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Objective: The present study aimed to explore the associations between food away-from-home (FAFH) consumption and body weight outcomes among Chinese adults., Design: FAFH was defined as food prepared at restaurants and the percentage of energy from FAFH was calculated. Measured BMI and waist circumference (WC) were used as body weight outcomes. Quantile regression models for BMI and WC were performed separately by gender., Setting: Information on demographic, socio-economic, diet and health parameters at individual, household and community levels was collected in twelve provinces of China., Subjects: A cross-sectional sample of 7738 non-pregnant individuals aged 18-60 years from the China Health and Nutrition Survey 2011 was analysed., Results: For males, quantile regression models showed that percentage of energy from FAFH was associated with an increase in BMI of 0·01, 0·01, 0·01, 0·02, 0·02 and 0·03 kg/m2 at the 5th, 25th, 50th, 75th, 90th and 95th quantile, and an increase in WC of 0·04, 0·06, 0·06, 0·04, 0·06, 0·05 and 0·07 cm at the 5th, 10th, 25th, 50th, 75th, 90th and 95th quantile. For females, percentage of energy from FAFH was associated with 0·01, 0·01, 0·01 and 0·02 kg/m2 increase in BMI at the 10th, 25th, 90th and 95th quantile, and with 0·05, 0·04, 0·03 and 0·03 cm increase in WC at the 5th, 10th, 25th and 75th quantile., Conclusions: Our findings suggest that FAFH consumption is relatively more important for BMI and WC among males rather than females in China. Public health initiatives are needed to encourage Chinese adults to make healthy food choices when eating out.

Objective: To examine the characteristics of 'eating out' behavior among Chinese adults and to explore it related risk factors., Methods: Data in the present study was from the China Health and Nutrition Study(CHNS), including those from Liaoning, Henan and Hunan as sample provinces. 2 cities and 2 counties from each province and 2 urban communities and 2 suburban communities from each city plus communities from 1 township and 3 villages from each county were chosen. A final 1013 Chinese adults aged 18 to 59 years old who participated in the 2011 CHNS with complete individual information and were available in the present study period were involved in the study. 'Eating out behavior' was estimated through face-to-face interview on the items as:frequency, cost, ways of transportation and distance between restaurants, eating at fast food restaurants/Chinese full service restaurants/Chinese fast food restaurants/mobile food carts/cafes/canteens or other restaurants during the last week. Information on the amount of food intake was collected through three '24 h recalls'. We described the eating out behaviors by types of restaurants they had gone to and comparing eating out eaters and non-eating out eaters for a set of nutritional indicators in order to explore the risk factors related to 'eating out' behaviors., Results: 'Eating out' was defined as individuals who consumed at least once in restaurants per week. In all the 1013 adults, 51.72% from urban and 39.14% from rural were defined as having 'eating out' experiences. Proportions of eating out in western fast food restaurants, Chinese full service restaurants, Chinese fast food restaurants, mobile food carts, cafes, canteens and other restaurants were 1.68%, 23.49%, 12.93%, 10.37%, 1.09%, 10.07% and 4.34%, respectively. Energy, Ca, Fe and Zn intake were substantially higher among eaters eating at Chinese full service restaurants than those who had not,Energy, protein, fibers, Ca and Zn intake were higher among canteens eaters than those who did not. Age, gender, education, income and residential areas were associated with eating out behaviors., Conclusion: Eating out is a significant nutritional issue among Chinese adults. Education related to nutrition should be taken into account to guide healthy food choices for adults who eat out.

Objective: To examine the trend in meat consumption patterns between 1991 and 2011 in Chinese children in nine provinces(autonomous region) aged 6 to 17 years., Methods: A multistage, random cluster sampling process was used to investigate 2720, 2702, 2525, 2405, 1509, 1238, 1085, and 936 children and adolescents aged 6-17 years in 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011 respectively in 9 provinces (autonomous region) in China. Their consecutive 3 d 24 h dietary recall data were analyzed to compare meat intake pattern in children and adolescents with different characteristics and different years., Results: The consumption rate increased from 60.9% (1657/2720) in 1991 to 87.2% (816/936) in 2011 for livestock meat (χ(2) = 458.23, P < 0.01), from 9.4% (257/2720) to 33.3% (312/936) for poultry (χ(2) = 446.07, P < 0.01) and from 27.3% (743/2720) to 40.6% (380/936) for seafood (χ(2) = 89.89, P < 0.01). The median of total meat intake increased from 47.4 g/d in 1991 to 100.0 g/d in 2011 (χ(2) = 516.77, P < 0.01), poultry intake from 33.3 g/d to 60.0 g/d (χ(2) = 420.13, P < 0.01), pork intake from 26.7 g/d to 50.0 g/d (χ(2) = 380.50, P < 0.01). The percentage of children whose livestock meat and poultry intakes higher than the recommended amount increased from 32.9% (896/2720) in 1991 to 59.8% (560/936) in 2011 (χ(2) = 392.97, P < 0.01); the percentage of children whose seafood intakes meeting the recommended amount increased from 6.9% (187/2720) in 1991 to 8.8% (82/936) in 2011 (χ(2) = 21.52, P < 0.01). The consumption rates of livestock meat in urban and rural children increased from 81.2% (536/660) and 54.4% (1121/2060) in 1991 to 94.7% (234/247) (χ(2) = 38.34, P < 0.01) and 84.5% (582/689) (χ(2) = 429.26, P < 0.01) in 2011. The intakes of livestock meat in rural children increased from 16.7 g/d in 1991 to 56.7 g/d in 2011 (χ(2) = 472.46, P < 0.01)., Conclusion: The overall pattern of meat consumption in Chinese children in nine provinces(autonomous region) was unreasonable between 1991 and 2011. There was a significant improvement in meat consumption in rural children over time.

Objective: To analyze the long-term shifts in fruit and vegetable intakes in Chinese children and adolescents between 1991 and 2009 and related impact from socio-economic factors on such dynamics., Methods: Data was from the seven waves of the China Health and Nutrition Survey. 12 596 children and adolescents aged 6 to 17 years with full data of 3-day-24-hour dietary recall, together with related demographic and socioeconomic factors were chosen as the study subjects., Results: The consumption rates of fruits and vegetables showed an significant increasing trend, from 58.3% in 1991 to 82.4%, on dark-color vegetables(χ(2) = 213.2, P < 0.01), from 94.4% to 96.9% on light-color vegetable(χ(2) = 11.6, P < 0.0001)and from 12.6% to 45.4% for fruits(χ(2) = 571.2, P < 0.0001)in 2009. The median intake of total vegetables decreased from 250.0 g/d in 1991 to 225.8 g/d in 2009(χ(2) = 72.4, P < 0.0001) and the light-color vegetable decreased by 36.6 g/d. However, among the corresponding consumers, the fruit intake increased about 50.0 g/d (χ(2) = 104.2, P < 0.01)and the dark-color vegetable intake decreased about 40.0 g/d (χ(2) = 92.8, P < 0.0001 ). The proportion of children who reached the minimum intake of vegetable(300 g/d)recommended by Dietary Guidelines for Chinese 2007 decreased from 38.9% in 1991 to 26.8% in 2011 and the proportion of children who had met the minimum intake(200 g/d)increased from 2.0% to 13.9% . 25.1% of the children consumed dark-color vegetables more than half of the total vegetable intake. Schooling of the mother and family income had important impact on fruit consumption of the children., Conclusion: Rates on fruit and vegetable consumption showed an increasing trend among Chinese children and adolescents over the past 20 years. However, the vegetable intake significantly decreased and the fruit intake increased slightly. Chinese Children posed a greater risk on insufficient intake on both vegetables and fruits. Comprehensive and effective programs should be taken to increase vegetable and fruit intakes in order to improve the nutritional status of children.

Objective: To understand the daily calcium intake, food sources and the trends among Chinese children and adolescents aged 4 to 17 years from 1991 to 2009., Methods: Consecutive 3-day-24-hour dietary recall data from the seven waves of the China Health and Nutrition Survey(CHNS)was used to describe the status and trends of daily calcium intake and related food sources., Results: Between 1991 and 2009, the daily intake of calcium in Chinese children and adolescents showed an increasing trend. In 2009, the average intakes of calcium in Chinese boys and girls were 311.2 mg/d and 294.6 mg/d, respectively. 81.5%-87.6% of boys and 87.0%-91.0% of girls had their calcium intakes less than half of the recommended amount of adequate intakes. Only 0.2%-0.8% of boys and 0.1%-0.8% of girls had their calcium intakes equal or higher than the recommended amount of adequate intakes. The sources of dietary calcium were mainly from vegetables, legumes, cereals and milk products for Chinese children and adolescents, accounting for more than 70% of the average daily intakes., Conclusion: During the past two decades, the dietary calcium intake of Chinese children and adolescents still remained at lower level, suggesting that the optimal food sources of calcium were under-consumed.

Objective: To examine and characterize the dietary patterns of Chinese adults in nine provinces., Methods: The subjects were selected from the 'China Health and Nutrition Survey' within age group of 18 - 70 years old in 2009. 24-hour dietary recall method for 3 consecutive days was used to collect information on food intake., Results: Major dietary patterns of Chinese adults in nine provinces were labeled "rice/pork" in both men and women while "fruit/egg", "beef, mutton/poultry"and "ethnic food/legumes" in men and "fruit/milk", "tubers/grains" in women. Urban or rural life style and related characteristics of the population showed an influence on the dietary pattern (men: β = -0.153 24, -0.153 24, 0.376 62, 0.148 10, P < 0.01; women: β = -0.139 43, 0.222 00, -0.308 36, P < 0.01)., Conclusion: The dietary patterns of Chinese adults varied by sex and "Rice/Pork" had been the typical dietary pattern among the Chinese adults.

Objective: To explore the status and trend of cereal consumption among Chinese adults aged 18 to 59 years in nine provinces (municipality) from 1989 to 2006., Methods: The survey data were collected by consecutive 3 d 24 h dietary recall method in 1989, 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey Project. The subjects aged 18-59 years with complete information on dietary survey were included. The sample number of the subjects were 5978, 7566, 7492, 7738, 8439, 7484 and 7157 in the 7 round surveys from 1989 to 2006, respectively. The trends of their cereal consuming rate and daily intake were analyzed by year, gender, age and regions., Results: The cereal intake of 18 - 59 years old Chinese adults in 9 provinces (municipality) decreased from 522.3 g/d in 1989 to 431.9 g/d in 2006 (χ(2) = 2421.76, P < 0.01). The cereal intake of males decreased from 545.6 g/d in 1989 to 471.6 g/d in 2006 (χ(2) = 861.21, P < 0.01) and females decreased from 500.3 g/d in 1989 to 395.5 g/d in 2006 (χ(2) = 1844.13, P < 0.01). Compared with 1989, the average cereal consumption were reduced to 104.8, 134.4, 103.3 and 98.2 g in the suburban, female, 18 to 29 years old age group and level of education for college and above separately in 2006. The rice consuming rate among 18 - 59 year-old residents increased from 79.9% (4776/5978) in 1989 to 87.3% (6248/7157) (Z = 18.45, P < 0.01) in 2006, the wheat consuming rate increased from 63.3% (3784/5978) in 1989 to 80.2% (5740/7157) (Z = 27.28, P < 0.01) in 2006., Conclusion: The present study indicated that there was a decreasing trend of cereal intake among Chinese adults aged 18 - 59 years in 9 provinces (municipality). In the stratified groups, cereal intake in groups of female, suburb, aged 18 - 59 years and higher educational level decreased significantly.

Objective: To analyze the trends of food consumption among Chinese residents aged from 18 to 59 years old in 9 provinces (autonomous region) from 1989 to 2006., Methods: The paper was based on data collected in 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey of Chinese residents of 24 h in three consecutive day dietary recall data. The healthy residents aged 18 - 59 years with twenty-four-hour dietary recall data were selected as study subjects. The sample sizes of these seven surveys were 5766, 7296, 7019, 7599, 8143, 7168 and 6827, respectively. The trends of their food consumption in each year were analyzed through Kruskal-wallis method., Results: The intake of cereals decreased significantly from (528.5 ± 192.9) g/d in 1989 to (427.7 ± 173.8) g/d in 2006 (χ(2) = 2833.13, P < 0.01). The minor variation of soybean food intake was observed. The average intake was (22.3 ± 39.4) g/d in 1989 and (18.9 ± 30.5) g/d in 2006 which was still at a low level. The trend of vegetables intake showed a small decrease. It was (374.5 ± 205.9) g/d in males and (346.4 ± 187.6) g/d in females in 2006, respectively. Both quantity and rate of fruits consumption showed an increase trend. Its consumption rate reached at 22.5% (741/3296) in males and 27.7% (1004/3619) in females in 2006, respectively. The average intake increased from (122.4 ± 126.9) g/d in 1989 to (228.5 ± 267.3) g/d in 2006 (χ(2) = 539.66, P < 0.01). At the same time, the daily intake of meat and egg showed a large increase, the average meat intake increased from (97.0 ± 111.5) g/d in males and (80.2 ± 97.0) g/d in females in 1989 to (141.5 ± 125.2) g/d in males and (118.4 ± 111.8) g/d in females in 2006, respectively. The oil consumption showed a significant increase. The average intake increased from (30.4 ± 37.9) g/d in 1989 to (42.8 ± 32.3) g/d in 2006 (χ(2) = 1646.94, P < 0.01)., Conclusions: There have been noticeable changes in the Chinese dietary pattern in the past 17 years. Some changes would be helpful for nutritional improvement in Chinese people, but it also caused some adverse effects on health because of improper food consumption.

Objective: To investigate the trend of milk consumption among Chinese children and adolescents in 9 provinces from 1991 to 2006., Methods: The paper was based on data collected in the China Health and Nutrition Survey in 1991, 1993, 1997, 2000, 2004, 2006 and the subjects aged 7 to 17 years old with complete 24-hour-dietary data for 3 days. Milk consumption in this paper was defined as intake of fresh milk, powdered milk or yogurt, excluding other milk products and milk drinks., Results: There were increasing trends of milk drinking rate and average amount of milk consumption per day in the period of 1991 - 2006, in which milk drinking rate among Chinese children and adolescents increased from 2.88% in 1991 to 13.88% in 2006. The average milk consumption per day increased from 3.90 g/day in 1991 to 26.11 g/day in 2006. There were significant differences regarding milk consumption, both on regional and economic levels. Although milk intake had been increasing in the past 15 years, there was still huge gap between the amount of consumption and the criterion of 300 g/day, proposed by the Chinese Dietary Guidelines (2007). The prevalence of dietary calcium intake under Adequate Intake value was still over 97%, indicating the need of more efforts to be made., Conclusion: The condition of milk intake was improved significantly from 1991 to 2006. However, there was widespread deficiency in milk consumption among Chinese children and adolescents, calling for strengthening the macro-control, optimizing the production and conducting education on nutrition, and improving milk consumption among the Chinese children and adolescents.