- Title
- Dietary intake, dietary quality, dietary pattern and non-communicable diseases among older Chinese population
- Creator
- Xu, Xiaoyue
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2016
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: China has a large and rapidly ageing population, with increasing numbers and proportions of people aged 60 years or over. By the end of 2012, the population aged 60 and above accounted for 14.3% (193.9 million) of the total population. The increase in age of the population means that the burden of Non-Communicable Diseases (NCDs) will continue to rise. The research presented in this thesis investigates gaps in knowledge about the diet of the ageing Chinese population in the following areas: dietary intake status; dietary quality; factors relating to dietary intake and dietary quality; the association between dietary patterns and NCDs, or chronic conditions (obesity, hypertension and anaemia). Methods: This thesis by publication consists of seven papers. Using information from the China Health and Nutrition Survey (CHNS), three cross-sectional studies were conducted to evaluate dietary intake, dietary quality, and the risk factors associated with suboptimal dietary intake and dietary quality. Three further cross-sectional studies were conducted to assess the associations between dietary patterns and NCDs, or chronic conditions. A total of 2,745 older Chinese people were involved in these six studies. Finally, one longitudinal study was conducted to evaluate transitions in dietary patterns from 2004 to 2011, and elucidated the associations between dietary pattern and change in BMI, weight (Wt), waist circumference (WC) and hypertension over that time period. A total of 6,348 observations were considered for this study. Key findings: The first three studies suggest that older Chinese people are only partially meeting the recommendations in the current dietary guidelines. For example, we found less than adequate intake of carbohydrates and fat for one third of older people, and of protein for less than one fifth. More than half of older people had a fat-energy intake above the dietary reference; and only ten per cent of the participants consumed dairy, with merely 0.5% meeting the recommended amount. Dietary intake and dietary quality were strongly associated with gender, marital status, work status, education level and regions (p<0.001). The three studies that evaluate dietary patterns and NCDs (or chronic conditions) suggest that a traditional dietary pattern (high intake of rice, pork and vegetables) was inversely associated with general/central obesity and hypertension; in contrast, a modern dietary pattern (high intake of fast food and processed meat) was positively associated with general/central obesity and hypertension. However, a traditional dietary pattern was positively associated with anaemia, whilst a modern dietary pattern was inversely associated with anaemia. Furthermore, dietary lead intake was positively associated with hypertension, and the association between dietary patterns and anaemia was mediated by serum magnesium. We also found considerable regional variations in dietary patterns, and associated risk of NCDs. The longitudinal study demonstrates that over time, older peoples’ diets were shifting towards a modern dietary pattern. Traditional and modern dietary patterns had distinct associations with BMI, Wt and WC. Conclusions and recommendation: Few older Chinese are meeting recommended dietary intakes and dietary quality specified in the current dietary guideline, with the shift towards a modern diet, thus increasing the risk of NCDs. Action is needed by the Chinese Nutrition Society and government to increase dissemination and adoption of nutrition education, with interventions targeted to the specific needs of the various local and regional levels. Moreover, our evidence suggests that dietary guidelines specific to older Chinese people should be developed to prevent NCDs.
- Subject
- dietary intake; dietary quality; dietary pattern; non-communicable diseases; older population; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1315775
- Identifier
- uon:22995
- Rights
- Copyright 2016 Xiaoyue Xu
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Abstract | 150 KB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Thesis | 23 MB | Adobe Acrobat PDF | View Details Download |