Eastern coastal Chinese diet associated with reduced obesity and improved cardiometabolic health

Abstract The dietary habits from eastern coastal China have recently garnered widespread attention for their potential health benefits; however, empirical evidence remains limited. Here we applied unsupervised clustering to dietary data from 8,931 participants in the WELL-China cohort from the eastern coastal region and identified a healthful dietary pattern, designated as the ‘EastDiet’. This EastDiet comprised both well-recognized healthy foods (higher intakes of vegetables, fruits, seafood, whole grains, dairy, nuts and eggs; lower intakes of refined rice, red meat and fried foods) and distinctive Chinese dietary elements (greater consumption of freshwater fish, starchy tubers and roots, soy products and edible fungi). Three key aspects of the EastDiet were highlighted in our analysis: (1) approximately 46% of participants adhered to the EastDiet, and these individuals were more likely to be female and older and prefer lighter flavours; (2) adherence to the EastDiet was associated with lower odds of central obesity (odds ratio, 0.83; 95% confidence intervals, 0.75–0.92) and a 22% lower risk of incident major adverse cardiovascular events (hazard ratio, 0.78; 95% confidence intervals, 0.64–0.96); and (3) omics profiling revealed favourable metabolomic and gut microbial signatures associated with the EastDiet, which were linked to reduced risks of central obesity and major adverse cardiovascular events. This dietary pattern and its association with central obesity was successfully replicated in an independent cohort. In conclusion, the EastDiet identified in this study represents an evidence-based dietary pattern rooted in Chinese food traditions, which may serve as a framework for promoting healthy eating in China.