Most Commonly-Consumed Food Items by Food Group, and by Province, in China: Implications for Diet Quality Monitoring

Dietary quality is of great significance to human health at all country income levels. However, low-cost and simple methods for population-level assessment and monitoring of diet quality are scarce. Within these contexts, our study aimed to identify the sentinel foods nationally and by province of 29 food groups to adapt the diet quality questionnaire (DQQ) for China, and validate the effectiveness of the DQQ using data from the China Health and Nutrition Survey (CHNS). The DQQ is a rapid dietary assessment tool with qualitative and quantitative analysis to determine appropriate sentinel foods to represent each of 29 food groups. Dietary data of 13,076 participants aged 15 years or older were obtained from wave 2011 of CHNS, and each food and non-alcoholic beverage was grouped into 29 food groups of the DQQ. The data were analyzed to determine the most commonly consumed food items in each food group, nationally and in each province. Key informant interviews of 25 individuals familiar with diets in diverse provinces were also conducted to identify food items that may be more common in specific provinces. China’s DQQ was finalized based on identification of sentinel foods from the key informant interviews, and initial national results of the quantitative data. Consumption of sentinel foods accounted for over 95% of people who consumed any food item in each food group, at national levels and in all provinces for almost all food groups, indicating the reliability of the sentinel food approach. Food-group consumption data can be obtained through DQQ to analyze dietary diversity as well as compliance with WHO global dietary guidance on healthy diets, providing a low-burden, food-group-based and simple method for China to evaluate diet quality at the whole population level.