The prevalence and influencing factors of metabolic syndrome (MetS) in Chinese residents aged 20 or older were investigated. The data were collected from China Nutrition and Health Surveillance (2015–2017), which used a stratified, multistage, random sampling method. A total of 130,018 residents aged 20 years or older from 31 provinces were included in this study. The National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria were used to define MetS. The standardised prevalence of high waist circumference, high blood pressure and low high-density lipoprotein cholesterol were 40.8%, 49.4% and 41.1%, respectively. The following factors were associated with a higher prevalence of MetS: female [odds ratio (OR) = 1.773, 95% CI = 1.709–1.840]; older age (OR = 1.037, 95% CI = 1.036–1.039); living in north China (OR = 1.087, 95% CI = 1.058–1.117); high body mass index (OR = 1.402, 95% CI = 1.395–1.408); higher income [OR (95% CI): 1.044 (1.007–1.083), 1.083 (1.044–1.124) and 1.123 (1.078–1.170) for moderate, high, and very high income, respectively]; family history of hypertension (OR = 1.237, 95% CI = 1.203–1.273); family history of diabetes (OR = 1.491, 95% CI = 1.426–1.558) and current smoking status (OR = 1.143, 95% CI = 1.098–1.191). Living in the countryside (OR = 0.960, 95% CI = 0.932–0.988), moderate alcohol consumption (OR = 0.917, 95% CI = 0.889–0.946) and being physically active (OR = 0.887, 95% CI = 0.862–0.913) were associated with a lower prevalence of MetS. The prevalence of MetS among residents aged 20 years or older in China is increasing, especially among women, people aged 45 years or older and urban residents. Preventive efforts, such as quitting smoking and engaging in physical activity, are recommended to reduce the risk of MetS.

This study aimed to investigate the prevalence of hyperuricemia (HUA) and associated risk factors in Chinese adults aged 18 to 59 years. All the data were collected from the China Nutrition and Health Surveillance during the period 2015–2017, which adopted a stratified, multistage, random sampling method on a national scale. A total of 52,627 participants aged 18 years or older were included in this study. The definition of hyperuricemia was 420 μmol/L for male and 360 μmol/L for female. The Rao–Scott chi-square test was used to compare the differences in prevalence between or among the subgroups. A weighted two-level multivariate survey-logistic regression was used to detect the correlations between HUA and demographic, physical, lifestyle and metabolic factors. The total prevalence of HUA was 15.1%, and that was higher in male, current smokers, higher BMI and less physical activities subgroups, and also in noninfectious chronic diseases (NCDs) subgroups. The subgroups of non-vegetarian diet, insufficient vegetable intakes and excessive red meat and alcohol intakes had significantly higher HUA prevalence. After introducing all the variables in the survey-logistic regression, gender, age, BMI, physically active, hypertension, diabetes mellitus, bean and nut intake, vegetable intake, red meat intake, alcohol consumption and vegetarian were associated with HUA. Among the significant variables, age and physical active served as a protective factor, and BMI showed to be a risk factor for HUA. Hypertension and dyslipidemia could increase the risk for HUA, while diabetes mellitus was shown a negative association with it. For dietary factors, vegetarian diet, sufficient beans and nuts and vegetables intake could lower the risk of HUA, but more alcohol could increase the risk of HUA. Dietary factor played a key role in HUA. It suggested that the intervention of dietary factor should receive more attention to ameliorate the high prevalence of HUA in China.

Childhood obesity is associated with both near- and longer-term health implications. Few studies have been conducted to explore the associations between dietary patterns and obesity among Chinese children and adolescents. The present study was designed to identify dietary patterns and their relationships with childhood obesity in medium and small cities. This is a cross-sectional study of children participants aged 6–17 years old in the 2010–2012 China Nutrition and Health Survey (CNHS). Socio-demographics, life-style, physical activity, anthropometric variables, and hundred-item food frequency questionnaires (FFQs) were collected. Household income was classified as low, middle, and high. Traffic tools, from non-advanced to advanced, included walking, biking, bus, and car. Dietary patterns were identified using factor analysis of data from FFQs. Two dietary patterns were identified: a Westernized pattern (i.e., high cakes, snacks, sugary beverages, aquatic products, red meat, fruits, and nuts) and a Traditional Chinese pattern (i.e., high cereals, tubers, legumes, fried cereal food, and vegetables). The Westernized pattern was positively correlated with energy intake, household income, traffic tools, and negative correlated with age and housework time. The Traditional Chinese pattern was positively correlated with age, energy intake, and housework time, and negatively correlated with household income and traffic tools. After adjusting for confounding factors, the Westernized pattern was found to be associated with BMI increment, yielding β coefficients (95% confidence interval, 95% CI) of 0.57 (0.40, 0.85) for the fourth quartile. In addition, the Westernized pattern was also found to be significantly associated with an increased risk of obesity, yielding an odds ratio (OR, 95% CI) of 1.49 (1.21, 1.84) from fully-adjusted confounders. Promoting healthier eating patterns could help to prevent obesity in Chinese children. The findings of this study could be used to guide the development of evidence-based preventive nutrition interventions to curb childhood obesity epidemic in small–medium cities in China.

Regional dietetic cultures were indicated in China, but how dietary patterns geographically varied across China is unknown. Few studies systematically investigated the association of dietary patterns with overweight/obesity and hypertension and the potential mechanism with a national sample. This study included 34,040 adults aged 45 years and older from China Nutrition and Health Surveillance (2015–2017), who had complete outcome data, reliable intakes of calorie and cooking oils, unchanged diet habits, and without diagnosed cancer or cardiovascular disease. Outcomes were overweight/obesity and hypertension. By using the Gaussian finite mixture models, four dietary patterns were identified—common rice-based dietary pattern (CRB), prudent diversified dietary pattern (PD), northern wheat-based dietary pattern (NWB), and southern rice-based dietary pattern (SRB). Geographic variations in dietary patterns were depicted by age–sex standardized proportions of each pattern across 31 provinces in China. We assessed the association of these dietary patterns with outcomes and calculated the proportion mediated (PM) by overweight/obesity in the association of the dietary patterns with hypertension. Evident geographic disparities in dietary patterns across 31 provinces were observed. With CRB as reference group and covariates adjusted, the NWB had higher odds of being overweight/obese (odds ratio (OR) = 1.44, 95% confidence interval (CI): 1.36–1.52, p < 0.001) and hypertension (OR = 1.07, 95%CI: 1.01–1.14, p < 0.001, PM = 43.2%), while the SRB and the PD had lower odds of being overweight/obese (ORs = 0.84 and 0.92, 95%CIs: 0.79–0.89 and 0.85–0.99, p < 0.001 for both) and hypertension (ORs = 0.93 and 0.87, 95%CIs: 0.87–0.98 and 0.80–0.94, p = 0.038 for SRB and p < 0.001 for PD, PMs = 27.8% and 9.9%). The highest risk of overweight/obesity in the NWB presented in relatively higher carbohydrate intake (about 60% of energy) and relatively low fat intake (about 20% of energy). The different trends in the association of protein intake with overweight/obesity among dietary patterns were related to differences in animal food sources. In conclusion, the geographic distribution disparities of dietary patterns illustrate the existence of external environment factors and underscore the need for geographic-targeted dietary actions. Optimization of the overall dietary pattern is the key to the management of overweight/obesity and hypertension in China, with the emphasis on reducing low-quality carbohydrate intake, particularly for people with the typical northern diet, and selection of animal foods, particularly for people with the typical southern diet.

The specific forms of 24 h dietary recall used by national nutrition surveys differ, such as two non-consecutive days and three consecutive days. However, it is unclear which form of 24 h dietary recall is more accurate in the Chinese population. The purpose of this study was to compare the performance of 24 h recalls on two consecutive days (C2), three consecutive days (C3), two non-consecutive days (NC2), and three non-consecutive days (NC3) in estimating Chinese adult dietary intake. A total of 595 participants completed more than twenty-three 24 h recalls. The average of all completed 24 h recalls of each subject was defined as the individual’s true dietary intake. The dietary intake in the four scenarios of 24 h recalls was calculated using the within-person mean (WPM) method and National Cancer Institute (NCI) method and compared with the true values. Equivalent testing was used to evaluate whether scenarios NC2 and C3 were equivalent. Bias and mean bias were used as a measure of precision and accuracy, respectively. For the WPM method, the precision between the four scenarios was similar. For mean, the accuracy between the four scenarios was similar, yielding estimates that were close to the true intakes. However, for percentiles, the accuracy in descending order was scenario NC3, C3, NC2, and C2. Furthermore, the difference between two and three days was greater than that between consecutive and non-consecutive days. In most case, the distribution of dietary intakes calculated from scenarios NC2 and C3 was equivalent with equivalence margins of 5% (p < 0.05). Usually, the NCI method was significantly more accurate than the WPM method. We concluded that three non-consecutive 24 h recalls relative to three consecutive days increases accuracy. Two non-consecutive days can be substituted to some extent for three consecutive days. The new form of 24 h recall needs to be used with caution when applied practically in the China nutrition surveys. Furthermore, using the NCI method to calculate dietary intake from 24 h recall may be a way to reduce costs and increase accuracy.

Our current study aimed to estimate the relationship between dietary patterns and hyperuricemia among the Chinese elderly over 60 years old. All the data were obtained from China Nutrition and Health Surveillance during 2015–2017. A total of 18,691 participants who completed the whole survey were included in our statistical analysis. The definition of hyperuricemia was 420 μmmol/L (7 mg/dL) for male and 360 μmmol/L (6 mg/dL) for female. Exploratory factor analysis was applied to explore posterior dietary patterns in our samples, and five dietary patterns were recognized, namely “Typical Chinese”, “Modern Chinese”, “Western”, “Animal products and alcohol”, and “Tuber and fermented vegetables”. After multiple adjusted logistic regression, participants in the highest quartile of “typical Chinese” (Q4 vs. Q1, OR = 0.32, 95% CI: 0.28–0.37, p-trend < 0.0001), “modern Chinese” (Q4 vs. Q1, OR = 0.81, 95% CI: 0.71–0.93, p-trend = 0.0021) and “tuber and fermented vegetables” (Q4 vs. Q1, OR = 0.78, 95% CI: 0.69–0.88, p-trend < 0.0001) showed a lower risk of hyperuricemia, while animal products and alcohol was positively associated with hyperuricemia (Q4 vs. Q1, OR = 1.49, 95% CI: 1.31–1.7, p-trend < 0.0001). We also found that participants who mainly ate a modern Chinese diet tended to meet the RNI/AI of nutrients we discuss in this paper, which may supply some information for hyperuricemia prevention and management by dietary methods.