Nutrition transition in China: the growth of affluent diseases with the alleviation of undernutrition.

Since 1950, the annual GNP in China increased from 104 to 1401 Yuan per capita, while household real purchasing power quadrupled. In addition, food production and distribution also rose. China's improved standard of living has brought about several health changes: a reduction in diseases of poverty (high infant mortality, communicable disease, nutritional deficiency), the doubling of life expectancy from 35 years in the 1950s to 67 (male) and 71 (female) years, but it has increased diseases of affluence, such as obesity and cardiovascular disease. The three leading causes of death in China today are cancer, cerebrovascular disease, and myocardial infarction, while deaths from tuberculosis and acute infectious illness are markedly reduced. About 60 million of the population suffer from hypertension and a quarter that number has diabetes. Because China is a vast territory with different levels of development and types of diet, pockets of nutritional deficiency remain; about 35 million people are undernourished. While most of the population receive sufficient macronutrients to satisfy the Chinese RDA, they frequently lack micronutrients. Childhood rickets and iron deficiency anaemia are prevalent in rural regions and close to half of the children under three years of age in the autonomous regions and provinces suffer from these conditions. Chinese diets are changing. They are becoming more westernised and people are consuming more food of animal origin. This is most noticeable in cities where, in 1988, fat accounted for 30% of the caloric intake (up from 26% in 1981). In urban areas about 10% of woman and 5% of men are now obese. China is encouraging citizens to eat a variety of foods along more traditional lines, with plant foods constituting the bulk of intake, and a lesser amount of food of animal origin. In 1993, the State Council approved a national position paper entitled "Outlines for China's Food Structure Reform and Development in the 1990s". The government hopes that this will lead to a healthier national diet by the year 2000.