP levels in children, indicating that regulating these could help prevent inflammation-related diseases. This study supports future dietary and health management strategies. This is first large-scale ML study linking amino acids to pediatric inflammation in China. The main limitations are the cross-section design and the use of self-reported dietary data. Full article

Background/Objectives: Healthy diets and proper nutrition are fundamental for human survival. With economic development and rising incomes, the food consumption structure of rural residents in China has noticeably changed. However, substantial disparities still exist in the quality of food consumption between urban and rural areas, and the dietary structure of rural populations remains imbalanced. Methods: This study uses 2020 China Rural Revitalization Survey (CRRS) samples of rural residents for analysis since it asked residents questions about their digital literacy and food consumption. A total of 2827 valid rural resident samples were finally obtained, and the participants had a mean age of 54.844 years. This study employs the ordinary least squares (OLS) model and the two-stage least squares (2SLS) method to examine the impact of digital literacy on the food consumption structure of rural households and its underlying mechanisms. Results: Based on the regression analyses, digital literacy significantly improves the food consumption structure of rural residents (p < 0.05). Heterogeneity analysis shows that at the regional level, digital literacy has a stronger impact on the food consumption structure of rural residents in southern China (β = −153.255, p < 0.05); at the individual level, its impact is more pronounced among rural residents with lower educational attainment (β = −427.506, p < 0.01) and among middle-aged and elderly populations (β = −212.705, p < 0.05). The mechanism analysis reveals that digital literacy can enhance the food consumption structure of rural residents by increasing their awareness of dietary health and food safety. Conclusions: These findings highlight the necessity of integrating the optimization of food consumption structures with enhancements in digital literacy into policy-making and provides valuable insights for developing policies aimed at improving the nutritional health of rural residents. Full article

Background: The Lingnan region is characterized by a hot and humid climate and abundant, diverse natural resources, while the Central Plains region experiences distinct four seasons and has a rich agricultural culture. Both regions possess unique dietary traditions and preferences. This study aims to investigate the differences in dietary structure between the Lingnan region (Guangdong, Guangxi, Hainan) and the Central Plains region (Shanxi, Shaanxi, Henan) and their impact on health. Methods: Using cross-sectional survey data from the 2015–2017 China National Nutrition and Health Survey, this study selected residents aged 18 and above as the research subjects. Generalized linear models were employed to analyze differences in the intake of various food groups between the two regions, while logistic regression models were used to examine regional differences in the prevalence of obesity, hypertension, diabetes mellitus, and hyperlipidemia. Results: A total of 14,484 adults were included in this study. Lingnan participants consumed significantly more rice products, red meat, poultry, seafood, and dark-colored vegetables, while Central Plains residents had higher intakes of wheat products, other cereals, soybeans, and eggs. Lingnan exhibited lower prevalence rates of obesity (8.6% vs. 18.1%), diabetes (7.6% vs. 9.8%), and hypertension (33.0% vs. 46.9%) compared to the Central Plains, with no significant difference in hyperlipidemia prevalence. Adjusted analyses confirmed that Lingnan residents had significantly reduced risks of obesity (OR = 0.431, 95% CI: 0.388–0.479), diabetes mellitus (OR = 0.841, 95% CI: 0.744–0.950), and hypertension (OR = 0.564, 95% CI: 0.523–0.608). Conclusions: The dietary structure in the Lingnan region plays a positive role in cardiometabolic health. Further analysis of the combined effects of different foods on health could provide a scientific basis for future nutrition and health management. Full article

Background/Objectives: Plant-based diets are associated with reduced chronic disease risk, though regional variations persist. In Zhejiang, China, where plant-based food intake is high, this study aimed to explore the association between plant-based diets and metabolic syndrome (MetS) in adults aged 35–75. Methods: This cross-sectional study utilized data from the 2024 Zhejiang Nutrition and Health Survey (ZJNHS). Three plant-based diet indices were calculated: the overall plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Multivariate logistic regression models evaluated associations between diet index quintiles and MetS and its components. Results: Among the 4695 participants included in the study, 23.9% (n = 1122) had MetS. After adjusting for demographic and lifestyle factors, individuals in the highest uPDI quintile showed a significantly higher MetS risk compared to the lowest quintile (OR = 1.37, 95% CI: 1.08–1.73, p-trend = 0.013). Subgroup analyses revealed significant gender interaction (p for interaction < 0.001), with women exhibiting elevated MetS risk (OR = 1.03, 95% CI: 1.01–1.04, p < 0.001). For MetS components, the highest uPDI quintile was associated with increased risks of abdominal obesity (OR = 1.32, 95% CI: 1.05–1.66; p-trend = 0.032), elevated blood pressure (OR = 1.41, 95% CI: 1.12–1.78; p-trend = 0.003), and elevated fasting glucose (OR = 1.27, 95% CI: 1.01–1.59; p-trend = 0.037). Conclusions: Unhealthy plant-based foods are associated with increased MetS risk, particularly in women. Reducing intake of such foods, considering sex differences, and implementing precision nutrition interventions are essential. Full article

Background/Objectives: Chrononutrition highlights the significance of temporal consumption behavior for a healthy dietary pattern. This study investigated the relationship between dietary fatty acid (FA) intake timing and type 2 diabetes mellitus (T2DM) risk. Methods: A total of 14,518 participants in the China Health and Nutrition Survey (1991–2015) were recruited. Dietary intake and mealtime were collected via three consecutive 24 h dietary recalls. Multivariable Cox proportional hazard models were employed to estimate the association between FA intake at meals and T2DM risk. Differences in FA intake between dinner and breakfast (Δ = dinner-breakfast) were calculated for each type of FA intake. Sensitivity analyses considering the effects of snacks, the sum of different types of FAs, and other confounding factors were performed. The isocaloric substitution model was used to view the risk changes according to the shifted mealtime. Results: During an average of 10.1-year follow-up, 1048 T2DM cases occurred. T2DM risk was inversely associated with n-3 polyunsaturated FAs (n-3 PUFAs) (p trend = 0.032) and plant-sourced monounsaturated FAs (P-MUFAs) (p trend = 0.002) intake at dinner versus breakfast. The highest category of Δ n-3 PUFAs and Δ P-MUFAs were respectively linked to a 19% and 29% reduced T2DM risk. Unanimous associations were found for the difference between lunch and breakfast rather than dinner and lunch. Isocalorically switching 1 standard deviation (SD) of n-3 PUFAs or MUFAs intake at breakfast with the corresponding type of FAs at dinner was associated with a 22% and 20% lower risk of T2DM, respectively. Conclusions: Timely consumption of dietary FAs, particularly n-3 PUFAs and plant-based MUFAs at dinner versus breakfast, is crucial for T2DM prevention. Full article

Background: Childhood obesity is a growing public-health concern in China and globally, a trend influenced by multiple factors, including poor eating behaviors and insufficient physical activity. While interactive health games have shown promise in improving children’s nutrition education and healthy eating behaviors, few have been tailored for the Chinese context. This study aimed to develop and evaluate Happy Farm, Happy Meal (HFHM), an alternate reality game (ARG) integrated into Chinese elementary students’ daily routines to enhance their nutrition knowledge and improve their eating behaviors. Methods: This pilot study employed a quasi-experimental design with two third-grade classes, which were randomly assigned to the HFHM intervention group (n = 40) or a no-game control group (n = 39). The game design was informed by a pre-intervention survey and interviews with caregivers and teachers, which identified key dietary challenges such as picky eating, slow eating, and food waste. Over a two-week period, the HFHM group engaged in food- and nutrition-focused tasks that were incorporated into their lunchtime routines. Pre- and post-intervention data were collected on nutrition knowledge, food waste, picky eating, and meal duration, with daily progress tracking in the HFHM group. Results: Compared to the control group, the HFHM group showed a significant increase in nutrition knowledge (p < 0.05), reduced food waste (p < 0.01), decreased picky eating (p < 0.01), and improved meal duration (p < 0.05). However, the small sample size and short intervention period limit generalizability. Conclusions: These findings suggest HFHM is a promising tool for improving nutrition education and dietary behaviors in Chinese children. Future research should validate these findings in a larger sample and assess long-term impacts. Full article

Background: Current research inadequately substantiates the impacts of dietary inflammatory potential based on the dietary inflammatory index (DII) on population health and environmental sustainability in Chinese adults. Objectives: We aimed to investigate the associations between the DII with the risk of all-cause mortality and greenhouse gas (GHG) emissions in Chinese adults. Methods: Data from adults (N = 15,318) in the China Health and Nutrition Survey 1997–2015 wave were included in the analysis. DII and energy-adjusted DII (E-DII) were calculated using dietary intake data collected with a combination of 3-day consecutive 24-h dietary recalls and the food weighing method. The total GHG emissions were calculated by summing the amount of emissions from all the food groups consumed by the participants. Cox proportional hazards regression models and linear regression models were conducted for statistical analysis. Results: A pro-inflammatory diet, as reflected by higher DII and E-DII scores was associated with an increased risk of all-cause mortality (DII: Q5 vs. Q1: HR = 1.82; 95% CI: 1.45–2.30; p-trend < 0.0001; E-DII: Q5 vs. Q1: HR = 1.86; 95% CI: 1.38–2.52; p-trend < 0.0001) and higher amounts of GHG emissions (both p-trend < 0.0001). Conclusions: These findings demonstrated positive associations between pro-inflammatory potentials with an increased risk of all-cause mortality and higher GHG emissions among Chinese adults, suggesting dual adverse impacts of a pro-inflammatory diet on health and environmental sustainability. Full article

Background: Environmental and cardiometabolic impacts of adherence to plant-based dietary patterns with different quality are unclear. Objectives: To investigate the associations between adherence to the overall, healthy, and unhealthy plant-based dietary patterns, as assessed by the plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI), respectively, and risk of myocardial infarction (MI), type 2 diabetes (T2D), stroke, and all-cause mortality and greenhouse gas (GHG) emissions. Methods: Data from adults (N = 14,652 for cardiometabolic diseases and 15,318 for all-cause mortality) in the China Health and Nutrition Survey (1997–2015 wave) were analyzed. PDI, hPDI, and uPDI scores were calculated with dietary intake data. The total GHG emissions were calculated by summing the amount of emissions from all food groups included in the index. Cox proportional hazard regression models and linear regression models were used for statistical analysis. Results: Greater adherence to an unhealthy plant-based dietary pattern, as reflected by higher uPDI scores, was positively associated with risk of MI (Q5 vs. Q1: HR = 5.90; 95% CI: 2.59–13.48), T2D (Q5 vs. Q1: HR = 2.18; 95% CI: 1.75–2.73), stroke (Q5 vs. Q1: HR = 5.96; 95% CI: 2.86–12.42) and all-cause mortality (Q5 vs. Q1: HR = 6.87; 95% CI: 4.70–10.03). PDI scores were inversely associated with the risk of MI, T2D, and all-cause mortality, and hPDI scores were inversely and positively associated with the risk of T2D and stroke, respectively. All scores were inversely associated with GHG emissions (all p-trends < 0.001). Conclusions: Long-term adherence to unhealthy plant-based dietary patterns guided by higher uPDI scores may be a risk factor for new-onset cardiometabolic diseases and all-cause death in Chinese adults. Food-based dietary guidelines, clinicians, and dietitians should consider the quality of plant-based dietary patterns prior to making recommendations for both healthy individuals and those with elevated cardiometabolic disease risk. Full article

As the role of pets evolves, they are increasingly regarded as members of the family. Although incapable of making independent decisions, pets become unique consumer groups through the purchases of specific products and services made by their owners. In China, the pet economy has developed into a novel economic sector. With the growing concern for pet health, the demand for pet nutritional products continues to rise. This study aims to explore Chinese consumers’ attitudes and intentions towards pet nutritional products in this burgeoning market. A survey was carried out on 600 Chinese consumers who had purchased pet nutritional products in 2024. A two-stage analysis using structural equation modeling and artificial neural network examined the correlation within the research model across 506 samples. The results indicate that perceived benefits, perceived severity, perceived susceptibility, and health consciousness positively influence attitudes towards pet nutritional products, while perceived barriers, health risks, and economic risks negatively impact attitudes. The attitudes of consumers significantly enhance their continuous purchase intentions. This study lays an essential groundwork for advancing pet food products, refining marketing approaches, and conducting future research. Full article

Background: Rapid socio-economic developments confront China with a rising consumption of ultra-processed foods (UPFs) and ultra-processed drinks (UPDs). This study aims to evaluate their potential impact on diet transformation towards sustainability including nutrition, environmental sustainability, and diet-related cost. Methods: Dietary intake was assessed by 24 h recalls in 27,311 participants (age: 40.5 ± 19.7; female, 51.1%) in the China Health and Nutrition Survey 1997–2011. The nutrient quality, environmental sustainability (greenhouse gas emission (GHGE), total water use (TWU), land use (LU), and diet cost were assessed as diet-related sustainability indicators. Foods and drinks were classified according to the degree of processing based on NOVA. Two-level mixed effects models were applied to explore the secular trends of the sustainability indicators being nested within random effect (individual level). Results: UPFs and UPDs are less nutrient-dense, containing more energy, sodium, and added sugar compared to unprocessed or minimally processed foods and drinks (MPFs and MPDs). UPFs and UPDs were higher for GHGE and TWU but lower for LU. Costs of UPDs tripled those of MPDs. In the period of 1997–2011, the percentage of UPFs and UPDs per 2000 kcal increased for both sexes. The increase in UPFs and UPDs was associated with a lower nutrient quality but a higher environmental impact and diet cost. Conclusions: From 1997 to 2011, there was a significant increase in the consumption of UPFs and UPDs in China. This trend had negative impacts on both the nutrient quality and environmental impact; meanwhile, it led to increased diet costs. Policies to reduce the production and consumption of UPFs and UPDs should be reinforced by making alternatives for ultra-processed breakfast cereals, snacks, and alcoholic beverages available and acceptable. Additionally, instead of only focusing on high-UPFD consumers, attention is needed on the currently low-UPFD consumers as their consumption has been growing rapidly in the last decades. Full article

Background/Objectives: As a widely consumed, nutritious, and affordable food, eggs and their derivatives’ impacts on obesity remain inconclusive. In this study, we aimed to determine the association between egg and egg-derived cholesterol consumption, and their change trajectories, with obesity among Chinese adults. Methods: Longitudinal data collected by the China Health and Nutrition Survey from 1997 to 2015 were analyzed. The latent growth mixture model was used to identify eggs and egg-derived cholesterol consumption trajectories. Cox proportional hazard models with shared frailty were used to analyze the association between egg and egg-derived cholesterol consumption, and their change trajectories, with obesity. Results: Data from 10,971 and 9483 participants aged ≥18 years old were used for the analyses of general obesity and central obesity, respectively. Compared to participants with an average egg intake of 0.1–50.0 g/d during the follow-up period, adults who never consumed eggs or those with an average egg intake of 50.1–100.0 g/d and >100.0 g/d had a higher risk of general obesity, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.31 (1.08, 1.58), 1.30 (1.07, 1.60), and 1.98 (1.17, 3.35), respectively, and had a higher risk of central obesity, with HRs (95% CIs) of 1.17 (1.04, 1.31), 1.31 (1.14, 1.50), and 1.64 (1.15, 2.36), respectively. Participants with a “Baseline Low-Significant Rising Pattern” or a “Baseline High-Rising then Falling Pattern” of egg consumption trajectories during the follow-up period had a higher risk of general obesity, with HRs (95% CIs) of 1.56 (1.25, 1.93) and 1.38 (1.13, 1.69), respectively, and central obesity, with HRs (95% CIs) of 1.47 (1.29, 1.68) and 1.52 (1.34, 1.72), respectively. Compared to the second quartile (Q₂) group of the average egg-derived cholesterol intake during the follow-up period, Q₁, Q₃, and Q₄ groups had a higher risk of general obesity, with HRs (95% CIs) of 1.28 (1.06,1.54), 1.21 (1.02, 1.44), and 1.43 (1.19, 1.71), respectively, and a higher risk of central obesity, with HRs (95% CIs) of 1.20 (1.08, 1.33), 1.11 (1.01, 1.23), and 1.32 (1.19, 1.46), respectively. Participants with a “Baseline Low-Significant Rising Pattern” or with a “Baseline High-Rising then Falling Pattern” of egg-derived cholesterol consumption during the follow-up period had a higher risk of general obesity, with HRs (95% CIs) of 1.54 (1.25, 1.92) and 1.37 (1.15, 1.64), respectively, and a higher risk of central obesity, with HRs (95% CIs) of 1.46 (1.28, 1.68) and 1.47 (1.32, 1.64), respectively. Conclusions: Both the insufficient and excessive intake of eggs and egg-derived cholesterol tended to be associated with a higher risk of general and central obesity. Suddenly increasing or consistently high levels of egg and egg-derived cholesterol intake seemed to be associated with a higher risk of obesity. To prevent obesity, people should consume a moderate amount of eggs and egg-derived cholesterol. Full article

Background: Aflatoxin B₁ (AFB₁), AFB₂, AFG₁, and AFG₂ are Group 1 human carcinogens, with AFB₁ notably increasing hepatocellular carcinoma (HCC) risk. Sichuan Province, China, with its subtropical monsoon climate, is susceptible to AF contamination in various food items. However, the HCC disease burden attributable to lifetime chronic dietary AF intake in Sichuan has not been investigated. Methods: The contamination data of AFB₁, AFB₂, AFG₁, AFG₂, and AFM₁ across 20 food categories were analyzed from 2012 to 2023 in Sichuan. Along with the consumption data gathered from the 2011 China National Nutrition and Health Survey, the FDA-iRISK simulated the lifetime chronic dietary exposure patterns of ∑₅AF and estimated the associated HCC burden using disability-adjusted life year (DALY) as the metric. Results: As for the mean AF contamination level in food from Sichuan, the estimated lifetime average daily dose (LADD) of ∑₅AF intake was 9.77 ng/kg bw/day at minimum and 26.0 ng/kg bw/day at maximum, resulting in the lifetime HCC risks per person of 0.106% and 0.283%. The corresponding HCC burdens were 16.87 DALY/100,000 people/year and 44.95 DALY/100,000 people/year, respectively. In the same scenario, the LADD and the risk of HCC in males were higher than in females, but the PAF was higher in females. However, the high (P₉₅) AF contamination level in food caused 2–3 times higher LADD and HCC burden than the mean level of AF occurrence. Among the studied food categories, grains and their products were the primary dietary sources of dietary AF exposure. Conclusions: Sichuan population’s lifetime exposure to ∑₅AF results in an HCC burden higher than the global level. It is recommended to continuously monitor and control AF contamination in Sichuan, particularly those highly vulnerable food categories, and the HCC disease burden should remain a concern in future research efforts. Full article

Background/Objectives: This study aimed to develop and validate a machine learning (ML)-based metabolic syndrome (MetS) risk prediction model. Methods: We examined data from 6155 participants of the China Health and Retirement Longitudinal Study (CHARLS) in 2011. The LASSO regression feature selection identified the best MetS predictors. Nine ML-based algorithms were adopted to build predictive models. The model performance was validated using cohort data from the Korea National Health and Nutrition Examination Survey (KNHANES) (n = 5297), the United Kingdom (UK) Biobank (n = 218,781), and the National Health and Nutrition Examination Survey (NHANES) (n = 2549). Results: The multilayer perceptron (MLP)-based model performed best in the CHARLS cohort (AUC = 0.8908; PRAUC = 0.8073), the logistic model in the KNHANES cohort (AUC = 0.9101, PRAUC = 0.8116), the xgboost model in the UK Biobank cohort (AUC = 0.8556, PRAUC = 0.6246), and the MLP model in the NHANES cohort (AUC = 0.9055, PRAUC = 0.8264). Conclusions: Our MLP-based model has the potential to serve as a clinical application for detecting MetS in different populations. Full article

The elimination of poverty in all its forms is the first global goal of the United Nations’ 2030 Agenda for Sustainable Development. Achieving this goal is recognized as a long-term process that is complicated by persistent vulnerabilities stemming from factors such as natural disasters, food insecurity, health challenges, educational disparities, and social inequality. This systematic bibliometric review provides a comprehensive survey of the impact of social protection-based policies in mitigating poverty vulnerability, focusing on selected countries and regions, including America, Europe, Oceania, and part of Asia and Africa. Our analysis reveals that 81% of the studies examine poverty vulnerability from a single dimension, predominantly focusing on food security and nutrition (23%), climate change shocks (18%), and health-related vulnerabilities (14%). The geographic distribution indicates that the United Kingdom and the United States lead research in this field, contributing 36 and 32 papers, respectively, followed by China (16 papers), South Africa (15 papers), and Canada (10 papers). The results indicate that these fiscal redistribution policies significantly contribute to reducing poverty and inequality and have positive impacts on other Sustainable Development Goals (SDGs), particularly SDG 1 (No Poverty), SDG 2 (Zero Hunger), SDG 3 (Good Health and Well-being), and SDG 10 (Reduced Inequalities). However, notable gaps remain, especially regarding the integration of these policies with environmental sustainability goals like SDG 13 (Climate Action), which are addressed in only a minority of studies. This study concludes by recommending the adoption of more holistic and integrated policy frameworks that bridge the gap between social protection and environmental sustainability, thereby advancing the entire 2030 Agenda for Sustainable Development. Full article