Changing Dietary Patterns among Chinese Older Adults: A Rural-Urban Comparative Analysis (2008-2018).

Background: Since the 1990s, Chinese residents have experienced rapid dietary shifts, with potential disparities emerging between rural and urban populations. This study examined dietary patterns and changes across these areas, particularly among older adults.

Methods: Data from four waves (2008-2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were used, covering 20,945 older adults aged 65 and above. Latent class analysis identified dietary patterns based on five core food items (fresh vegetable, fruit, meat, egg, dairy products). Multinomial logistic regression assessed correlates of class membership for rural and urban participants.

Results: The study sample included 11,357 rural and 9,588 urban residents. Dietary trends showed greater fluctuations among urban residents than rural residents. Four distinct dietary classes were identified: vegetable-dominant (27.39% rural vs. 37.66% urban), low-frequency (63.42% rural vs. 24.10% urban), balanced (5.10% rural vs. 15.84% urban), and egg-dominant (4.09% rural vs. 22.39% urban). Among rural participants, the odds of following a balanced or egg-dominant diet were significantly higher compared to the low-frequency group (reference group; odds ratio [OR] > 1). Among urban participants, those with formal education, regular exercise, or better self-rated health were more likely to follow vegetable-dominant, balanced, or egg-dominant diets compared to the low-frequency group (OR > 1).

Conclusions: Targeted interventions addressing dietary disparities and promoting balanced diets may reduce nutritional inequality and improve health outcomes, particularly for rural residents.