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Table 1 showed the demographic data of all the respondents. Among the 170, 847 participants, 73, 030 (42.7%) were males and 97, 817 (57.3%) were females. The average age of the male and female respondents was 51.6 ± 14.7 and 51.5 ± 13.9 years, respectively. The average age of all respondents was 51.5 ± 14.2 years. With regard to residence location, 32, 070 (40.8%) male and 46, 609 (59.2%) female respondents lived in urban areas, and 40, 960 (44.4%) male and 51, 208 (55.6%) female respondents lived in rural areas.
Characteristics Male Female n % n % Total 73, 030 42.7 97, 817 57.3 Age (years) 18-24 3, 072 50.8 2, 974 49.2 25-34 7, 807 44.9 9, 596 55.1 35-44 13, 119 41.3 18, 653 58.7 45-54 17, 031 39.5 26, 134 60.5 55-64 18, 290 43.1 24, 183 56.9 65 13, 711 45.7 16, 277 54.3 Ethnicity Han nationality 64, 241 42.5 86, 834 57.5 Other 8, 789 44.5 10, 983 55.6 Education Illiterate or some primary school 13, 935 28.9 34, 302 71.1 Primary school graduate 15, 095 44.4 18, 910 55.6 Junior high school graduate 26, 423 49.5 26, 948 50.5 Senior high school graduate or above 17, 577 49.9 17, 657 50.1 Urban/rural residence Urban 32, 070 40.8 46, 609 59.2 Rural 40, 960 44.4 51, 208 55.6 Geographic location South 8, 717 40.9 12, 587 59.1 North 10, 138 41.1 14, 523 58.9 Northeast 9, 562 44.3 12, 047 55.8 East 9, 651 43.3 12, 659 56.7 Central 17, 169 44.3 21, 572 55.7 Southwest 7, 377 42.8 9, 861 57.2 Northwest 10, 416 41.7 14, 568 58.3 Marital status Single 4, 810 64.2 2, 683 35.8 Married or cohabitating 62, 992 43.0 83, 634 57.0 Other 5, 228 31.3 11, 500 68.8 Family income* ≤ $1045.3 15, 677 44.5 19, 586 55.5 $1045.3-1881.6 10, 483 43.5 13, 633 56.5 $1881.6-3658.6 16, 487 42.5 22, 341 57.5 ≥ $3658.6 14, 231 43.8 18, 294 56.3 Unknown 16, 152 40.3 23, 963 59.7 Note. *Household income per capita per year. Table 1. Characteristics of Participants in the 2013 China Chronic Disease and Risk Factor Surveillance (n = 170, 847)
Table 2 showed VF consumption by the overall population, as well as by subpopulation (Figure 1A and Figure 2A). The average fruit consumption was 102.3 g/day (95% CI: 97.0-107.6); the average vegetable consumption was 350.6 g/day (95% CI: 339.3-361.8); and the average combined VF consumption was 452.9 g/day (95% CI: 439.4-466.3). Individuals aged ≥ 65 years and from other ethnicities had significantly lower vegetable consumption than other age groups and those with Han ethnicity [others 312.4 g/day 95% CI: (293.0-331.7) vs. Han 354.2 g/day (95% CI: 342.6-365.8)]. Fruit consumption was significantly lowest among those aged ≥ 65 years, men [91.5 g/day (95% CI: 86.6-96.3) vs. women 113.3 g/day (95% CI: 107.0-119.6)], and rural residents [87.0 g/day (95% CI: 80.7-93.3) vs. urban 120.3 g/day (95% CI: 113.5-127.2)]. Fruit consumption increased with higher educational levels (P for trend < 0.01). Total VF consumption increased with education (P for trend < 0.01). Individuals who live in rural areas reported lower VF consumption than those who live in urban areas [437.0 g/day (95% CI: 418.8-455.1) vs. urban 471.6 g/day (95% CI: 457.4-485.9)]. Figure 3 showed age-standardized VF consumption in 2002 and 2013. Vegetable and fruit consumption was 350.6 and 102.4 g, respectively, in 2013. These values are both higher than those reported in 2002.
Characteristics Fruit Vegetable Fruit and Vegetable % (95% CI)* All 102.3 (97.0-107.6) 350.6 (339.3-361.8) 452.9 (439.4-466.3) 53.2 (50.9-55.4) Age (years) 18-24 124.6 (115.9-133.3) 345.4 (329.6-361.2) 470.0 (450.4-489.6) 56.0 (53.2-58.9) 25-34 120.7 (114.4-127.0) 345.2 (334.2-356.3) 465.9 (452.7-479.2) 55.1 (52.9-57.4) 35-44 107.1 (101.1-113.2) 357.1 (345.5-368.6) 464.2 (449.7-478.7) 55.0 (52.6-57.3) 45-54 93.8 (88.3-99.2) 362.1 (349.8-374.5) 455.9 (441.8-460.0) 54.1 (51.5-56.7) 55-64 81.1 (76.0-86.3) 359.4 (347.4-371.4) 440.5 (426.6-454.4) 51.7 (49.2-54.1) 65- 69.1 (63.3-75.0) 325.2 (310.3-340.1) 394.3 (376.9-411.8) 42.8 (39.6-45.9) P for trend < 0.01 0.22 < 0.01 < 0.01 Gender Male 91.5 (86.6-96.3) 356.7 (345.3-368.1) 448.2 (435.1-461.4) 52.8 (50.6-55.1) Female 113.3 (107.0-119.6) 344.3 (332.7-356.0) 457.6 (442.9-472.3) 53.5 (51.1-56.0) P for difference < 0.01 < 0.01 < 0.01 - Ethnicity Han nationality 103.3 (97.8-108.9) 354.2 (342.6-365.8) 457.5 (443.9-471.2) 54.1 (51.9-56.3) Others 91.3 (77.1-105.6) 312.4 (293.0-331.7) 403.7 (373.4-434.0) 43.6 (37.9-49.4) P for difference < 0.01 < 0.01 < 0.01 - Education Illiterate or some primary school 62.1 (56.7-67.5) 335.4 (321.2-349.6) 397.5 (380.8-414.3) 44.4 (41.5-47.3) Primary school graduate 83.8 (78.1-89.5) 351.2 (336.9-365.4) 435.0 (418.3-451.6) 50.3 (47.3-53.2) Junior high school graduate 104.7 (99.1-110.2) 355.7 (343.4-367.9) 460.3 (445.8-474.8) 54.5 (52.0-57.0) Senior high school graduate or above 138.1 (131.1-145.2) 353.9 (342.1-365.7) 492.1 (477.4-506.7) 59.3 (57.2-61.4) P for trend < 0.01 0.01 < 0.01 < 0.01 Urban/rural residence Urban 120.3 (113.5-127.2) 351.3 (340.0-362.5) 471.6 (457.4-485.9) 56.0 (53.7-58.3) Rural 87.0 (80.7-93.3) 350.0 (334.8-365.1) 437.0 (418.8-455.1) 50.8 (47.8-53.8) P for difference < 0.01 < 0.01 < 0.01 - Geographic location South 85.4 (75.4-95.4) 376.5 (342.9-410.0) 461.9 (429.9-493.9) 56.8 (51.6-62.0) North 111.7 (95.7-127.7) 331.7 (293.7-369.7) 443.4 (393.6-493.2) 50.8 (40.9-60.7) Northeast 122.4 (103.8-141.1) 333.9 (309.9-357.9) 456.3 (422.6-490.1) 51.1 (46.3-55.9) East 111.6 (96.6-126.7) 332.2 (304.6-359.8) 443.8 (408.1-479.5) 52.0 (45.9-58.0) Central 115.4 (103.8-126.9) 348.6 (325.0-372.2) 464.0 (434.9-493.0) 53.8 (49.7-57.8) Southwest 85.2 (69.7-100.7) 339.6 (315.4-363.8) 424.8 (391.5-458.1) 51.1 (45.1-57.0) Northwest 82.4 (70.1-94.6) 374.6 (352.7-396.6) 457.0 (428.7-485.3) 53.9 (48.9-58.8) P for difference < 0.01 < 0.01 < 0.01 - Marriage Single 121.4 (113.1-129.6) 343.5 (328.7-358.2) 464.8 (447.3-482.3) 55.1 (52.2-57.9) Married or cohabitating 101.4 (96.1-106.7) 353.4 (342.3-364.6) 454.9 (441.3-468.4) 53.5 (51.2-55.8) Other 72.2 (65.4-78.9) 323.8 (309.4-338.2) 396.0 (378.3-413.6) 44.3 (41.2-47.4) P for difference < 0.01 < 0.01 < 0.01 - Family income ≤ $1045.3 84.9 (77.9-91.9) 345.3 (329.9-360.8) 430.2 (412.1-448.4) 49.2 (46.1-52.2) $1045.3-1881.6 96.7 (90.2-103.2) 351.5 (338.2-364.8) 448.2 (431.8-464.6) 52.5 (49.9-55.1) %1881.6-3658.6 109.4 (102.9-115.9) 357.3 (344.9-369.6) 466.7 (451.2-482.2) 55.7 (53.1-58.2) ≥ $3658.6 127.2 (118.6-135.9) 358.4 (344.8-372.7) 485.6 (468.0-503.3) 57.3 (54.9-59.7) Unknown 95.4 (86.7-104.2) 342.2 (325.5-358.9) 437.6 (417.3-458.0) 51.6 (47.9-55.3) P for difference < 0.01 < 0.01 < 0.01 - Note. *Statistical difference for the prevalence of adequate VF consumption among different groups was equal with that for the prevalence of low VF consumption shown in Table 3. Table 2. Average and prevalence of adequate VF consumption (g/day) based on the WHO recommendation among Chinese Adults by demographic characteristics: The 2013 China Chronic Disease and Risk Factor Surveillance [n = 170, 847, mean (95% CI)]
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Table 3 showed that the prevalence of overall low VF consumption rate is 46.8% (95% CI: 44.6%-49.1%). VF consumption rate marked varied by age, ethnicity, educational level, urban/rural residence, marital status, and family income. The highest prevalence of low VF consumption was observed among those aged ≥ 65 years (57.2%, 95% CI: 54.1%-60.4%) and those who are illiterate or have an educational attainment of primary school (55.6%, 95% CI: 52.7%-58.5%). Nearly half [47.2% (95% CI: 44.9%-49.4%)] of men and 46.5% (95% CI: 44.1%-48.9%) of women did not consume sufficient VF.
Variable Low VF* Low Vegetable† Low Fruit† % (95% CI) χ2 P % (95% CI) χ2 P % (95% CI) χ2 P All 46.8 (44.6-49.1) 38.9 (36.7-41.2) 82.4 (81.0-83.8) Age groups (years) 167.9 < 0.01 43.8 < 0.01 307.3 < 0.01 18-24 44.0 (41.1-46.8) 39.5 (36.0-42.9) 77.5 (75.2-79.8) 25-34 44.9 (42.6-47.1) 39.5 (37.2-41.8) 78.3 (76.5-80.1) 35-44 45.0 (42.7-47.4) 37.6 (35.4-39.9) 81.6 (79.9-83.3) 45-54 45.9 (43.3-48.5) 37.1 (34.7-39.6) 84.0 (82.5-85.6) 55-64 48.3 (45.9-50.8) 37.5 (35.0-40.0) 87.1 (85.8-88.5) 65- 57.2 (54.1-60.4) 44.4 (41.1-47.6) 89.9 (88.5-91.3) Gender 1.2 0.27 10.0 < 0.01 102.9 < 0.01 Males 47.2 (44.9-49.4) 38.1 (35.9-40.3) 85.0 (83.7-86.2) Females 46.5 (44.1-48.9) 39.8 (37.3-42.2) 79.8 (78.1-81.6) Ethnicity 14.3 < 0.01 2.0 0.15 2.1 0.15 the Han nationality 45.9 (43.8-48.1) 38.7 (36.3-41.0) 82.2 (80.7-83.7) Others 56.4 (50.6-62.1) 41.9 (37.8-46.0) 84.9 (81.8-88.0) Education 198.5 < 0.01 11.1 0.01 546.1 < 0.01 Illiterate or some primary school 55.6 (52.7-58.5) 41.4 (38.6-44.2) 91.7 (90.5-92.8) Primary school graduate 49.7 (46.8-52.7) 38.6 (35.7-41.6) 86.9 (85.5-88.4) Junior high school graduate 45.5 (43.0-48.0) 37.6 (35.2-40.1) 82.2 (80.7-83.6) Senior high school graduate or above 40.7 (38.6-42.8) 39.1 (36.6-41.7) 73.7 (71.4-76.0) Urban/rural residence 10.8 < 0.01 0.5 0.50 51.4 < 0.01 Urban 44.0 (41.7-46.3) 39.5 (36.9-42.2) 77.9 (75.9-80.0) Rural 49.2 (46.2-52.2) 38.4 (35.6-41.2) 86.2 (84.7-87.8) Geographic location 2.8 0.83 16.2 0.01 30.4 < 0.01 North 49.2 (39.3-59.1) 32.3 (27.2-37.5) 86.2 (83.9-88.6) South 43.2 (38.0-48.4) 43.5 (35.2-51.7) 79.9 (75.8-84.0) Northeast 48.9 (44.1-53.7) 44.4 (39.9-48.9) 77.6 (73.5-81.8) East 48.0 (42.0-54.1) 42.4 (36.2-48.6) 79.6 (75.1-84.2) Central 46.3 (42.2-50.3) 41.8 (37.3-46.3) 79.5 (76.2-82.9) Southwest 49.0 (43.0-54.9) 37.1 (29.8-44.5) 87.4 (85.0-89.8) Northwest 46.1 (41.2-51.1) 32.4 (28.1-36.7) 87.2 (84.2-90.3) Marital status 45.1 < 0.01 16.0 < 0.01 56.7 < 0.01 Single 45.0 (42.2-47.8) 40.2 (36.7-43.6) 77.9 (75.3-80.4) Married or cohabitating 46.5 (44.2-48.8) 38.4 (36.1-40.6) 82.7 (81.3-84.1) Others 44.3 (52.6-58.8) 44.7 (41.6-47.8) 88.3 (86.4-90.2) Family income 31.3 < 0.01 1.5 0.83 83.8 < 0.01 ≤ $1045.3 50.8 (47.8-53.9) 39.2 (35.9-42.5) 86.7 (85.1-88.3) $1045.3-1881.6 47.5 (44.9-50.1) 38.8 (36.1-41.5) 84.5 (82.9-86.1) $1881.6-3658.6 44.3 (41.8-46.9) 37.8 (35.3-40.3) 80.5 (78.6-82.4) ≥ $3658.6 42.7 (40.3-45.1) 39.5 (36.7-42.3) 76.2 (73.7-78.6) unknown 48.4 (40.3-45.1) 39.5 (35.9-43.2) 84.0 (81.6-86.3) Note. *Recommendation of WHO (VF ≥ 400 g/day); †Chinese Dietary Guidelines (≥ 200 g/day for fruits and ≥ 300 g/day for vegetables). Table 3. Prevalence (%) of Low Vegetable and Fruit (VF) Consumption, Low Vegetable Consumption, and Low Fruit Consumption Among Chinese Adults in 2013 (n = 170, 847). Rates were Based on the WHO Recommendation and Chinese Dietary Guidelines
The prevalence of low VF consumption among urban residents was lower than that among rural residents [44.0% (95% CI: 41.7%-46.3%) vs. 49.2% (95% CI: 46.2%-52.2%), P = 0.01]. Low VF consumption was associated with old age (P for trend < 0.01) but inversely related with education (P for trend < 0.01). The prevalence of low fruit consumption was 82.4% (95% CI: 81.0%-83.8%) and that of low vegetable consumption was 38.9% (95% CI: 36.7%-41.2%).
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Table 4 showed that age, gender, ethnicity, educational level, marital status, family income, BMI, health literacy, breakfast frequency, lunch frequency, and LTPA are significantly associated with low VF consumption rate (P < 0.05). The effect of urban/rural residence was trivial (OR = 1.04, 95% CI: 0.93-1.16). Compared with individuals with normal weight, underweight individuals were 1.17 times (95% CI: 1.03-1.33) more likely to have low VF consumption, whereas obese individuals had lower odds (OR = 0.90, 95% CI: 0.84-0.97). Individuals with higher educational attainment were more likely to consume adequate VF by approximately 14%-27% than those without. Health literacy is also associated with low VF consumption rate. Compared with those without LTPA, active individuals were less likely to have low VF consumption rate by approximately 12%-26%. Compared with their counterparts, irregular breakfast (OR = 1.20, 95% CI: 1.04-1.38) or irregular lunch (OR = 1.58, 95% CI: 1.26-1.99) frequencies were associated with lower VF intake. Dinner regularity, however, was not associated with low VF consumption.
Covariates OR 95% CI P Intercept 0.80 0.24 Age (years) 1.01 1.00, 1.01 < 0.01 Gender Male (ref) Female 0.93 0.88, 0.97 < 0.01 Ethnicity Han nationality (ref) Others 1.41 1.15, 1.74 < 0.01 Education Illiterate or some primary school (ref) Primary school graduate 0.86 0.81, 0.93 < 0.01 Junior high school graduate 0.79 0.73, 0.85 < 0.01 Senior high school graduate or above 0.73 0.66, 0.81 < 0.01 Urban/rural residence Urban (ref) Rural 1.04 0.93, 1.16 0.49 Marital status Married or cohabitating (ref) Single 1.20 1.08, 1.33 < 0.01 Others 1.15 1.06, 1.24 < 0.01 Income ≤ $1045.3 (ref) $1045.3-1881.6 0.94 0.86, 1.03 0.16 $1881.6-3658.6 0.88 0.79, 0.98 0.02 ≥ $3658.6 0.90 0.78, 1.02 0.10 Unknown 0.99 0.87, 1.13 0.88 Weight (BMI) status Normal (ref) (18.50-23.99) Underweight (< 18.50) 1.17 1.03, 1.33 0.02 Overweight (24.00-27.99) 1.00 0.95, 1.05 0.97 Obesity(≥ 28) 0.90 0.84, 0.97 < 0.01 Health literacy Literate and positive (ref) Semiliterate and positive 0.90 0.80, 1.01 0.07 Illiterate and positive 1.32 1.15, 1.52 < 0.01 Negative 1.29 1.06, 1.57 0.01 Breakfast frequency Regular (ref) Irregular 1.20 1.04, 1.38 0.01 Lunch frequency Regular (ref) Irregular 1.58 1.26, 1.99 < 0.01 Dinner frequency Regular (ref) Irregular 0.97 0.72, 1.31 0.85 Leisure-time physical activity No (ref) Low (METs ≤ 1200) 0.88 0.80, 0.98 0.02 High (METs ≥ 1200) 0.74 0.66, 0.83 < 0.01 Note. *Geographic locations were also included in the model but had no significant associations (P > 0.05). Thus, the results for geographic locations were not reported. Table 4. Associations (OR and 95% CI) between covariates and low vegetable and fruit consumption rate among Chinese adults based on weighted logistic regression analysis (n = 160, 897)*