Family income and nutrition-related health: Evidence from food consumption in China

Dietary diversity moderates household economic inequalities in the double burden of malnutrition in Tanzania

OBJECTIVE

Improved food availability and a growing economy in Tanzania may insufficiently decrease pre-existing nutritional deficiencies and simultaneously increase overweight within the same individual, household or population, causing a double burden of malnutrition (DBM). We investigated economic inequalities in DBM at the household level, expressed as a stunted child with a mother with overweight/obesity, and the moderating role of dietary diversity in these inequalities.

DESIGN

We used cross-sectional data from the 2015-2016 Tanzania Demographic and Health Survey.

SETTING

A nationally representative survey.

PARTICIPANTS

Totally, 2867 children (aged 6-23 months) and their mothers (aged 15-49 years). The mother-child pairs were categorised into two groups based on dietary diversity score: achieving and not achieving minimum dietary diversity.

RESULTS

The prevalence of DBM was 5·6 % (sd = 0·6) and significantly varied by region (ranging from 0·6 % to 12·2 %). Significant interaction was observed between dietary diversity and household wealth index (Pfor interaction < 0·001). The prevalence of DBM monotonically increased with greater household wealth among mother-child pairs who did not achieve minimum dietary diversity (Pfor trend < 0·001; however, this association was attenuated in those who achieved minimum dietary diversity (Pfor trend = 0·16), particularly for the richest households (P = 0·44). Analysing household wealth index score as a continuous variable yielded similar results (OR (95 % CI): 2·10 (1·36, 3·25) for non-achievers of minimum dietary diversity, 1·38 (0·76, 2·54) for achievers).

CONCLUSIONS

Greater household wealth was associated with higher odds of DBM in Tanzania; however, the negative impact of household economic status on DBM was mitigated by minimum dietary diversity.

The effect of Internet use on nutritional intake and health outcomes: new evidence from rural China

Introduction

Internet use is changing nutritional intake and health outcomes, but the results are mixed, and less attention is given to the rural developing regions. Based on the China Health and Nutrition Survey (CHNS) data from 2004 to 2015, this study seeks to better understand the effect of Internet use on nutritional intake and health outcomes.

Methods

An instrumental variable estimation is used to address endogeneity problem.

Results

The results show that Internet use improves the dietary knowledge of rural residents, and thus has a positive impact on dietary quality, such as healthy eating index (HEI) and dietary diversity score (DDS). The higher the dietary quality, the better the nutritional health status. However, results also show that Internet use increases the risk of overweight, and obesity among rural Chinese residents. Because Internet use has significantly reduced the physical activity of rural residents in China. Interestingly, we also find that the Internet increases the risk of chronic diseases such as diabetes and high blood pressure, but there is a positive causal relationship between Internet use and the self-assessment score of health.

Discussion

Our findings suggest that there may be a serious lack of awareness of the health risks of chronic diseases among Chinese rural residents. Therefore, policymakers are suggested to consider the possible negative effects when promoting digital development.

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.

Spatiotemporal Pattern Evolution of Food and Nutrient Production in China

Ensuring food and nutrient supply is a crucial aspect of achieving food safety. With rapid population growth, urbanization, and social and economic development, the challenges related to China's food and nutrient production have become increasingly prominent. This paper analyzed the characteristics of the spatiotemporal pattern evolution of food and nutrient production in China from 1995 to 2020, utilizing the conversion of various food nutrients and the establishment of a gravity center model. The results showed that: (1) Food production exhibited increasing trends in China, six regions, and 90% of the provinces. Notably, the structure of food production underwent significant changes in China, East China, Central-South China, Southwest China, Northwest China, and 60% of the provinces. (2) The output of all categories of food nutrients demonstrated increasing trends in China, six regions, and most provinces. At three different geographical scales, the changes of six food nutrients production structure showed significant differences. (3) Natural, political, social, economic, and technological factors played pivotal roles in influencing the gravity centers of food and nutrient production in China. The gravity centers of cereal production shifted northeast, while those of root and tuber, oil crops, and stimulants production moved westward. Additionally, the gravity centers of sugar crop, pulse, vegetable, fruit, and aquatic product production moved southwest and those of livestock and poultry production shifted northward. (4) Affected by the food production, the gravity centers of food energy, food protein, and food carbohydrate production shifted northward, while those of food fat, food vitamins, and food minerals production shifted northwest, southwest, and westward, respectively. The results of this study are of great significance for policy adjustments pertaining to the distribution pattern of food production, food security stability, and sustainable development in China.

The relationship between dietary patterns and blood mineral concentration among children in Hunan Province of China

BACKGROUND

Minerals have crucial biological functions in metabolism and are primarily obtained through diet. As a result, various dietary patterns can impact blood mineral levels. The aim of this study was to investigate the correlation between dietary patterns and the concentration of calcium, magnesium, iron, zinc, and copper in the bloodstream.

METHODS

Three hundred eighty healthy children (53.7% male) were recruited in a region of Hunan Province in September 2019. We gathered basic information and measured physical proportions, along with completing a food frequency questionnaire (FFQ). Using principal component analysis (PCA), we determined dietary patterns. To analyze mineral levels in the blood, we used flame atomic absorption spectrometry (FAAS). We utilized linear regression models to investigate if certain dietary patterns are related to mineral concentration.

RESULTS

Three dietary patterns were identified: 'Vegetables/Nuts,' 'Snacks/Beverages,' and 'Cereal/Beans.' Children from high-income families (annual average income > 50,000 yuan) prefer the 'Vegetables/Nuts' dietary pattern (P = 0.004). In comparison, those from low-income families (annual average income < 20,000 yuan) prefer the 'Snacks/Beverages' dietary pattern (P = 0.03). Following adjustment for age, gender, guardian's identity, education level, and annual household income. We found that an increase in the 'Vegetables/Nuts' pattern score (β = 0.153, CI: 0.053 ~ 0.253; P = 0.003) and 'Snacks/Beverages' pattern score (β = 0.103, CI: 0.002 ~ 0.204; P = 0.033) were significantly associated blood copper concentration.

CONCLUSIONS

Household income was found to be associated with dietary behavior. Furthermore, higher blood copper concentration was significantly correlated with the 'Vegetables/Nuts' dietary pattern and 'Snacks/Beverages' dietary pattern, but the correlation is extremely low.

Dietary diversity indices v. dietary guideline-based indices and their associations with non-communicable diseases, overweight and energy intake: evidence from China

OBJECTIVES

To evaluate various diet quality indices and to estimate their associations with major non-communicable diseases (NCD) (i.e. diabetes mellitus (DM) and myocardial infarction (MI)) and risk for overweight (OW).

DESIGN

Four dietary diversity indices (namely, count index (Count), dietary diversity score index, berry index (BI) and entropy index (EI)) and three Chinese dietary guideline-based indices (namely, China healthy diet index, Chinese food pagoda score and diet quality divergence index) were employed to evaluate Chinese diet quality. DM, MI and OW were used as diet-related health indicators. Logit regressions were employed to unveil the associations between diet quality indices and NCD and risk for OW. The relationships between diet quality indices and daily energy intakes were checked with ordinary least squares linear regressions.

SETTING

Four recent waves (2004, 2006, 2009, 2011) of longitudinal individual data from China Health and Nutrition Survey.

PARTICIPANTS

Chinese adults (aged 18-64 years) from twelve provinces were included in the analysis (n 30 350).

RESULTS

Count, BI, and EI were positively associated with higher OW risk and daily energy intakes. As dietary guideline-based indices got better, people were exposed to lower DM and OW risks and got lower daily energy intakes. Finally, dietary guideline-based indices properly revealed the expected relationships that high-quality diets would reduce NCD and risk for OW, while high diversity indices were usually correlated with over-nutrition and high risks.

CONCLUSIONS

Increasing diversity of the diet does not necessarily improve the nutrition and health. Dietary guideline-based indices are more robust than dietary diversity indices; thus, they should be highly recommended when evaluating diet quality.

Do Peers Matter? Unhealthy Food and Beverages Preferences among Children in a Selected Rural Province in China

With the growing problem of childhood obesity, unhealthy dietary preferences among children have become an issue of worldwide concern. This article examines the class-peer effect of these preferences using random class assignment data from a field survey. The results show significant positive peer effects for both unhealthy food and beverages preference. These results remained robust after controlling for endogeneity issues using instrumental variables. Further analysis of the mechanism of peer effect shows that the better the relationship between classmates, the greater the influence peers have on unhealthy diet preferences among rural children. The same peer effect is found in situations where it is easy for children to obtain unhealthy food and beverages. The analysis of heterogeneity finds that the peer effects of unhealthy dietary preferences are stronger for girls, older students, and obese students. This paper also discusses the role of parents and schools in mitigating the peer effect. This paper proposes policy recommendations for rural areas in China to improve dietary preferences in children. These results may also provide useful guidelines for policy in other developing countries.

How did consumers’ self-protective behavior formed during the COVID-19 pandemic?

Introduction

This study explored the formation mechanism of consumers’ self-protective behavior during the COVID-19 pandemic, which is very important for policy settings to regulate consumer behavior. Based on the basic framework of the Protective Action Decision Model (PADM), this study analyzed the formation mechanism of consumers’ self-protective willingness from the perspective of risk information, and explained the deviation between consumers’ self-protective willingness and behavior from the perspective of protective behavior attributes.

Methods

Based on 1,265 consumer survey data during the COVID-19 pandemic, the empirical test was carried out.

Results and Discussion

The amount of risk information has a significant positive impact on the consumers’ self-protective willingness, where the credibility of risk information plays a positive moderating role between them. Risk perception plays a positive mediating role between the amount of risk information and the consumers’ self-protective willingness, and the positive mediating effect of risk perception is negatively moderated by the credibility of risk information. In the protective behavior attributes, hazard-related attributes play a positive moderating role between the consumers’ self-protective willingness and behavior, while resource-related attributes play the opposite role. Consumers pay more attention to hazard-related attributes than resource-related attributes, and they are willing to consume more resources to reduce risk.

Effects of Intergenerational Care Behavior on Residents' Nutrition Intake-Descriptive Statistical Analysis of Rural China Survey 2010-2014

Nutritional status plays an indispensable role in enhancing human capital and preventing the return to poverty. In the context of the three-child policy and the aging society in China, intergenerational care will inevitably become a core component of family support. Thus, this paper evaluates the impacts of intergenerational care behavior on nutritional intake in Chinese rural residents from the perspective of household consumption. The study's data is from the China Family Panel Studies (CFPS) (2010-2014), and, the fixed effect model and analyses are applied to achieve the study's objective. The results reveal that rural residents with intergenerational family care behavior have significantly higher food diversity. Thus, Chinese rural residents with intergenerational care consumed 22.4% more food. A possible mechanism is that intergenerational care improves young mothers' labor participation and income, thus optimizing their dietary structure. Moreover, there was heterogeneity concerning the nutrition intake among rural residents in different geographic and family net income groups. Finally, the robust check is consistent with the baseline regression results. In summary, governments should fully affirm the elderly contribution to families to give full play to the elderly family benefit maximization.

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.

Correlation between reduced telomere length and behavioural and emotional problems in left-behind children in a rural area in China

Evidence shows that being left behind experience (LBE) during childhood may increase the risks of poor psychopathological outcomes. However, it is unclear to what extent the mental health is affected by the LBE. Telomere length (TL), one of the most extensively studied biological markers of cellular ageing, provides a valuable tool for exploring the potential effects of parent-child separation on psychological problems by integrating genetic and environmental factors. In this study, a total of 613 children (mean age = 10.77, SD = 1.92) were recruited from the rural area of Deyang, Sichuan Province, China. We used a self-designed questionnaire to assess LBE, and collected psychopathological outcomes by using the Piers-Harris Children's Self-concept Scale, the Teacher's Report Form 6/18 and the Youth Self-Report 11/18. Terminal restriction fragment analysis was used to measure TL in peripheral blood leukocytes. Analyses revealed that 342 out of 613 participants (55.79%) were Left-behind children. LBE was observed to associated with shorter TL, lower self-esteem, and increased behavioural and emotional problems. The cumulative effects of LBE may be reflected by greater altered telomere homeostasis, decreased self-esteem, and worsened behavioural and emotional problems. The association of the total time of being left behind with self-esteem and behavioural and emotional problems was significantly mediated by altered telomere homeostasis, with estimated effects of 14.19%, 47.95% and 45.13%, respectively. The LBE in childhood, especially prolonged parent-child separation, increases the risk of mental health problems in childhood and adolescence.

The Effect of Household Dependency Ratio on the Mental Health of Workforce: Evidence From China

Based on the Chinese General Social Survey (CGSS) 2010, this article investigates the relationship between household dependency ratio and the mental health of household workforce. The empirical results verify the negative impacts of both household old-age dependency ratio and child dependency ratio on the mental health of the workforce and find that the negative effect of old-age dependency ratio is greater than that of child dependency ratio. Moreover, the depression source of the young workforce mainly comes from the child dependency ratio, while the depression source of the older workforce comes from the old-age dependency ratio. The mental health of the workforce in poor regions is impaired by the household dependency burden, but we found no same evidence in rich regions. The old-age dependency ratio negatively affects the mental health of the workforce due to the household healthcare burden, while the child dependency ratio negatively affects the mental health of the workforce due to the education expenditure pressure. Our findings provide evidence on how household structure affects the welfare of the family, and give implications to the improvement of residents' health.

Adherence to the Chinese Food Pagoda in the High-Risk Population of Non-communicable Diseases Aged 35–59 in Central China

Objectives

A healthy dietary habit is essential for preventing non-communicable diseases (NCDs). We aimed to assess the adherence to the Chinese Food Pagoda (CFP) proposed in the Chinese Dietary Guidelines 2016 in the high-risk population of NCDs in central China.

Methods

A cross-sectional study was conducted in two large enterprises (totally 3,016 employees) from October to December 2019 in Hubei Province (central China). The high-risk population of NCDs was identified by physical examination, laboratory test and face-to-face questionnaire survey according to the National Norms for Prevention and Control of Non-communicable Diseases issued by the Chinese government. We assessed the deviation of real diet from the CFP recommended diet in the high-risk population of NCDs.

Results

A total of 821 participants aged 35–59 years old with at least one high-risk factor of NCDs were enrolled in our study. Of them, 53.8% were daily smokers, 49.6% had elevated blood cholesterol, 31.4% were centrally obese, 23.3% had high normal blood pressure, and 3.5% had impaired fasting glucose. Significant disparity was detected in the high-risk population of NCDs between real food consumption and the CFP's recommendation (P < 0.05), such as the deficient intake of nuts and milk and dairy products, and the over-consumption of cereals, meat and poultry, oil, and salt. Participants with impaired fasting glucose had the highest intake of cereals and vegetables on average. Participants with central obesity were more likely to consume meat and poultry (P < 0.05). The lowest average intake of eggs and the highest average intake of milk and dairy products were found in participants with high blood cholesterol (P < 0.05). The daily smokers were more likely to consume beans and nuts (P < 0.05). The lowest average intake of fruits and the highest average intake of tubers were found in participants with high normal blood pressure (P < 0.05).

Conclusion

Adherence to CFP in the high-risk population of NCDs appeared to be challenging. It is necessary to adopt dietary education campaign focusing on the high-risk population of NCDs to prevent or delay the occurrence of NCDs.

Hypertriglyceridemic waist phenotype: Association with initial neurological severity and etiologic subtypes in patients with acute ischemic stroke

OBJECTIVE

To explore the relationship of hypertriglyceridemic waist phenotype (HTWP) with initial neurological severity and etiologic subtypes in patients with acute ischemic stroke.

METHODS

The data for this study were collected from hospitalized patients within 72 h of acute ischemic stroke onset at the Department of Neurology of the Affiliated Hospital of Beihua University from 1 July 2020 to 30 June 2022. The initial neurological severity was assessed by the National Institute of Health Stroke Scale (NIHSS) on the day of admission: NIHSS <6 was defined as mild stroke, and NIHSS ≥6 as moderate to severe stroke. HTWP was defined by fasting serum triglycerides ≥1.7 mmol/L and waist circumference ≥90 cm in men and ≥80 cm in women. Differentiation of etiologic subtypes was based on the method reported in the Trial of Org 10 172 in Acute Stroke Treatment. Multivariate logistic regression analysis was used to analyze the association of HTWP with initial neurological severity and etiologic subtypes.

RESULTS

The study included 431 patients. Compared with the normal waist-normal blood triglyceride group, patients with HTWP had reduced risks of moderate to severe stroke [odds ratio (OR): 0.384, 95% confidence interval (CI): 0.170-0.869; P = 0.022]. In addition, the risk of small-artery occlusion stroke was 2.318 times higher in the HTWP group than in the normal triglyceride-normal waist (NWNT) group (OR: 2.318, 95% CI: 1.244-4.319; P = 0.008).

CONCLUSION

Initial neurological severity was less severe in patients with HTWP, and HTWP was associated with an increased risk of small-artery occlusion stroke.

The Impact of Family Income on Body Mass Index and Self-Rated Health of Illiterate and Non-illiterate Rural Elderly in China: Evidence From a Fixed Effect Approach

Background: Rural communities worldwide are experiencing the most significant levels of aging. Most rural elderly have no stable pension, and leading family income plays an indispensable role in the life security of rural elderly. This study aims to investigate whether the association between annual family income per capita and body mass index (BMI) and self-rated health (SRH) in rural elderly is moderated by education during fast economic development.

Methods: We chose the fixed-effects model to analyze the impact of the annual family income per capita change on BMI and SRH based on a large, nationally representative longitudinal dataset of rural respondents aged above 60 of the China Family Panel Studies (CFPS) from 2010 to 2018.

Results: Six hundred and fifty-eight were eligible for inclusion in our analysis in CFPS. The median age of participants was 65 years in 2010, and 379 (57.60%) participants were male. Self-rated health increased with higher the logarithmized family income per capita among the rural illiterate elderly (β = 0.0770; 95% CI = 0.0065–0.1473). Body mass index increased with higher the logarithmized family income per capita among the rural elderly (β = 0.1614, 95% CI: 0.0325–0.2903), and it was more evident among the illiterate elderly (β = 0.2462, 95% CI: 0.05519–0.4372).

Conclusion: Family income has an impact on BMI and SRH moderated by education level among rural elderly in China. These results contribute to developing more targeted strategies in the context of a developing country. In addition, it also reminds us to consider the differences in the educational level of the elderly in rural areas when examining the relationship between family income and health.

The interactions between childhood adversities and recent stress were associated with early-adulthood depression among Chinese undergraduate students

BACKGROUND

It is widely acknowledged that childhood adversities (CAs) and recent stress are potential risk factors for adult depression. However, the mechanism(s) by which interactions of CAs with recent stress affect adult depression remain unclear.

AIMS

To investigate the predictive association of the interaction among CAs and recent stress with early-adult depression.

METHOD

We conducted an annual survey of all freshmen for the period of 2016-2018 in a Chinese comprehensive university, with a sample size of 23,206. An online questionnaire including standardized self-report instruments was used to assess sociodemographic factors, childhood experiences of left-behind (CELB), and maltreatments (CEMTs) including beating (CEB), neglect (CEN), sexual abuse (CESA), recent stress, and current depression (measured by the 9-item Patient Health Questionnaire).

RESULTS

The correlation of Individual CAs and recent stress was significant. In addition to their significant independent/direct incremental effects, all surveyed CAs were associated with increased severity of early-adult depression, and increased frequency of clinically significant depression (CSD), through significant associations with recent stress (mediation effect). History of CEMTs including CEB, CEN, and CESA significantly increased the effects of recent stress on depression (moderation effect).

CONCLUSIONS

Chinese undergraduate students reported frequent history of exposure to CAs, which increased the likelihood of depression in early adulthood, not only directly but also through the increasing the likelihood (mediation effect) and impact (moderation effect) of recent stress on depression. These novel findings may help to extend our understanding of environmental determinants of depression, and to guide further research, clinical practice, and policy in this context.

Food consumption changes among teachers during the COVID-19 pandemic

The present study aimed to analyze changes in food consumption among teachers of state schools in Minas Gerais in the context of the pandemic of coronavirus disease 2019 (COVID-19). This is a cross-sectional study of teachers at elementary, middle, and high schools in Minas Gerais. An online questionnaire was made available to all participants through the Google Forms platform. For the analysis, sociodemographic, economic, occupational profile, health conditions, and behavioral/habitual variables were used. Food consumption was assessed through the weekly frequency of eating foods considered healthy and unhealthy before and during the pandemic. The changes observed in the frequency were classified as: decreased intake, no change in intake, and increased intake during the pandemic. Statistical analysis was performed using bivariate and multiple analysis using the Multinomial Logistics Regression model. The data were tabulated with the aid of the Statistical Package for Social Sciences (SPSS), version 18.0. A total of 15,641 teachers participated in this study, with an average age of 42.96 (±9.27) years, and most of them were female (81.9%). During the pandemic, approximately 40% reported altered sleep quality and alcohol consumption, and lack of physical activity with 60.4% of the professionals categorized as overweight. During this period, there was an increase in the consumption of sweets (19.5%), soft drinks (13.3%), sausages (12.0%), frozen foods (8.9%), salty foods (6.3%), vegetables (13.1%), fruits (12.6%), and wholegrain products (8.3%). In the regression analysis, several factors were found to be associated with changes in teachers' food consumption in a bidirectional way when associated with variables related to sociodemographic characteristics, occupational profile, general health, and lifestyle.

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

OBJECTIVE

The aim of this study was to examine the association among family income, dietary knowledge, their interaction, and the multiple household dietary diversity indices (HDDIs), including dietary diversity score (DDS), entropy index (EI), Shannon equitability index (SEI), Herfindahl index (HI), and Simpson index (SI).

METHODS

Based on 24-h dietary recall data collected from 1076 rural households in three provinces of Central China, we calculated HDDIs and compared them according to different levels of income and dietary knowledge. A set of multivariate linear regression were further established and estimated to examine the association among family income, dietary knowledge, and household dietary diversity.

RESULTS

Although the calculation formulas are different, the distributions of the five diversity indices, namely, DDS, EI, SEI, HI, and SI are similar. Family income and dietary knowledge were significantly and positively correlated with various HDDIs (P < 0.01) in addition to HI. Specifically, with a 1-unit (10 000 yuan [US $1545]) income increase, the DDIs respectively changed by 1.70% (DDS), 1.23% (EI), 0.92% (SEI), -0.62% (HI, reverse), and 0.45% (SI). With a 1-point dietary knowledge score increase, the DDIs changed by 0.91% (DDS), 1.33% (EI), 1.29% (SEI), -1.19% (HI, reverse), and 0.81% (SI). The interaction effect of income and dietary knowledge on HDDIs were significantly and negatively correlated with various HDDIs (P < 0.05) in addition to HI.

CONCLUSIONS

The present findings indicated that with an increase in income and dietary knowledge, rural residents in China would consume more diversified foods. There was a substitution effect of family income and dietary knowledge on HDDIs; that is, with an increase in family income, the effect of dietary knowledge on HDDIs would decrease. The findings of this study contributed to a better understanding of issues related to the dietary diversity of rural residents in China in the context of rising income and residents' increasing dietary knowledge.

The Impacts of Urbanization and Dietary Knowledge on Seaweed Consumption in China

Edible seaweed, a nutrient-rich and sustainable food, has a long dietary history in China. To get a better understanding of the seaweed consumption of consumers in China, this study investigates the quantity and trend of seaweed consumption of Chinese residents and employs a Tobit model to examine the effects of urbanization and dietary knowledge on seaweed consumption among residents. The results show an increasing trend of household seaweed consumption in China, including both seaweeds consumed at home (SAH) and seaweeds consumed away from home (SAFH). Households in urban areas consumed more seaweeds on average than those in rural areas. Urbanization promotes total household seaweed consumption, including SAH and SAFH, whilst dietary knowledge has a significantly positive impact on total household seaweed consumption and SAH. The findings supplement empirical evidence on the seaweed consumption behavior of Chinese residents and have important policy implications for further promoting Chinese seaweeds consumption in the context of urbanization and increasing dietary knowledge.

Internet Access and Nutritional Intake: Evidence from Rural China

Over the past 4 decades, China has experienced a nutritional transition and has developed the largest population of internet users. In this study, we evaluated the impacts of internet access on the nutritional intake in Chinese rural residents. An IV-Probit-based propensity score matching method was used to determine the impact of internet access on nutritional intake. The data were collected from 10,042 rural households in six Chinese provinces. The results reveal that rural residents with internet access have significantly higher energy, protein, and fat intake than those without. Chinese rural residents with internet access consumed 1.35% (28.62 kcal), 5.02% (2.61 g), and 4.33% (3.30 g) more energy, protein, and fat, respectively. There was heterogeneity in regard to the intake of energy, protein, and fat among those in different income groups. Moreover, non-staple food consumption is the main channel through which internet access affects nutritional intake. The results demonstrate that the local population uses the internet to improve their nutritional status. Further studies are required to investigate the impact of internet use on food consumed away from home and micronutrient intake.

Growth and Weight Status in Chinese Children and Their Association with Family Environments

The growth status and weight status of Chinese children have experienced remarkable changes in the past decades. Using China Health and Nutrition Survey (CHNS) data, this paper examines the secular trends and disparity of the growth status and weight status in Chinese children and further investigates the impact of various family environments on children’s growth from 1991 to 2011. We found an increasing trend in standardized growth indicators (height, weight, and BMI), overweight, and obesity from 1991 to 2011. We also observed an increasing disparity in overweight and obesity over time. Family environments had a significant impact on children’s growth status and weight status. In particular, children that live in families with a small size, higher family income, better sanitary conditions, and with well-educated parents or overweight parents tended to be taller and heavier and have a higher BMI, lower risk of being underweight, and higher risk of exhibiting overweight and obesity. Further decomposition analysis showed that more than 70% of the disparity in standardized height, weight, and overweight and around 50% of the disparity in standardized BMI, underweight, and obesity could be attributed to heterogeneity in family environments. Moreover, the disparity associated with family environments tended to increase over time.

The Impact of Dietary Knowledge on Health: Evidence from the China Health and Nutrition Survey

Promoting a healthy diet through education is part of the Healthy China 2030 action plan. However, studies examining how dietary knowledge affects public health in China are sparse. This study employs multiple waves of the China Health and Nutrition Survey (CHNS) data to examine the impacts of dietary knowledge on Chinese adults' health, with a particular emphasis on how the impacts of dietary knowledge vary across different demographic groups. Moreover, we contribute to the literature by incorporating the spouse's dietary knowledge into the analysis framework to inspect the relationship between a spouse's dietary knowledge and an individual's health. Our results indicate that dietary knowledge significantly improves an individual's health status. However, there is no evidence that an individual's health is influenced by his/her spouse's dietary knowledge. Moreover, we find that individuals with a lower level of education and rural residents benefit more from increasing dietary knowledge. Policy implications of this study are also discussed.

Nutrition Transition with Accelerating Urbanization? Empirical Evidence from Rural China

Although rapid urbanization is often considered as one of the most important drivers for changing dietary patterns, little attention has been paid to rural areas despite the profound transformation they have undergone. Using longitudinal data from the China Health and Nutrition Survey (CHNS) for the period from 2004 to 2011, this study seeks to better understand the relationship between the urbanization of rural areas and dietary transition, with the focus on nutrition intake and dietary quality. Our results suggest that with increasing urbanization, rural residents tend to have on average lower calorie intakes but higher dietary quality. Specifically, increasing urbanization consistently reduces carbohydrate consumption and reduces fat consumption after a turning point; protein consumption first decreases and then increases after the turning point with increasing urbanization. Urbanization shows a significant and positive effect on the Healthy Eating Index (HEI). In addition to sociodemographic changes, we find that changing consumer preferences and knowledge serve as important determinants in explaining the dietary transition in rural China from 2004 to 2011. In our study, urbanization appears to positively affect rural residents’ healthy food preferences and dietary knowledge. This study is a first attempt for better understanding the nutrition transition resulting from accelerating urbanization in rural China; several limitations and areas for future research have been highlighted.

Impacts of the COVID-19 pandemic on consumers' food safety knowledge and behavior in China

This study assesses the impacts of the COVID-19 pandemic on Chinese residents' food safety knowledge and behavior, and explores the possible influence mechanism, namely, focus on media information. The study is based on internet survey data of 1 373 residents in China. A series of econometric models are developed to estimate food safety knowledge and behavior of residents. Both the descriptive and econometric results indicate that the existence of COVID-19 cases in a community has a significantly positive effect on residents' food safety knowledge and behavior. Residents focusing on food safety-related information tend to have higher food safety knowledge and practice food safety behavior. When controlling the variable focused on food safety-related information, the marginal effects of the existence of COVID-19 cases in a community on residents' food safety knowledge and behavior significantly decrease. However, the decrease in consumers' food safety knowledge is quite minor. Hence, the COVID-19 pandemic indeed improves Chinese residents' food safety knowledge and behavior, while focus on food safety-related information is an important mechanism for improving food safety behavior. Moreover, the estimation results of the simultaneous equations model reveal that consumers' food safety knowledge has a significant and positive effect on their food safety behavior. Heterogeneous impacts of the COVID-19 pandemic on residents' food safety knowledge and behavior among different regions and income groups are observed. The findings of this study provide evidence that public health events could enhance residents' safety awareness and behavior, while residents' focus on relevant information plays an important role in improving knowledge and impacting behavior.

Are the Chinese Moving toward a Healthy Diet? Evidence from Macro Data from 1961 to 2017

The change in diet structure is one of the critical features of social transformation, and diet structure is directly related to human health. In China, with rapid economic development, changes in the diet structure of the population have begun and are proceeding at a fairly rapid rate. In order to reveal how the Chinese diet is approaching or deviating from the nutritional goal, a novel index, NDBI (National Dietary Balance Index), is developed in this study to investigate the Chinese diet from 1961 to 2017 at a national level. The results show that the Chinese diet has transitioned from the under-intake stage to the over-intake stage. Before the 1980s, Chinese people ate all foods inadequately except staple foods; after the 1980s, the issue of under-intake began to fade, and the intake of meats even became excessive. The intake of staple foods is always excessive during this period. Currently, the Chinese diet is still unhealthy because of the inadequate intake of dairy products and the excessive intake of staple foods and meats. By evaluating diet structure on a national level, this study can help people to better understand how the Chinese diet deviated from the nutritional goal and provides information for policymakers intervening in China’s food consumption.

The association between iodine intake and semen quality among fertile men in China

BACKGROUND

Iodine intake is essential in the production of thyroid hormone but very few foods are rich in it. Iodine deficiency or excess iodine level may both lead to thyroid disorders, which further affects human fertility function. The objective of this study is to investigate the relationship between iodine intake and seminal parameters among fertile men in China.

METHODS

A total of 1098 couples were recruited by trained physicians at different family planning service stations in 2015. Semen and iodine samples were obtained from male respondents. A questionnaire survey inquired about demographic information from couples. The main outcome variables of semen quality were semen volume, semen concentration, semen motility, and sperm count, and time to pregnancy. Urinary iodine concentration (UIC) was used to measure iodine levels for male respondents. Ordinary least squared regressions and logistic regressions were performed to estimate the association between iodine intake level and semen quality parameters.

RESULTS

Male respondents with deficient or excess iodine levels had a 5% higher semen volume relative to those with optimal iodine intake (p < 0.1). Suboptimal iodine intake was negatively associated with semen concentration and semen counts (p < 0.01). Longer time of pregnancy was observed in iodine deficiency and excess group than those in the optimal group (p < 0.01).

CONCLUSION

In general, iodine deficiency and excess were both associated with decreasing semen quality parameters in male respondents.

Dynamics of Chinese Diet Divergence from Chinese Food Pagoda and Its Association with Adiposity and Influential Factors: 2004-2011

Nutrition transition in China has a strong impact on dietary quality and health of Chinese consumers. This study developed the diet quality divergence Index (DQD), the divergence between real food consumption and the Chinese food pagoda 2016 (CFP), to measure the quality of diet in China. Using four waves of data (2004, 2006, 2009, and 2011) from China Health and Nutrition Survey (CHNS), this study shed light on the transition of diet quality for Chinese residents. Results indicate that the DQD generally decreased and Chinese diet quality improved during 2004-2011. The divergence was mainly caused by over-consumption of legumes and nuts, and under-consumption of milk and milk products. Rising income and urbanization were positively correlated with diet quality for the people with low DQD. However, both of them had negative impacts on diet quality for those with high DQD. Females and rural residents held a lower DQD than their counterparts. The results also revealed that healthy food preference, education, dining at home, household size, proportions of teens (6-17) and elders (over 64) in the families are positively correlated with Chinese diet quality. However, labor intensity, frequency of drinking alcohol, and smoking have negative impacts on diet quality. Moreover, higher DQD was found to be associated with increasing risks of overweight/obesity. Therefore, we suggest national healthy policies should pay more attention to nutrition education. It is also necessary to focus on populations with poor diet quality and to adopt measures to control drinking alcohol and smoking.