Shufa Du

University of North Carolina at Chapel Hill, North Carolina, United States

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Publications (33)116.58 Total impact

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    ABSTRACT: Little is known about whether large-scale environmental changes, such as those seen with urbanization, are differentially associated with SBP versus DBP, and whether those changes vary by birth cohort. We used data from the China Health and Nutrition Survey, a population-based cohort study of Chinese adults (n = 18 754 aged 18-70 years), seen a maximum of seven times from 1991 to 2009. We used hierarchical multivariable linear models to simultaneously estimate SBP and DBP as correlated outcomes over time, accounting for their physiologic, time-varying correlation. Main exposure variables were urbanicity, age, and birth cohort. Over 18 years of modernization, median SBP and DBP increased by 10 and 7 mmHg, respectively. Our hierarchical model results suggest greater temporal increases in SBP and particularly DBP at lower versus higher urbanicity. At the same chronological age, for a 10-year difference in birth cohort (i.e. born in 1980s versus 1970s), the adjusted mean DBP was approximately 3 mmHg higher for the later birth cohort (P < 0.001). Pulse pressure (calculated as model-predicted SBP minus DBP) was also higher at low versus high urbanicity. These results suggest increased susceptibility of DBP (and thus peripheral vascular resistance) to environmental change, particularly in younger Chinese adults. Because DBP more strongly predicts cardiovascular disease risk in younger adulthood, hypertension-related health burden in China may increase over time.
    Journal of Hypertension 02/2015; DOI:10.1097/HJH.0000000000000522 · 4.22 Impact Factor
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    ABSTRACT: The objective of this study was to investigate the genetic association of 4 candidate variants with blood pressure and test the modifying effects of environmental factors including age, sex, and body mass index (BMI). We used a linear mixed-effects model to test for variant main effects and variant interactions with age, sex, and BMI on systolic (SBP) and diastolic (DBP) blood pressure in 7,319 Chinese adults from the China Health and Nutrition Survey (CHNS). We attempted to replicate our significant interaction findings in 1,996 Chinese men from the Fangchenggang Area Male Health and Examination Survey (FAMHES). Two variants (rs11105378 near ATP2B1 and rs1458038 near FGF5) were significantly associated (P < 0.00625 = 0.05/8) with both SBP and DBP in CHNS. Variant rs1378942 near CSK was nominally associated with SBP (P = 0.01). The signal at rs1458038 exhibited a genotype-by-BMI interaction affecting blood pressure (P interaction = 0.0018 for SBP; P interaction = 0.049 for DBP), with the strongest variant effects in those with the highest BMI. In FAMHES, rs1458038 also showed stronger effects on SBP and DBP among men with the highest BMI. Our findings suggest high BMI increases the effect of the blood pressure-increasing allele at rs1458038 near FGF5, further highlighting the importance of obesity prevention in reducing hypertension risk. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
    American Journal of Hypertension 01/2015; DOI:10.1093/ajh/hpu263 · 3.40 Impact Factor
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    ABSTRACT: To identify dietary patterns that influence cardiometabolic risk among individuals with type 1 diabetes (T1D) in China.
    Journal of Diabetes and its Complications 12/2014; DOI:10.1016/j.jdiacomp.2014.12.014 · 1.93 Impact Factor
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    ABSTRACT: This paper addresses the need for diet assessment methods that capture the rapidly changing beverage consumption patterns in China. The objective of this study was to develop a 3-day smartphone-assisted 24-hour recall to improve the quantification of beverage intake amongst young Chinese adults (n=110) and validate, in a small subset (n=34), the extent to which the written record and smartphone-assisted recalls adequately estimated total fluid intake, using 24-hour urine samples. The smartphone-assisted method showed improved validity compared with the written record-assisted method, when comparing reported total fluid intake to total urine volume. However, participants reported consuming fewer beverages on the smartphone-assisted method compared with the written record-assisted method, primarily due to decreased consumption of traditional zero-energy beverages (i.e. water, tea) in the smartphone-assisted method. It is unclear why participants reported fewer beverages in the smartphone-assisted method than the written record -assisted method. One possibility is that participants found the smartphone method too cumbersome, and responded by decreasing beverage intake. These results suggest that smartphone-assisted 24-hour recalls perform comparably but do not appear to substantially improve beverage quantification compared with the current written record-based approach. In addition, we piloted a beverage screener to identify consumers of episodically consumed SSBs. As expected, a substantially higher proportion of consumers reported consuming SSBs on the beverage screener compared with either recall type, suggesting that a beverage screener may be useful in characterizing consumption of episodically consumed beverages in China's dynamic food and beverage landscape.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4). DOI:10.6133/apjcn.2014.23.4.10 · 1.36 Impact Factor
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    ABSTRACT: AimsTo describe the contribution of diabetes nutrition therapy to disease self-management among individuals with Type 1 diabetes mellitus in China and to estimate the association of diabetes nutrition therapy with dietary intake.Methods The 3C Study was an epidemiological study of the coverage, cost and care of Type 1 diabetes in China. The data reported in the present study are from the 3C Nutrition Ancillary Study, a follow-up study conducted 1AUTHOR: Please insert text explaining what ‘1.6±0.2′ represents, e.g. ‘a mean (sd) of’ or ‘a mean (se) of’.6±0.2 years later. Diabetes nutrition therapy was assessed by an interviewer-administered questionnaire. Dietary intake was assessed using three 24-h recalls. The association of diabetes nutrition therapy with dietary intake was estimated using ancova.ResultsParticipants (n=100; 54% male) had a mean ± sd age of 41.7±16.3 years old and a mean ± sd diabetes duration of 11.8±9.7 years. Fewer than half of the participants reported that they had ‘ever’ met with a dietician. While 64% of participants were taught carbohydrate counting, only 12% ‘ever’ use this tool. Participants on insulin pumps and those testing ≥1 time/day reported greater dietary flexibility and higher fruit intakes compared with participants on other insulin regimens and testing less frequently. After adjustment for confounding by age and occupation, there were no consistent differences in dietary intake across subgroups of diabetes nutrition therapy.Conclusions In this sample of individuals with Type 1 diabetes in China there is little dietician involvement or carbohydrate counting. Increased frequency of nutrition education in conjunction with intensified self-monitoring of blood glucose is needed to improve care.This article is protected by copyright. All rights reserved.
    Diabetic Medicine 11/2014; DOI:10.1111/dme.12634 · 3.24 Impact Factor
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    ABSTRACT: Influenced by pathogen exposure and obesity, inflammation provides a critical biological pathway linking changing environments to the development of cardiometabolic disease. This study tests the relative contribution of obesogenic and pathogenic factors to moderate and acute CRP elevations in Chinese children, adolescents and adults. Data come from 8795 participants in the China Health and Nutrition Study. Age-stratified multinomial logistic models were used to test the association between illness history, pathogenic exposures, adiposity, health behaviors and moderate (1-10 mg/L in children and 3-10 mg/L in adults) and acute (>10mg/L) CRP elevations, controlling for age, sex and clustering by household. Backward model selection was used to assess which pathogenic and obesogenic predictors remained independently associated with moderate and acute CRP levels when accounting for simultaneous exposures. Overweight was the only significant independent risk factor for moderate inflammation in children (RRR 2.10, 95%CI 1.13-3.89). History of infectious (RRR 1.28, 95%CI 1.08-1.52) and non-communicable (RRR 1.37, 95%CI 1.12-1.69) disease, overweight (RRR 1.66, 95%CI 1.45-1.89) and high waist circumference (RRR 1.63, 95%CI 1.42-1.87) were independently associated with a greater likelihood of moderate inflammation in adults while history of infectious disease (RRR 1.87, 95%CI 1.35-2.56) and overweight (RRR 1.40, 95%CI 1.04-1.88) were independently associated with acute inflammation. Environmental pathogenicity was associated with a reduced likelihood of moderate inflammation, but a greater likelihood of acute inflammation in adults. These results highlight the importance of both obesogenic and pathogenic factors in shaping inflammation risk in societies undergoing nutritional and epidemiological transitions. Am. J. Hum. Biol., 2013. © 2013 Wiley Periodicals, Inc.
    American Journal of Human Biology 01/2014; 26(1). DOI:10.1002/ajhb.22462 · 1.93 Impact Factor
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    ABSTRACT: Recent studies have shown inconsistent effects of sodium reduction, potassium intake, and the ratio of sodium to potassium (Na/K ratio) on hypertension and other cardiovascular diseases. Major gaps exist in knowledge regarding these issues in China. We analyzed the patterns and trends of dietary sodium intake, potassium intake, and the Na/K ratio and their relations with incident hypertension in China. The China Health and Nutrition Survey cohort includes 16,869 adults aged 20-60 y from 1991 to 2009. Three consecutive 24-h dietary recalls and condiment and food weights provided detailed dietary data. Multinomial logistic regression models determined trends and patterns of sodium and potassium intake and the Na/K ratio. Models for survival-time data estimated the hazard of incident hypertension. Sodium intake is decreasing but remains double the Institute of Medicine recommendations. Most sodium comes from added condiments. Adults in the central provinces have the highest sodium intake and the most rapid increase in hypertension. Potassium intake has increased slightly but is below half of the recommended amount. The Na/K ratio is significantly higher than the recommended amounts. Recent measurements of high sodium intake, low potassium intake, and high Na/K ratio have strong independent dose-response associations with incident hypertension. Reducing sodium in processed foods, the major public health strategy in Western countries, may be less effective in China, where salt intake remains high. Replacing sodium with potassium in salt to control and prevent hypertension in China should be considered along with other public health and clinical prevention options.
    American Journal of Clinical Nutrition 11/2013; 99(2). DOI:10.3945/ajcn.113.059121 · 6.50 Impact Factor
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    ABSTRACT: BACKGROUND:: Although it is clear that there are short-term effects of sodium intake on blood pressure, little is known about the most relevant timing of sodium exposure for the onset of hypertension. This question can be addressed only in cohorts with repeated measures of sodium intake. METHODS:: Using up to seven measures of dietary sodium intake and blood pressure between 1991 and 2009, we compared the association of baseline, mean, and most recent sodium intake with incident hypertension, in 6578 adults enrolled in the China Health and Nutrition Survey (age 18 to 65 years and free of hypertension at baseline). We used survival methods that account for the interval-censored nature of this study and inverse-probability weights to generate adjusted survival curves and time-specific cumulative risk differences; hazard ratios were also estimated. RESULTS:: Baseline sodium intake was not associated with incident hypertension. For the mean and most recent measures, the probability of hypertension-free survival was the lowest among those with the highest sodium intake compared with all other intake groups across the entire follow-up. In addition, the most recent sodium intake had a positive dose-response association with incident hypertension (risk difference at 11 years of follow-up = 0.04 [95% confidence interval = 0.00 to 0.08], 0.06 [0.02 to 0.11], 0.18 [0.12 to 0.24], and 0.20 [0.12 to 0.27] for the second to fifth sodium-intake groups compared with the lowest group, respectively). CONCLUSION:: We found that, among the various time frames, the most recent exposure to sodium was most strongly associated with incident hypertension.
    Epidemiology (Cambridge, Mass.) 03/2013; 24(3). DOI:10.1097/EDE.0b013e318289e047 · 6.18 Impact Factor
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    ABSTRACT: Recent US work identified "metabolically healthy overweight" and "metabolically at risk normal weight" individuals. Less is known for modernizing countries with recent increased obesity. Fasting blood samples, anthropometry and blood pressure from 8,233 adults aged 18-98 in the 2009 nationwide China Health and Nutrition Survey, were used to determine prevalence of overweight (Asian cut point, BMI ≥23 kg/m(2) ) and five risk factors (prediabetes/diabetes (hemoglobin A1c ≥5.7%) inflammation (high-sensitivity C-reactive protein (hsCRP) ≥3 mg/l), prehypertension/hypertension (Systolic blood pressure/diastolic blood pressure≥130/85 mm Hg), high triglycerides (≥150 mg/dl), low high-density lipoprotein cholesterol (<40 (men)/ <50 mg/dl (women)). Sex-stratified, logistic, and multinomial logistic regression models estimated concurrent obesity and cardiometabolic risk, with and without abdominal obesity, adjusting for age, smoking, alcohol consumption, physical activity, urbanicity, and income. Irrespective of urbanicity, 78.3% of the sample had ≥1 elevated cardiometabolic risk factor (normal weight: 33.2% had ≥1 elevated risk factor; overweight: 5.7% had none). At the age of 18-30 years, 47.4% had no elevated risk factors, which dropped to 6% by the age 70, largely due to age-related increase in hypertension risk (18-30 years: 11%; >70 years: 73%). Abdominal obesity was highly predictive of metabolic risk, irrespective of overweight (e.g., "metabolically at risk overweight" relative to "metabolically healthy normal weight" (men: relative risk ratio (RRR) = 39.06; 95% confidence interval (CI): 23.47, 65.00; women: RRR = 22.26; 95% CI: 17.49, 28.33)). A large proportion of Chinese adults have metabolic abnormalities. High hypertension risk with age, underlies the low prevalence of metabolically healthy overweight. Screening for cardiometabolic-related outcomes dependent upon overweight will likely miss a large portion of the Chinese at risk population.
    Obesity 01/2013; 21(1):E166-74. DOI:10.1002/oby.20409 · 4.39 Impact Factor
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    ABSTRACT: China faces a major increase in cardiovascular disease, yet there is limited population-based data on risk factors, particularly in children. Fasting blood samples, anthropometry and blood pressure were collected on 9,244 children and adults aged ≥7 years in late 2009 as part of the national China Health and Nutrition Survey. Prevalent overweight, elevated blood pressure, and cardiometabolic risk factors: glucose, HbA1c, triglycerides (TG), total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), and C-reactive protein (CRP) are presented. We found that 11% of Chinese children and 30% of Chinese adults are overweight. Rates of diabetes, dyslipidaemia, hypertension and inflammation are high and increased with age and were associated with urbanization. Approximately 42% of children have at least one of the following: pre-diabetes or diabetes, hypertension, high TC, LDL-C, TG, and CRP and low HDL-C, as do 70% men and 60% women aged 18-40 years and >90% of men and women ≥60 years. In sum, the HbA1c findings suggest that as many as 27.7 million Chinese children and 334 million Chinese adults may be pre-diabetic or diabetic. The high prevalence in less urban areas and across all income levels suggests that cardiometabolic risk is pervasive across rural and urban China.
    Obesity Reviews 06/2012; 13(9):810-21. DOI:10.1111/j.1467-789X.2012.01016.x · 7.86 Impact Factor
  • American Journal of Clinical Nutrition 08/2011; 94(3):960-961. DOI:10.3945/ajcn.111.020818 · 6.92 Impact Factor
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    ABSTRACT: It has been hypothesized that monosodium glutamate (MSG), a flavor enhancer, is positively associated with weight gain, which influences energy balance through the disruption of the hypothalamic signaling cascade of leptin action. The objective was to examine the longitudinal association between MSG consumption and incidence of overweight. Data were collected from the China Health and Nutrition Survey (CHNS), a prospective open-cohort, ongoing nationwide health and nutrition survey, consisting of 10,095 apparently healthy Chinese adults aged 18-65 y at entry from 1991 to 2006. Diet, including MSG and other condiments, was assessed with a weighed food inventory in combination with three 24-h recalls. Incident overweight was defined as a body mass index (BMI; in kg/m(2)) ≥ 25 or ≥23 based on World Health Organization recommendations for Asian populations. Multilevel mixed-effects models were constructed to estimate change in BMI, and Cox regression models with gamma shared frailty were used to determine the incidence of overweight. The mean follow-up was 5.5 y. The cumulative mean (±SD) MSG intake of 2.2 ± 1.6 g/d was positively associated with BMI after adjustment for potential confounders and cluster effects at different levels (individual, household, and community). The adjusted hazard ratio of overweight was 1.33 (95% CI: 1.01, 1.75; P for trend < 0.01) for participants in the highest quintile of MSG intake compared with those in the lowest quintile after adjustment for age, physical activity, total energy intake, and other major lifestyle factors. MSG consumption was positively, longitudinally associated with overweight development among apparently healthy Chinese adults. Additional studies are needed to elucidate mechanisms of action and to establish causal inference.
    American Journal of Clinical Nutrition 04/2011; 93(6):1328-36. DOI:10.3945/ajcn.110.008870 · 6.50 Impact Factor
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    ABSTRACT: Television (TV) use has been linked with poor eating behaviors and obesity in young people. This study examines the association between TV watching and paying attention to TV commercials with buying and requesting snacks seen on commercials, and eating snacks while watching TV among youth in China. Data from 1,552 participants (ages 6-17.99) in the 2004 China Health and Nutrition Survey were analyzed cross-sectionally. The 2004 China Health and Nutrition Survey was conducted in nine Chinese provinces. Most respondents (92.2%) reported watching TV; on average children (6-11.99 years old) and adolescents (12-17.99 years old) watched TV for 9-10 hours per week. Nearly half (42.9%) of all the respondents said they "sometimes" or "often" paid attention to TV commercials. Respondents who reported paying attention to commercials had higher odds of requesting snacks (odds ratio [OR] = 3.43; 95% confidence interval [CI] = 2.55-4.60) and buying snacks (OR = 2.73; 95% CI = 2.17-3.43) seen on TV, and eating snacks while watching TV (OR = 1.60; 95% CI = 1.23-2.07) than those who did not pay attention. However, frequency of watching TV was not significantly related to snacking. Attention to TV commercials for snack foods may be one of the factors affecting the increase in obesity among children and adolescents in China.
    Journal of Adolescent Health 04/2010; 46(4):339-45. DOI:10.1016/j.jadohealth.2009.08.002 · 2.75 Impact Factor
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    ABSTRACT: China's overweight and obesity problems are increasing at an alarming rate, particularly among youth, due apparently to excessive caloric intake, low physical activity, and sedentary lifestyles. Increasing television (TV) viewing may also be a contributing factor. This study examines the relationship between TV watching, physical activity and snacking behaviors among Chinese children and adolescents between 2000 and 2006. Responses from 4,643 total participants aged 6 through 18 in three waves (2000, 2004, and 2006) of the China Health and Nutrition Survey (CHNS) were analyzed cross-sectionally to evaluate trends of weekly TV watching time, number of and duration of physical activities per week, and snacking behaviors. Results showed that TV watching among youth increased from six hours per week in 2000 to nearly 11 hours in 2006. The average number of weekly physical activities also increased, but the duration of activity did not increase. Weekly TV watching time was negatively related to the number of physical activities engaged in by youth. This negative relationship is more pronounced over time. The instance of youth requests to their parents for snacks seen on TV also increased slightly between 2004 and 2006. These cross-sectional trends indicate that TV watching may be one of the factors in the growing problem of obesity among children and adolescents in China, as it is associated with changes in physical activity and snacking across a large number of Chinese youth.
    137st APHA Annual Meeting and Exposition 2009; 11/2009
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    International Journal of Epidemiology 11/2009; 39(6):1435-40. DOI:10.1093/ije/dyp322 · 9.20 Impact Factor
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    ABSTRACT: The aim of the prospective study reported here was to examine the effects of social and economic transformation on dietary patterns and nutritional status in China. The study began in 1989 and continued with follow-ups in 1991, 1993, 1997, 2000, and 2004. A total of 5000 subjects aged 18-45 years from 4280 households in nine provinces were included. Weighed records and three consecutive 24-h recalls were used. Over the study period, average consumption of all animal foods except milk increased, while cereal intake decreased. The proportion of animal protein and fat as a percentage of energy also increased. However, vitamin A and calcium intake did not increase and remained low. Child height and weight increased while undernutrition decreased and overweight increased. The results indicate that rapid changes in dietary pattern are associated with economic reforms in China.
    Nutrition Reviews 05/2009; 67 Suppl 1:S56-61. DOI:10.1111/j.1753-4887.2009.00160.x · 4.60 Impact Factor
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    ABSTRACT: The purpose of the study is to examine the dynamic eating behaviors of the Chinese people, focusing on snacking and the choice of cooking methods, and to identify the influences of socioeconomic factors on these eating behaviors. Data for this study were from the China Health and Nutrition Survey (CHNS). There were 11780 subjects, older than two years (y), from the 1991 and 11169 from the 2004 surveys respectively. Logistic regressions of pooled data were performed to evaluate how socioeconomic status (SES) was associated with two eating behaviors: snacking and consuming excessive amounts of fried foods. Simulation techniques were used to clarify the effects of the results that included significant interaction terms. Results showed that the rapid shift in the food and nutrient profile of the Chinese population is accompanied by equally profound changes in meal and cooking patterns. Snacking behavior is beginning to emerge and there are shifts away from the steaming and boiling of food to the, less healthy, frying of food. Income is positively associated with the consumption of both snacks and excessive fried food. Urban residents are also more likely to snack and to consume excessive amounts of fried foods than rural residents. These findings indicate that eating behaviors are beginning to change rapidly toward less healthy options in China. SES plays a vital role in the early stages of the eating behavior transition in China. Future health promotion programs targeting the higher-SES population will exert far-reaching effects on the improvement of health status in this group.
    Asia Pacific Journal of Clinical Nutrition 02/2008; 17(1):123-30. · 1.36 Impact Factor
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    ABSTRACT: To describe body mass index (BMI, in kg/m(2)) distribution patterns and trends among Chinese adults, aged 20-45 years (1989-2000). A descriptive, population-based study of BMI change. Chinese provinces (eight in 1989 and 1997; nine in 2000), representative of the household-based surveys (the China Health and Nutrition Survey, 1989-2000) using multistage, random cluster sampling, supplemented with annual household consumption survey data of the State Statistical Bureau (SSB). A total of 4527, 4507 and 4046 adults, aged 20-45 years, in 1989, 1997 and 2000, respectively. BMI (underweight: BMI<18.5 kg/m(2) and overweight: BMI>/=25 kg/m(2)). Percentile curves for BMI in 1989 and 2000 were constructed by gender and age using the LMS (lambda, mu, sigma) method. Compared with 1989, the 2000 BMI distribution curves flattened at higher levels of BMI (men and women). There was a 13.7% increase in the proportion of men and a 7.9% increase of women who were overweight or obese with a resulting greater change in the annualized prevalence rate for men. This increase in the prevalence of overweight and obesity was far greater than the decrease (2.1% for men; 2.2% for women) in that of underweight. Age-gender-specific percentile curves showed BMI increases mainly among women, aged 35-45 years, and among men at all age groups. Chinese BMI dynamics show much greater rates of change among men, aged 20-45 years, than among women, with the increase among women concentrated between ages 35 and 45 years. These changes portend large shifts in other diet-related non-communicable diseases in China over the following decades. Controlling the increasing trends of BMI, especially in men, is an important public health problem facing China.
    International Journal of Obesity 03/2007; 31(2):272-8. DOI:10.1038/sj.ijo.0803416 · 5.39 Impact Factor
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    ABSTRACT: To compare and contrast youth physical activity (PA) and inactivity patterns in two developing Asian countries: the Philippines and China. Comparative analysis of 1997-1999 Cebu Longitudinal Health and Nutrition Survey and the 1997 China Health and Nutrition Survey, large-scale surveys that included questions on type, frequency and duration of: commuting mode to school, sports/exercise in and outside of school, select sedentary activities and chores. Filipino data included 760 males and 872 females aged 14-16 years. The comparable Chinese sample consisted of 202 males and 197 females. Active commuting is proportionately high in both countries (70-71% in the Philippines vs. 77-90% in China), although commuting by bicycling is rare in the Philippines (<1%) vs. China ( approximately 35%). Patterns of school sport/exercise participation differ between countries by gender; more Filipino males report school sport/exercise than females (63 vs. 49%) vs. China, where more females participate than males (75 vs. 69%). Sport/exercise outside of school is proportionately low (6-12%) for youth from both countries with a single exception: 74% of Filipino males participate in extra-curricular sport/exercise. Although a higher percentage of Filipino youth report watching television >4 h/day (<10%) vs. Chinese youth (<1%), both are lower than comparable US reports. In the Philippines, continued modernization augurs a decrease in local primary PA sources (chores and active commuting). In China, where youth already are not expected to perform chores, shifts to more passive commuting modes (i.e. increased motorized transportation) are anticipated.
    Child Care Health and Development 01/2007; 33(1):59-66. DOI:10.1111/j.1365-2214.2006.00612.x · 1.83 Impact Factor
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    ABSTRACT: Twenty-five years ago, China introduced sweeping reforms in the structure of its rural economy, family planning program, and financial accountability within enterprises and service sector organizations. A rapid rise in economic productivity has resulted in continuing increases in income and changes to the traditional Chinese diet. The aim of this study is to examine how the social and economic transformation of China affects dietary patterns and nutritional status of people. The data from a prospective study, China Health and Nutrition Survey, begun in 1989 and followed up in 1991, 1993, 1997, 2000 and 2004. The population used in this study included 5000 subjects aged 18-45 from 4280 households in nine provinces. Dietary intakes were measured using a combination of the weighing method and three consecutive 24-h recalls. All other data were directly measured or obtained by in-depth interviews. The average consumption of all animal source foods except milk and eggs increased by 34g per capita per day, while the average intake of cereals decreased by 130g per capita per day. The proportion of animal source protein increased greatly and fat contributed an increasing proportion of energy. However, vitamin A and calcium intake did not increase from their low levels of intake during this period. Child height and weight increased and were linked with a decline in under-nutrition. For example, the prevalence of overweight increased from 11.4% to 22.8% in women and from 6.4% to 25.1% in men in the same period, climbing much faster than before. The rapid shift in diet and obesity linked with social and economic changes in China continues unabated. In association with the economic reform, the dietary pattern changed rapidly in these years.
    Asia Pacific Journal of Clinical Nutrition 01/2007; 16 Suppl 1:374-82. · 1.36 Impact Factor

Publication Stats

1k Citations
116.58 Total Impact Points

Institutions

  • 2000–2015
    • University of North Carolina at Chapel Hill
      • • Carolina Population Center
      • • Department of Nutrition
      North Carolina, United States
  • 2009
    • China National Center for Food Safety Risk Assessment
      Peping, Beijing, China
  • 2003–2007
    • Beijing Centers for Disease Control and Prevention
      Peping, Beijing, China
  • 2003–2004
    • Chinese Center For Disease Control And Prevention
      • Institute for Nutrition and Food Safety
      Beijing, Beijing Shi, China