Association between the traditional Chinese diet, non-communicable diseases and all-cause mortality: a longitudinal study based on China Health and Nutrition Survey (CHNS).

Jizhao Niu, Bai Li, Zumin Shi, Angeliki Papadaki

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Article in European journal of nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 authors.

Jizhao NiuCentre for Exercise, School for Policy Studies, Nutrition and Health Sciences, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK. jizhao.niu@bristol.ac.uk.ORCID http://orcid.org/0009-0003-6787-4976

Bai LiCentre for Exercise, School for Policy Studies, Nutrition and Health Sciences, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.

Zumin ShiDepartment of Nutrition Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.

Angeliki PapadakiCentre for Exercise, School for Policy Studies, Nutrition and Health Sciences, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.

Funding

University of Bristol - China Scholarship Council jointed Scholarship University of Bristol - China Scholarship Council jointed Scholarship

6 · The paper itself

Abstract

purposeTraditional diets may reduce non-communicable disease (NCDs) risk. No research has examined associations between the traditional Chinese diet (TCD), defined using an a priori method, and NCD-related outcomes or all-cause mortality. This study aimed to assess the relationship between TCD adherence, NCD-related outcomes, and all-cause mortality.

methodsThis longitudinal study utilised data from the China Health and Nutrition Survey (CHNS) between 1997 and 2011. Eligible participants were aged 18-74, had no NCDs at baseline, and participated in at least two survey waves. TCD adherence was assessed using a recently developed TCD index. Higher index scores indicate greater adherence; participants were categorised into low (0-6), medium (7-11), and high (12-23) adherence. Mixed-effects multilevel logistic regression and Cox proportional hazards models assessed associations with CVD, diabetes, cancer, obesity/central obesity, hypertension, and all-cause mortality.

resultsAmong 11,158 participants (mean age 42.2 years, 51.3% women), high TCD adherence was associated with lower risk of CVD (OR: 0.73, 95% CI 0.61, 0.87) and all-cause mortality (HR: 0.73, 95% CI 0.63, 0.87), but higher risk of obesity (OR: 1.19, 95% CI 1.08, 1.32) and central obesity (OR: 1.19, 95% CI 1.12, 1.26). However, when standardising the energy intake on a common basis, TCD adherence was inversely associated with obesity and central obesity.

conclusionsHigher adherence to the TCD was associated with reduced risk of CVD and all-cause mortality in this sample of Chinese adults. The positive association with obesity highlights the need to consider total energy intake in future dietary recommendations.

Indexed as

DietNoncommunicable DiseasesNutrition SurveysAdolescentAdultAgedCardiovascular DiseasesCause of DeathChinaEast Asian PeopleFemaleHumansLongitudinal StudiesMaleMiddle AgedObesityAll-cause mortalityDietary patternsNon-communicable diseasesTraditional Chinese dietTraditional diets

Identifiers

PMID42435090

DOI10.1007/s00394-026-04057-w

PMCPMC13356078

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.