Half of Chinese adults face the double burden of overweight/obesity and micronutrient deficiencies, and nearly 40% of them are severely overweight/obese or have micronutrient deficiencies. This study used the data from China Nutrition and Health Survey (CNHS) from 2015 to 2017 to estimate the prevalence of inadequate dietary micronutrient intake (including vitamin A, vitamin B₁, vitamin B₂, vitamin C, cCalcium, iron and sodium) in Chinese adults and further determine the differences in micronutrient intake by gender, age and BMI. A total of 61,768 subjects were included in this study, of which 33,262 (54%) were female. The intake of energy and all macronutrients decreased with age, and the intake was higher in men than in women. Inadequate energy intake occurs in adults of all ages. In terms of nutrient intake, women had a higher rate of insufficient carbohydrate intake than men in all age groups. Inadequate protein intake was more common in women aged 18–49 years (60.9%) than in men. Compared with women, men had a higher rate of vitamin B2 intake. Insufficient vitamin B3 intake was more common in women aged 18–49 years (35.6%), men aged 65–79 years (39.7%) and men aged 80 years and above (47.9%). In all age groups, insufficient vitamin C intake is higher in women than in men—up to 85.8 percent in women aged 80 years old and above. Compared with men in the same age group, insufficient intake of calcium and iron is more obvious in women. Women have significantly higher rates of inadequate intake of calcium, iron and sodium than men. In the analysis of correlations between BMI or demographic data and micronutrient intakes, the likelihood of micronutrient intakes being insufficient was higher in the central and western regions in all age groups compared to the eastern regions. The risk of insufficient micronutrient intake was higher in obese men and women aged 18–49 years and 50–64 years. Underweight and overweight women in the 65–79 age group were more likely to have inadequate micronutrient intake. Obese women over 80 years of age were less likely to have inadequate micronutrient intake. No significant difference was found between urban and rural areas for each age group.

Previous studies have used the traditional average-value method to calculate the usual dietary intake of a population, but the results may be biased due to the measurement errors. The aim of this study was to provide an assessment of the usual micronutrient intake and estimate the prevalence of inadequate intake among Chinese adults. Data from the Chinese Nutrition and Health Surveillance 2015–2017 as well as a total of 72,231 subjects aged 18 years and older were included in the analysis. The 24 h recall method combined with the condiment weighing method were used for three consecutive days to collect daily food and condiments intake. The daily intake of 16 micronutrients was calculated based on the Chinese Food Component Tables. The National Cancer Institute (NCI) method was used to estimate the usual intake of micronutrients, and the prevalence of inadequate intake was estimated using the estimated average requirement (EAR) cut-point method. The results showed that, except for sodium, copper, iron (only for males), vitamin E, and phosphorus, the usual intake of micronutrients in Chinese adults was low, and the prevalence of inadequate intake ranged from 38.67 to 97.63%. The prevalence of inadequate calcium and riboflavin intake was more than 90%, and the proportion of individuals with a usual intake of thiamine, vitamin A, potassium, and selenium below EAR also reached 80%. Manganese, magnesium, vitamin C, and zinc were potentially deficient micronutrients, with the prevalence of inadequate intake ranging from 38.67% to 77.09%. However, usual sodium intake was extremely high with an average of 5139.61 mg/day, and only a quarter of Chinese adults were below the World Health Organization (WHO) recommended value. For most micronutrients, the usual dietary intake declined with age and the prevalence of inadequate intake increased with age. Except for zinc, vitamin A, and B-vitamins, the prevalence of micronutrient deficiencies was higher in females than in males in the same age group (p < 0.05). Therefore, Chinese adults do not receive enough micronutrients. Effective nutrition supplementary strategies and measures are needed to address these problems.

Studies focused on the association between dietary patterns and elevated blood pressure (BP) and hypertension (HTN) among children and adolescents remain insufficient. This study aimed to explore a dietary pattern that could be helpful for the prevention of abnormal BP and to investigate the association between this dietary pattern and elevated BP and HTN among Chinese children and adolescents. A total of 52,080 Chinese children and adolescents aged 6~17 years old from the China Nutrition and Health Surveillance (CNHS) 2015–2017 were included in the current study. The reduced rank regression (RRR) method was applied to derive a dietary pattern that is associated with BP. Multivariable logistic regression was used to assess the association between dietary pattern (DP) and elevated BP and HTN. The Dietary Approach to Stop Hypertension (DASH) score was also calculated for each participant as a comparative method to validate the dietary pattern derived with the RRR method. A protective dietary pattern (PDP) for BP among Chinese children and adolescents was derived, which was characterized by high intakes of dairy products, mushrooms/edible fungi, fresh vegetables, fresh fruits, fresh eggs, aquatic products, mixed legumes, soybeans and related products, offal, dried fruits, and coarse cereals, with low intakes of refined grains. After multiple adjustments, there were significant inverse associations between PDP scores and the odds of elevated BP and HTN (elevated BP: Q5 vs. Q1, OR = 0.849, 95%CI = 0.755–0.931, P-trend < 0.05; HTN: Q5 vs. Q1, OR = 0.795, 95%CI = 0.694–0.911, P-trend < 0.05). The DASH diet was also observed to have protective effects on elevated BP in model I (Q5 vs. Q1, OR = 0.899, 95%CI = 0.828–0.975, P-trend < 0.05), but was not observed to have protective effects on HTN (HTN: Q5 vs. Q1, OR = 0.958, 95%CI = 0.876–1.048, P-trend > 0.05). The current study suggested that greater adherence to the PDP for BP among Chinese children and adolescents might be associated with lower odds of elevated BP and HTN.

Background/Objectives: The Lancet Diabetes & Endocrinology Commission recently proposed distinguishing preclinical obesity from clinical obesity, in which excess adiposity is accompanied by obesity-related disease. Using data from the China Nutrition and Health Surveillance 2015, we estimated the prevalence and comorbidity burden of clinical obesity among Chinese adults and further explored the association between physical activity and clinical obesity. Methods: This cross-sectional study included adults aged 18–79 years from the China Nutrition and Health Surveillance 2015 (N = 180,480). Excess adiposity was identified using body mass index, waist circumference, and waist-to-height ratio. Participants were classified as having no obesity, preclinical obesity, or clinical obesity, defined as excess adiposity plus at least one obesity-related comorbidity. We estimated the prevalence of clinical obesity overall and across sociodemographic subgroups. In secondary analyses, we examined the association of physical activity (MET-min/week) with clinical obesity prevalence and ordered obesity status using fully adjusted proportional-odds models. Results: Overall, 33.9% of adults had excess adiposity, and 26.9% met the criteria for clinical obesity. The prevalence of clinical obesity increased from 15.3% among adults aged 18–39 years to 33.3% among those aged ≥60 years and varied across sociodemographic subgroups. Among individuals with clinical obesity, dyslipidemia, hypertension, and diabetes were the most common comorbidities, indicating a substantial cardiometabolic burden. Higher physical activity was associated with a lower prevalence of clinical obesity and lower odds of more severe ordered obesity status. Conclusions: Clinical obesity affects more than one quarter of Chinese adults and is associated with a substantial cardiometabolic burden. Higher physical activity was associated with a lower prevalence of clinical obesity and less severe obesity status. These findings provide nationally relevant evidence to inform prevention and clinical management in China.

Background/Objectives: Alcohol consumption can increase the risk of dyslipidemia, thereby elevating the risk of cardiovascular diseases. However, the relationship between alcohol consumption patterns and dyslipidemia remains controversial. Based on large-scale cross-sectional data from the Chinese population, this study aims to investigate the correlations between various alcohol consumption behaviors and dyslipidemia among adult residents in China. Methods: Our analysis utilized data from the 2015–2017 China Nutrition and Health Surveillance project, which provides a large, nationally representative sample (N = 52,471). We employed a binary logistic regression model specifically designed for complex sampling frameworks. This model was utilized to assess the relationship between various alcohol consumption behaviors (including daily alcohol intake levels and drinking frequency) and the incidence of hypercholesterolemia, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol (low HDL-C), and elevated levels of low-density lipoprotein cholesterol (high LDL-C). Drinking behaviors were classified into three distinct categories for analysis: China classification (never, moderate, excessive), WHO classification (never, low-risk, medium-risk, high-risk), and drinking frequency (never, <1, 1–3, 4–6, ≥7 times/week). Results: Compared with never drinkers, the risk of hypercholesterolemia was significantly higher in men who were excessive drinkers (aOR = 1.39, 95%CI: 1.24–1.57), medium-risk drinkers (aOR = 1.24, 95%CI 1.01–1.53), high-risk drinkers (aOR = 1.67, 95%CI: 1.4–1.95), and those who drank more than once a week (aOR range: 1.27–1.65), and there was no such association in women (p > 0.05). Compared with never drinkers, the risk of hypertriglyceridemia was higher in male drinkers with excessive drinking (aOR = 1.35, 95%CI: 1.24–1.47), medium-risk drinking (aOR = 1.29, 95%: 1.11–1.50), high-risk drinking (aOR = 1.52, 95%CI: 1.3–1.71), and a drinking frequency more than 1 time/week (aOR range: 1.22–1.38), while in women, it was moderate drinking (aOR = 0.85, 95%CI 0.77–0.94), low-risk drinking (aOR = 0.86, 95%CI 0.78–0.94), and a drinking frequency of more than once a week (aOR = 0.74, 95%CI 0.63–0.87) that reduced the occurrence of hypertriglyceridemia. Compared with non-drinkers, men with any drinking status had a lower risk of low HDL-C (aOR range: 0.38–0.90) and a similar association was also observed in women (aOR range: 0.26–0.84). Compared with never drinkers, male excessive drinkers (aOR = 0.86, 95%CI: 0.77–0.97), medium-risk drinkers (aOR = 0.80, 95%CI:0.65–0.99), high-risk drinkers (aOR = 0.83, 95%CI: 0.70–0.97), and those with a drinking frequency of 1–3 times/week (aOR = 0.89, 95%: 0.79–0.99) had a lower risk of high LDL-C, and there was no such association in women (p > 0.05). Conclusions: Significant gender differences were observed in the effects of alcohol consumption on lipid profiles. Men who were excessive drinkers, medium-risk drinkers, high-risk drinkers, and those who drank more than once a week had a higher risk of hypercholesterolemia and hypertriglyceridemia, but a lower risk of low HDL-C and high LDL-C. In women, moderate drinking was associated with a reduced risk of hypertriglyceridemia. Any alcohol consumption and drinking frequency more than 1 time/week were associated with a lower risk of low HDL-C in women. No significant association was found between alcohol consumption and hypercholesterolemia or high LDL-C in women.