Objective
This study investigates secular trends in diet quality distribution and related socioeconomic disparity from 1991 to 2011 in the Chinese adult population.
Methods
The analysis uses the 1991–2011 China Health and Nutrition Survey data on 13,853 participants (6,876 men; 6,977 women) ages 18 to 65 with 56,319 responses. Dietary assessment was carried out over a 3-day period with 24-hour recalls combined a household food inventory. We tailored Alternative Healthy Eating Index 2010 (named as tAHEI) to measure diet quality and performed quantile regression to investigate shifts in tAHEI scores at different percentiles and used mixed-effect linear regression to examine average diet quality trend and potential sociodemographic disparity.
Results
The energy-adjusted mean tAHEI scores increased from 36.9 (36.7–37.1) points in 1991 to 50.3 (50.1–50.5) in 2011 for men (p < 0.001) and from 35.6 (35.4–35.8) to 46.9 (46.7– 47.1) for women (p < 0.001). The covariates-adjusted score of polyunsaturated fatty acids increased by 6.8 (6.6, 7.0) and 7.0 (6.9, 7.2) and the score of long chain ((ω-3) fats increased by 5.3 (5.2, 5.4) and 5.3 (5.2, 5.5) in men and women, respectively, while the cereal fiber and red meat scores decreased slightly. Increasing tAHEI score occurred across the entire distribution and diet quality transition varied across sociodemographic groups.
Conclusion
Chinese diet quality is far from optimal with moderate improvement over 21-year period. Findings suggest that nutritional intervention should give priority to low income, low urbanized communities, and southern provincial adults with low diet quality in China.
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