The Association Between Urbanized Diet and the Prevalence of Overweight, Diabetes, and Hypertension in China

The unprecedented urbanization has become a public health concern for the population of China. The “nutrition transition” in Asia explains the dramatic changes in food consumption and eating habits: the increase in consumption of refined sugars, sodium, and saturated and trans-fats. Thus, there is an urgent need to understand how an urbanized diet is associated with diet-related chronic diseases, such as hypertension, diabetes, and overweight to work toward improving the health of the nation. We used data from the China Health and Nutrition Survey, year 2015. Our team also has developed a diet urbanization index based on foods and eating habits considered a part of an urban diet. The development of the urbanized diet measure was based on consumption of different food groups as defined based on a household weighted inventory in combination with three consecutive 24-hour recall, ownership of specific cooking equipment, and eating habits that were regarded as urban. We quantified the association between the urbanized diet measure and cardiometabolic risk, measuring outcomes (hypertension, overweight, and diabetes) using adjusted odds ratios. We ran mixed effect logistics models, analyzing odds ratios and their complementary confidence intervals, accounting for correlation at both the community and household level using random intercepts. Our findings suggest a positive association between urbanized diet with overweight and diabetes, even after controlling for a wide range of sociodemographic and lifestyle factors related to overall urbanization. As such, consuming an urbanized diet, composed of high fats, processed foods, sweet snacks, and eating out was associated with higher overweight and diabetes prevalence. However, we did not find a similar association for hypertension. Our findings suggest that to reduce risk of cardiometabolic diseases, particularly overweight and diabetes, preventive and policy efforts to reduce the percentage of fat, sodium, and added sugars in processed foods and drinks. Furthermore, fast food restaurants should provide healthier options for customers. Our greatest limitation is the self-report data from CNHS. There is always self-reporting error in questionnaires. As for future research, since cardiometabolic diseases develop overtime and one’s diet can change throughout the years, it would be exciting and possibly more informative to conduct a longitudinal study.Bachelor of Science in Public Healt