This article is reproduced from the "Mace Medical" public account.
"People are like their food", modern diet men and women began to want to eat better, in order to harvest health. As a result, people began to spend a lot of time and energy making choices in eating, carefully counting calories, and meticulously treating the oil, salt, and sugar in their food. So in fact, are we really eating healthy?
In 2019, The Lancet released the first large-scale blockbuster study in the global diet field - mortality and disease burden caused by the diet structure of 195 countries and regions, and the results showed that in 2017, one in five deaths worldwide was related to poor diet, equivalent to 11 million people. And China has the top death toll due to dietary problems!
Figure 1. Findings (Source: The Lancet)
The data shows that none of the people in 195 countries and regions around the world have reached optimal standards for healthy food and nutrient intake. Among the 15 poor eating habits, the highest mortality rates were caused by a high-sodium (salt) diet, inadequate intake of whole grains and insufficient intake of fruits. And those red meats, processed meats, sugary drinks and even trans fats that we are wary of every day are ranked last in the death contribution...
This subverts our previous impression of the wrong eating patterns – it turns out that the deadliest health killer is not consuming too much sugar and fat, but eating the wrong sodium (salt), grains and fruits!
Figure 2. The top three are high salt, low grains and low fruits (Source: The Lancet)
In China, the dietary problem is even more serious: among the top 20 populous countries in the world, Chinese have the highest cardiovascular mortality rate (57.99%) and cancer mortality due to poor diet (15.32%). Japan, also in East Asia, has the lowest all-cause mortality rates, cardiovascular disease mortality, and diabetes mortality due to dietary patterns.
Figure 3. The Lancet mentions China twice (Source: The Lancet)
Our problems with eating are very consistent with, if not more prominent, the problems facing the world – Chinese are consuming too much sodium, while the intake of whole grains, fruits, vegetables, etc. is far from optimal.
The survey in the article shows that our per capita salt intake is more than 8 grams, while the optimal intake advocated in the study is only 3 grams; our whole grain intake is only about 30 grams, far less than the optimal intake of 125 grams advocated in the study; and fruits, which not only provide sugar, but also contain dietary fiber, vitamins and minerals, but our average intake is about 80 grams, which is far from reporting a recommended optimal intake of 250 grams.
Figure 4. High sodium intake, low whole grain intake, and low fruit intake. (Source: The Lancet)
This is probably because China, which has a vast land and rich food culture, has always been "profound in skill" in "eating", and although dishes in various places have their own genres, they consistently pursue salty stimulation for taste buds, which also makes the salt intake of Chinese people exceed the standard. Moreover, nowadays, the "low-carbon and low-sugar" trend is in full swing, and many people are afraid of carbohydrates, but ignore that they are the largest part of the dietary pagoda.
Figure 5. Dietary Pagoda (Source: Balanced Dietary Pagoda for Chinese Residents)
The health problems caused by such a rich and diverse Chinese diet have long been the focus of nutritionists. The Chinese Center for Disease Control and Prevention and the Institute of Nutrition and Health of the Center also published the latest study on the changes in dietary patterns (including 12 dietary factors) and cardiometabolic disease deaths in the Chinese 30 years in the international authoritative journal "The Lancet - Diabetes and Endocrinology", and found that between 1982 and 2012, the dietary quality of Chinese improved, but the proportion of cardiovascular disease deaths caused by poor dietary factors is still a considerable burden of disease. With the increase in the total population and the aging of the population, the number of deaths from cardiovascular disease caused by unhealthy diets will continue to increase gradually.
Figure 6. Research Results (Source: The Lancet Diabetes & Endocrinology)
The study, based on multiple China National Nutrition Surveys (CNNS), included 204802 adults aged 20 and older in 27-31 provinces across the country. The effect of intake of these 12 dietary factors on the burden of cardiovascular disease mortality was estimated by studying changes in chinese adult dietary patterns over the 30-decade period from 1982 to 2012, including the intake of 12 major dietary factors: sodium, marine omega-3 fatty acids, fruits, whole grains, nuts, monounsaturated fatty acids, vegetables, processed meat, red meat, refined grains, low-fat dairy products, and sugary drinks.
The researchers found that dietary shifts were significantly associated with the burden of chronic diseases in China. Over the past 30 years, Chinese have improved in terms of diet, including reducing sodium intake and increasing intake of fruits, nuts, marine omega-3 fatty acids, and polyunsaturated fatty acids.
However, the current consumption patterns of these dietary factors are still not optimal. During the same period, Chinese diet underwent rapid Westernization, including increased consumption of red meat, processed meat, and sugary drinks. Although the proportion of cardiometabolic disease burden caused by this sub-optimal diet has declined over the past few decades, the overall burden remains alarmingly high, highlighting the need for public health nutrition and policy strategies to improve the quality of China's diet.
Figure 7. Cardiometabolic disease mortality rate correlates with overall suboptimal eating habits of Chinese adults from 1982 to 2012 (Credit: The Lancet Diabetes & Endocrinology)
So, how do we deal with this dietary pattern that is not loved or hated? The "Scientific Research Report on Dietary Guidelines for Chinese Residents (2021)" (hereinafter referred to as the "Report") organized and compiled by the Chinese Nutrition Society provides detailed guidelines for all rice cookers
The report notes that healthy eating patterns can reduce the risk of cardiovascular disease, hypertension, cancer and type 2 diabetes. Healthy eating patterns here mainly include the Mediterranean diet, the DASH diet and the Gangnam diet. Xiaobian explained it in detail for everyone.
1. Mediterranean dietary patterns: food varied, light, simple processing, nutrient-rich, monounsaturated fatty acids (olive oil) and dietary fiber (whole grains) intake is high.
2. DASH diet (mainly for lowering blood pressure): Consuming enough vegetables, fruits, low-fat or skim milk to maintain adequate potassium, magnesium, calcium plasma intake, and minimize the intake of salt, oil (especially animal fats rich in saturated fatty acids) can effectively reduce blood pressure. The DASH diet can also prevent osteoporosis, cancer, heart disease, stroke and diabetes. DASH mode has been voted the best comprehensive diet of the year for many years
3. The diet of the Jiangnan region represented by the Jiangsu, Zhejiang and Shanghai regions in China: rice is the main food, fresh vegetables and fruits are sufficient, animal foods are mainly pork and fish and shrimp, fish and shrimp intake is relatively high, and pork is low. Cooking is light, less oil and less salt, which is closer to the ideal dietary pattern.
Of course, in order to meet the nutritional needs of patients with certain special groups or certain diseases, the Report also develops a detailed dietary model for these people. For example, adjust the ratio of 3 major nutrients to the diet: low-energy diet, low-carbon diet, ketogenic diet, etc., and such as valley breaking, light fasting, intermittent fasting, etc. This has a certain effect on overweight and obese people, or may be used as an adjunct to certain diseases, but it is not suitable for everyone, especially adolescents, pregnant women, and the elderly. There are currently no studies demonstrating the long-term health benefits of this dietary pattern.
The majority of foodies friends, chronic diseases are not a meal to attract, want a healthy body, must adhere to healthy eating habits for a long time. In daily life, we should also pay attention to the combination of work and leisure, and maintain a good mood
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Resources:
[1] GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019 May 11;393(10184):1958-1972. doi: 10.1016/S0140-6736(19)30041-8. Epub 2019 Apr 4. Erratum in: Lancet. 2021 Jun 26;397(10293):2466. PMID: 30954305; PMCID: PMC6899507.
[2] He Y, Li Y, Yang X, et al. The dietary transition and its association with cardiometabolic mortality among Chinese adults, 1982-2012: a cross-sectional population-based study. Lancet Diabetes Endocrinol. 2019 Jul;7(7):540-548. doi: 10.1016/S2213-8587(19)30152-4. Epub 2019 May 10. PMID: 31085143; PMCID: PMC7269053.