China's eastern coastal region is associated with lower obesity, cardiovascular risk, and higher life expectancy. It's also where, for generations, market stalls selling fresh leafy greens, lotus seed pods, vegetables, tofu, and freshwater fish have shaped the diet of those living there.

Now, researchers led by Professor Zhu Shankuan from Zhejiang University's School of Public Health have looked into whether this specific diet – one specific to the eastern coastal region south of the Yangtze River – has something to do with the low rates of obesity and cardiovascular disease.

"The dietary habits from eastern coastal China have recently garnered widespread attention for their potential health benefits; however, empirical evidence remains limited," the researchers note in their paper.

Using data sourced from 8,931 participants in the WELL-China cohort living in this eastern coastal region, the team identified what they deem a regionally specific way of eating: 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)," the researchers write.

Working with the National Institute for Nutrition and Health under the Chinese Center for Disease Control and Prevention and the Nutrilite Health Institute, the team found that nearly half (46%) of participants adhered to the EastDiet, with this group more likely to be female and older.

This group had, on average, around a 22% lower risk of major cardiovascular events and a 17% lower risk of abdominal (or visceral) obesity. Among males, cardiovascular risk was reduced by as much as 36%.

"This dietary pattern and its association with central obesity was successfully replicated in an independent cohort," the researchers write.

Further analysis "revealed favorable metabolomic and gut microbial signatures associated with the EastDiet, which were linked to reduced risks of central obesity and major adverse cardiovascular events", according to the paper.

The EastDiet, which has emerged naturally over centuries in the Yangtze River Delta region, has parallels with another well-known ancient way of eating from the Mediterranean Basin. While it's undergone change as the region's cultures and communities have influenced local food consumption, the Mediterranean diet as we know it is also one centered around unprocessed grains and vegetables, favoring fish and seafood over other kinds of meat.

The Mediterranean diet is, of course, known for promoting cardiovascular and metabolic health, including being linked to lower abdominal fat. Recent studies have tied it to better mental and gut health.

Similarly, the EastDiet hasn't been concocted by nutritionists in a lab; instead, it's been shaped by local, natural resources. Key aspects are the use of waterways and fertile farmland and the seasonal availability of produce.

"The concept of the EastDiet was not something we designed ourselves," Zhu told China Daily. "We didn't begin with a predetermined answer and ask people to follow it. We wanted to see whether a healthier dietary pattern already existed within the real population."

And while the EastDiet features foods deeply rooted in traditional Chinese culture, there's also a universality that makes it accessible for anyone with access to fresh seasonal vegetables, fish, soy products, eggs and starchy tubers like sweet potato and taro.

It's also characterized by a low intake of refined grains and fried foods, and a higher amount of edible fungi.

"Although research linking fungi intake to omics profiles is limited, our study identified positive associations with beneficial gut microbial taxa and metabolites," the researchers write.

"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."

The study was published in the journal Nature Health.

Source: China Daily

Fact-checked by Mike McRae