Table 3_Is takeout culture associated with rising colorectal cancer in young Chinese adults? An ecological analysis of GBD and CHNS data.xlsx

ObjectiveTo explore the epidemiology of diet-related diseases and shifts in dietary habits among frequent takeout consumers in China over the previous decade.
MethodsThis study utilized data from the Global Burden of Disease (GBD) 2021 to analyze incidence trends of 12 diet-related diseases, including nutritional deficiencies, non-neoplastic digestive diseases, and gastrointestinal cancers, spanning from 2010 to 2021. Additionally, we assessed changes in Disability-Adjusted Life Years (DALYs) attributable to various risk factors. Changes in dietary behavior among young Chinese adults were evaluated using data from the China Health and Nutrition Survey (CHNS).
ResultsThe standardized incidence of Vitamin A deficiency has consistently declined over the past decade. Among non-neoplastic digestive diseases, inflammatory bowel disease showed the most pronounced decrease. In contrast, the burden of colorectal cancer has increased annually across all age groups. Significant risk factors for colorectal cancer—including low intake of whole grains and milk, and high consumption of red and processed meats, as well as smoking—have contributed to an increase in DALYs in 2021 compared to 2010. Additionally, these shifts in beverage consumption—particularly the steep rise in soft drinks—are a key public health concern given their established dietary risks. Critically, their temporal coincidence with the explosive growth of the takeout market posits the delivery ecosystem as a potential amplifier of these unhealthy dietary patterns.
ConclusionFrom 2010 to 2021, colorectal cancer incidence rose among Chinese adults aged 20–39, despite declining burdens of nutritional deficiencies and non-neoplastic digestive diseases. This trend parallels shifts in dietary behavior and the rapid growth of the takeout industry. These findings call for further research into causal links and platform-based public health interventions promoting healthier diets.

研究目的：本研究旨在探索近十年来中国高频外卖消费者群体中，膳食相关疾病的流行病学特征，以及饮食习惯的变化趋势。
研究方法：本研究采用2021年全球疾病负担（Global Burden of Disease, GBD）研究数据，对2010至2021年间12种膳食相关疾病的发病趋势进行分析，涵盖营养缺乏症、非肿瘤性消化系统疾病以及胃肠道恶性肿瘤。此外，本研究还评估了各类危险因素导致的伤残调整寿命年（Disability-Adjusted Life Years, DALYs）的变化情况。同时，本研究借助中国健康与营养调查（China Health and Nutrition Survey, CHNS）的数据，评估了中国青年成年人膳食行为的改变。
研究结果：过去十年间，维生素A缺乏症的标准化发病率持续下降。在非肿瘤性消化系统疾病中，炎症性肠病的发病率降幅最为显著。与之形成鲜明对比的是，结直肠癌的疾病负担在所有年龄组中均呈逐年上升趋势。结直肠癌的明确危险因素包括全谷物与奶类摄入不足、红肉及加工肉类摄入过量，以及吸烟，上述因素使得2021年的DALYs较2010年有所升高。此外，饮品消费结构的变化——尤其是含糖软饮料消费量的大幅攀升——已成为重要的公共卫生关切问题，因其已被证实存在膳食相关健康风险。尤为关键的是，这类不健康膳食模式的变化与外卖市场的爆发式增长在时间上高度重合，提示外卖配送生态系统可能是这类膳食模式的潜在助推因素。
研究结论：2010至2021年间，尽管营养缺乏症与非肿瘤性消化系统疾病的疾病负担有所下降，但20-39岁中国成年人的结直肠癌发病率呈上升趋势。这一趋势与膳食行为的变迁以及外卖行业的快速发展相契合。本研究结果呼吁开展更多关于因果关联的深入研究，并推动基于平台的公共卫生干预措施以促进健康膳食。