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Chinese National Nutrition Survey 2012

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 July 2017) | Viewed by 62826

Special Issue Editor

Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
Interests: dietary pattern; micronutrients; epidemiology; anemia; obesity; diabetes; biostatistics and cardiovascular disease
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Special Issue Information

Dear Colleagues,

China is undergoing rapid nutrition transition and is facing an epidemic of diabetes and other chronic diseases. The Chinese government has put a great effort into the monitoring of change of food consumption and burden of non-communicable chronic diseases, which is shown by the implementation of the National Nutrition Survey in 1959, 1982, 1992, 2002, and 2012. This Special Issue will welcome original research using data from the 2012 Chinese National Nutrition Survey. Manuscripts can either describe the dietary intake (nutrients, foods, and overall dietary patterns), lifestyle and burden of chronic diseases or assess the association between dietary intake/lifestyle and chronic diseases.

Dr. Zumin Shi
Guest Editor

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Published Papers (8 papers)

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Research

225 KiB  
Article
Vitamin D Nutritional Status and its Related Factors for Chinese Children and Adolescents in 2010–2012
by Yichun Hu, Jing Chen, Rui Wang, Min Li, Chunfeng Yun, Weidong Li, Yanhua Yang, Jianhua Piao, Xiaoguang Yang and Lichen Yang
Nutrients 2017, 9(9), 1024; https://doi.org/10.3390/nu9091024 - 15 Sep 2017
Cited by 89 | Viewed by 7028
Abstract
Vitamin D plays a critical role in calcium and phosphate metabolism and helps maintain skeletal integrity in childhood, yet vitamin D status in Chinese children and adolescents is not well documented. The aim of this study was to assess the vitamin D status [...] Read more.
Vitamin D plays a critical role in calcium and phosphate metabolism and helps maintain skeletal integrity in childhood, yet vitamin D status in Chinese children and adolescents is not well documented. The aim of this study was to assess the vitamin D status and analyze the risk factors for vitamin D deficiency in Chinese children and adolescents aged 6–17 years. Serum 25 hydroxyvitamin D (25(OH)D) was measured with a radioimmunoassay kit in 15,000 children and adolescent participants in the Chinese national nutrition and health survey (CNNHS) 2010–2012. Age, gender, region type, ethnicity, outdoor time, and vitamin D supplementation were recorded in unified design questionnaires. The season was recorded by the date of blood taken; location was divided into north and south by China′s Qinling Mountains and Huaihe River; and ambient ultraviolet B (UVB) radiation level was classified according to the corresponding dose of each participant living area from National Aeronautics and Space Administration data. 14,473 participants from the cross-sectional study of CNNHS 2010–2012 were included in this study. The median serum 25(OH)D concentration was 48.2 (35.4–63.4) nmol/L, and the concentration for males was 50.0 (36.5–65.7) nmol/L, which was statistically higher than that of females (46.7 (34.4–60.9) nmol/L) (P < 0.001). The general prevalence of vitamin D deficiency was 53.2%; 50.0% for males and 56.5% for females at the cut-off 50 nmol/L. According to the results of the log-binomial regression analysis, vitamin D deficiency in Chinese children and adolescents was specifically related to female gender (P < 0.0001), to ages 12–14 years (P < 0.0001) and 15–17 years (P < 0.0001), living in large cities (P < 0.0001) or ordinary rural areas (P < 0.0001), low ambient UVB levels (P < 0.0001) and medium ambient UVB levels (P < 0.0001), spring (P < 0.0001), autumn (P < 0.0001) and winter seasons (P < 0.0001). The data showed that vitamin D deficiency was very common among children and adolescents aged 6–17 years in China. Effective sun exposure should be encouraged in both genders aged 6–17 years, dietary vitamin D and vitamin D supplements are also recommended, especially in the seasons of spring and winter. Full article
(This article belongs to the Special Issue Chinese National Nutrition Survey 2012)
239 KiB  
Article
Effect of Low-Dose Vitamin D Supplementation on Serum 25(OH)D in School Children and White-Collar Workers
by Ronghua Zhang, Xiamusiye Muyiduli, Danting Su, Biao Zhou, Yueqiang Fang, Shuying Jiang, Shuojia Wang, Lichun Huang, Minjia Mo, Minchao Li, Bule Shao and Yunxian Yu
Nutrients 2017, 9(5), 505; https://doi.org/10.3390/nu9050505 - 17 May 2017
Cited by 5 | Viewed by 7886
Abstract
Objective: Our study aimed to investigate the nutritional vitamin D status of school children aged 9–15 years and white-collar workers in Zhejiang province, and evaluate the efficacy of low-dose-oral vitamin D supplementation in both populations. Methods: We conducted a prospective controlled trial during [...] Read more.
Objective: Our study aimed to investigate the nutritional vitamin D status of school children aged 9–15 years and white-collar workers in Zhejiang province, and evaluate the efficacy of low-dose-oral vitamin D supplementation in both populations. Methods: We conducted a prospective controlled trial during March 2014 to November 2015, comparing the efficacy of vitamin D supplements (400 IU/day) with non-intervention for 18 months in school children aged 9–15 years. Meanwhile, a before-after study was conducted among white-collar workers for 1 year. Serum 25(OH)D concentration was measured at baseline and after vitamin D supplementation, respectively. Results: At the baseline, 95% of school children and 84% of adult participants had vitamin D deficiency (<20 ng/mL). In school children, no difference was observed between the intervention and control groups with regard to anthropometric data. Serum 25(OH)D concentrations of the school children intervention group, school children control group and white-collar workers were 12.77 ± 3.01 ng/mL, 14.17 ± 3.59 ng/mL and 16.58 ± 3.66 ng/mL at baseline and increased to 17.34 ± 3.78 ng/mL, 18.04 ± 4.01 ng/mL and 17.75 ± 5.36 ng/mL after vitamin D supplementation, respectively. Although, after adjusting for potential confounders, the 400 IU oral vitamin D supplementation increased serum 25(OH)D concentration in school children (β = 0.81, p = 0.0426) as well as in white-collar workers (p = 0.0839), the prevalence of vitamin D deficiency was still very high among school children (79.23% in intervention group and 72.38% in control group) and white-collar workers (76.00%). Conclusions: High prevalence of vitamin D deficiency was common in these two study populations. Daily doses of 400 IU oral vitamin D supplementation was not able to adequately increase serum 25(OH)D concentrations. A suitable recommendation regarding the level of vitamin D supplementation is required for this Chinese population. Full article
(This article belongs to the Special Issue Chinese National Nutrition Survey 2012)
235 KiB  
Article
Do Chinese Children Get Enough Micronutrients?
by Huijun Wang, Dantong Wang, Yifei Ouyang, Feifei Huang, Gangqiang Ding and Bing Zhang
Nutrients 2017, 9(4), 397; https://doi.org/10.3390/nu9040397 - 18 Apr 2017
Cited by 50 | Viewed by 8796
Abstract
The aim of this study was to examine usual daily micronutrient intake of Chinese children based on data from the 2011 China Health and Nutrition Survey. We analyzed data from 4 to 17-year-old participants, who provided dietary data on three consecutive days combined [...] Read more.
The aim of this study was to examine usual daily micronutrient intake of Chinese children based on data from the 2011 China Health and Nutrition Survey. We analyzed data from 4 to 17-year-old participants, who provided dietary data on three consecutive days combined with the household weighing method in 2011. Usual daily intake of each nutrient was estimated using a mixed effects model based on the China Food Composition published in 2009. The means, medians and percentages below Estimated Average Requirements (EAR) were reported for selected micronutrients, including calcium, sodium, potassium, iron, zinc, selenium, vitamin A, thiamine, riboflavin and vitamin C. For sodium and potassium, the means and the distribution of intakes were compared to the Adequate Intake (AI) level. The average usual daily intakes of all micronutrients increase with age, and the intakes of boys were found to be higher than girls in the same age group. The average calcium intake increased from 272 mg/day in 4–6 years to 391 mg/day in 14–17 years, but the percentage of inadequate calcium intake remained very high (>96%). The prevalence of inadequacy of calcium was the highest among the mineral nutrients reported in this study. As the requirements of micronutrients increased with age, the percentage of subjects with inadequate intake increased in the 11–17 years age groups. Among 14–17 years group, the percentages of study participants with dietary intakes of calcium, iron, zinc, selenium, vitamin A, thiamine, riboflavin and vitamin C below the EAR were 96.8%, 18.8%, 37.6%, 72.8%, 36.8%, 91.8%. 85.9% and 75.5%, respectively. Among 11–13 years group, the percentages of study participants with dietary intakes of iron, zinc and vitamin A below the EAR were 23.5%, 41.5%, and 41.6%, respectively. Thus, micronutrient deficiency is a problem in Chinese children. Nutrition education and intervention programs are needed to address these nutritional gaps. Full article
(This article belongs to the Special Issue Chinese National Nutrition Survey 2012)
237 KiB  
Article
Reference Values of 14 Serum Trace Elements for Pregnant Chinese Women: A Cross-Sectional Study in the China Nutrition and Health Survey 2010–2012
by Xiaobing Liu, Yu Zhang, Jianhua Piao, Deqian Mao, Yajie Li, Weidong Li, Lichen Yang and Xiaoguang Yang
Nutrients 2017, 9(3), 309; https://doi.org/10.3390/nu9030309 - 21 Mar 2017
Cited by 63 | Viewed by 7700
Abstract
The development of reference values of trace elements is recognized as a fundamental prerequisite for the assessment of trace element nutritional status and health risks. In this study, a total of 1400 pregnant women aged 27.0 ± 4.5 years were randomly selected from [...] Read more.
The development of reference values of trace elements is recognized as a fundamental prerequisite for the assessment of trace element nutritional status and health risks. In this study, a total of 1400 pregnant women aged 27.0 ± 4.5 years were randomly selected from the China Nutrition and Health Survey 2010–2012 (CNHS 2010–2012). The concentrations of 14 serum trace elements were determined by high-resolution inductively coupled plasma mass spectrometry. Reference values were calculated covering the central 95% reference intervals (P2.5–P97.5) after excluding outliers by Dixon’s test. The overall reference values of serum trace elements were 131.5 (55.8-265.0 μg/dL for iron (Fe), 195.5 (107.0–362.4) μg/dL for copper (Cu), 74.0 (51.8–111.3) μg/dL for zinc (Zn), 22.3 (14.0–62.0) μg/dL for rubidium (Rb), 72.2 (39.9–111.6) μg/L for selenium (Se), 45.9 (23.8-104.3) μg/L for strontium (Sr), 1.8 (1.2–3.6) μg/L for molybdenum (Mo), 2.4 (1.2–8.4) μg/L for manganese (Mn), 1.9 (0.6–9.0) ng/L for lead (Pb), 1.1 (0.3-5.6) ng/L for arsenic (As), 835.6 (219.8–4287.7) ng/L for chromium (Cr), 337.9 (57.0–1130.0) ng/L for cobalt (Co), 193.2 (23.6–2323.1) ng/L for vanadium (V), and 133.7 (72.1–595.1) ng/L for cadmium (Cd). Furthermore, some significant differences in serum trace element reference values were observed between different groupings of age intervals, residences, anthropometric status, and duration of pregnancy. We found that serum Fe, Zn, and Se concentrations significantly decreased, whereas serum Cu, Sr, and Co concentrations elevated progressively compared with reference values of 14 serum trace elements in pregnant Chinese women. The reference values of serum trace elements established could play a key role in the following nutritional status and health risk assessment. Full article
(This article belongs to the Special Issue Chinese National Nutrition Survey 2012)
408 KiB  
Article
Trends in Determinants of Hypercholesterolemia among Chinese Adults between 2002 and 2012: Results from the National Nutrition Survey
by Peng-kun Song, Hong Li, Qing-qing Man, Shan-shan Jia, Li-xiang Li and Jian Zhang
Nutrients 2017, 9(3), 279; https://doi.org/10.3390/nu9030279 - 15 Mar 2017
Cited by 29 | Viewed by 7589
Abstract
Hypercholesterolemia is a known risk factor for cardiovascular diseases and affects a high proportion of the population. This study aimed to assess and compare the determinants of hypercholesterolemia among Chinese adults aged 18 years and above, from 2002 to 2012. The study used [...] Read more.
Hypercholesterolemia is a known risk factor for cardiovascular diseases and affects a high proportion of the population. This study aimed to assess and compare the determinants of hypercholesterolemia among Chinese adults aged 18 years and above, from 2002 to 2012. The study used a stratified multistage cluster sampling method to select participants. Sociodemographic and lifestyle information was collected during face-to-face interviews. Dietary intake was calculated by 3-day, 24-h dietary records in combination with weighted edible oil and condiments. Hypercholesterolemia was defined as total cholesterol above 6.22 mmol/L (240 mg/dL) from fasting blood samples. The study included 47,701 (mean age 43.0 years) and 39,870 (mean age 51.0 years) participants in 2002 and 2010–2012 surveys respectively. The weighted prevalence of hypercholesterolemia increased from 1.6% (2.1% urban, 1.0% rural) in 2002 to 6.0% (6.4% urban, 5.1% rural) in 2012. The intake of plant-based food decreased but the intake of pork increased over the 10 years. A high intake of protein and pork, alcohol drinking and overweight/obesity were positively associated with hypercholesterolemia. Neither education nor fruit and vegetable intake were associated with hypercholesterolemia. In conclusion, the burden of hypercholesterolemia increased substantially between 2002 and 2012 in China. Unhealthy lifestyle factors and change in traditional dietary pattern were positively associated with hypercholesterolemia. Further research on the role of diet in the development and prevention of hypercholesterolemia is needed. Full article
(This article belongs to the Special Issue Chinese National Nutrition Survey 2012)
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2231 KiB  
Article
Does the Dietary Pattern of Shanghai Residents  Change across Seasons and Area of Residence:  Assessing Dietary Quality Using the Chinese Diet  Balance Index (DBI)
by Jiajie Zang, Huiting Yu, Zhenni Zhu, Ye Lu, Changhe Liu, Chunxia Yao, Pinqing Bai, Changyi Guo, Xiaodong Jia, Shurong Zou and Fan Wu
Nutrients 2017, 9(3), 251; https://doi.org/10.3390/nu9030251 - 8 Mar 2017
Cited by 32 | Viewed by 6803
Abstract
Background: Few studies have applied the Chinese Diet Balance Index (DBI) in evaluating dietary quality across seasons. Method: The Shanghai Diet and Health Survey (SDHS) included 1680 participants from all districts of Shanghai from 2012 to 2013. Dietary data were obtained using three‐day [...] Read more.
Background: Few studies have applied the Chinese Diet Balance Index (DBI) in evaluating dietary quality across seasons. Method: The Shanghai Diet and Health Survey (SDHS) included 1680 participants from all districts of Shanghai from 2012 to 2013. Dietary data were obtained using three‐day 24‐h recall in spring, summer, fall, and winter. Higher bound score (HBS), lower bound score (LBS) and diet quality distance (DQD) were calculated according to compliance with the dietary guidelines and based on the recommendations for consumption within the main food groups. HBS, LBS, and DQD represent over‐intake, under‐intake, and overall imbalance of the diet, respectively. Results: 836 males and 844 females were included. The HBS indicated that 10.08%, 11.84%, 10.31%, and 12.73% people have moderate or high levels of over‐intake of food in spring, summer, fall, and winter, respectively; and 74.04%, 37.61%, 53.09%, and 42.72% people have moderate or high levels of deficit food intake for each of the four seasons. The mean HBS and LBS among the four seasons were statistically significant difference (p < 0.001). The mean (SD) DQD was 43.27 (10.21), 35.67 (9.71), 39.19 (9.36), and 36.84 (9.45) in each season. A multivariable model showed statistically significant differences in DQD according to age, gender, occupational status, education, smoking, drinking status, season, and residency (p < 0.001). Conclusion: An unbalanced diet is common among people living in Shanghai. Seasonality and area of residence were found to be two significant predictors. Strengthening the accessibility and the supply of food across seasons and regions should be considered. Full article
(This article belongs to the Special Issue Chinese National Nutrition Survey 2012)
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533 KiB  
Article
Dietary Patterns and Insomnia Symptoms in Chinese Adults: The China Kadoorie Biobank
by Canqing Yu, Zumin Shi, Jun Lv, Yu Guo, Zheng Bian, Huaidong Du, Yiping Chen, Ran Tao, Ying Huang, Junshi Chen, Zhengming Chen and Liming Li
Nutrients 2017, 9(3), 232; https://doi.org/10.3390/nu9030232 - 4 Mar 2017
Cited by 45 | Viewed by 8854
Abstract
Limited attention has been paid to the effect of dietary patterns on sleep problems. In the present study, we analyzed the cross-sectional data of 481,242 adults aged 30–79 years from the China Kadoorie Biobank. A laptop-based questionnaire was administered to collect information on [...] Read more.
Limited attention has been paid to the effect of dietary patterns on sleep problems. In the present study, we analyzed the cross-sectional data of 481,242 adults aged 30–79 years from the China Kadoorie Biobank. A laptop-based questionnaire was administered to collect information on food intakes and insomnia symptoms. Logistic regression was used to estimate the odds ratios of each insomnia symptom according to quartiles of each dietary pattern, with adjustment for potential confounders. Two major dietary patterns were derived by factor analysis. The traditional northern dietary pattern was characterized by high intakes of wheat and other staple food, whereas the modern dietary pattern was characterized by high intakes of meat, poultry, fish, eggs, fresh fruit, and dairy products. Both dietary patterns were associated with a decreased prevalence of insomnia symptoms (p for trend < 0.001); after adjustment for potential confounders, individuals who had the highest quartile score of traditional northern dietary pattern were 12%–19% less likely to have insomnia symptoms compared to those in the lowest quartile (odds ratio: 0.81–0.88), and the corresponding values for the modern dietary pattern were 0.89–1.01. Furthermore, interactions of these two dietary patterns on insomnia symptoms were observed. Further prospective studies are needed to elucidate the relationship between diet and insomnia. Full article
(This article belongs to the Special Issue Chinese National Nutrition Survey 2012)
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379 KiB  
Article
Prevalence of Anemia among Chinese Rural Residents
by Min Li, Yichun Hu, Deqian Mao, Rui Wang, Jing Chen, Weidong Li, Xiaoguang Yang, Jianhua Piao and Lichen Yang
Nutrients 2017, 9(3), 192; https://doi.org/10.3390/nu9030192 - 24 Feb 2017
Cited by 36 | Viewed by 6954
Abstract
This paper presents an analysis of the level of blood hemoglobin and the rates of anemia in Chinese rural residents in the 2010–2012 National Nutrition and Health Survey, and the change in its prevalence in rural residents during the last ten years. Our [...] Read more.
This paper presents an analysis of the level of blood hemoglobin and the rates of anemia in Chinese rural residents in the 2010–2012 National Nutrition and Health Survey, and the change in its prevalence in rural residents during the last ten years. Our methodology included data from the Chinese Nutrition and Health Surveillance in 2010–2012, where samples were selected through the method of probability proportion to size. The study objects were from 150 sites in provinces, autonomous regions, or municipalities in China. The concentration of blood hemoglobin was determined using the cyanmethemoglobin method. Anemia was judged by the anemia standard recommended by the World Health Organization (WHO), combined with elevation correction standard. The level of blood hemoglobin, the prevalence of anemia, and the 95% CI (Confidence interval) value were analyzed using complex sampling weighted processing, combined with the population figures released by the National Bureau of Statistics in 2009. Our results indicate that the level of blood hemoglobin of the Chinese rural area population was 145.92 ± 0.83 g/L, with the prevalence of anemia in the Chinese rural population at 9.7% (95% CI: 9.4%-10.0%). The prevalence of anemia in children 6-11 years old was 5.5% (95% CI: 5.0%-6.0%), 8.1% (95% CI: 7.5%–8.7%) for 12–17‐year‐old teenagers, 10.0% (95% CI: 9.4%-10.6%) for 18-44‐year‐old adults, 9.6% (95% CI: 9.0%–10.1%) for 45–59‐year‐old adults, and 12.6% (95% CI: 11.9%-13.3%) for the elderly above 60 years old. Our conclusion shows that the prevalence of anemia in the Chinese rural population in 2010–2012 had obviously decreased compared to the last decade; however, women of reproductive age and the elderly still had a high prevalence of anemia. Full article
(This article belongs to the Special Issue Chinese National Nutrition Survey 2012)
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