Over the past four decades, Chinese tables have gained meat, eggs and dairy while losing whole grains, vegetables and fruit. Adult obesity rose from 7.1% in 2002 to 16.4% in 2015–2019; by 2021, cardiovascular disease accounted for 43.5% of all deaths. The problem, increasingly, is not how much people eat but how. A study published in The Innovation Nutrition points to one answer drawn from China's own food culture.
Researchers led by Yuna He and Yuexin Yang of the National Institute for Nutrition and Health at the Chinese Center for Disease Control and Prevention focused on the Jiangnan and Southeastern Coastal Areas — Shanghai, Zhejiang, Jiangsu, Guangdong and Fujian — a region with the country's lowest cardiovascular burden attributable to poor diet and some of its highest life expectancy. There, aquatic products, soy foods, seasonal produce and lightly seasoned cooking are part of everyday eating.
Using the 2015 China National Chronic Non-Communicable Disease and Nutrition Surveillance, a nationally representative survey of 54,920 adults, the team quantified the regional difference: residents of the coastal south ate 60.8 grams of aquatic products per day on average, versus 32.0 grams elsewhere, along with more dark-colored vegetables, citrus and soy foods, and less cooking oil and salt. From these patterns, combined with the Chinese Dietary Guidelines, they built a 10-point Eastern Healthy Diet score: seven food groups to eat adequately, oil and salt to keep moderate, and a food-variety component.
Adherence tracked with health. After adjusting for age, sex, energy intake, socioeconomic status, smoking and physical activity, adults scoring 5.5–10 had 24% lower odds of obesity, 22% lower odds of central obesity and 21% lower odds of hypertension than those scoring 0–3.5. Each 1-point increase was associated with roughly 8% lower odds of obesity and central obesity and 6% lower odds of hypertension. Notably, the association held both inside and outside the region of origin.
Whether the pattern protects over the long run was tested in an independent cohort — the China Health and Nutrition Survey, following 28,037 adults from 1989 to 2018. With scores updated over time, high scorers had a 15% lower risk of incident obesity (hazard ratio 0.85, 95% confidence interval 0.75–0.96) and each 1-point increase came with about 5% lower risk of death from any cause (HR 0.95, 0.91–0.99).
The authors are careful about causality: both analyses are observational, residual confounding cannot be excluded, and the hypertension trend in the cohort just grazed statistical significance. Intervention trials and mechanistic work, they note, are needed before the score can be treated as a prescription. Even so, the study gives Chinese dietary guidance something the Mediterranean diet gave Europe — a pattern rooted in local tables, with numbers behind it.
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He Y., Wang H., Fang Y., et al. (2026). Eastern healthy diet derived from regional food culture is associated with lower long-term health risks in Chinese adults. The Innovation Nutrition 1:100038. https://doi.org/10.59717/j.xinn-nutri.2026.100038
10.59717/j.xinn-nutri.2026.100038
Data/statistical analysis
People
Eastern healthy diet derived from regional food culture is associated with lower long-term health risks in Chinese adults
23-Sep-2026
Xiang Gao is an Editorial Board member of The Innovation Nutrition and was blindedfrom reviewing or making final decisions on the manuscript. Peer review was handledindependently of this member and their research group. The other authors declare no conflicts of interest.