The Double Burden of Poor Nutrition in China:
Roles of Fathers and Grandparents for Children’s Diet Quality
Over the past two decades, China has met its first Millennium Development Goal (MDG) of halving the proportion of people who suffer from hunger. Particularly impressive progress has been made to improve the nutritional status of Chinese children. From 1990 to 2010, the prevalence of stunting and underweight caused by malnutrition in children below 5 years old were decreased by about 70%. Meanwhile, the improvement in nutritional status resulted in a general acceleration of growth and development of children. China has employed a number of strategies to help achieve this progress, mainly including scaling up political commitment, increasing resources and taking urgent actions on nutrition.
Since 1990, the Chinese government has promulgated the Outline Program for the Development of Children in 1990-2000, 2001-2010 and 2011-2020, respectively, to implement the principle of giving priority to children. Under the guidance of this policy, various programs and activities for improving children’s nutritional status and health have been implemented, especially in rural areas. For example, with the launch of Nutrition Improvement for Children in Impoverished Areas Program, the National Health and Family Planning Commission started promoting a nutritional parcel (a soybean-based micronutrient-fortified food supplement with a demonstrated effect on the reduction of anaemia and other micronutrient deficiencies) among children aged 6-24 months. To date, with the allocated government funds, around 4 million children in 341 poverty counties have enjoyed the benefits of this nutritional parcel. Another fruitful activity is the China Nutrition Improvement Plan (2011), which covered children in 699 impoverished counties, provided free daily school meals for 26 million children. Except for nutrition interventions, the National Health and Family Planning Commission has issued a new version of the "Chinese dietary guidelines (2016)" recently, which includes specialized guides to infants, children and adolescents, respectively, to meet their needs of physiological characteristics and nutrition.
In spite of the remarkable achievements in improving children’s nutrition, new threats to children’s health continuously arise in China. For example, with the rapid develoment of economy, nutritional shifts in recent decades are driving the obesity epidemic in Chinese children. China, now, has been one of the developing countries struggle with the so-called ‘double burden’ of the undernutrition and overnutrition. A recent work carried out by our group suggests that the diet quality of Chinese children, in general, was not very cheerful. Underconsumption of soybeans, ﬁsh and shrimp, eggs, vegetables and fruits, and overconsumption of fried foods and meats were becoming growing threats to Chinese children. Notably, this study has proposed an impact of paternal, rather than maternal, education level on the children’s diet quality, suggesting the important role of fathers which had been ignored before, in children’s nutrition. It is conceivable that fathers can exert great influences on children’s eating since fathers play a major role in the traditional Chinese family. Another novel finding of this research was the relevance of family size for children’s diet quality, which indicated the grandparents’ impacts in the three-generation family.
Taken together, the persistent undernutrition and the increasing overnutrition among Chinese children demand sustained targeted efforts to promote optimal nutrition. Future priorities should be given to the special roles of fathers and grandparents in improving children’s nutrition.