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Published: 14:47, July 17, 2026
Healthy living
By Li Yingxue
Study shows China’s ‘EastDiet’, followed south of the Yangtze, can help lower risk of obesity, heart disease
At neighborhood markets in Hangzhou, Zhejiang province, summer mornings begin long before the city has fully woken
Stalls brim with freshly harvested lotus seed pods, leafy greens glistening with dew, seasonal mushrooms, and freshwater fish from nearby rivers and ponds, and tofu and vegetables that have long been staples of local kitchens
For generations, these foods have been part of everyday life in the eastern coastal region south of the Yangtze River. They were never marketed as “superfoods” or assembled according to a scientifically designed nutrition plan
Rather, they emerged naturally from a landscape rich in waterways, fertile farmland, and a deep respect for the seasonal availability of produce
Now, modern science is looking at whether this traditional way of eating may offer important lessons for the future of public health
A study recently published in Nature Health has identified what researchers call the “EastDiet” — an eating pattern associated with lower risks of obesity and cardiovascular disease and rooted in the food traditions of China’s eastern coastal region
Led by Professor Zhu Shankuan at Zhejiang University’s School of Public Health, the study was conducted in collaboration with the National Institute for Nutrition and Health under the Chinese Center for Disease Control and Prevention and the Nutrilite Health Institute
The findings suggest that people who adhere to this diet have a roughly 22 percent lower risk of major adverse cardiovascular events and a 17 percent lower risk of central obesity. Among men, the protective effect was even stronger, with cardiovascular risk reduced by as much as 36 percent
What makes the discovery even more interesting is that the EastDiet was not created in a laboratory or developed as a meal plan. Instead, researchers identified it by analyzing the eating habits of thousands of ordinary people
The study sought to answer an increasingly important question: beyond the Mediterranean diet, is there a healthy diet deeply rooted in Chinese culture and lifestyle that can also be validated by modern science?
Zhu said this question was the starting point of the research
“The concept of the EastDiet was not something we designed ourselves,” he said. “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.”
For decades, discussions about healthy eating habits have largely revolved around the Mediterranean diet
Rich in olive oil, nuts, whole grains, fruits, vegetables, and seafood, the diet has been linked to lower risks of cardiovascular disease and metabolic disorders, making it one of the most widely recommended dietary models in public health
But China’s culinary traditions, food systems, and eating habits differ dramatically from those of the Mediterranean region. From the hearty stews of the northeast and the spicy cuisine of Sichuan and Chongqing to Cantonese soups and the freshwater specialties of the eastern coastal region, China’s food culture is far too diverse to fit neatly into an imported framework
If healthy eating should be grounded in everyday life, could China already have its own healthy diet?
Seeking answers, Zhu’s team turned to existing data
The study drew on the WELLChina cohort, which recruited nearly 10,000 residents from three urban districts of Hangzhou between 2016 and 2019. Researchers followed 8,931 healthy adults for an average of 6.3 years
Rather than deciding in advance which foods were healthy, the team employed an unsupervised clustering approach, allowing patterns to emerge naturally from data based on the consumption of 22 food groups
Two major dietary patterns surfaced. Nearly 46.8 percent of participants fell into one distinct cluster, which researchers named the EastDiet
The pattern was characterized by higher consumption of vegetables, fruits, whole grains, nuts, dairy products, and eggs; greater intake of seafood and freshwater fish; more soy products, mushrooms, and starchy root vegetables such as sweet potatoes, taro, and lotus root; and lower consumption of refined grains, fried foods, red meat, processed meat, and alcohol
Shi Yuwei, the paper’s first author and a doctoral student at Zhejiang University, said the logic behind the EastDiet is straightforward
“It is essentially a diet with more plant-based foods, more whole grains replacing refined staples, a greater diversity of high-quality proteinained
The pattern aligns closely with modern nutritional recommendations, but nutrition scientists did not invent it. “It has always existed in Chinese daily life,” Zhu said
A closer look at the diet reveals unmistakable characteristics of China’s eastern coastal region
Freshwater fish and aquatic products, tofu and other soy foods, bamboo shoots, mushrooms, lotus root, taro, and a wide variety of seasonal vegetables all feature prominently in the dietary pattern
Yu Bin, founder of the Michelin two-star restaurant Jie Xiang Lou in Hangzhou, said this is hardly surprising
The diet, he said, was shaped not by health-conscious planning but by geography and generations of accumulated culinary wisdom. “Hangzhou places tremendous emphasis on terroir (the combination of soil, climate, and sunlight) and seasonal freshness,” Yu said
In the eastern coastal region’s culinary tradition, the changing seasons dictate not only the landscape but also what is put on the dining table
Spring brings shepherd’s purse, Indian kalimeris, and bamboo shoots. Summer offers lotus seed pods, water caltrops, and tender freshwater delicacies. Autumn is the season of lake crabs and aquatic produce, while winter features winter bamboo shoots and preserved foods
This seasonal rhythm naturally increases dietary diversity, a characteristic nutrition researchers increasingly recognize as a hallmark of healthy eating
Modern nutritional science suggests that good health rarely comes from eating a single “superfood”. Instead, it emerges from a varied and balanced diet
The traditional food culture of China’s eastern coastal region appears remarkably consistent with contemporary understandings of healthy eating
The region’s dense network of rivers and lakes has also shaped its proteinnated the dinner table, freshwater fish, shrimp, and other aquatic products have long played a central role in local diets. Soy products such as tofu, dried bean curd, and tofu sheets further diversify protein intake
What may appear to be ordinary dietary choices today, researchers argue, form the nutritional backbone of the EastDiet
The study also uncovered a culturally intriguing feature: people adhering to the EastDiet generally preferred lighter flavors. For many consumers accustomed to heavily seasoned food, “light” flavors are often associated with blandness
Yu disagreed. “People should be able to taste the ingredient itself,” he said. “Freshness comes from the ingredient. Seasoning should be restrained.”
This philosophy has long shaped Hangzhou cuisine, where steaming, braising, poaching, and gentle simmering are widely used to highlight natural flavors rather than mask them
What traditional cooks describe as qingdan xianhua — light, fresh, and smooth — is, in essence, respecting the ingredient’s original taste
Remarkably, this culinary philosophy aligns closely with modern nutritional advice to reduce excessive salt, sugar, and ultra-processed foods
Unlike the Mediterranean diet, which relies heavily on olive oil, China’s eastern coastal food culture developed its own form of what might be called “subtraction cooking” — preserving natural flavors while minimizing unnecessary calories and sodium
If culinary traditions explain how the EastDiet emerged, biomedical science is beginning to explain why it may be beneficial
The researchers found significant associations between the EastDiet and 96 circulating blood metabolites. They also identified 21 gut microbial genera linked to the dietary pattern
Many of these microbes are involved in the fermentation of dietary fiber and the production of short-chain fatty acids, compounds increasingly associated with reduced inflammation, improved metabolic health, and cardiovascular protection
The study further found higher levels of several beneficial metabolites among EastDiet followers. These included indole-3-propionic acid (IPA), a gut-derived compound that has attracted growing attention for its potential protective effects against cardiometabolic disease
Together, the findings suggest a biological pathway linking diet, gut microbes, metabolism, and disease risk
Nutritionist Gu Zhongyi was not surprised by the results. “Food shapes the gut microbiome,” he said. “The foods people eat over time select certain microbial communities, and those microbes in turn influence metabolism.”
At the same time, Gu cautioned against over-interpreting the findings. “This remains an observational study,” he said. “Further randomized controlled trials are needed before causality can be firmly established.”
Still, he said that he believes the study’s greatest strength lies in its real-world relevance
“This isn’t an idealized dietary intervention designed in a laboratory,” he said. “It reflects what people are actually eating. Seeing a roughly 20 percent health benefit under real-life conditions is already very meaningful.”
For ordinary consumers, the value of the EastDiet lies less in complex metabolic pathways than in its practicality. Gu said that the diet offers not a rigid menu but a set of principles that can be adapted to modern life
One of the most important lessons, he said, is reducing reliance on refined carbohydrates
The EastDiet incorporates a variety of root vegetables, including sweet potatoes, taro, and lotus root, to replace some of the refined rice and wheat products that dominate many modern diets
This simple substitution can increase fiber intake, stabilize blood sugar levels, and provide fuel for beneficial gut microbes. Meanwhile, tofu, dried bean curd, mushrooms, and other traditional ingredients remain affordable and widely available throughout China
“They are among the most cost-effective health foods you can find,” Gu said
For young urban professionals increasingly dependent on food delivery services, he recommends focusing on achievable improvements rather than perfection. “The first step is finding reliable restaurants,” he said
He also encourages consumers to ensure each meal contains vegetables and quality protein while limiting fried foods and heavily seasoned dishes
“Healthy eating doesn’t have to be expensive, nor does it require a complete lifestyle overhaul,” Gu said. “Small changes sustained over time often produce the biggest results.”
To determine whether the EastDiet was unique to Hangzhou, researchers subsequently validated the findings in an independent cohort spanning multiple Chinese cities
The results were strikingly consistent. Both the dietary pattern itself and its association with lower risks of central obesity were replicated across the validation cohort
The findings suggest that the EastDiet may represent more than a regional eating habit. It could serve as the foundation for a broader Chinese framework for healthy eating
The research team has already extended follow-up data through early 2026, and the team plans to develop an EastDiet scoring system for use in future intervention studies and public health assessments
Zhu said the study’s significance extends beyond nutrition science
For decades, discussions about healthy eating in China have often looked outside the country for answers. This research suggests that some of those answers may already exist within China’s own culinary traditions
“We can think of the EastDiet as a Chinese version of the Mediterranean diet,” Zhu said. “But unlike a diet that was designed, this one grew naturally out of the real lives of Chinese people.”
From the fish, lotus roots, and soy foods of China’s eastern coastal region to the metabolomic maps and microbiome analyses of modern laboratories, the EastDiet represents more than a new scientific concept
It is a rediscovery of a way of eating that has existed for generations — one that modern science is only now beginning to measure, understand, and validate
As dietary habits around the world become increasingly homogenized and chronic diseases continue to rise, the evidence emerging from China’s own dining tables may offer a new vision of healthy eating for the future
Contact the writers at liyingxue@chinadaily.com.cn
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