Personal Prioritization of Healthy Eating among Chinese Adults and Its Association with Dietary Behaviors: Findings from the China Health and Nutrition Survey

Objective: China faces a growing non-communicable disease (NCD) burden linked with diet.  The link between attitudes towards healthy diets and specific eating behaviors has been underexplored in Chinese settings. The aim of this study is to evaluate disparities in personal healthy eating prioritization among Chinese adults and its association with specific dietary patterns. Methods: Data from the 2011 China Health and Nutrition Survey (CHNS) was used to examine healthy eating prioritization (how important “eating a healthy diet” was to participants) and its association with socio-demographic, interpersonal, and physical health variables, along with plant-based and healthy eating dietary patterns, and consumption of specific food groups.  Results: Of the 13,653 participants with healthy eating prioritization data, 94% believed eating a healthy diet to be important. Odds of believe healthy eating to not be important was negatively associated with increased age (AOR:0.98, 95%CI:0.98-0.99), higher educational attainment (AOR:0.12, 95%CI: 0.07-0.19), living in urban environments (AOR:0.76, 95%CI:0.63-0.83), living with both parents (AOR:0.69, 95%CI:0.48-0.98), and past diagnosis of NCDs (AOR:0.76, 95%CI:0.59-0.96). Men and those who were single had higher odds of believing eating a healthy to not be important (AOR:1.36, 95%CI:1.08-1.71; AOR:1.36, 95%CI:1.08-1.71). Compared to those who believed eating a healthy diet to be important, those who did not had a lower odds of higher vegetable intake (AOR:0.77, 95%CI:0.62-0.96) and higher meat intake (AOR:0.80, 95%CI:0.63-1.00).  Conclusion: Findings provide novel insights on how interventional and observational dietary attitude research in China may need to explore the unique role vegetable and meat intake play in the diet attitude-behavior link.