BANOO PARPIA: And now let's turn our attention to what was found from the China project in terms of the rural Chinese dietary pattern and examine this description of the macronutrient composition of the Chinese and US diets and compare the two. , First the Chinese in rural China-- and this is for a sedentary male aged 19 to 45 years old-- consumes more calories than a similar male in the US. And this is adjusted for physical activity. So despite their small size, they're consuming more calories. And yet there's much less obesity in China. This is a noteworthy observation. This could be due to the increased physical activity levels, but it's also in part due to the macronutrient profile of the Chinese diet. And by macronutrients we mean those nutrients that contribute to the overall energy intake or caloric intake of the diet.
When we examine this slide, we see that carbohydrate intake in the US is only 42% of total calorie intake, whereas in China it's over 70% of intake. Protein is more or less the same-- 15% in the US of total calories, 10% of total calories in China. But it's the source of the protein that's remarkably different. 70% of protein calories are from animal sources in the US, whereas only 11% of protein calories come from animal sources in China. Fat intake is remarkably different as well. You see 36% of our intake in the US is from fat, compared to only 14% to 15% in China.
However, we know that much we don't consume nutrients, we consume food. So it's useful to look at what types of foods are consumed and how different they are between the US and China. So in the US, the total number of grains consumed-- again, for this average sedentary male adjusted for physical activity-- is 278 grams. And this translates into, let's say, one slice of bread and a bowl of oatmeal and raisin cereal. In China, in total the amount of grain consumed per day is over 600 grams, or 666 grams a day. And that translates into about 5 slices of bread, a bowl and a half of rice, two sweet potatoes, and a quarter cup of cornmeal. So this is remarkably different in terms of grain consumption.
If we look at vegetable consumption, in the US we have 181 grams consumed, which translates into, let's say, a stalk of broccoli. In China this stalk of broccoli would then be supplemented by two very large bowls of cabbage and spinach, if we were to translate that 315 grams into actual foods. Of course we know it varies-- there is a variety of foods that's consumed, a variety of vegetables. But this is just for comparison purposes that we've done this here.
Next, if we move on to animal foods and look at the pork, beef and poultry consumption in the two countries, in the US it's 131 grams per day compared to just 34 grams in China. And that translates to in the US that's a quarter pound of hamburger or quarter pound of pork chop and then maybe some slices of boiled luncheon meat or boiled ham. In China, it's only just one ounce if at all for the day. And this ounce of pork, typically pork, is eaten in very, very small, just to flavor the tsai dish, and in fact would be much less.
And the most dramatic difference is if we look at milk and dairy consumption. If in fact the ethnic minority populations were not included in the study population, we would have zero consumption of milk and dairy in rural China. But because we include the ethnic populations, we have something like a teaspoon of milk consumed per day in China, 2.4 grams. In the US, of course, it's 287 grams and growing.
So up to now we've really compared China and the US. But we haven't really looked at trends within China and looked at changes that are occurring in the Chinese dietary pattern. And this slide essentially tells us how change is occurring in the six year period between '83 and '89. We see that calorie intake has gone down slightly. It's carbohydrate intake that is primarily responsible for that. So we see carbohydrate intake with a downward trend. But it's fat intake that has gone up. Fat as a percentage of calories in this six year period went from 15% of total calories in '83 to almost 20% in 1989. And it has grown significantly ever since then as well. So we're approaching almost US levels with the advent of economic reform, and modernization, and globalization coming into the country. But more on that later, as we comment further on the analytical results.
So next let's turn our attention to the descriptive findings from the study and look at a comparison between the mortality rates in the US and in China. Here we see it for males. And we see how different the disease profile is in the two countries. For example, esophageal, stomach, and liver cancer are the predominant cancers in China, and much higher than they are in the US. For stomach cancer, for example, it's 15 times higher in China than it is in the US. This is very different for colon cancer, which is higher in the US than it is in China. The disease that is predominantly different is in fact coronary heart disease and myocardial infarction. This is 198 deaths in the US per 100,000 compared to just 11 deaths in China per 100,000 population.
We see a similar pattern for females, with the same kinds of cancers-- stomach, liver, and so on-- being much higher in China. But here we have the rates for breast cancer. And you see that breast cancer is very, very low in China. And it's five times higher in the US.
Let's next turn our attention to a comparison of US and Chinese values on selected markers of biochemical nutritional status. Starting first with the lipid fractions-- things like cholesterol, triglycerides, and the apolipoprotein B and A1 fractions, which tell you about the lipid status of the individual in the blood. Let's look at cholesterol first. The average value in cholesterol is 127 milligrams per deciliter, compared it to in the US an average of about 212. The ranges are particularly useful to look at. Ranges from a low of 88 to 165 in China, whereas the US ranges from 155 to 274. So you see their high is equivalent to our low.
If we look at the bad cholesterol, the non-HDL cholesterol here, look at the ranges in males in China. It ranges from 41 to 128, whereas in the US it's from 90 to 205. Again, almost double at the high end of the range.
Another lipid fraction that has been implicated and been associated with the risk of heart disease is the apolipoprotein B fraction. And you look at it, it's almost double again in the US compared to China-- 58 milligrams per deciliter in China and 90 in the US.
We continue this comparison of biochemical markers of nutritional status by looking at plasma values or blood values of vitamin C levels, red blood cell hemoglobin, total protein, urea nitrogen, and so on. If we look at vitamin C, again in China it ranges from a low of about 0.0 to 3.2. In the US, the high end of the range is only 2.0. So again you've got a real difference between what the values are in China and the values are in the US. In fact, it's highest in China than it is in the US. Markers of protein status, such as urea nitrogen and total protein, also show this much higher level in the US than in rural China.
Hemoglobin, which is typically used as a marker of iron status, is thought to be compromised in a diet which has very high fiber and not enough heme iron or not enough animal foods. But here if you look at it, you see that the status in China is not compromised at all. In fact it is equivalent to what we see in the US.
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This study room provides a general overview and introduction to the Cornell-China-Oxford project. The project is a large and comprehensive epidemiologic study designed to explore and investigate the relationship between diet and disease.
In addition to the general descriptive findings of the study, the implications of this body of research evidence for prevention of chronic diseases such as heart disease and cancer are discussed.
This video is part 6 of 8 in the The China Project: Studying the Link Between Diet and Disease series.