Objective To compare and analyze the regional differences in dietary and nutrient intake and the prevalence of chronic disease comorbidities among Chinese adults aged 65 years and over in 2015.

Methods Data were collected from the 2015 China National Chronic Disease and Nutrition Surveillance, with a multi-stage stratified cluster sampling method across 298 monitoring sites in 31 provinces (autonomous regions, municipalities) of China. A total of 35 873 individuals were included in the survey, with 14 214 participating in the dietary survey, categorized into seven regions of China (North China, Northeast China, East China, Central China, South China, Southwest China, and Northwest China). Dietary intake data were collected using a continuous 3-day 24-hour dietary recall combined with weighing methods. Food categories were classified according to the China Food Composition Table, and energy and nutrient intakes were calculated.

Results Elderly people in South China had higher daily intakes of rice and rice products (245.2 g/d), fresh vegetables (277.0 g/d), livestock and poultry meat (130.7 g/d), fish and shrimp (37.8 g/d), protein (55.0 g/d), vitamin A (262.0 μg/d), vitamin B₂ (0.7 mg/d), vitamin C (84.0 mg/d), zinc (9.5 mg/d), and selenium (37.4 mg/d). Elderly people in Northwest China had higher daily intakes of wheat flour and wheat products (186.9 g/d), cooking salt (9.6 g/d), carbohydrates (248.5 g/d), vitamin B₁ (0.8 mg/d), and vitamin E (53.7 mg/d). Older adults in north China had higher daily intakes of wheat flour and wheat products (184.3 g/d), whole grains and legumes (41.6 g/d), eggs (29.4 g/d), dairy (30.5 g/d), carbohydrates (241.6 g/d), dietary fiber (10.1 g/d), vitamin B₁ (0.8 mg/d), and magnesium (254.2 mg/d). Older adults in East China had higher daily intakes of fresh vegetables (269.3 g/d), soybeans and nuts (18.3 g/d), dairy (25.2 g/d), fish and shrimp (37.6 g/d), protein (55.7 g/d), dietary fiber (9.7 g/d), vitamin A (280.4 μg/d), vitamin B₂ (0.7 mg/d), vitamin C (82.7 mg/d), folate (166.6 μg/d), calcium (388.7 mg/d), potassium (1 449.3 mg/d), iron (18.6 mg/d), and selenium (37.3 mg/d). Older adults in northeast China had higher daily intakes of tubers (64.7 g/d), fresh fruit (62.0 g/d), and dairy (30.3 g/d). Older adults in Central China had higher daily intakes of fresh vegetables (281.7 g/d), cooking salt (9.7 g/d), cooking oil (45.2 g/d), dietary fiber (9.6 g/d), vitamin C (78.3 mg/d), sodium (5 803.6 mg/d), and iron (19.0 mg/d). Older adults in southwest China had higher daily intakes of fresh vegetables (260.6 g/d), cooking oil (49.8 g/d), energy (1 821.5 kcal/d), fat (78.8 g/d), and zinc (9.4 mg/d). The prevalence rates of two and three chronic disease comorbidities among older adults were 24.7% and 20.6%, respectively. Statistically significant differences (P<0.05) were observed across the seven regions in the prevalence of comorbidities such as hypertension combined with neck or lumbar disease, hypertension combined with stomach disease, hypertension combined with diabetes and dyslipidemia, and hypertension combined with hyperuricemia and dyslipidemia.

Conclusions Regional differences exist in the intake of major foods and dietary nutrients, as well as in the prevalence of certain chronic disease comorbidities, among elderly people in the seven regions of China in 2015.