Overweight and obesity have increased rapidly in the past few decades in China, and less research has focused on the association between the consumption of ultra-processed foods (UPFs) and overweight or obesity in Chinese adults. The objective of this study was to determine the relationship of UPF consumption with the risk of overweight or obesity in Chinese adults. Residents aged 18 years and above who participated in the nationally representative survey Chinese Food Consumption Survey in 2017–2020 were included in this study. Dietary intake data were collected via non-consecutive three-day 24 h dietary recalls and weighing household foods and condiments. According to the NOVA food classification system, UPFs were classified depending on the purpose and extent of food processing. Multiple logistic regression and multivariate-adjusted restricted cubic spline (RCS) regressions were performed to estimate the association between UPF consumption (categorized into quartiles: quartile 1 (Q1), quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4)) and risk of overweight or obesity. A total of 38,658 adults aged 18 years and above participated in the present study. The prevalence of overweight and obesity in adults was 33.0% (95% CI: 32.91–33.10) and 9.6% (95% CI 9.55–9.67), respectively. After a multivariable adjustment, the risk of overweight or obesity was increased by 10% in Q3 (OR: 1.10, 95% CI: 1.04–1.17) compared to Q1 as a reference. Women (OR: 1.10, 95% CI: 1.01–1.20) and adults living in small and medium-sized cities (OR: 1.13, 95% CI: 1.01–1.26) with higher UPF consumption had higher odds of overweight or obesity. Nevertheless, the effect of higher UPF consumption on the risk of overweight or obesity was relatively weak for overall adults in China. The top three categories of subgroups consumption of UPFs were 1: sugar-sweetened beverages; 2: sauces, cheeses, spreads, and gravies; and 3: ultra-processed breads and breakfast cereals. These findings provide evidence that higher UPF consumption was positively associated with overweight or obesity, which was defined based on Chinese criteria among women and adults living in small and medium-sized cities in China. Further studies, such as intervention trials, are needed to identify the mechanism of correlation between the consumption of UPFs and health-related outcomes in Chinese adults. From a public health perspective, with the prevalence of overweight and obesity growing and the increase in UPF consumption in Chinese adults, it is necessary to promote healthy food intake and a balanced diet through active nutritional education actions for overweight and obesity prevention and control.

The Yellow-Bohai Sea is an important semi-enclosed continental shelf marginal seas with an intensive aquaculture industry in China. The current study analyzed the contamination status and the time variations of paralytic shellfish toxins (PSTs) in shellfish between 2019 and 2020 from the Yellow-Bohai Sea in the Dalian area and estimated the acute health risks to consumers in China. A total of 199 shellfish samples (including 34 Pacific oysters, 25 Mediterranean blue mussels, 34 Manila clams, 36 bay scallops, 34 veined rapa whelks and 36 bloody clams) were analyzed from four representative aquaculture zones around the Yellow-Bohai Sea in Dalian. Among the samples, scallops and blood clams were the shellfish species with the highest detection rate of PSTs (94.4%), and the highest level of PSTs was detected in scallops with 3953.5 μg STX.2HCl eq./kg (μg STX.2HCL equivalents per kg shellfish tissue), followed by blood clams with 993.4 μg STX.2HCl eq./kg. The contents of PSTs in shellfish showed a time variation trend, and autumn was the season of concern for PST contamination in Dalian. For general Chinese consumers, the probability of acute health risks to shellfish consumers from dietary exposure to PSTs was around 13%. For typical consumers in coastal areas of China, especially those with higher shellfish intake, there was an acute health risk associated with exposure to PSTs through shellfish consumption during the occurrence of harmful algal blooms. It is suggested that the government continue to strengthen the monitoring of the source of PSTs and the monitoring of harmful algal blooms and give reasonable advice on shellfish consumption for consumers in coastal areas, such as not eating scallop viscera.

Biogenic amines (BAs) are frequently detected in seafood products, wines, and fermented foods, and they pose potential risks to human health. The current study analyzed the concentrations of five common BAs in seafood, fermented food, and complementary food for infants and children (fish sausage, canned complementary food for infants containing fish and shrimp ingredients, and fish floss) in China and estimated the acute health risks of histamine (HIS) from fermented foods in Chinese consumers. Among all the samples analyzed, HIS exhibited the highest detection rate (51.9%), followed by PUT (50.1%), and the detection rate of TRY (12.5%) was the lowest. The total average concentration of the five BAs across major food categories revealed that fermented bean curd had the highest total concentration of BAs (816.8 mg/kg), followed by shrimp (383.2 mg/kg) and cheese (328.0 mg/kg). In contrast, samples of complementary food for infants and children contained the lowest concentrations of BAs; the total average concentration of the five BAs was 12.0 mg/kg. The point assessment results showed that acute dietary exposure to HIS was highest from cheese (76.2 mg/d), followed by fermented bean products (74.5 mg/d). Furthermore, the probability assessment indicated that the probability of acute health risks from exposure to HIS was 0.44% for fermented bean product consumers and 0.014% for cheese consumers, respectively. Thus, for the general consumer, the probability of acute health risks caused by HIS in seafood and fermented foods is low. However, individuals with high consumption of cheese and fermented bean products may need to be concerned.

Objective: To identify major sugar-sweetened beverage (SSB) consumption patterns among Chinese children and adolescents and examine their associations with childhood overweight/obesity. Methods: Data were drawn from the Chinese Food Consumption Survey (2017–2020), including 7979 children and adolescents. SSB intake was assessed using a non-consecutive 3-day 24 h dietary recall and classified into nine types. Principal component analysis identified SSB consumption patterns. Nutritional status was defined using BMI Z-scores, following the World Health Organization growth standards. Multivariable logistic regression was used to assess the associations between SSB patterns and overweight/obesity, with subgroup analyses by sex, age, and residence area. Results: Three major SSB patterns were identified: (1) Carbonated Beverage and Milk Tea Pattern (dominated by carbonated beverages and milk tea); (2) Functional Beverages Pattern (dominated by coffee beverages and sports beverages); and (3) Plant Hybrid Pattern (dominated by plant protein beverages and plant-based beverages). Preschool-aged children exhibited lower scores across all three patterns. Higher pattern scores were observed among school-aged children and adolescents and those with lower parental education levels, parents working as unskilled labor or homemakers, lower family annual income per capita, and residence in rural areas. All three identified SSB consumption patterns demonstrated significant positive associations with overweight/obesity in children, where higher consumption levels corresponded to greater odds of overweight/obesity. Children exhibiting higher scores in two or more patterns had higher odds of being overweight/obese (Medium-high: OR = 1.249, 95% CI = 1.053, 1.482; High: OR = 1.256, 95% CI = 1.081, 1.459). Subgroup analysis further indicated that the association between the Plant Hybrid Pattern score and overweight/obesity varied significantly by sex. Conclusions: Three SSB consumption patterns were associated with a higher likelihood of overweight/obesity among Chinese children, particularly among those with preferences for multiple SSB types. Interventions should be tailored to SSB consumption habits and socioeconomic contexts, with special attention to rural populations.

The overall prevalence of dyslipidemia among adults continues to rise. However, limited attention has been devoted to the association between free sugar intake and dyslipidemia. This study aimed to explore the association between free sugar intake and dyslipidemia, as well as its subtypes, in Chinese adults. A total of 38,656 adults from the Chinese Food Consumption Survey (CFCS) and 3974 from the China Health and Nutrition Survey (CHNS) were included in the final analysis. Dietary intake data were collected by 24 h dietary recalls and the weighing of household foods and condiments. For the CHNS, multivariable Cox proportional hazards regression models were used to examine the association between free sugar intake and the risk of dyslipidemia and its subtypes. Restricted cubic spline (RCS) regression was used to evaluate the nonlinear relationship between free sugar intake and dyslipidemia. Stratified analyses and interaction tests were performed across key covariates to explore potential effect modifiers of the association between free sugar intake and dyslipidemia risk. For the CFCS, the mean free sugar intake among Chinese adults was 6.4 g/d. For the CHNS, a total of 1052 individuals were diagnosed with dyslipidemia, corresponding to an incidence rate of 26.5% during a total of 24,531 person-years of follow-up (median follow-up, 6.0 years) in the CHNS cohort. After multivariable adjustment, the risk of dyslipidemia was increased by 38% with >20 g/d free sugar intake (HR = 1.38, 95% CI: 1.04–1.84, p for trend = 0.006), with <5 g/d free sugar intake as a reference. For different subtypes of dyslipidemia, with <5 g/d free sugar intake as a reference, the risk of hypo-HDL-cholesterolemia and hyper-LDL-cholesterolemia was increased by 91% (HR = 1.91, 95% CI: 1.34–2.74, p for trend < 0.001) and 52% (HR = 1.52, 95% CI: 1.01–2.29, p for trend = 0.004) with > 20g/d free sugar intake, respectively. Stratified analyses demonstrated that the impact of high free sugar intake on the development of hypo-HDL-cholesterolemia and hyper-LDL-cholesterolemia was significantly amplified among urban residents and those with insufficient physical activity. While linear dose–response associations were observed between free sugar intake and the risk of dyslipidemia (p for nonlinearity > 0.05), a nonlinear, inverted U-shaped association emerged for hyper-LDL-cholesterolemia (p for nonlinearity = 0.007). Our study demonstrates that free sugar intake levels in Chinese adults were relatively low compared to the recommended intake level (<50 g/d) in the Chinese Dietary Guidelines 2022. Nevertheless, increased free sugar intake was positively associated with a higher risk of incident dyslipidemia, as well as incident hypo-HDL-cholesterolemia and hyper-LDL-cholesterolemia. Targeted nutrition education is recommended to promote balanced dietary patterns and enhance overall dietary quality, thereby effectively reducing the risk of dyslipidemia.