Paradox of Plenty in China and Hong Kong

by Georgia S. Gulden

Chinese Food in China, Hong Kong, and/or Taiwan

Spring Volume: 1998 Issue: 5(1) page(s): 9

Yes, in China and Hong Kong, there are departures from tradition and healthy nutrient proportions. Allow me to introduce you to them. As a nutritionist based in China and later in Hong Kong since 1988, I have seen first hand the fascinating movement away from traditional diets toward more modern versions. Since the 1980's, a basically adequate food supply produced by a large agricultural population, coupled with increases in modernization and increasing affluence are resulting in overnutrition. Thus, the diet and health of Chinese populations are changing. This is ironic.

Many Chinese people are deserting their traditional diets with healthy proportions of carbohydrate and fat in favor of less healthy higher fat and lower carbohydrate Western diet proportions. Western health officials are trying to move these diets back toward earlier traditional dietary proportions.

China's population can be divided into a rural majority, perhaps seventy percent, with the remaining more affluent, educated minority living in large cities. Getting two-thirds of their energy from grains, the Chinese have had a grain-based diet, mainly wheat in the north and rice in the south, with urban residents consuming both.

From the most recent nutrition survey conducted in 1992, overall diet consumption is in line with the goals proposed in Western countries; that is with high-carbohydrate low-fat proportions that are considered healthy. That survey showed urban folk getting fifty-seven percent of their calories from grain, thirty-eight percent from fat, and more protein from animal sources, their rural compatriots getting seventy-two and nineteen percent, respectively. Since the last survey in 1982, grain and tuber intake decreased and animal foods, sugar, and alcohol consumption increased.

Chinese children now grow taller and heavier in both urban and rural areas, more among the former, less so among the latter. Malnutrition prevails in rural areas, mostly due to poor weaning practices including over dependence on breast milk and due to poor supplementary feeding.

Nowadays, obesity is a problem for older children in urban areas. Adult obesity has also increased with about fifteen percent of the population considered obese in urban areas, eight percent in rural areas. Obesity is highest in Beijing, about thirty-five percent there are considered obese. Iron deficiency is found in both areas, children under three having the highest prevalence of anemia, eleven to twenty-three percent in urban areas and sixteen to twenty-nine percent in rural areas. Obesity is also a problem for thirty percent of those over age seventy in both areas. Clearly, income is a factor in dietary intake, more means eating more animal foods. Urban groups are also eating more processed foods, a result of growing industrialization.

Hong Kong, a prosperous and modern city, is considered by many to be the eating-capital of the world. Here, six million healthy residents live in high-rise apartments and they have a high life expectancy. Their infant mortality is flat. Good health for these people originates from healthy traditional diets coupled with some aspects of Chinese culture that include strong families, a traditional health concept stressing balance, harmony, and strengthening the constitution, and little alcohol or drug use.

Diet-wise, Hong Kong has also undergone transition with an increase in, among other things, coronary heart disease and stroke. Cancers associated with nutrition such as lung, colon, breast, and liver are also rising along with the increase in obesity. High rates of diabetes are now found among the elderly, as are increasing rates of osteoporotic hip fractures.

While the growth of Hong Kong's children has improved compared to information from the 1960's, childhood and adolescent obesity are also increasing. Several small recent studies show diets that are high in protein and some find high cholesterol levels in seven-year-olds. Anorexia nervosa and interest in dieting is of emerging interest among adolescents. Modernization and affluence have ushered in abundant food supplies, better growth, improved health for children, and over-nutrition-related problems for the adults.

Appropriate promotion of nutrition awareness for those in Hong Kong, China, and Chinese peoples everywhere is a solution. In China, established nutrition policies help manage these problems. In 1997, China revised its dietary guidelines in hopes of bringing diets more in line with healthy proportions. These guidelines stress, among other things, limiting animal intake, eating more soy products, and consuming more vegetables, fruits, and starchy roots. Let's wish them every success with their promotion!
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Georgia S. Gulden is an Associate Professor teaching and conducting research with the Food and Nutritional Sciences Program at the Chinese University of Hong Kong. Her education includes a PhD in nutrition from Tufts University and more than twenty years of nutrition-related experience in various Asian countries.

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