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. 2015 Jun 9;7(6):4661–4688. doi: 10.3390/nu7064661

The Difference in Nutrient Intakes between Chinese and Mediterranean, Japanese and American Diets

Ronghua Zhang 1,, Zhaopin Wang 2,3,, Ying Fei 2,3, Biao Zhou 1, Shuangshuang Zheng 2,3, Lijuan Wang 2,3, Lichun Huang 1, Shuying Jiang 2,3, Zeyu Liu 2,3, Jingxin Jiang 2,3, Yunxian Yu 2,3,*
PMCID: PMC4488807  PMID: 26066014

Abstract

Across countries, the predominant diets are clearly different and highly related with human health. Therefore, it is necessary to evaluate dietary nutrients between them. This study aimed to evaluate dietary nutrients in China and compare those between Chinese and Mediterranean (Italian), Japanese and American diets. Dietary intakes of 2659 subjects in south-east China, Zhejiang province, from 2010 to 2012, were estimated by three consecutive 24-h dietary recalls. The contribution of carbohydrate to total energy in Chinese subjects was lower than that in Japanese and American subjects, but higher than that in Italian subjects. However, the energy contribution from fat in Chinese subjects was higher than that in Japanese and American subjects, and similar to that in Italian subjects. Moreover, the Chinese diet had lower daily intakes of fiber, calcium, phosphorus, potassium, selenium, vitamin A, vitamin B1, vitamin B2 and vitamin C, compared with the Japanese, American and Italian diets. Nevertheless, intakes of sodium, iron, copper and vitamin E were higher among Chinese people relative to the people of other three countries. The present study demonstrated that the structure of the Chinese diet has been shifting away from the traditional diet toward high-fat, low-carbohydrate and low-fiber diets, and nutrients intakes in Chinese people have been changing even worse than those in American people.

Keywords: Chinese diet, Mediterranean diet, Japanese diet, American diet, nutrient intake, macronutrients, micronutrients

1. Introduction

Over the past decade, along with rapid economic growth and social changes, Chinese people have experienced remarkable shifts in its traditional diet and disease patterns [1,2]. As the classic eating pattern shifts, grain intake has significantly decreased; fat intake has dramatically increased; daily intake of salt has been much greater than that recommended; but intake of fruit and vegetables is insufficient [3]. These shifts in the composition of diet have been the basis for the change in nutrient intakes. An imbalanced nutrient intake is associated with increased morbidity and mortality from diseases, including diabetes, hypertension, dyslipidemia, cardiovascular diseases, certain cancers, etc. [4,5]. Moreover, assessing intake of nutrient is necessary to monitor nutritional status. It allows us to identify people nutritionally at risk due to inadequate or excessive intake of specific nutrients, to plan and evaluate nutrition intervention projects, and to establish dietary recommendations and food regulations [6,7].

Nowadays, there are predominant types of diets in each country. Some predominant diets are described as healthy diets while others are generally qualified as unhealthy. Both the Mediterranean and Japanese diets are known to be healthy. People in the Mediterranean countries have a low risk of cardiovascular disease, while the Japanese people are famous for their longevity/healthy life expectancy [8]. The Mediterranean diet has long been reported to be the optimal diet for preventing non-communicable diseases and preserving good health [9]. It is characterized by a high intake of cereals, nuts, fruit and vegetables, fish and olive oil, a low intake of dairy products, red meat, processed meats and sweets, and a moderate intake of wine during meals [9,10]. The Japanese diet also covers large amounts of rice, fruit and vegetables, soy-derived proteins and fish, but there is much lower intake of energy and oils/fats [11]. However, the Western diet is characterized by a high consumption of red and processed meats, high-fat dairy products, refined grains, and high-sugar drinks and desserts besides alcoholic beverages, and relatively low intakes of fruit, vegetables, whole-grain foods, fish and poultry [12]. This diet may have negative effects on health, specifically on the risk for obesity, metabolic syndrome, type 2 diabetes, cardiovascular disease as well as cancer [13].

There have been four national nutrition surveys in China, conducted in 1959, 1982, 1992 and 2002. With rapid economic development and urbanization, the pace of nutrition transition has dramatically accelerated in China [2,14]. It is difficult to reflect the nutritional and healthy problems of residents timely for the national nutrition survey carried out once every 10 years. Therefore, the way of national nutrition survey has changed to one cycle every 5 years since 2010 (three years for the first time). Our study was based on the data of the fifth national nutrition survey in south-east China, Zhejiang province, from 2010 to 2012. Although the nutrition survey in Zhejiang province cannot completely reflect the nutritional status all over China, it can indicate the nutritional status in eastern-coast developed provinces and in urbanized provinces. So far, there has been no report which compared the nutrient intakes between Chinese and other types of diets in males and females for different age groups. Therefore, this study aimed to evaluate energy, macro- and micro-nutrients intakes in south-east Chinese diet and compare those between Chinese and Mediterranean (Italian), Japanese and Western (American) diets in males and females for different age groups.

2. Methods

2.1. Study Design and Subjects

All data of Chinese population in this study were derived from part of the fifth national nutrition survey, China National Nutrition and Health Monitoring Survey, from 2010 to 2012. For Zhejiang province, large cities of Jianggan District in Hangzhou and Jiangdong District in Ningbo were selected in 2010; small-medium cities of Jindong District in Jinhua and Tongxiang County in Jiaxing in 2011; Songyang County in Lishui and Anji County in Huzhou in 2012. We randomly selected six communities in each city, district or county using a randomized probability-proportional-to-size sampling scheme. 25 households in each community constituted a cluster by geography of house address. We randomly selected three clusters, totally 75 households, in each community. Dietary data of 30 households, which were constituted from 25 households in the first cluster and the first five households in second cluster, were collected using three consecutive 24-h dietary recalls. The rest 20 households in second cluster and 25 households in the third cluster were investigated, using instant food questionnaire and food frequency questionnaire to obtain dietary data. The survey was conducted from August to October in each calendar year.

In the present study, we only used dietary data from three consecutive 24-h dietary recalls to compare nutrient intakes between Chinese and other types of diets. That was because 24-h dietary recalls obtained extensive and complete data on all foods and beverages consumed, and then it provided a more precise assessment of intake of nutrients than food frequency methods [15,16]. Overall, 8175 subjects (3908 males and 4267 females) were recruited in this nutrition survey. Among them, 2659 individuals (1274 males and 1385 females) aged 2.0–89.2 years, participating in 24-h dietary recalls, were selected in the present study. The protocol of this survey was approved by the Medical Ethical Committee of Zhejiang Provincial Center of Disease Control and Prevention (CDC), and written informed consent was obtained from all participants.

2.2. Dietary Assessment

In this study, dietary intakes at the individual level for all household members aged ≥2 years were collected by well-trained CDC workers, using three consecutive 24-h dietary recalls (two weekdays and one weekend day) [2,17]. For the younger children aged below 12 years, their parents or primary caregivers were asked to recall the child’s food consumption. The investigated information included the type and amount of all food items and consumption place by the aid of food models and pictures. Additionally, home cooking oil and condiment consumption in each household were collected with a household food inventory weighing method on the same 3 days. The percentage of the oil and condiments of each family member was calculated by the ratio of his or her energy intake to the energy intake of all family members [18]. The daily intake of energy and nutrients was averaged over 3 days to assess usual dietary intake. The main nutrients of interest were total energy, carbohydrate, protein, fat, fiber and cholesterol, and intake of vitamins and minerals. Nutrient intakes for each food item consumed were calculated by multiplying the nutrient content listed in the Chinese Food Composition Table (FCT) [19]. Total dietary intake of each nutrient was calculated by adding the intake of that nutrient from each food item consumed.

2.3. Anthropometric and Demographic Variables Assessment

Anthropometric measurement (only for subjects aged ≥6 years) and demographic variables were collected from each individual. Body weight and height were respectively measured to the nearest 0.1 kg and 0.1 cm when the subjects wore light clothing and no shoes. Body mass index (BMI) was calculated as weight (kg)/height squared (m2). Waist circumference was measured to the nearest 0.1 cm at the midpoint between the top of the iliac crest and the lower margin of the last palpable rib in the mid axillary line using a tape measure. A questionnaire was used to collect information on demographic variables, including age, sex, educational level, marital status, occupation, annual family income, smoking and alcohol consumption and history of diseases.

2.4. Data of Mediterranean, Japanese and Western Diets

To compare nutrient intakes between Chinese diet and Mediterranean, Japanese, and Western diets, the data of the third National Food Consumption Survey (INRAN-SCAI 2005–06) in Italy [7], the National Health and Nutrition Survey (2007) in Japan provided by National Institute of Health and Nutrition [20], and the National Health and Nutrition Examination Survey (NHANES 2009–2010) in America from CDC [21] were obtained from corresponding website, respectively.

2.5. Statistical Analysis

The data of energy and nutrient intakes were presented as mean ± SD by sex and age. Due to different age categories across countries, age categories were grouped as 1–6 years, 7–14 years, 15–19 years, 20–29 years, 30–39 years, 40–49 years, 50–59 years, 60–69 years, and 70 years and above in data of Japanese and American diets, while age categorized in children (3–9 years), teenagers (10–17 years), younger adults (18–64 years) and older adults (65 years and above) in data of Italian diets. When nutrient intakes were compared between Chinese and other country population, the age categories in Chinese population were grouped according to corresponding age categorization. Food energy was expressed as kilocalories (kcal). Vitamin A was expressed in retinol equivalents (REs). The distributions of variables between male and female subjects were tested using Student’s t-test for the continuous variables and Pearson’s χ2 test for the categorical variables. Comparison of daily intake of nutrients adjusted for energy by age in Chinese was tested using one-way analysis of variance. Moreover, one-sample t-test was used to compare nutrient intakes between Chinese and Japanese, Italian diets, and two-independent-sample t-test was used to compare nutrient intakes between Chinese and American diets. All statistical tests were two-tailed. We used the false discovery rate (FDR) to control the false rate of multiple testing [22], and p value less than 0.04 was considered statistically significant after FDR adjustment. All analyses were performed using Statistical Analysis System software version 9.2 (SAS Institute Inc., Cary, NC, USA).

3. Results

3.1. Characteristics of the Study Population in Chinese

The anthropometric and socio-demographic characteristics of the Chinese subjects by sex are presented in Table 1. Of 2659 participants, 47.91% were males. Mean ages of males and females were 49.43 and 47.80 years, respectively. Distributions of BMI, annual family income and history of diseases (hypertension, diabetes, dyslipidemia and stroke) were comparable between males and females. However, males were more likely to be married, higher educational level, longer waist circumference, and more tobacco smoking and alcohol drinking than females. In general, intake of energy and nutrients in males were significantly higher than those in females (Supplementary Table S1). Mean energy intakes were 2194.78 kcal and 1766.14 kcal for males and females, respectively. Compared with females, males consumed more cholesterol (323.10 mg versus 289.91 mg), fat (89.06 g versus 72.73 g), protein (73.01 g versus 61.89 g) and carbohydrate (261.47 g versus 219.11 g) except fiber (10.67 g versus 10.21 g). However, the mean energy contributions from fat, protein and carbohydrate in males were 36.46%, 13.62% and 48.06%, respectively, which were mildly lower than those in females (37.03%, 14.27% and 49.44%, respectively) with no significant difference in fat. In addition, males consumed more calcium, phosphorus, potassium, sodium, iron, zinc, copper, selenium, manganese, vitamin A, vitamin B1, vitamin B2 and vitamin E (all p < 0.05) except vitamin C (p > 0.05). Besides, we also presented the details of energy and nutrient intakes in Chinese by age and sex in Table 2, Table 3, Table 4, Table 5 and Table 6.

Table 1.

The distributions of socio-demographic characteristics of study subjects by sex in the Chinese group (N = 2659).

Variables Males (N = 1274) Females (N = 1385) p value
Mean ± SD
Age, year 49.43 ± 18.77 47.80 ± 18.21 0.0229 *
Height, cm 165.15 ± 9.37 154.93 ± 7.22 <0.0001
Weight, kg 63.37 ± 12.59 55.33 ± 10.17 <0.0001
Body mass index, kg/m2 23.06 ± 3.54 22.95 ± 3.55 0.4271
Waist circumference, cm 82.55 ± 11.11 78.65 ± 10.50 <0.0001
N (%)
Education <0.0001
Primary school or below 549 (43.09) 714 (51.55)
Junior or senior high school 636 (49.92) 586 (42.31)
College or above 89 (6.99) 85 (6.14)
Missing -- --
Marital status 0.0008
No 205 (16.09) 293 (21.16)
Yes 1069 (83.91) 1092 (78.84)
Missing -- --
Occupation <0.0001
Student 98 (7.69) 113 (8.16)
Mental worker 120 (9.42) 79 (5.70)
Manual worker 553 (43.41) 508 (36.68)
Retiree 203 (15.93) 265 (19.13)
Other 300 (23.55) 420 (30.32)
Missing -- --
Income, yuan/year 0.7306
<10,000 252 (21.25) 291 (22.45)
10,000–30,000 759 (64.00) 811 (62.58)
>30,000 175 (14.76) 194 (14.97)
Missing 88 89
Tobacco smoking <0.0001
No 558 (47.57) 1254 (98.51)
Yes 615 (52.43) 19 (1.49)
Missing 101 112
Alcohol drinking <0.0001
No 529 (45.1) 991 (77.79)
Yes 644 (54.9) 283 (22.21)
Missing 101 111
Hypertension 0.2011
No 899 (78.38) 960 (76.19)
Yes 248 (21.62) 300 (23.81)
Missing 127 125
Diabetes 0.3341
No 591 (88.08) 672 (86.38)
Yes 80 (11.92) 106 (13.62)
Missing 603 607
Dyslipidemia 0.8895
No 492 (85.86) 582 (85.59)
Yes 81 (14.14) 98 (14.41)
Missing 701 705
Stroke 0.1418
No 1153 (98.29) 1262 (98.98)
Yes 20 (1.71) 13 (1.02)
Missing 101 110

* Bold represents statistical significance.

Table 2.

Comparison of daily intake of energy and macronutrients by age and sex in the Chinese, Japanese and American groups.

Energy, Macronutrients and Age Males (N = 1274) Females (N = 1385)
Chinese Japanese American Chinese Japanese American
N Mean ± SD N Mean N Mean ± SD N Mean ± SD N Mean N Mean ± SD
Total energy, kcal
1–6 37 1287 ± 610 243 1389 552 1522 ± 463 * 33 1027 ± 366 245 1270 * 539 1441 ± 439 *
7–14 63 1777 ± 702 392 2103 * 622 1997 ± 617 * 75 1524 ± 494 403 1871 * 594 1830 ± 551 *
15–19 23 1951 ± 687 201 2440 * 360 2505 ± 923 * 29 1579 ± 568 192 1873 * 316 1806 ± 653
20–29 61 2229 ± 771 304 2183 363 2553 ± 959 * 84 1959 ± 1242 361 1684 446 1877 ± 645
30–39 147 2270 ± 901 540 2208 394 2672 ± 966 * 185 1802 ± 587 661 1725 442 1835 ± 587
40–49 267 2423 ± 842 537 2153 * 407 2601 ± 929 * 292 1898 ± 610 570 1719 * 508 1759 ± 573 *
50–59 259 2339 ± 855 587 2214 * 407 2387 ± 914 301 1858 ± 692 681 1774 * 384 1715 ± 576 *
60–69 255 2150 ± 846 664 2195 399 2071 ± 724 263 1696 ± 765 762 1759 401 1633 ± 563
≥70 162 1982 ± 769 696 1982 417 1884 ± 575 123 1583 ± 589 846 1613 469 1509 ± 515
Carbohydrate, g
1–6 37 161.2 ± 97.9 243 195.9 * 552 207.1 ± 68.4 * 33 115.1 ± 47.0 245 174.7 * 539 195.3 ± 64.1 *
7–14 63 207.9 ± 89.9 392 268.1 * 622 265.9 ± 85.8 * 75 182.3 ± 79.0 403 251.6 * 594 247.3 ± 77.4 *
15–19 23 250.5 ± 102.2 201 333.6 * 360 323.4 ± 125.4 * 29 184.2 ± 78.9 192 245.4 * 316 237.5 ± 90.1 *
20–29 61 254.0 ± 114.1 304 300.2 * 363 319.4 ± 126.4 * 84 238.2 ± 231.3 361 223.2 446 244.6 ± 89.1
30–39 147 269.0 ± 142.3 540 299.3 * 394 322.3 ± 129.7 * 185 212.0 ± 91.8 661 235.4 * 442 232.2 ± 82.0 *
40–49 267 279.8 ± 111.1 537 290.4 407 314.4 ± 120.5 * 292 233.8 ± 91.2 570 233.1 508 226.3 ± 82.8
50–59 259 275.1 ± 115.3 587 296.8 * 407 282.6 ± 114.7 301 234.4 ± 102.9 681 248.2 * 384 217.6 ± 82.8 *
60–69 255 266.0 ± 129.2 664 306.7 * 399 247.9 ± 91.6 263 215.4 ± 116.5 762 256.7 * 401 203.5 ± 74.8
≥70 162 243.6 ± 102.1 696 289.1 * 417 230.5 ± 78.3 123 211.0 ± 91.0 846 244.1 * 469 194.1 ± 70.9
Protein, g
1–6 37 41.8 ± 20.0 243 48.8 * 552 56.6 ± 19.0 * 33 36.7 ± 15.9 245 44.7 * 539 53.9 ± 18.9 *
7–14 63 60.3 ± 26.4 392 75.3 * 622 73.7 ± 26.6 * 75 51.9 ± 17.8 403 67.7 * 594 66.3 ± 22.8 *
15–19 23 69.0 ± 28.9 201 87.5 * 360 96.2 ± 42.2 * 29 54.2 ± 20.5 192 68.3 * 316 64.4 ± 25.3
20–29 61 77.3 ± 27.8 304 76.7 363 99.4 ± 40.4 * 84 69.9 ± 38.3 361 62.9 446 68.7 ± 24.6 *
30–39 147 77.1 ± 32.6 540 76.6 394 104.4 ± 39.1 * 185 63.2 ± 21.6 661 62.5 442 72.0 ± 25.2 *
40–49 267 76.7 ± 29.5 537 75.8 407 102.1 ± 37.9 * 292 63.4 ± 23.3 570 63.1 508 69.0 ± 23.2
50–59 259 76.3 ± 28.7 587 80.5 * 407 95.8 ± 39.0 * 301 66.1 ± 31.6 681 68.1 384 67.1 ± 24.0
60–69 255 73.0 ± 33.4 664 80.9 * 399 84.6 ± 34.1 * 263 62.4 ± 32.5 762 69.1 * 401 65.7 ± 24.9 *
≥70 162 69.0 ± 29.3 696 74.8 * 417 74.4 ± 25.6 * 123 53.9 ± 23.4 846 62.5 * 469 60.0 ± 23.0
Fat, g
1–6 37 53.2 ± 28.2 243 43.8 552 54.0 ± 19.8 33 47.1 ± 21.4 245 42.2 539 51.4 ± 19.2
7–14 63 80.4 ± 45.4 392 69.6 622 73.2 ± 27.9 75 66.9 ± 29.4 403 63.2 594 66.4 ± 25.6
15–19 23 77.1 ± 36.7 201 78.2 360 91.6 ± 40.2 29 71.7 ± 33.1 192 65.4 316 67.7 ± 30.5 *
20–29 61 102.0 ± 44.5 304 66.3 * 363 89.0 ± 40.8 * 84 82.4 ± 41.5 361 55.6 * 446 67.5 ± 29.7 *
30–39 147 95.1 ± 44.3 540 65.1 * 394 96.1 ± 43.4 185 79.3 ± 35.1 661 54.4 * 442 68.1 ± 29.0 *
40–49 267 101.5 ± 51.3 537 60.6 * 407 97.0 ± 45.8 292 80.0 ± 41.2 570 53.9 * 508 63.7 ± 27.6 *
50–59 259 94.8 ± 46.7 587 61.1 * 407 90.2 ± 47.1 301 74.3 ± 36.5 681 52.7 * 384 63.1 ± 27.7
60–69 255 82.1 ± 37.0 664 55.3 * 399 77.3 ± 35.3 263 66.1 ± 33.7 762 47.8 * 401 61.5 ± 29.4
≥70 162 73.3 ± 36.7 696 47.8 * 417 71.3 ± 27.7 123 60.1 ± 34.7 846 40.7 * 469 55.6 ± 23.1 *
Fiber, g
1–6 37 4.7 ± 3.3 243 8.6 * 552 11.5 ± 5.3 * 33 5.2 ± 3.2 245 8.1 * 539 10.8 ± 4.9 *
7–14 63 7.5 ± 5.5 392 13.3 * 622 14.3 ± 6.0 * 75 7.0 ± 4.9 403 12.4 * 594 14.1 ± 6.1 *
15–19 23 8.6 ± 5.5 201 13.2 * 360 16.8 ± 8.1 * 29 7.4 ± 4.0 192 12.1 * 316 12.4 ± 5.8 *
20–29 61 9.8 ± 7.7 304 12.6 * 363 17.9 ± 9.6 * 84 10.0 ± 6.7 361 12.1 * 446 13.9 ± 6.6 *
30–39 147 10.3 ± 6.7 540 12.9 * 394 19.3 ± 9.9 * 185 9.9 ± 6.1 661 12.5 * 442 16.2 ± 8.5 *
40–49 267 10.4 ± 6.3 537 13.2 * 407 19.9 ± 11.4 * 292 10.2 ± 9.2 570 12.5 * 508 15.0 ± 7.7 *
50–59 259 11.5 ± 8.6 587 14.7 * 407 19.3 ± 9.5 * 301 11.9 ± 9.4 681 15.2 * 384 15.9 ± 7.8 *
60–69 255 12.2 ± 8.5 664 16.9 * 399 17.9 ± 9.1 * 263 10.5 ± 6.6 762 16.6 * 401 15.6 ± 7.0 *
≥70 162 11.0 ± 7.9 696 16.5 * 417 17.1 ± 8.7 * 123 10.0 ± 7.5 846 15.3 * 469 15.0 ± 7.2 *
Cholesterol, mg
1–6 37 262 ± 169 243 244 552 185.3 ± 118.1 * 33 297 ± 240 245 234 539 178.1 ± 103.1
7–14 63 308 ± 217 392 352 622 229.8 ± 128.0 * 75 236 ± 160 403 334 * 594 212.8 ± 130.2 *
15–19 23 321 ± 190 201 467 * 360 299.1 ± 181.4 29 373 ± 282 192 382 316 217.2 ± 130.7 *
20–29 61 360 ± 212 304 369 363 330.8 ± 189.8 84 362 ± 247 361 317 446 231.1 ± 142.2 *
30–39 147 353 ± 230 540 365 394 345.5 ± 197.0 185 309 ± 184 661 296 442 240.7 ± 141.3 *
40–49 267 329 ± 256 537 351 407 354.5 ± 206.2 292 295 ± 239 570 311 508 233.4 ± 136.0 *
50–59 259 344 ± 241 587 369 407 343.3 ± 234.1 301 297 ± 229 681 309 384 227.9 ± 136.7 *
60–69 253 315 ± 256 664 353 * 399 304.3 ± 180.5 260 285 ± 234 762 297 401 228.2 ± 143.1
≥70 161 271 ± 183 696 317 * 417 273.4 ± 163.6 122 206 ± 182 846 265 * 469 194.8 ± 111.6 *
% Total energy from
Carbohydrate, %
1–6 37 48.7 ± 13.3 243 58.2 * 552 54.4 ± 7.2 * 33 45.6 ± 10.9 245 56.8 * 539 54.3 ± 7.7 *
7–14 63 47.9 ± 13.1 392 56.1 * 622 53.5 ± 7.3 * 75 47.8 ± 12.4 403 55.2 * 594 54.3 ± 6.9 *
15–19 23 52.0 ± 12.8 201 57.1 360 51.9 ± 8.5 29 46.9 ± 11.9 192 54.5 * 316 52.8 ± 8.1 *
20–29 61 45.6 ± 11.4 304 58.9 * 363 50.5 ± 8.9 * 84 46.7 ± 11.6 361 55.9 * 446 52.5 ± 8.2 *
30–39 147 46.6 ± 12.0 540 59.8 * 394 48.6 ± 10.2 185 46.6 ± 12.3 661 57.4 * 442 51.0 ± 9.3 *
40–49 267 47.0 ± 12.7 537 60.6 * 407 48.8 ± 9.1 292 49.6 ± 12.9 570 57.3 * 508 51.5 ± 9.2
50–59 259 47.7 ± 11.9 587 60.9 * 407 47.9 ± 9.9 301 50.3 ± 11.3 681 58.2 * 384 50.9 ± 9.9
60–69 255 49.3 ± 11.9 664 62.5 * 399 48.5 ± 9.5 263 50.3 ± 12.0 762 60.1 * 401 50.3 ± 9.3
≥70 162 50.1 ± 12.8 696 63.4 * 417 49.3 ± 8.9 123 53.9 ± 14.2 846 62.3 * 469 51.7 ± 8.5 *
Protein, %
1–6 37 13.2 ± 3.2 243 14 552 15.0 ± 3.0 * 33 14.3 ± 3.2 245 14 539 15.1 ± 3.3
7–14 63 13.7 ± 3.3 392 14.4 622 14.9 ± 3.2 * 75 13.8 ± 3.2 403 14.6 594 14.6 ± 3.1
15–19 23 14.1 ± 3.2 201 14.5 360 15.6 ± 4.1 29 14.1 ± 5.0 192 14.7 316 14.6 ± 3.7
20–29 61 14.0 ± 2.9 304 14.2 363 15.8 ± 3.9 * 84 15.0 ± 4.6 361 15 446 14.9 ± 3.5
30–39 147 13.9 ± 3.5 540 14 394 16.1 ± 4.5 * 185 14.5 ± 3.8 661 14.7 442 15.9 ± 3.7 *
40–49 267 13.0 ± 3.5 537 14.3 * 407 16.0 ± 3.7 * 292 13.7 ± 3.9 570 14.8 * 508 16.1 ± 4.0 *
50–59 259 13.4 ± 3.4 587 14.6 * 407 16.3 ± 3.9 * 301 14.3 ± 3.8 681 15.4 * 384 16.0 ± 4.2 *
60–69 255 13.8 ± 3.5 664 14.9 * 399 16.6 ± 4.1 * 263 14.8 ± 4.0 762 15.8 * 401 16.5 ± 4.6 *
≥70 162 14.3 ± 3.9 696 15.1 * 417 16.0 ± 3.8 * 123 13.7 ± 3.4 846 15.4 * 469 16.2 ± 4.2 *
Fat, %
1–6 37 38.2 ± 12.7 243 27.8 * 552 31.8 ± 5.7 * 33 40.6 ± 9.3 245 29.2 * 539 31.8 ± 5.8 *
7–14 63 39.4 ± 12.1 392 29.5 * 622 32.7 ± 5.8 * 75 39.4 ± 11.3 403 30.2 * 594 32.2 ± 5.8 *
15–19 23 35.0 ± 11.4 201 28.4 * 360 32.6 ± 6.6 29 40.3 ± 11.3 192 30.8 * 316 33.3 ± 6.7 *
20–29 61 41.0 ± 11.0 304 26.9 * 363 30.9 ± 6.6 * 84 39.0 ± 10.6 361 29.1 * 446 31.9 ± 6.7 *
30–39 147 38.2 ± 10.8 540 26.2 * 394 32.1 ± 7.7 * 185 39.7 ± 11.0 661 27.9 * 442 32.9 ± 7.3 *
40–49 267 37.2 ± 10.9 537 25.1 * 407 32.9 ± 7.6 * 292 37.4 ± 11.7 570 27.9 * 508 32.1 ± 7.0 *
50–59 259 36.3 ± 10.9 587 24.5 * 407 33.1 ± 7.6 * 301 36.0 ± 10.9 681 26.4 * 384 32.7 ± 7.8 *
60–69 255 34.9 ± 11.0 664 22.6 * 399 33.1 ± 7.6 * 263 35.5 ± 10.9 762 24.1 * 401 33.2 ± 7.9 *
≥70 162 33.2 ± 10.7 696 21.5 * 417 33.7 ± 6.9 123 33.5 ± 12.7 846 22.3 * 469 32.8 ± 6.7

* p < 0.04 after FDR adjustment versus Chinese.

Table 3.

Comparison of daily intake of minerals by age and sex in the Chinese, Japanese and American groups.

Minerals and Age Males (N = 1274) Females (N = 1385)
Chinese Japanese American Chinese Japanese American
N Mean ± SD N Mean N Mean ± SD N Mean ± SD N Mean N Mean ± SD
Calcium, mg
1–6 37 277 ± 148 243 456 * 552 1044 ± 425 * 33 263 ± 128 245 421 * 539 988 ± 444 *
7–14 63 354 ± 193 392 711 * 622 1134 ± 503 * 75 344 ± 164 403 623 * 594 980 ± 523 *
15–19 23 388 ± 212 201 578 * 360 1233 ± 572 * 29 344 ± 163 192 493 * 316 873 ± 507 *
20–29 61 416 ± 188 304 475 * 363 1189 ± 641 * 84 439 ± 285 361 445 446 902 ± 441 *
30–39 147 468 ± 253 540 451 394 1189 ± 640 * 185 406 ± 190 661 474 * 442 934 ± 421 *
40–49 267 453 ± 226 537 472 407 1107 ± 568 * 292 389 ± 213 570 466 * 508 865 ± 403 *
50–59 259 466 ± 248 587 517 * 407 1053 ± 565 * 301 433 ± 264 681 542 * 384 868 ± 431 *
60–69 255 458 ± 241 664 589 * 399 940 ± 558 * 263 430 ± 256 762 580 * 401 815 ± 433 *
≥70 162 473 ± 267 696 587 * 417 880 ± 429 * 123 388 ± 236 846 553 * 469 806 ± 412 *
Phosphorus, mg
1–6 37 595 ± 282 243 744 * 552 1135 ± 370 * 33 511 ± 198 245 683 * 539 1071 ± 376 *
7–14 63 812 ± 328 392 1140 * 622 1364 ± 484 * 75 707 ± 214 403 1033 * 594 1208 ± 405 *
15–19 23 925 ± 364 201 1192 * 360 1613 ± 627 * 29 739 ± 269 192 955 * 316 1132 ± 475 *
20–29 61 1025 ± 347 304 1030 363 1640 ± 655 * 84 940 ± 532 361 875 446 1192 ± 436 *
30–39 147 1054 ± 440 540 1042 394 1740 ± 658 * 185 862 ± 274 661 895 442 1257 ± 441 *
40–49 267 1040 ± 373 537 1046 407 1683 ± 624 * 292 864 ± 300 570 898 508 1181 ± 403 *
50–59 259 1045 ± 379 587 1115 * 407 1567 ± 618 * 301 915 ± 413 681 984 * 384 1157 ± 418 *
60–69 255 1014 ± 438 664 1158 * 399 1396 ± 564 * 263 874 ± 433 762 1010 * 401 1128 ± 423 *
≥70 162 969 ± 422 696 1078 * 417 1261 ± 434 * 123 773 ± 329 846 925 * 469 1052 ± 398 *
Potassium, mg
1–6 37 950 ± 465 243 1571 * 552 2108 ± 670 * 33 924 ± 449 245 1455 * 539 1995 ± 649 *
7–14 63 1375 ± 746 392 2356 * 622 2272 ± 797 * 75 1231 ± 470 403 2145 * 594 2134 ± 773 *
15–19 23 1661 ± 878 201 2329 * 360 2761 ± 1177 * 29 1389 ± 639 192 2052 * 316 1968 ± 782 *
20–29 61 1704 ± 763 304 2181 * 363 2860 ± 1195 * 84 1672 ± 998 361 1913 * 446 2195 ± 863 *
30–39 147 1808 ± 785 540 2204 * 394 3132 ± 1216 * 185 1577 ± 614 661 2018 * 442 2431 ± 890 *
40–49 267 1771 ± 715 537 2266 * 407 3180 ± 1343 * 292 1564 ± 704 570 2088 * 508 2392 ± 851 *
50–59 259 1827 ± 841 587 2518 * 407 3082 ± 1164 * 301 1693 ± 846 681 2425 * 384 2450 ± 888 *
60–69 255 1800 ± 850 664 2742 * 399 2906 ± 1133 * 263 1603 ± 834 762 2613 * 401 2390 ± 891 *
≥70 162 1733 ± 911 696 2650 * 417 2731 ± 967 * 123 1463 ± 789 846 2401 * 469 2323 ± 857 *
Sodium, mg
1–6 37 3719 ± 3757 243 2559 552 2242 ± 816 * 33 2749 ± 1813 245 2323 539 2146 ± 788
7–14 63 4374 ± 2242 392 3858 622 3247 ± 1212 * 75 4371 ± 2501 403 3543 * 594 2953 ± 1004 *
15–19 23 4228 ± 1807 201 4606 360 4135 ± 1689 29 3637 ± 2015 192 3740 316 2932 ± 1195
20–29 61 4711 ± 2125 304 4488 363 4248 ± 1729 84 5112 ± 3326 361 3701 * 446 3116 ± 1107 *
30–39 147 6081 ± 4251 540 4449 * 394 4428 ± 1713 * 185 5112 ± 3393 661 3776 * 442 3061 ± 1063 *
40–49 267 6664 ± 6882 537 4606 * 407 4346 ± 1768 * 292 6121 ± 10810 570 3898 * 508 2905 ± 1032 *
50–59 259 7344 ± 6507 587 4961 * 407 3955 ± 1636 * 301 5703 ± 4413 681 4252 * 384 2791 ± 1037 *
60–69 255 6061 ± 5731 664 4961 * 399 3575 ± 1404 * 263 5307 ± 5011 762 4291 * 401 2775 ± 1071 *
≥70 162 5540 ± 3385 696 4685 * 417 3210 ± 1061 * 123 5148 ± 4228 846 4094 * 469 2553 ± 968 *
Magnesium, mg
1–6 37 148 ± 72 243 158 552 209 ± 69 * 33 141 ± 61 245 144 539 196 ± 65 *
7–14 63 212 ± 101 392 238 622 244 ± 89 * 75 198 ± 66 403 216 * 594 227 ± 81 *
15–19 23 241 ± 96 201 248 360 300 ± 122 * 29 202 ± 68 192 216 316 217 ± 84
20–29 61 276 ± 110 304 241 * 363 326 ± 137 * 84 261 ± 168 361 204 * 446 245 ± 95
30–39 147 295 ± 131 540 250 * 394 358 ± 139 * 185 248 ± 88 661 219 * 442 272 ± 106 *
40–49 267 299 ± 113 537 257 * 407 357 ± 149 * 292 254 ± 111 570 224 * 508 265 ± 100
50–59 259 299 ± 116 587 279 * 407 336 ± 127 * 301 270 ± 123 681 256 384 271 ± 102
60–69 255 300 ± 127 664 301 399 309 ± 125 263 262 ± 130 762 274 401 258 ± 95
≥70 162 284 ± 127 696 284 417 283 ± 125 123 231 ± 99 846 248 469 241 ± 94
Iron, mg
1–6 37 11.3 ± 5.1 243 4.9 * 552 11.7 ± 5.1 33 11.3 ± 6.7 245 4.5 * 539 11.1 ± 5.1
7–14 63 17.3 ± 8.9 392 7.3 * 622 15.5 ± 6.8 75 14.6 ± 5.7 403 6.6 * 594 14.2 ± 6.1
15–19 23 18.0 ± 7.6 201 8.4 * 360 18.5 ± 9.6 29 15.0 ± 5.5 192 7.2 * 316 12.6 ± 6.1
20–29 61 21.5 ± 8.8 304 7.8 * 363 18.0 ± 9.2 * 84 18.7 ± 11.1 361 7.1 * 446 14.0 ± 7.2 *
30–39 147 22.5 ± 10.5 540 8 * 394 18.8 ± 9.2 * 185 18.9 ± 7.0 661 7.5 * 442 14.0 ± 6.1 *
40–49 267 23.1 ± 9.7 537 8 * 407 18.5 ± 8.2 * 292 19.9 ± 18.8 570 7.1 * 508 12.7 ± 5.3 *
50–59 259 23.7 ± 11.8 587 8.7 * 407 17.0 ± 8.4 * 301 21.4 ± 17.3 681 8.3 * 384 12.9 ± 6.1 *
60–69 255 22.9 ± 12.3 664 9.4 * 399 15.8 ± 8.1 * 263 19.9 ± 12.0 762 9 * 401 12.3 ± 5.8 *
≥70 162 20.4 ± 9.0 696 9 * 417 16.0 ± 7.3 * 123 17.5 ± 12.1 846 8.1 * 469 12.4 ± 6.0 *
Zinc, mg
1–6 37 6.3 ± 3.0 243 5.8 552 8.7 ± 3.5 * 33 5.5 ± 2.4 245 5.4 539 8.3 ± 3.5 *
7–14 63 9.2 ± 3.6 392 9.3 622 11.5 ± 6.3 * 75 7.8 ± 2.3 403 8.2 594 9.9 ± 4.2 *
15–19 23 10.6 ± 3.9 201 11 360 13.9 ± 12.5 * 29 8.1 ± 2.7 192 8.2 316 8.9 ± 4.3
20–29 61 11.5 ± 3.8 304 9.4 * 363 13.7 ± 6.7 * 84 10.5 ± 7.2 361 7.5 * 446 9.6 ± 4.6
30–39 147 12.0 ± 5.0 540 9.4 * 394 14.6 ± 6.2 * 185 9.6 ± 3.0 661 7.4 * 442 10.2 ± 6.4
40–49 267 12.4 ± 4.4 537 9.1 * 407 14.3 ± 6.2 * 292 10.0 ± 3.5 570 7.3 * 508 9.7 ± 5.0
50–59 259 12.1 ± 4.3 587 9.2 * 407 13.6 ± 8.3 * 301 10.3 ± 4.7 681 7.7 * 384 9.9 ± 7.2
60–69 255 11.6 ± 5.2 664 9.3 * 399 11.9 ± 6.1 263 9.7 ± 5.0 762 7.8 * 401 9.2 ± 4.5
≥70 162 10.6 ± 4.0 696 8.6 * 417 11.7 ± 6.1 * 123 8.4 ± 3.3 846 7.2 * 469 9.2 ± 4.9
Selenium, ug
1–6 37 26.9 ± 14.2 243 ––– 552 74.5 ± 26.9 * 33 27.4 ± 17.7 245 ––– 539 71.6 ± 26.3 *
7–14 63 42.8 ± 31.4 392 ––– 622 101.5 ± 39.2 * 75 31.8 ± 14.3 403 ––– 594 92.1 ± 34.8 *
15–19 23 41.8 ± 22.0 201 ––– 360 130.1 ± 59.6 * 29 36.4 ± 21.7 192 ––– 316 87.6 ± 35.2 *
20–29 61 50.8 ± 24.9 304 ––– 363 138.5 ± 62.1 * 84 48.7 ± 37.7 361 ––– 446 95.8 ± 35.8 *
30–39 147 51.4 ± 28.7 540 ––– 394 142.7 ± 58.2 * 185 44.8 ± 23.9 661 ––– 442 99.6 ± 37.6 *
40–49 267 50.7 ± 33.3 537 ––– 407 140.4 ± 54.1 * 292 39.4 ± 21.8 570 ––– 508 94.6 ± 36.3 *
50–59 259 52.1 ± 29.7 587 ––– 407 129.0 ± 56.4 * 301 45.8 ± 37.0 681 ––– 384 91.0 ± 35.3 *
60–69 255 48.6 ± 32.6 664 ––– 399 117.2 ± 47.7 * 263 46.3 ± 34.9 762 ––– 401 91.1 ± 38.0 *
≥70 162 46.0 ± 26.7 696 ––– 417 103.0 ± 37.1 * 123 35.9 ± 23.9 846 ––– 469 81.3 ± 34.5 *
Copper, mg
1–6 37 1.2 ± 0.9 243 0.75 * 552 0.8 ± 0.3 * 33 1.0 ± 0.6 245 0.67 * 539 0.8 ± 0.4
7–14 63 2.0 ± 1.4 392 1.13 * 622 1.0 ± 0.5 * 75 1.4 ± 0.5 403 1.03 * 594 1.0 ± 0.4 *
15–19 23 1.9 ± 1.1 201 1.32 * 360 1.3 ± 0.9 * 29 1.6 ± 1.0 192 1.03 * 316 0.9 ± 0.4 *
20–29 61 2.2 ± 1.4 304 1.23 * 363 1.4 ± 0.7 * 84 2.0 ± 1.5 361 1.00 * 446 1.1 ± 0.6 *
30–39 147 2.1 ± 1.2 540 1.24 * 394 1.5 ± 0.7 * 185 1.8 ± 0.8 661 1.02 * 442 1.2 ± 0.7 *
40–49 267 2.2 ± 1.0 537 1.25 * 407 1.5 ± 0.7 * 292 1.9 ± 1.0 570 1.02 * 508 1.2 ± 0.9 *
50–59 259 2.2 ± 1.2 587 1.32 * 407 1.4 ± 0.7 * 301 2.1 ± 1.6 681 1.16 * 384 1.2 ± 0.8 *
60–69 255 2.2 ± 1.2 664 1.4 * 399 1.3 ± 0.6 * 263 1.8 ± 1.2 762 1.23 * 401 1.2 ± 1.1 *
≥70 162 2.0 ± 1.2 696 1.33 * 417 1.3 ± 1.5 * 123 1.8 ± 1.1 846 1.15 * 469 1.1 ± 0.7 *

* p < 0.04 after FDR adjustment, versus Chinese.

Table 4.

Comparison of daily intake of vitamins by age and sex in the Chinese, Japanese and American groups.

Vitamins and Age Males (N = 1274) Females (N = 1385)
Chinese Japanese American Chinese Japanese American
N Mean ± SD N Mean N Mean ± SD N Mean ± SD N Mean N Mean ± SD
Vitamin A, μg REs &
1–6 37 277 ± 397 243 419 * 552 589 ± 263 * 33 282 ± 236 245 407 * 539 570 ± 288 *
7–14 63 377 ± 395 392 618 * 622 641 ± 369 * 75 270 ± 184 403 606 * 594 569 ± 307 *
15–19 23 364 ± 237 201 805 * 360 640 ± 390 * 29 398 ± 264 192 561 * 316 469 ± 338
20–29 61 482 ± 630 304 603 363 617 ± 469 84 400 ± 335 361 627 * 446 550 ± 463 *
30–39 147 577 ± 1020 540 592 394 669 ± 522 185 415 ± 345 661 529 * 442 584 ± 398 *
40–49 267 444 ± 498 537 630 * 407 650 ± 461 * 292 422 ± 434 570 519 * 508 569 ± 569 *
50–59 259 554 ± 969 587 601 407 650 ± 451 301 467 ± 559 681 612 * 384 635 ± 527 *
60–69 255 453 ± 466 664 674 * 399 628 ± 463 * 263 466 ± 549 762 695 * 401 620 ± 634 *
≥70 162 445 ± 444 696 750 * 417 772 ± 949 * 123 361 ± 332 846 617 * 469 651 ± 468 *
Vitamin B1, mg
1–6 37 0.51 ± 0.28 243 0.61 * 552 1.30 ± 0.52 * 33 0.44 ± 0.17 245 0.58 * 539 1.22 ± 0.46 *
7–14 63 0.72 ± 0.38 392 1.28 * 622 1.72 ± 0.68 * 75 0.62 ± 0.24 403 1.19 * 594 1.54 ± 0.60 *
15–19 23 0.80 ± 0.31 201 1.42 * 360 1.97 ± 0.90 * 29 0.64 ± 0.26 192 0.95 * 316 1.33 ± 0.58 *
20–29 61 0.98 ± 0.47 304 1.39 * 363 1.97 ± 0.97 * 84 0.82 ± 0.49 361 1.05 * 446 1.48 ± 0.67 *
30–39 147 1.03 ± 0.52 540 1.23 * 394 2.05 ± 1.06 * 185 0.74 ± 0.29 661 1.19 * 442 1.48 ± 0.61 *
40–49 267 1.14 ± 0.64 537 1.25 * 407 2.01 ± 0.90 * 292 0.80 ± 0.35 570 1.27 * 508 1.35 ± 0.54 *
50–59 259 1.08 ± 0.61 587 1.42 * 407 1.84 ± 0.83 * 301 0.82 ± 0.42 681 1.48 * 384 1.36 ± 0.58 *
60–69 255 0.91 ± 0.46 664 1.44 * 399 1.70 ± 0.81 * 263 0.74 ± 0.41 762 1.88 * 401 1.31 ± 0.57 *
≥70 162 0.87 ± 0.48 696 1.71 * 417 1.65 ± 0.68 * 123 0.65 ± 0.31 846 2.3 * 469 1.31 ± 0.57 *
Vitamin B2, mg
1–6 37 0.55 ± 0.29 243 0.91 * 552 1.91 ± 0.68 * 33 0.48 ± 0.24 245 0.82 * 539 1.81 ± 0.69 *
7–14 63 0.71 ± 0.33 392 1.38 * 622 2.14 ± 0.84 * 75 0.59 ± 0.21 403 1.33 * 594 1.85 ± 0.71 *
15–19 23 0.81 ± 0.39 201 1.75 * 360 2.32 ± 1.17 * 29 0.66 ± 0.25 192 1.27 * 316 1.59 ± 0.84 *
20–29 61 0.85 ± 0.36 304 1.43 * 363 2.33 ± 1.42 * 84 0.81 ± 0.44 361 1.39 * 446 1.77 ± 1.01 *
30–39 147 0.91 ± 0.50 540 1.34 * 394 2.54 ± 1.37 * 185 0.73 ± 0.29 661 1.41 * 442 1.87 ± 0.80 *
40–49 267 0.90 ± 0.46 537 1.39 * 407 2.44 ± 1.13 * 292 0.73 ± 0.35 570 1.28 * 508 1.79 ± 0.80 *
50–59 259 0.89 ± 0.40 587 1.62 * 407 2.37 ± 1.23 * 301 0.78 ± 0.44 681 1.56 * 384 1.83 ± 0.83 *
60–69 255 0.85 ± 0.46 664 1.57 * 399 2.16 ± 1.11 * 263 0.75 ± 0.48 762 1.57 * 401 1.75 ± 0.84 *
≥70 162 0.78 ± 0.37 696 1.5 * 417 2.17 ± 0.91 * 123 0.61 ± 0.31 846 1.76 * 469 1.74 ± 0.77 *
Niacin, mg
1–6 37 8.2 ± 4.0 243 8.3 552 16.2 ± 6.5 * 33 7.3 ± 3.6 245 7.6 539 15.2 ± 6.2 *
7–14 63 12.9 ± 5.8 392 12.9 622 23.1 ± 8.9 * 75 10.4 ± 3.6 403 11.5 * 594 20.7 ± 7.8 *
15–19 23 15.8 ± 7.6 201 16.5 360 30.2 ± 14.7 * 29 11.6 ± 5.2 192 13.3 316 19.7 ± 8.3 *
20–29 61 17.1 ± 6.0 304 16.9 363 31.9 ± 15.5 * 84 14.7 ± 9.1 361 13.2 446 22.2 ± 9.5 *
30–39 147 17.5 ± 8.3 540 17.6 394 33.4 ± 14.0 * 185 13.5 ± 4.7 661 13.3 442 22.0 ± 8.2 *
40–49 267 18.3 ± 8.0 537 17.5 407 31.8 ± 13.3 * 292 13.9 ± 5.6 570 14.1 508 20.8 ± 8.1 *
50–59 259 18.1 ± 8.0 587 18.9 407 29.0 ± 13.1 * 301 14.6 ± 7.6 681 15.2 384 20.5 ± 8.3 *
60–69 255 16.6 ± 7.6 664 18.7 * 399 25.7 ± 11.1 * 263 13.9 ± 7.5 762 15.4 * 401 19.6 ± 8.1 *
≥70 162 15.0 ± 7.2 696 16.2 * 417 24.4 ± 10.5 * 123 11.0 ± 4.5 846 13.5 * 469 18.5 ± 8.1 *
Vitamin C, mg
1–6 37 24.8 ± 20.5 243 55 * 552 83 ± 55 * 33 32.8 ± 22.6 245 55 * 539 83 ± 56 *
7–14 63 44.7 ± 45.6 392 83 * 622 77 ± 58 * 75 43.0 ± 37.1 403 79 * 594 82 ± 80 *
15–19 23 109.9 ± 156.0 201 108 360 101 ± 92 29 57.2 ± 44.3 192 91 * 316 79 ± 69 *
20–29 61 62.4 ± 143.2 304 92 363 92 ± 96 84 58.9 ± 40.3 361 105 * 446 84 ± 86 *
30–39 147 66.7 ± 45.2 540 85 * 394 91 ± 79 * 185 62.3 ± 40.9 661 95 * 442 78 ± 67 *
40–49 266 62.1 ± 43.2 537 87 * 407 94 ± 92 * 292 60.5 ± 40.5 570 112 * 508 81 ± 71 *
50–59 259 61.5 ± 44.0 587 115 * 407 93 ± 86 * 301 67.9 ± 50.7 681 144 * 384 85 ± 64 *
60–69 255 68.5 ± 49.3 664 135 * 399 90 ± 88 * 263 72.9 ± 60.5 762 159 * 401 77 ± 60
≥70 162 71.6 ± 52.1 696 131 * 417 89 ± 74 * 123 59.8 ± 40.7 846 142 * 469 82 ± 56 *
Vitamin E, mg
1–6 37 17 ± 11 243 4.9 * 552 4.8 ± 2.6 * 33 17 ± 9 245 4.5 * 539 4.3 ± 2.1 *
7–14 63 23 ± 17 392 6.7 * 622 6.1 ± 3.1 * 75 24 ± 15 403 6.3 * 594 6.2 ± 3.9 *
15–19 23 22 ± 11 201 9.3 * 360 7.7 ± 4.5 * 29 26 ± 15 192 6.9 * 316 5.8 ± 3.0 *
20–29 61 35 ± 20 304 7.9 * 363 8.1 ± 5.6 * 84 30 ± 19 361 6.5 * 446 6.3 ± 3.5 *
30–39 147 32 ± 18 540 7.4 * 394 8.7 ± 4.9 * 185 29 ± 17 661 8.3 * 442 6.9 ± 5.3 *
40–49 267 35 ± 24 537 8.1 * 407 8.7 ± 5.5 * 292 29 ± 17 570 8.9 * 508 6.6 ± 4.3 *
50–59 259 33 ± 22 587 9.5 * 407 8.1 ± 5.1 * 301 27 ± 15 681 8.9 * 384 6.9 ± 4.4 *
60–69 255 30 ± 17 664 9.1 * 399 7.4 ± 4.3 * 263 25 ± 13 762 9.8 * 401 6.7 ± 4.4 *
≥70 162 27 ± 16 696 9.9 * 417 7.7 ± 4.9 * 123 24 ± 14 846 11.8 * 469 6.2 ± 3.7 *

& REs: Retinol equivalents; * p < 0.04 after FDR adjustment, versus Chinese.

Table 5.

Comparison of daily intake of energy and nutrients # by age in children ^ and males in the Chinese and Italian groups.

Energy and Nutrients Children (3–9 Years) Males (10–17 Years) Males (18–64 Years) Males (65 Years and Above)
Chinese (N = 112) Italian (N = 193) Chinese (N = 53) Italian (N = 108) Chinese (N = 896) Italian (N = 1068) Chinese (N = 263) Italian (N = 202)
Total energy, kcal 1322.2 ± 560.9 1914 ± 488 * 1889 ± 684 2576 ± 744 * 2330 ± 865 2390 ± 650 * 1981 ± 740 2296 ± 556 *
Carbohydrate, g 157.4 ± 81.0 239.8 ± 69.8 * 231.5 ± 92.8 326.7 ± 110.2 * 274.9 ± 123.8 283.1 ± 88.7 243.6 ± 101.4 274.9 ± 81.4 *
Protein, g 44.9 ± 20.2 74.1 ± 18.5 * 63.3 ± 26.1 99.3 ± 26.2 * 76.9 ± 31.0 92.6 ± 25.3 * 67.9 ± 28.1 88.2 ± 21.4 *
Fat, g 57.9 ± 30.3 79.5 ± 22.8 * 81.5 ± 45.5 105.4 ± 32.3 * 95.9 ± 46.4 95.4 ± 29.5 73.9 ± 35.3 87.0 ± 23.4 *
Fiber, g 5.5 ± 3.7 14.4 ± 5.2 * 8.6 ± 5.8 18.1 ± 5.9 * 11.0 ± 7.6 19.6 ± 7.3 * 11.3 ± 8.1 21.6 ± 8.2 *
Cholesterol, mg 275.1 ± 198.4 286 ± 118 301 ± 217 355 ± 153 339 ± 247 331 ± 157 281 ± 202 302 ± 137
% Total energy from
Carbohydrate, % 47.5 ± 12.3 46.8 ± 5.8 50.3 ± 13.6 47.2 ± 5.6 47.4 ± 12.0 44.3 ± 6.2 * 49.8 ± 12.8 44.8 ± 6.3 *
Protein, % 13.8 ± 3.3 15.7 ± 2.3 * 13.5 ± 3.0 15.6 ± 1.9 * 13.5 ± 3.4 15.7 ± 2.2 * 14.1 ± 3.8 15.5 ± 2 *
Fat, % 39.2 ± 11.1 37.4 ± 4.9 37.6 ± 12.7 36.9 ± 4.9 37.0 ± 10.9 36.0 ± 5.3 * 33.8 ± 11.1 34.3 ± 5.7
Minerals
Calcium, mg 292.1 ± 140.0 749 ± 252 * 381 ± 216 892 ± 344 * 460 ± 241 799 ± 337 * 458 ± 246 825 ± 331 *
Phosphorus, mg 619.1 ± 254.6 1180 ± 299 * 875 ± 339 1479 ± 396 * 1049 ± 406 1386 ± 389 * 951 ± 387 1331 ± 332 *
Potassium, mg 1050.5 ± 473.0 2441 ± 633 * 1552 ± 883 3123 ± 879 * 1811 ± 808 3218 ± 921 * 1702 ± 824 3300 ± 859 *
Magnesium, mg 162.7 ± 70.4 230 ± 69 * 229 ± 99 286 ± 75 * 300 ± 122 305 ± 93 282 ± 119 295 ± 81
Zinc, mg 6.7 ± 2.7 9.9 ± 2.9 * 9.9 ± 3.8 13.3 ± 3.9 * 12.2 ± 4.7 12.6 ± 3.9 * 10.5 ± 3.8 12.2 ± 3.2 *
Vitamins
Vitamin A, ug REs & 299.7 ± 346.8 740 ± 941 * 352 ± 316 802 ± 767 * 507 ± 770 890 ± 1004 * 429 ± 407 888 ± 851 *
Vitamin B1, mg 0.5 ± 0.2 0.92 ± 0.3 * 0.78 ± 0.40 1.23 ± 0.46 * 1.06 ± 0.58 1.11 ± 0.38 * 0.85 ± 0.45 1.01 ± 0.3 *
Vitamin B2, mg 0.6 ± 0.3 1.43 ± 0.41 * 0.76 ± 0.38 1.69 ± 0.53 * 0.89 ± 0.45 1.53 ± 0.5 * 0.78 ± 0.35 1.48 ± 0.41 *
Vitamin C, mg 31.5 ± 27.4 107 ± 64 * 77 ± 114 136 ± 93 * 64 ± 57 126 ± 79 * 71 ± 50 127 ± 74 *
Vitamin E, mg 18.6 ± 10.7 10.4 ± 3.5 * 24.2 ± 17.7 13.9 ± 5 * 33.3 ± 21.1 13.5 ± 4.6 * 26.9 ± 15.6 13.3 ± 4.5 *

# Mean ± SD; & REs: Retinol equivalents; ^ Two infants (< 3 years) were not included, with males and females grouped in the case of children; * p < 0.04 after FDR adjustment, versus Chinese.

Table 6.

Comparison of intake of energy and nutrients # by age in females in the Chinese and Italian groups.

Energy and Nutrients Females (10–17 Years) Females (18–64 Years) Females (65 Years and above)
Chinese (N = 75) Italian (N = 139) Chinese (N = 1027) Italian (N = 1245) Chinese (N = 231) Italian (N = 316)
Total energy, kcal 1549 ± 516 2091 ± 532 * 1845 ± 750 1939 ± 526 * 1613 ± 558 1834 ± 486 *
Carbohydrate, g 181.8 ± 82.5 263.1 ± 80.1 * 227.8 ± 118.8 236.5 ± 75.3 * 210.2 ± 89.3 233.7 ± 71.7 *
Protein, g 53.1 ± 17.9 81.8 ± 20.1 * 64.5 ± 29.6 76 ± 19.5 * 57.8 ± 23.5 71.4 ± 18.8 *
Fat, g 69.2 ± 30.2 86 ± 23.1 * 76.5 ± 38.5 79.1 ± 23.4 * 61.7 ± 31.2 69.6 ± 22.2 *
Fiber, g 6.8 ± 4.6 16.4 ± 5.8 * 10.7 ± 8.3 17.7 ± 6.3 * 10.0 ± 6.7 18.7 ± 6.7 *
Cholesterol, mg 283 ± 205 311 ± 144 304 ± 230 265 ± 125 * 239 ± 198 243 ± 106
% Total energy from
Carbohydrate, % 46.6 ± 12.3 46.8 ± 5.8 49.1 ± 12.3 45.5 ± 6.3 * 52.2 ± 13.0 47.8 ± 7.3
Protein, % 14.1 ± 4.0 15.8 ± 2.2 * 14.2 ± 3.9 15.9 ± 2.3 * 14.5 ± 3.9 15.7 ± 2.4 *
Fat, % 40.2 ± 11.5 37.2 ± 5 * 37.3 ± 11.3 36.8 ± 5.3 34.2 ± 11.7 34.1 ± 6.1
Minerals
Calcium, mg 339 ± 166 770 ± 280 * 415 ± 241 730 ± 277 * 409 ± 236 754 ± 290 *
Phosphorus, mg 712 ± 214 1252 ± 333 * 886 ± 391 1168 ± 312 * 818 ± 317 1117 ± 305 *
Potassium, mg 1241 ± 494 2737 ± 796 * 1621 ± 800 2861 ± 797 * 1515 ± 733 2822 ± 794 *
Magnesium, mg 199 ± 67 251 ± 91 259 ± 122 257 ± 74 245 ± 101 243 ± 66
Zinc, mg 7.9 ± 2.3 10.9 ± 3 * 10.0 ± 4.6 10.6 ± 3 * 8.9 ± 3.2 9.9 ± 2.9 *
Vitamins
Vitamin A, ug REs & 318 ± 221 751 ± 855 * 437 ± 471 818 ± 885 * 418 ± 450 773 ± 466 *
Vitamin B1, mg 0.64 ± 0.24 1 ± 0.32 * 0.79 ± 0.39 0.95 ± 0.32 * 0.68 ± 0.32 0.86 ± 0.26 *
Vitamin B2, mg 0.61 ± 0.22 1.42 ± 0.4 * 0.76 ± 0.42 1.38 ± 0.43 * 0.66 ± 0.33 1.31 ± 0.39 *
Vitamin C, mg 48 ± 40 128 ± 92 * 64 ± 47 123 ± 74 * 67 ± 52 127 ± 84 *
Vitamin E, mg 25.4 ± 16.2 11.8 ± 3.5 * 27.8 ± 16.3 11.9 ± 3.8 * 23.6 ± 12.7 10.9 ± 3.7 *

# Mean ± SD; & REs: Retinol equivalents; * p < 0.04 after FDR adjustment, versus Chinese.

3.2. Comparison of Age- and Sex-Specific Intake of Energy and Macronutrients between Chinese and Italian, Japanese and American Subjects

Table 2, Table 5 and Table 6 show the comparison of intake of energy and macronutrients by age and sex. Compared with the subjects of other three countries, Chinese subjects consumed much less fiber in all age groups of both sexes (all p < 0.04). In general, compared with the Japanese subjects, young Chinese subjects consumed lower total energy, while adult Chinese subjects consumed higher total energy; compared with the American subjects, Chinese males and young Chinese females consumed lower total energy, while adult Chinese females consumed higher total energy. Carbohydrate and protein intakes in Chinese subjects were lower than those in Japanese and American subjects. Fat intake in Chinese subjects was higher than that in Japanese adults of both sexes and American females, while similar to that in American males (except 20–29 age group). In addition, Chinese, Japanese, American and Italian subjects consumed similar cholesterol, except American females. Furthermore, total energy and macronutrients in Chinese subjects were lower than those in Italian subjects in both sexes except for a similar intake of cholesterol.

The percent energy from carbohydrate in Chinese subjects ranged from 45.6% to 53.9%. It was lower than that in Japanese and American subjects, while higher than that in adult Italian subjects. However, the energy contribution from fat in Chinese subjects ranged between 33.2% and 41.0%. It was higher than that in Japanese and American subjects in both sexes (except ≥70 age group), while similar to that in Italian subjects. The contribution of protein to energy in Chinese subjects (13.0%–15.0%) was lower than that in Japanese, American and Italian subjects; nevertheless, there were no significant differences for Japanese subjects aged <40 years and American females aged <30 years.

3.3. Comparison of Age- and Sex-Specific Intake of Minerals between Chinese and Italian, Japanese and American Subjects

For macro-minerals, daily intakes of calcium, phosphorus and potassium in Chinese subjects were generally lower than those in Japanese, American and Italian subjects (Table 3, Table 5 and Table 6). Nevertheless, Chinese subjects consumed a higher intake of sodium than Japanese and American subjects (Table 3). In addition, magnesium intake in Chinese subjects was higher than that in younger adult Japanese subjects, but lower than that in American males aged <60 years and females aged 1–14 and 30–39 years, and Italian children and males aged below 18 years.

For micro-minerals, intakes of iron and copper in both male and female age groups in Chinese subjects were higher than those in Japanese and American subjects, but selenium intake was lower than that in American subjects (Table 3). Zinc intake in Chinese subjects was higher than that in adult Japanese subjects, but lower than that in American males and Italian subjects (Table 3, Table 5 and Table 6).

3.4. Comparison of Age- and Sex-Specific Intake of Vitamins between Chinese and Italian, Japanese and American Subjects

For vitamins, intakes of vitamin B1 and vitamin B2 were lower among Chinese subjects in all age groups of both sexes, compared with those in the people of the other three countries; but vitamin E intake was higher (all p < 0.04, Table 4, Table 5 and Table 6). Compared with the people of other three countries, Chinese subjects consumed a lower level of vitamin A and vitamin C in both sexes (Table 4, Table 5 and Table 6), with no significant differences across several age groups in Japanese and American subjects (Table 4). Although niacin intake by age and sex in Chinese subjects was lower than that in American subjects (all p < 0.04), these significant differences were only found in Japanese older adults and females aged 7–14 years (Table 4).

3.5. Comparison of Age- and Sex-Specific Intake of Nutrients Adjusted for Energy between Chinese and Italian Subjects

As presented in Supplementary Tables S2 and S3, intakes of fiber, calcium, phosphorus, potassium, zinc, vitamin A, vitamin B1, vitamin B2 and vitamin C after energy adjusted in Chinese subjects were lower than those in Italian subjects, while intakes of cholesterol, iron, magnesium and vitamin E were higher among Chinese subjects relative to Italian subjects (p < 0.04). These results were quite similar before and after energy adjustment.

4. Discussion

The present study described intakes of energy and nutrients in south-east Chinese people and presented the comparison of those between Chinese and Italian, Japanese and American diets in males and females for different age groups. There were marked differences in nutrients consumption between Chinese subjects and those from the other three countries. Firstly, the contribution of carbohydrate to energy in Chinese subjects was lower than that in Japanese and American subjects, but higher than that in Italian subjects; however, the energy contribution from fat in Chinese subjects was higher than that in Japanese and American subjects, and similar to that in Italian subjects. Secondly, the Chinese diet had lower daily intakes of fiber, calcium, phosphorus, potassium, selenium, vitamin A, vitamin B1, vitamin B2 and vitamin C, compared with the Japanese, American and Italian diets; nevertheless, intakes of sodium, iron, copper and vitamin E were higher among Chinese subjects relative to the people of other three countries.

4.1. Nutrients Intakes in Chinese People Changing Even Worse than Those in American People

Across countries, the predominant diets are clearly different and highly related with human health. Both the Italian and Japanese diets are known to be healthy, while the American diet is generally qualified as unhealthy [11]. The traditional Chinese diet includes rice, wheat and wheat products and vegetables with low animal-source foods [23]. It has been considered as extremely healthy diet, like the Italian and Japanese diets [14]. However, China seems to be rapidly relinquishing its traditional diet with its rapid economic development. China has experienced remarkable shifts in its disease patterns from the decreasing prevalence of malnutrition and nutrition deficiencies to a high prevalence of diet-related non-communicable diseases, such as obesity, diabetes, cardiovascular disease, and cancer [14]. In addition, China is also undergoing a remarkably fast, but undesirable shift towards a stage of nutrition transition dominated by a high intake of edible oils, processed foods and animal foods and a low intake of coarse grains, legumes and other healthy foods [2]. These shifts have been the basis for the change in nutrient intakes. The shifts of nutrient intakes accompanied by major cooking and eating behavior changes are leading to what might be characterized as an unhealthy Western diet. Therefore, we evaluated the dietary nutrients in south-east Chinese subjects and compared those to the healthy Italian, Japanese diets and unhealthy American diet. In the present study, 2659 participants aged 2.0–89.2 years were enrolled to evaluate the dietary nutrients in south-east Chinese subjects. We found that compared with the American subjects, Chinese subjects consumed lower intakes of fiber, carbohydrate and protein. Nevertheless, fat and cholesterol intakes in Chinese subjects were higher than those in American females, and similar to those in American males. Lower contribution of carbohydrate and protein and higher contribution of fat to energy in Chinese subjects than those in American subjects were also found. Therefore, macronutrients intakes of Chinese subjects had been close to those of American subjects, and many macronutrients were even worse than those of American subjects. Furthermore, the Chinese diet had lower daily intakes of calcium, phosphorus, potassium, selenium, vitamin A, vitamin B1, vitamin B2, vitamin C and niacin, and higher intakes of sodium, iron, copper and vitamin E, compared with the American diet. Therefore, these results demonstrated that nutrients intakes in Chinese people have been changing even worse than those in American people. The relative low prices of animal-source foods and oils partially explain these shifts and income increases are a second important cause [24,25]. In addition, another reason is that cooking and eating behaviors are changing rapidly, including the decrease in the percentage of food cooked in healthy ways (steamed, boiled, baked) and the increase in snacking, fried foods and away from-home food consumption [26].

4.2. Nutritional Transition of the Chinese Diet from Traditional to Non-Traditional Diet

Compared with the 2002 China National Nutrition and Health Survey data [27], intakes of total energy, carbohydrate, fiber, phosphorus, potassium, sodium, iron, copper, vitamin A, vitamin B1, vitamin B2, vitamin C and vitamin E decreased, while intakes of fat, calcium and selenium increased, with stable intake of protein. In addition, in the nine provinces in the China Health and Nutrition Survey, there were rapid changes in the percent energy intake from carbohydrate and fat between 1991 and 2011 [2]. The energy contributions from carbohydrate were 66.0%, 59.8% and 54.3% in 1991, 2000 and 2011, respectively; while the proportions of energy derived from fat were 21.8%, 27.8% and 32.0% in 1991, 2000 and 2011, respectively. Moreover, our study found that the percent energy from carbohydrate and fat in Chinese subjects ranged from 45.6% to 53.9% and from 33.2% to 41.0% in different age groups, respectively. Furthermore, Zhou et al. [28] once compared nutrient intakes of middle-aged men and women, aged 40–59 years, in Chinese, Japanese and American subjects in the late 1990s (1997–1999). This study showed higher fiber intake and percent energy from carbohydrate and lower cholesterol intake and percentage of energy from fat in Chinese subjects than those in Japanese and American subjects; these findings were consistent with another study carried out in women aged 40–70 years in Shanghai (China), Japan and America, from 1997 to 2000 [26]. Nevertheless, in our study we found lower fiber intake and percent energy from carbohydrate and higher percentage of energy from fat in Chinese subjects than those in Japanese and American subjects, which were opposite to the results in the late 1990s. In summary, these results demonstrated that fat intake has increased but the intake of complex carbohydrates and fiber has decreased in Chinese people in the past two decades. Therefore, the structure of the Chinese diet has been shifting away from the traditional diet toward high-fat, low-carbohydrate and low-fiber diets. However, it is noted that the older adults tended to retain the traditional diet (Supplementary Table S4).

4.3. Trends of Minerals and Vitamins

The truly healthy trends for Chinese diet were the reduction in intakes of sodium and increases in intakes of calcium. High sodium and low potassium intakes are the key risk factors for hypertension [29,30,31,32]. Although sodium intake decreased, it remained double those recommended by the Institute of Medicine and the WHO; and potassium intake was below the recommended amount [33]. Our findings were consistent with other studies [28,33]. However, it should be noted that dietary method is an inadequate assessment of sodium, and 24-h urine sodium is the only way to estimate sodium intake [34]. Nowadays, the major source of dietary sodium remains added salt, followed by soy sauce, processed foods, and monosodium glutamate [33]. Therefore, replacing sodium with potassium in salt is an option with the potential to control and prevent hypertension and improve the health of the Chinese population [33]. In addition, calcium intake increased in the past decade. Nevertheless, it remained far below the recommended amount [35]. Deficient intake of calcium from cereals, vegetables, legumes and dairy mainly accounted for the low intake of calcium [36]. Iron intake in males was higher than that recommended by the Chinese Nutrition Society [35], while it was comparable for females. However, the main source of iron intake was from plant-based foods among this study population, which has low bioavailability [37]. So iron intake might not meet the needs of the body, especially in females. Besides, vitamin B2 intake was inadequate. Its deficiency has been shown to negatively affect iron absorption and utilization, which is associated with increased risk of anemia [38]. Consequently, a higher intake of fruit, vegetables, cereals, legumes, dairy and certain animal-source foods should be recommended.

Zhou et al. [28] also compared intakes of minerals and vitamins in Chinese, Japanese and American people in the late 1990s. The compared results of calcium, sodium, phosphorus, potassium, selenium, magnesium, vitamin A and vitamin C intakes in this study were consistent with our results. However, this study showed similar intake of iron (between Chinese and American people) and vitamin E (between Chinese and Japanese, American people), while we found higher intakes of iron and vitamin E in Chinese people than those in Japanese and American people. Nevertheless, Chen et al. [26] reported higher intakes of iron and vitamin E in Chinese people than those in Japanese and American people in the late 1990s, which were consistent with our study. Together, these findings demonstrated that excessive, especially inadequate intakes of a range of minerals and vitamins have been persistent in the past decade.

4.4. Strengths and Limitations

To the best of our knowledge, this was the first study to compare of nutrient intakes between Chinese and Italian, Japanese and American diets in males and females for different age groups. However, our research has several limitations. First, as expected, in some age and sex groups, and in particular in children and teenagers, the sample size might be not sufficient. Second, energy and nutrient intakes in present study were estimated by three consecutive 24-h dietary recalls, which is frequently used in dietary assessment. We could not avoid the possibility of recall bias and other unknown confounding factors, which might influence the precise assessment of nutrient intakes. However, the average intake over three days can offer a relatively valid estimate of usual nutrient intakes [39,40]. In addition, the diet data collected between August and October of each year may not reflect seasonal differences in nutrients consumption. Third, it is noted that our present results were without adjustment for sampling weight, which might limit the ability to generalize our findings to the general population. Finally, because of possible differences in sampling frame, dietary assessment methods (24-h dietary recall or dietary record) and data-processing methods, a detailed cross-country comparison of nutritional data would introduce bias. However, Kroes et al. [41] found a similar effect on estimating dietary intake between 24-h dietary recall and dietary record. Moreover, it was clear that the nutrient intakes of the Chinese people in this study were quite different from those found in the people of other three countries, regardless of nutrients adjusted for energy.

5. Conclusions

The present study demonstrated that the structure of the Chinese diet has been shifting away from the traditional diet toward high-fat, low-carbohydrate and low-fiber diets, and nutrients intakes in Chinese people have been changing even worse than those in American people. From a public health perspective, the present findings imply that a healthy diet should be advocated in the Chinese people.

Authors Contributions

Yunxian Yu developed the initial idea and designed the study. Zhaopin Wang, Biao Zhou, Lijuan Wang, Lichun Huang, Shuying Jiang, Zeyu Liu and Jingxin Jiang were responsible for the data and sample collection. Ronghua Zhang and Biao Zhou was responsible for the quality control. Ying Fei and Shuangshuang Zheng conducted the statistical analysis. Ronghua Zhang and Zhaopin Wang wrote the manuscript. All authors contributed to the interpretation of the results and were involved in preparing the final manuscript.

Acknowledgments

We are particularly grateful for the supports and contributions of all participants and their families. This study was supported by the National Basic Research Program of China (973 Program) (Grant No.: 2011CB503706, funding open access publication charges), Natural Science Foundation of Zhejiang Province in China (Grant No.: LY14H260003) and Institute of Sports Science of Zhejiang Province in China (Grant No.: J20131484).

Supplementary Files

Supplementary File 1

Conflicts of Interest

The authors declare no conflict of interest.

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