China Health And Nutrition Survey Research Articles

Trends in dietary choline and betaine intake among Chinese adults: the China Health and Nutrition Survey 1991-2011.

Choline and its derivative betaine are important methyl donors, components of cell membrane phospholipids, or precursors of the neurotransmitter acetylcholine and the gut microbial metabolite trimethylamine-N-oxide. We aimed to investigate trends in dietary intake and food sources of total choline, individual choline forms, and betaine in Chinese adults using data from the China Health and Nutrition Survey (CHNS) 1991-2011. The sample was drawn from urban and rural communities in 12 provinces or autonomous regions with a multistage, random cluster design. Dietary intake was estimated using three consecutive 24-hour dietary recalls in combination with a household food inventory. Linear mixed-effect models were constructed to calculate adjusted mean intake values and 95% confidence intervals (CIs) using R version 4.2.2. A total of 11,188 men and 12,279 women aged 18 years or older were included. Between 1991 and 2011, total choline intake increased from 219.3 (95% CI: 215.1-223.4) mg/d to 269.0 (95% CI: 265.6-272.5) mg/d in men and from 195.6 (95% CI: 191.8-199.4) mg/d to 240.4 (95% CI: 237.4-243.5) mg/d in women (both P-trends <0.001). Phosphatidylcholine was the major form of dietary choline and its contribution to total choline increased from 46.9% in 1991 to 58.8% in 2011. Cereals were the primary food source of total choline before 2000 while eggs had ranked at the top since 2004. Dietary betaine intake was relatively steady over time with a range of 134.0-151.5 mg/d in men (P-trend <0.001) and 111.7-125.3 mg/d in women (P-trend >0.05). In conclusion, Chinese adults experienced a significant increase in dietary intake of choline, particularly phosphatidylcholine during 1991-2011 and animal-derived foods have replaced plant-based foods as the main food sources of choline. Betaine intake remained relatively stable over time. Future efforts should address the health effects of these changes.

Interaction of serum uric acid with overweight on hypertension: findings from the China Health and Nutrition Survey

BackgroundBoth serum uric acid (SUA) levels and body mass index (BMI) are recognized as important risk factors for hypertension. The current study aimed to investigate the interaction effects between SUA levels and overweight (defined as BMI ≥ 24 kg/m2 in Chinese) on the incidence of hypertension among Chinese adults.Methods1124 hypertensive participants and 7283 non-hypertensive participants, extracted from the China Health and Nutrition Survey (CHNS), were analyzed. Participants were categorized based on their SUA levels and BMI, to investigate the interaction effects between SUA levels and overweight on hypertension.ResultsIn comparison with the reference group (BMI < 24 kg/m2 and in the 1st quintile of SUA), multivariable adjusted analysis demonstrated that the odds ratio (OR) (95% confidence interval, 95% CI) of hypertension for participants with overweight alone was 2.18 (1.41–3.37); for elevated SUA levels alone, the ORs (95% CIs) were 1.57 (1.08–2.30), 1.84 (1.24–2.74), 2.21 (1.47–3.32), and 2.48 (1.55–3.96) across SUA quintiles; and for the combined effect of higher SUA levels and overweight, the ORs (95% CIs) were 3.25 (2.19–4.82), 3.73 (2.51–5.55), 5.17 (3.42–7.80), and 6.21 (4.01–9.60). The relative excess risk due to interaction (RERI) was 3.26 (1.43–5.09) at the 5th quintile of SUA, indicating the presence of additive interaction between overweight and SUA levels on hypertension.ConclusionInteraction between SUA levels and overweight on hypertension exists specifically at the highest quintile (Q5, > 6.39 mg/dL) of SUA among Chinese adults. Therefore, strategies to lower SUA levels could be considered as a potential approach to mitigate hypertension risk in overweight individuals within this specific subgroup.

Vertical Association Between Dietary Total Choline and L-alpha-glycerylphosphorylcholine and the Cognitive Function in Chinese Adults Aged over 55, Result from China Health and Nutrition Survey 1997-2018.

With the aging process in China showing an accelerated trend, cognitive decline and impairment have become a major issue in older people. Dietary choline supplement may be a changeable lifestyle to improve this situation. We analyzed 7659 adults aged over 55 in the China Health and Nutrition Survey (CHNS), evaluated cognitive function by the global cognition score, and found the association between cognitive function and dietary intake of total choline or L-alpha-glycerylphosphorylcholine (GPC). Linear and logistic mixed models with three levels were applied to analyze the association between dietary total choline/GPC intake and global cognition score, and the risk of poor cognition. The average dietary intake at baseline was 178.8 mg/d for total choline, and 16.3 mg/d for GPC. After an average follow up of 6.8 years, we found that higher intake of total choline (β = 0.083, 95%CI: 0.046,0.119, p < 0.001) and GPC (β = 0.073, 95%CI: 0.034-0.111, p < 0.001) had positively associated with global cognitive scores. Additionally, higher intake of total choline had a better effect on improving the cognitive function of women (β = 0.092, 95%CI: 0.042-0.142, p < 0.01) and individuals between 55-65 years old (β = 0.089, 95%CI: 0.046-0.132, p < 0.01). However, higher GPC intake had a better effect on the cognitive function of men (β = 0.080, 95%CI: 0.020-0.141, p < 0.05). Higher total choline intake had a protective factor against poor cognition (OR = 0.762, 95%CI: 0.676,0.860, p < 0.001); the protective effect was more pronounced for women (OR = 0.750, 95%CI: 0.639,0.879, p < 0.001) and individuals aged 55-65 (OR = 0.734, 95%CI: 0.636-0.848, p < 0.001). higher dietary choline and GPC intake were beneficial for cognitive function, although we found that higher dietary choline was more effective in improving global cognitive scores at older ages; dietary choline should be supplemented as early as possible in old age to prevent poor cognition.

Mediterranean diet lowers risk of new-onset diabetes: a nationwide cohort study in China

BackgroundThe Mediterranean diet (MD) has shown promising results in preventing type 2 diabetes, particularly in Mediterranean and European populations. However, the applicability of these benefits to non-Mediterranean populations is unclear, with contradictory findings in the literature.MethodsIn this study, we included 12,575 participants without diabetes at baseline from the China Health and Nutrition Survey (CHNS). Dietary intake was measured by three consecutive 24-h dietary recalls. The Mediterranean diet adherence (MDA) was measured by a score scale that included nine components of vegetables, legumes, fruits, nuts, cereals, fish, red meat, dairy products, and alcohol. New-onset diabetes was defined as self-reported physician-diagnosed diabetes during the follow-up.ResultsDuring a median follow-up of 9.0 years, 445 (3.5%) subjects developed diabetes. Overall, there was an inverse association between the MDA score and new-onset diabetes (per score increment, HR 0.83, 95% CI 0.76–0.90). Moreover, age, sex, BMI, and energy intake significantly modified the association between the MDA score and the risk of new-onset diabetes (all P interactions < 0.05). Greater fruit, fish, and nut intake was significantly associated with a lower risk of new-onset diabetes.ConclusionThere was an inverse association between Mediterranean diet adherence and new-onset diabetes in the Chinese population.

Leisure sedentary time and elevated blood pressure: evidence from the statutory retirement policy.

The relationship between sedentary behaviors and elevated blood pressure remains inconclusive, and the socioeconomic mechanisms underlying the linkage are rarely discussed. Since retirement is often associated with behavioral changes that impact health, this study aims to provide evidence on changes in leisure sedentary time after the statutory retirement age on elevated blood pressure, along with the socioeconomic mechanisms. We utilized data from five waves (2004-2015) of the China Health and Nutrition Survey (CHNS), focusing on males aged 55-65 employed in the formal sector. Leisure sedentary time, the independent variable, was measured based on self-reported data, while diastolic (DBP) and systolic (SBP) blood pressure were the dependent variables. Using statutory retirement policy as an exogenous variation, we employed a continuous difference-in-differences (DID) framework and a propensity score matching difference-in-differences (PSM-DID) approach to examine the relationship between changes in leisure sedentary time after the statutory retirement age and elevated blood pressure. The analysis was conducted using ordinary least squares (OLS). To address potential endogeneity, we applied the instrumental variable (IV) method via two-stage least squares (2SLS). Our findings indicate an increase in diastolic blood pressure after statutory retirement, attributed to increased leisure sedentary time. However, there was no significant increase in systolic blood pressure. Moreover, physical activity did not appear to offset this rise in blood pressure, while higher educational attainment and having family members employed in the medical field helped mitigate its negative effects. This study highlights the potential adverse impact of increased leisure sedentary time on diastolic blood pressure among middle-aged men in the formal sector, while also exploring the socioeconomic factors that may alleviate these effects. These results provide a foundation for public health initiatives aimed at addressing the rising prevalence of sedentary behavior and its association with blood pressure issues.

Intraindividual Discordance Between Remnant Cholesterol and Low-Density Lipoprotein Cholesterol Associated With Incident Stroke: Results From 2 National Cohorts.

The atherogenic effect of remnant cholesterol is being increasingly acknowledged. This study aimed to explore the association of discordance between remnant cholesterol and low-density lipoprotein cholesterol with stroke onset using 2 Chinese national cohorts. We studied 11 139 participants from CHARLS (China Health and Retirement Longitudinal Study) and 5993 participants from CHNS (China Health and Nutrition Survey) aged 45 years or older. The discordance between remnant cholesterol and low-density lipoprotein cholesterol was defined using the difference in percentile units (>15 units). There were 988 (8.9%) and 128 (2.1%) stroke events reported during follow-up in the 2 cohorts. Elevated remnant cholesterol was significantly associated with a higher risk of total stroke in 2 cohorts. After adjusting for remnant cholesterol level, the discordantly high remnant cholesterol group was significantly associated with an increased stroke risk (CHARLS: subdistribution hazard ratio [sHR], 1.31 [95 CI, 1.10-1.55]; CHNS: sHR, 1.84 [95 CI, 1.15-3.08]) compared with the discordantly low group. Consistent results were shown even among those with optimal low-density lipoprotein cholesterol level. The discordance between remnant cholesterol and low-density lipoprotein cholesterol, representing the intraindividual discrepancy, is significantly associated with stroke onset among Chinese adults.

Taxation and entrepreneurship of migrant workers: evidence from China

PurposeMigrant workers play a vital role in the development of countries such as China. However, they often face greater barriers in entrepreneurship. Yet, few studies have focused on the effect of institutional factors on migrant workers' entrepreneurial behaviors. To address this gap, this study concentrates on the role of taxation.Design/methodology/approachThis study takes the agricultural tax abolition reform implemented in rural China since 2004 as an exogenous shock and uses the difference-in-difference (DID) method to examine its effect on migrant workers' entrepreneurship based on longitudinal data from the China Health and Nutrition Survey (CHNS).FindingsWe find that the reform significantly improves the probability of migrant workers engaging in entrepreneurship. Heterogeneity analysis reveals that the reform exerts a notably more pronounced positive impact on male, younger and migrant workers in the Western region. Further analysis reveals that the three main mechanisms are increased household income, female human capital accumulation and increased social capital, including social networks and social trust.Originality/valueThis study is first to offers an institutional perspective on the determinants of migrant workers' entrepreneurship in China. Additionally, the study can provide insights for policymaking intended to support employment and entrepreneurship among low-skill migrant workers.

Gender differences in adolescent food preferences and their association with parent food preferences: data from the China Health and Nutrition Survey (CHNS).

Food preference is an important factor that affects one's eating behavior and dietary intake. Parent food preferences and food choices may influence children food preferences. This study is aimed to describe gender differences and time trends of Chinese adolescent food preferences and to explore the association between adolescent and their parent food preferences. The data were drawn from four waves of the China Health and Nutrition Survey (CHNS) conducted between 2006 and 2015. Participants were asked to indicate their degree of preferences for five food categories (fast food, salty snack food, fruits, vegetables, and soft/sugary drinks) using a 5-point Likert scale (from "dislike very much" to "like very much"). Logistic regression was performed to determine the association of food preferences between adolescents and their parents. Adolescent preferences for unhealthy foods were significantly higher than those of adults. Adolescent food preferences for fruits and vegetables decreased slightly over nine years, and there were gender differences in healthy food preferences (girls > boys, P < 0.05). Regardless of boys or girls, adolescent food preferences for healthy foods (fruits and vegetables) were significantly associated with both their fathers (OR: 3.64-4.58 for boys and 2.71-4.39 for girls) and mothers (OR: 2.13-4.11 for boys and 3.07-5.66 for girls) food preferences. For fast food and salty snack food preferences, boys appeared to be influenced greater by their fathers than girls, while girls appeared to be influenced greater by their mothers than boys. The present study reveals a high degree of unhealthy food preferences among Chinese adolescents and a gender-specific association of fast food and salty snack preference between Chinese adolescents and their parents. Our results may be useful for interventions to reduce adolescent unhealthy food preferences and intakes.

An empirical investigation of health dynamics of elders in China

Using data from the China Health and Nutrition Survey (CHNS), an index of health frailty is developed for individuals ages fifty-five and older. The evolution of the Frailty Index with age is first contrasted with self-reports of health. Then the temporal moments of the data are examined by considering the covariance structure of shocks that arrive at different ages with frailty in subsequent years. Then a formal model is estimated that incorporates both age-dependent auto-regressive and transitory components. The covariance structure of frailty is found to be convex in age. Larger shocks arrive as the sample ages but they decline rapidly. The evolutions of shocks beyond a specific age are modestly persistent (auto-regressive). The initial age-dependent transitory shocks become a larger portion of the total health risk as age increases.

Influence of eating while watching TV on food preference and overweight/obesity among adolescents in China: a longitudinal study.

Eating while watching TV was found associated with unhealthy food preferences and obesity in adolescents in foreign studies, which is not clear in China. The study aims to explore the influence of eating while watching TV on food preferences and overweight/obesity in Chinese adolescents. Data from 1768 adolescents (aged 12-17 years) in the 2006, 2009, 2011, and 2015 China Health and Nutrition Survey (CHNS) was analyzed. The height and weight were measured. Mixed effect models were used to identify the associations between eating while watching TV and adolescents' food preferences and overweight/obesity. Adolescents eating while watching TV ≥1 time/week were more likely to prefer fast food, salty snacks and soft drinks than those eating while watching TV <1 time/week. Adolescents eating meals while watching TV ≥1 time/week were less likely to prefer vegetables than those eating meals while watching TV <1 time/week. In addition, adolescents eating snacks while watching TV ≥1 time/week were more likely to be overweight/obesity than those eating meals while watching TV <1 time/week (odds ratio [OR] = 7.16; 95% confidence interval [CI] 1.39-36.93). Eating snacks while watching TV was positively associated with adolescents' unhealthy food preferences and overweight/obesity. Eating meals while watching TV was associated with adolescents' unhealthy food preferences. Implementing web-based Community-based participatory research (CBPR) about reducing eating while watching TV may be a practical strategy to develop healthy food preferences and prevent overweight/obesity in Chinese adolescents.

Dietary calcium intake at breakfast is associated with a lower risk of cognitive impairment than at dinner in Chinese adults: the CHNS cohort study.

If the proportion of calcium intake over a whole day is related to the risk of cognitive impairment in adults is still largely unknown. This research aimed to examine the relation of dietary calcium intake at dinner versus breakfast with the risk of cognitive impairment by using data from the China Health and Nutrition Survey (CHNS). A total of 2,099 participants (including 668 cognitive impairment) in the CHNS (1997-2006) were included. The participants were categorized into 5 groups in accordance with the ratio of dietary calcium intake at dinner and breakfast (Δ = dinner/breakfast). After adjustment was conducted for a series of confounding factors, Cox hazard regression modelling was performed to discuss the relation of Δ with cognitive impairment. Dietary substitution models were used to explore the changes in cognitive impairment risk when a 5% dietary calcium intake at dinner was replaced with dietary calcium intake at breakfast. Participants in the highest distribution of Δ showed a greater susceptibility to cognitive impairment than those in the lowest quintile, with an adjusted hazard ratio of cognitive impairment of 1.38 (95% CI: 1.08-1.76). When maintaining total calcium intake, substituting 5% of dietary calcium intake at dinner with calcium intake at breakfast was related to an 8% decrease in the risk of cognitive impairment. Higher dietary calcium intake at dinner was associated with an increased risk of cognitive impairment, emphasizing the importance of appropriately distributing dietary calcium intake between breakfast and dinner.

Dietary Nutrients Intake and Type 2 Diabetes in Chinese: Data from China Health and Nutrition Survey (CHNS)

Dietary Nutrients Intake and Type 2 Diabetes in Chinese: Data from China Health and Nutrition Survey (CHNS)

Associations between Long-Term Dietary Coenzyme Q10 Intake and New-Onset Hypertension in Adults: Insights from a Nationwide Prospective Cohort Study.

Coenzyme Q10 (CoQ10) supplementation appears to be associated with a lower blood pressure. Nevertheless, it remains unclear whether food-sourced CoQ10 will affect new-onset hypertension in general adults. This study investigated the relationship between dietary CoQ10 intake and new-onset hypertension among the general population. Participants without hypertension at baseline from the China Health and Nutrition Survey (CHNS) prospective cohort study were included (n = 11,428). Dietary CoQ10 intake was collected by validated dietary recalls and the food weighing method. Linear and non-linear relationships between dietary CoQ10 intake and new-onset hypertension were analyzed using multivariable Cox proportional hazards models and restricted cubic splines. During follow-up (median: 6 years), 4006 new-onset hypertension cases were documented. Compared with non-consumers, the hazard ratio (HR) and 95% confidence interval (CI) from quintile 2 to 4 total dietary CoQ10 were 0.83 (0.76, 0.91), 0.86 (0.78, 0.94) and 1.01 (0.92, 1.11); total plant-derived CoQ10 were 0.80 (0.73, 0.88), 1.00 (0.91, 1.09) and 1.10 (1.00, 1.20); and animal-derived CoQ10 were 0.65 (0.59, 0.71), 0.58 (0.53, 0.64) and 0.68 (0.62, 0.75). The lowest risk was found at moderate intake, with a non-linear relationship (P nonlinearity < 0.05). Furthermore, the overall inverse association was stronger among individuals without alcohol consumption or eating a low-fat diet. Moderate long-term dietary CoQ10 intake might be protective against new-onset hypertension. However, it follows a non-linear relationship and excessive intake may increase the risk of new-onset hypertension in the Chinese population.

Association between Dietary Acid Load and Chronic Kidney Disease in the Chinese Population: A Comprehensive Analysis of the China Health and Nutrition Survey (2009).

Dietary acid load (DAL) is closely related to several chronic diseases. However, the link between DAL and chronic kidney disease (CKD) remains scarce and without data from the Chinese populations whose diet is quite different from people in Western countries. This study evaluated DAL by potential renal acid load (PRAL) and net endogenous acid production (NEAP). We clarified the relationship between DAL and CKD by logistic regression analysis based on data from the China Health and Nutrition Survey (CHNS). The final analysis included 7699 individuals, of whom 811 (11.44%) were CKD patients. Although there was no notable link between PRAL and CKD, higher NEAP levels were independently correlated with CKD. As NEAP values rise, so does CKD prevalence. This trend remains highly significant even after adjustments. In subgroup analyses, the relationship between NEAP and CKD was more consistent in the elderly and subjects with a waistline of less than 82 cm and those without diabetes and heart disease. RCS analysis further confirmed the clear linear relationship between the OR of CKD and NEAP score. This study highlighted that higher NEAP was positively correlated with the risk of CKD.

Association between dietary vitamin A intake and risk of cardiometabolic multimorbidity

The association between vitamin A and single cardiometabolic diseases has been extensively studied, but the relationship between dietary vitamin A intake and the risk of cardiometabolic multimorbidity (CMM) has not been studied. Therefore, the present study was conducted to explore the association with CMM risk by analyzing different sources of vitamin A. This study utilized 13,603 subjects aged ≥ 18 years from 1997 to 2015 from the China Health and Nutrition Survey (CHNS). Dietary intake was calculated from 3 consecutive 24-h dietary recalls combined with a house hold food inventory. CMM is defined as the development of at least two cardiometabolic diseases. After a median follow-up of 9.0 years, there were 1050 new cases of CMM. The risk of CMM was significantly lower in those with higher vitamin A intake (Q1 vs Q5 HR 0.66, 95% CI 0.54–0.81). β-carotene (Q1 vs Q5 HR 0.82, 95% CI 0.66–1.02) and retinol (Q1 vs Q5 HR 0.59, 95% CI 0.48–0.73) intake had a similarly negative correlation. Using restricted cubic spline found an L-shaped relationship between retinol intake and CMM (p non-linear < 0.001). Negative associations were also found in specific CMD groups (hypertension, cardiovascular disease, stroke and diabetes). Dietary intake of vitamin A was negatively associated with CMM risk, and this protective effect was more pronounced in patients with cardiovascular disease. There was an L-shaped association between retinol intake and CMM risk.

Seafood intake in childhood/adolescence and the risk of obesity: results from a Nationwide Cohort Study

Background & aimsObesity has been linked to various detrimental health consequences. While there is established evidence of a negative correlation between seafood consumption and obesity in adults, the current research on the association between seafood intake in childhood/adolescence and the risk of obesity is lacking. Our aim was to evaluate the association between seafood intake in childhood/adolescence and the risk of obesity in a Chinese nationwide cohort.MethodsWe utilized data from the China Health and Nutrition Survey (CHNS) from the year of 1997 to 2015. Seafood consumption was evaluated through 3-day 24-hour recalls. In our study, overweight/obesity status was determined based on the Chinese Criteria of Overweight and Obesity in School-age Children and Adolescents (WS/T 586–2018), while abdominal obesity status was determined according to the Chinese Criteria of Waist Circumference Screening Threshold among Children and Adolescents (WS/T 611–2018).ResultsDuring an average follow-up of 7.9 years, 404 cases developed overweight/obesity among 2206 participants in the seafood-overweight/obesity analysis, while 381 cases developed abdominal obesity among 2256 participants in the seafood-abdominal-obesity analysis. The high-consumer group was associated with 35% lower risk of overweight/obesity risk and 26% lower risk of abdominal obesity after fully adjusting for sociodemographic and lifestyle factors, compared with the non-consumer group. Considering different cooking methods, boiled seafood consumption was associated with 43% lower risk of overweight/obesity and 23% lower risk of abdominal obesity in the fully adjusted model, while stir-fried seafood did not demonstrate a statistical significance.ConclusionHigher intake of seafood in childhood/adolescents, particularly in a boiled way, was associated with lower obesity risk.

The association of physical activity and leisure-time sedentary behavior with perceived stress among Chinese adults: A cross-sectional study based on the Chinese health and nutrition survey data

ObjectivePhysical activity (PA) and sedentary behavior (SB) include several domains, whether the association of PA and SB with perceived stress is domain-specific is not clear. This study aims to identify associations of physical activity (exercise and housework) and leisure-time sedentary behavior (LTSB) with perceived stress among Chinese adults. MethodsThe data were collected from the 2015 China Health and Nutrition Survey (CHNS). Respondents completed multiple questionnaires developed by the CHNS team, from which we extracted and sorted PA and LTSB data. Perceived stress was measured using the 14-item Perceived Stress Scale. PA was measured using a questionnaire covering 7 types of commonly practiced exercises and 4 types of housework activities among Chinese individuals. Consecutive questions were used to inquire about the time spent on each type of PA. The measurement of LTSB was conducted in the same manner. Data analysis involved Chi-square test and logistic regression. Results11,471 adults were included, with an average age of 52.3 years, and 48.3 % were male. 69.9 % (8,019) of respondents reported high perceived stress. Following adjustment for age, gender and other factors, perceived stress was lower for adults reporting medium exercise time (1–2 h) compared with excessively (≥2 h) (OR=1.314 [95 %CI 1.071, 1.612], P<0.001) and least (<1 h) (OR=1.273 [95 %CI 1.115, 1.413], P<0.001) active adults. Perceived stress was higher for adults reporting less housework time (<1 h) compared with adults spending medium (1–2 h) (OR=0.860 [0.744, 0.993], P<0.05) and long (≥2 h) (OR=0.725 [95 %CI 0.628, 0.838], P<0.001) time on housework. Low-level LTSB (<2 h) was associated with higher perceived stress than medium- (2–4 h) (OR=0.817 [0.718, 0.930], P<0.01) and high-level LTSB (≥4 h) (OR=0.668 [0.577, 0.773], P<0.001). ConclusionsThe association of PA and SB with perceived stress is domain-specific. Medium exercise time and extended housework time are associated with reduced perceived stress. Additionally, our findings suggesting that increasing the time spent on LTSB is linked to lower perceived stress levels.

Association between 29 food groups of diet quality questionnaire and perceived stress in Chinese adults: a prospective study from China health and nutrition survey

PurposeDiet plays a fundamental role in promoting resilience against stress-related disorders. We aimed to examine the overall and sex-specific association between food groups and perceived stress in adults.MethodsWe analyzed the prospective data of 7,434 adults who completed both the 2011 and 2015 surveys of the China Health and Nutrition Survey (CHNS). The Diet Quality Questionnaire (DQQ) was used to code all the food items of 2011 dietary intake into 29 food groups, and perceived stress in 2015 was measured using a 14-item perceived stress scale (PSS-14). Univariate analysis and logistic regression models were used to examine the relationship between food groups and perceived stress.ResultsPeople who perceived a higher level of stress (PSS-14 total score > 25) made up 41.5% and 45.1% of the male and female groups, respectively (χ2 = 9.605, p = 0.002). Individuals with increased intake of food groups such as legumes, other vegetables, other fruits, yogurt, poultry, fish & seafood, fluid milk, and fruit juice were less likely to experience a higher level of psychological stress (OR range: 0.544–0.892, p < 0.05). Additionally, we found sex-specific associations between food groups and perceived stress. The difference in the proportion of food groups, such as fluid milk and fish & seafood, between the two stress groups in men was statistically significant (p < 0.025). In the female group, the distribution of eight food groups, like legumes and nuts & seeds, between the two stress groups was statistically significant (p < 0.025).ConclusionThis study indicated that food groups were differentially associated with perceived stress.

The impact of dietary preference on household food waste: evidence from China.

Food waste jeopardizes food security and causes economic and resource losses. Household food waste is the most significant source of global food waste and urgently needs to be reduced. Based on the China Health and Nutrition Survey (CHNS), our study estimates the daily food waste data of 6,418 sample observations across China and the dietary preference scores of their household heads. Using a count regression model, our study explores the relationship between dietary preference and household food waste in Chinese households, and further explores the moderating function of household refrigerator use. The study has found that: (1) improving dietary preference score can significantly reduce household food waste ratio, and robustness tests support this finding. (2) There is a positive moderating effect of refrigerator use in the process of how dietary preference influence food waste. (3) Heterogeneity analysis shows that the impact of dietary preference on household food waste varies by gender and age of the household head, household size, economic level, urban-rural type, and north-south region. Our study provides evidence that improving dietary preference can reduce household food waste in China, which has certain implications for waste reduction in other developing countries.

Intergenerational care and rural childhood obesity in the digital era: Based on screen exposure perspective

BackgroundRural Chinese children are experiencing increasing obesity rates, yet studies often neglect the impact of IT and screen media growth on obesity risks in the context of intergenerational care, leading to incomplete strategies for the digital era. MethodsBy comprehensively utilizing the data on rural children aged 6–17 from the China Family Panel Studies (CFPS) and the China Health and Nutrition Survey (CHNS), this study aims to test the logical chain and specific mechanisms regarding “intergenerational care - screen exposure - rural childhood obesity”. We employ the Propensity Score Matching (PSM) and Generalized Propensity Score Matching (GPSM) methods to respectively address the self-selection biases associated with inter-generational care and children's screen exposure behaviors. Results1) Intergenerational care significantly increases screen exposure among rural children. 2) Gender bias increases the risk of screen exposure for rural boys under intergenerational care. 3) Children with higher screen exposure levels are more affected by intergenerational care, which further undermines parental supervision. 4) Children's screen exposure leads to increased sedentary time and higher probability of purchasing unhealthy foods, thereby exacerbating obesity. This process is facilitated by enhancing preferences for snacks, fast food, and beverages, and weakening preferences for physical activity. 5) GPSM analysis indicates that children's screen exposure has an inverted “U"-shaped impact on unhealthy dietary preferences and a “U"-shaped impact on activity preferences. It results in a nonlinear positive impact of screen exposure on obesity. This study reveals a positive association between screen exposure and obesity, offering new insights into how intergenerational care in the digital era may elevate obesity prevalence through excessive screen time for rural children.