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Diet, Health Concerns, Perceptions of the Diet – Disease Link, and Their Associated Factors in Urban Chinese Population: Results from an Eight-City Cross-Sectional Study


 
 
 Over the past decades, social changes and rapid economic development had significantly impacted people's lifestyle and physical health in China. This study aimed to examine nutrition and diet-related perceptions, knowledge, and concerns for chronic diseases as well as their relationships with dietary intake in the general Chinese population.
 
 
 
 A health survey was conducted among 1708 participants living in urban areas in eight cities in mainland China in 2016. Food frequency questionnaire and a 24-hour recall were used for dietary assessment. The intake of nutrients was estimated based on the Chinese food database. Non-proportional odds ordinal and multi-nominal regression models were performed on Stata 15.1 to analyze the associations.
 
 
 
 Participants (66% female, mean age: 50.6 y-o) consumed, on average, 33.4%, 14%, and 52% of calories from fat, protein, and carbohydrate respectively. 42.9% of the participants perceived low fruits and vegetable intake as their major dietary problem. And the average intake of dietary fiber is 12.5 grams in the study population. Total of 57.5% of the participants have overweight or obesity (OWOB) and 34.4% self-reported at least one chronic disease. People who were older, OWOB, more educated, or have reported any chronic disease were more likely to be more concerned about their health. 45% – 50% of participants indicated a strong belief that an improved diet can benefit the prognosis of Type II diabetes, hypertension, and hyperlipidemia. Higher education, being younger (aged 18–33 y-o), and never smokers were associated with stronger beliefs. After adjusting for age, gender, income, education, BMI, and total energy intake, people from the highest quantile of belief scores ate more protein (β = 4.1, 95% CI: 0.8, 7.4), and have lower sodium to potassium ratio (β = –0.6, 95% CI: –0.9, –0.2) in their diets compared to those from the lowest quantile.
 
 
 
 Factors such as age, education, and health status influence people's perception of nutrition and disease, which contribute to the difference in dietary intake. This study provided insights into factors that should be taken into consideration when designing and implementing nutritional education and interventions targeting the Chinese population.
 
 
 
 National key research and development projects YFD0400602.
