It was not that long ago that Chinese, at least in the cities, were eating good food vegetables, rice or noodles, and not much meat.

But now, residents of major cities such as Beijing, Shanghai and Guangzhou have crossed the Golden Arches of McDonald's for its burgers, got well acquainted with Colonel Sanders' fried chicken in KFC and eat other food filled with carbohydrates and fat.

A boy eats an orange at a kindergarten in Nanjing, Jiangsu Province. A national survey finds that 45.1 per cent of Chinese children aged 3-12 suffer from Vitamin A deficiency. [China Daily]

And it is showing in the latest nutritional surveys.

When a 36-year-old accountant in Nanjing began losing weight suddenly, he was scared.

"I was not on a diet," said the man, surnamed Yang. "Instead, I dined out a lot and ate high-calorie foods."

Yang went to hospital and was stunned when he was diagnosed with diabetes. "I thought that I was not old enough to develop the disease," he said.

He was told that all those delicious dishes, containing high quantities of fat and sugar, could have caused his condition.

More and more young people today suffer from diabetes and other chronic conditions such as high blood pressure, often thought to be the realm of only the middle-aged and senior citizens.

With more money in their pockets, they are now eating food that is higher in quantity and lower in quality, according to some of the country's best nutritionists.

"Urban residents are taking in too much fat and too few minerals," said Chen Chunming, nutritionist and former president of the Chinese Academy of Preventive Medicine in Beijing.

"As a result, a growing number of them are overweight and suffer from chronic diseases such as diabetes and high blood pressure."

More than one in five adults is now overweight, and nearly one in five is a victim of high blood pressure, he said.

On the other hand, more than two-thirds of the 30 million residents in China's poverty-stricken rural areas are short of nutrition, according to a 2005 study by the National Development and Reform Commission (NDRC).

The main shortage in Chinese diets, both urban and rural, seems to be iron. One in every five suffers from anaemia, a Ministry of Health survey found last year.

Other problems are the lack of calcium the average person takes in 391 milligrams of calcium a day, only about 40 per cent of the recommended level and zinc, especially among young children. About 40 per cent of those aged below 7 suffer from a zinc deficiency.

"The problematic nutritional intake of the Chinese may hinder the country's economic development in the long run, and it has to be tackled seriously," the NDRC report said.

In Chinese cities, an unbalanced diet has become the primary factor in the increase of chronic diseases, Chen said, adding that grains should contribute between 55 and 65 per cent of a person's food intake and fat should contribute below 30 per cent.

But among urban Chinese, cereals contributed well below 55 per cent of intakes and fat contributed much more than 30 per cent, according to a survey published last October by the Ministry of Health, the Ministry of Science and Technology and the State Bureau of Statistics.

The "Survey of the Status of Nutrition and Health of Chinese Residents" sampled more than 24,000 residents in all provinces.

Last year, an estimated 160 million Chinese suffered from high blood pressure - or 19 per cent of the adult population - compared with 90 million in 1991, a rise of 78 per cent in 14 years.

About 20 million Chinese suffered from diabetes last year, the survey showed.

Also, about 200 million Chinese adults, or 22.8 per cent, were overweight. And 70 million of them, or 7.1 per cent, suffered from obesity. The obesity percentage was about half as high in 1992, the survey said.

"The high ratio of chronic disease occurrence is related to changes that have taken place on Chinese dinner tables in recent decades," said Chen, the nutritionist.

In 1959, a nationwide survey showed that Chinese did not have enough food. They were eating mainly coarse grains, while rice and wheat only accounted for a little more than 10 per cent of their diet. They were also severely lacking in protein.

By 1982, people had full stomachs, but their diet still consisted primarily of coarse grains.

In the following two decades, the Chinese were eating less and less of the coarse grains and taking in more and more protein and fat.

Mi Jie, a professor at the Capital Institute of Paediatrics under the Chinese Academy of Medical Science in Beijing, said high calorie intake was being compounded by low levels of exercise.

Younger generation

Children are also becoming more affected by food-related diseases and disorders.

For example, one of every 20 diabetes sufferers in Beijing is a child aged 13 or younger, Xinhua News Agency has reported. And Ministry of Education statistics last year showed that 11.5 per cent of urban Chinese boys aged 7 to 22 were obese, and so were 8 per cent of urban girls of the same age group.

Some experts see the situation as evidence of deeper problems of a more psychological nature, and not just in the children.

"Chinese parents tend to feel better when their children eat more," Mi said. "But this can be no good for the children."

Jiang Yifang, director of the Department of Nutrition at Shanghai Children's Hospital, blames parents for what he calls "their special 'compensational' psychology."

"They don't want their children to eat coarse grains as they themselves did in their childhood, and are willing to provide their children with as much food as possible and food that's as expensive as possible," Jiang said.

He added that most overweight children in cities are eating not because of hunger but because of psychological problems. They go to the refrigerator when they feel lonely, when they have pressures from schoolwork and when they see parents quarrelling, for example.

"If these children are still fat when they become teenagers, they have an 80 per cent probability of suffering from obesity as adults," Jiang said.

Nutritional divide

While many people in the cities seem to have eaten too much, their compatriots in the countryside are generally confronted with a lack of nutrition.

What is more, "the situation has not been obviously improved in the last two decades with the economic development," the NDRC report said.

"And it even worsened in some of the areas with the worst poverty."

Compared with overweight children in the cities, more than 9 per cent of children under the age of 5 in the countryside were underweight in 2005, and in poverty-stricken areas, the figure was 14.4 per cent, according to the 2005 survey.

About 17 per cent of rural children aged below 5 were growing more slowly than they should be, the survey said.

"All these ratios have decreased by more than 50 per cent since 1992," Chen said. "They show that rural children are getting better in their nutritional intake, but there is still much room for improvement."

Among rural children, those in underdeveloped areas such as the Guangxi Zhuang Autonomous Region and Guizhou Province are those most lacking the necessary nutrition, according to a survey of eight provinces released last September by the Ministry of Health.

As many as one-third of the children in Guizhou and nearly one-fourth of those in Guangxi are physically developing more slowly than they should be, the report said.

On the whole, the Chinese lack minerals in their diet, according to Chen Junshi, a researcher at the Institute of Nutrition and Food Safety, an affiliation of the Chinese Centre for Disease Control and Prevention in Beijing.

"The lack of minerals in the diet of the Chinese has not improved in the past decade even though people are eating more and better food," he said.

"It is because people want their food more refined so it will taste better. The refining procedures reduce the content of minerals in the food."

Solutions

To tackle the shortage of mineral intake in people's diet, researchers at the Chinese Centre for Disease Control and Prevention are exploring ways to add minerals into seasonings most often used in Chinese dishes.

They recently succeeded in adding iron to soy sauce and are promoting the new product, according to Chen Junshi, the researcher.

But to improve the diet of the Chinese on the whole, the first thing that has to be done is to tell people what they should eat more and what they should eat less, said Chen Chunming, the nutritionist.

Chinese people also need a "better attitude towards eating," said Wang Chengyu, a professor of nutrition at the Nanjing Institute of Sports.

"People are getting so busy, but they should never eat to work," she said.

"They have to think that they are working in order to have a better quality of food and happier lives."

(China Daily 05/16/2006 page1)