Multiple indicators of household dietary diversity in rural China: Effects of income and dietary knowledge

Dietary behaviors of rural residents in northeastern China: implications for designing intervention information and targeting high-risk population

Background

Dietary behavior is a pivotal modifiable determinant in reducing the occurrence of obesity/overweight and chronic non-communicable diseases. Improving the dietary behavior of rural residents in China is imminent due to the poor performance of their dietary behavior. Nutrition knowledge and health literacy are considered as elements that are linked intimately to healthy dietary behaviors but lack research in the Chinese setting.

Purpose

The study is designed to explore the relationship between nutritional knowledge, health literacy and dietary behaviors and to analyze the performance under different demographic characteristics.

Methods

A face-to-face survey of 400 rural residents on their nutrition knowledge, functional health literacy and dietary intake of five food categories consisting of 32 items was conducted based on a validated questionnaire. Descriptive analysis, difference test including ANOVA, t-test and non-parametric test, and multivariate linear regression were used for data analysis.

Results

The results indicate that declarative nutrition knowledge, individuals' information application capacity, and dietary behaviors, especially the intake of fruits, dairy and beans, and vegetable are not ideal and requires improvement. Male, elder, low-income, unmarried, and low-education populations performed significantly worse and were the high-risk group. Procedural nutrition knowledge, information access capacity, information understanding capacity, and information application capacity have remarkable effects on better dietary behavior.

Conclusion

This study provides evidence-based guidance for prioritizing information and populations for healthy dietary interventions.

Family Income Level, Income Structure, and Dietary Imbalance of Elderly Households in Rural China

In rural areas, the aging of households is becoming increasingly severe, and the issue of dietary imbalance among the elderly is becoming increasingly prominent. Using data from the China Health and Nutrition Survey (CHNS), the negative binomial regression method was used to investigate the impact of household income level on dietary imbalance among rural elderly people, and to explore the heterogeneity of household income structure and its role in the relationship between the two. Research has found that an increase in total household income significantly improves the dietary quality of rural elderly people, and the income structure variable enhances its negative pulling effect on dietary imbalance. For elderly people with moderate dietary imbalance, the effect of increased family income is most significant. In different income groups, the impact of total household income on dietary imbalance in the high-income group is greater than that in the low-income group, and there is also a significant difference in the role played by the proportion of net income from agricultural operations. Therefore, it is necessary to increase the non working income of the elderly, strengthen social responsibility for elderly care, and alleviate the problem of dietary imbalance among rural elderly people.

Biodiversity is overlooked in the diets of different social groups in Brazil

Food biodiversity is essential for improving nutrition and reducing hunger in populations worldwide. However, in middle and low-income countries, the biodiversity of food production does not necessarily represent food consumption patterns by population. We used Brazil, one of the world's megabiodiverse countries, as a case study to investigate the following questions: what is the prevalence of consumption of biodiverse foods in Brazil, and what are the socioeconomic factors that influence their consumption throughout the country? We used data from a Brazilian representative national dietary survey to estimate the frequency of food consumption of unconventional food plants, edible mushrooms, and wild meat, in according to socioeconomic variables. Thus, we investigated the socioeconomic predictors of Unconventional Food Plants consumption using methods of Machine Learning (ML) and multiple zero-inflated Poisson (ZIP) regression. We showed that biodiverse food consumption in Brazil is low, just related by 1.3% of the population, varying in according to area, ethnicity, age, food insecurity, sex, and educational level. Our findings of low utilization of biodiversity suggest an important mismatch between the rich biodiversity of the country and its representation in the human diet.

Spatial Distribution and Temporal Trends of Dietary Niacin Intake in Chinese Residents ≥ 5 Years of Age between 1991 and 2018

Limited knowledge exists on trends in niacin consumption and the prevalence of inadequate intakes in China. Understanding trends and the spatial distribution of the prevalence of inadequate niacin intake is crucial to identifying high-risk areas and sub-populations. The dietary intakes of niacin between 1991 and 2018 were analyzed using the China Health and Nutrition Survey (CHNS) data. The estimated average requirement cut point was applied to estimate inadequacy. The geographic information system's ordinary kriging method was used to estimate the spatial distribution of the prevalence of inadequate niacin intakes. However, between 1991 and 2018, the prevalence of inadequate niacin intake increased from 13.00% to 28.40% in females and from 17.75% to 29.46% in males. Additionally, the geographically significant clusters of high and low prevalence were identified and remained stable over almost three decades. The high prevalence of insufficient niacin intake was more pronounced in Henan and Shandong over 27 years. Further, effective and tailored nutrition interventions are required to address inadequate niacin intake in China.

The effect of dietary awareness on household food waste

How to reduce household food waste has emerged as an important issue worldwide. Considering the potential endogeneity issue, the present study utilizes the treatment effects model to analyse the effect of dietary awareness on household food waste using data from China. The results showed that improving dietary awareness could significantly increase household food waste overall. However, this impact is heterogeneous among households of different characteristics. Improving dietary awareness leads to more food waste for households with young and old food decision-makers, but contributes to less food waste for households of middle-aged makers. Also, the positive effect of dietary awareness on household food waste weakens as income increases. These findings propose a new perspective to understand the heterogeneity in household food waste in the context of dietary awareness promotion.

The Direct and Structure Effect of Income on Nutrition Demand of Chinese Rural Residents

Although a significant body of literature has analyzed the effect of income-mediated policies on nutrition, research on how income affect nutrition consumption is scant. This paper contributes to the literature by decomposing the overall income effect on rural residents' calorie intake into the direct income effect and the structure effect by building a simple theoretical model and conducting related empirical research with an instrumental variable (IV) approach. Using nationally representative data from China, we find that the structure effect of income, represented by fat share growth induced by income, occupies a considerable proportion (38.03%) of overall income effect. Additionally, we provide evidence of an asymmetric distributional effect of income on calorie intake. In particular, the structure effect of income substantially accounts for a larger proportion in the higher quantiles of the calorie intake distribution. Our findings help better evaluate the effectiveness of the income-mediated policies from quantity and structure perspectives in a comprehensive framework.

Dietary diversity and determinants of young adults in central China: A cross-sectional study from 2015 to 2020

Background

Early adulthood is a vulnerable period for improved nutrition at all phases of the life cycle. However, there is limited research on diversity information in young adults from middle-income countries undergoing an apparent nutritional transition. The purpose of this study was to explore dietary diversity and determinants among young adults aged 18–35 years in central China.

Methods

From January 2015 to December 2020, a cross-sectional survey of 49,021 young adults in a health management center of central China was conducted through report and phone-assisted self-report for information. The outcome variable was the Dietary Diversity Score. Independent variables included age, sex, race, material status, education, BMI, taste preference, regular meals, midnight snacks, sugared beverage/coffee consumption, and smoking/drinking status. Multivariate logistic regression was performed.

Results

Of 49,021 young adults, 38,374 (78.3%) reported insufficient dietary diversity, and 422 (0.9%) reported sufficient dietary diversity. Light taste preference [adjusted odds ratio (aOR) = 2.325; 95% CI: 1.779, 3.039] and those who had meals regularly (aOR = 1.241; 95% CI: 1.018, 1.513) and consumed coffee (aOR = 2.765; 95% CI: 2.257, 3.387) were more likely to be associated with sufficient dietary diversity. Midnight snacks (aOR = 0.728; 95% CI: 0.588, 0.901) and sugary beverages (aOR = 0.666; 95% CI: 0.535, 0.829) were less likely to be associated with sufficient dietary diversity. Higher BMI (aOR = 1.092; 95% CI: 1.061, 1.125) was associated with higher odds of sufficient dietary diversity. Additionally, participants who were 18–30 years old, with master or above degree and away from cigarette/alcohol were more likely to report better dietary diversity.

Conclusion

Our results painted a less than ideal nutritional condition affecting young adults. High-fat/sugar/salt dietary practices can lead to low dietary diversity, while high dietary diversity might have adverse BMI outcomes in youth. This study highlighted the importance of increasing the diversity of healthy and selective food items before wide recommendation for dietary diversity.