Both stunting and overweight are present in children across China. Seemingly paradoxical, these two conditions can also coexist in the same child. The aim was to examine the associations between dietary food/nutrient intake and plasma lipid profiles related to stunting and overweight status.

The 2002 China National Nutrition and Health Survey was a family-based nationally representative cross-sectional study.

Thirty-one provinces, autonomous regions and municipalities.

The study included 13 770 children aged 2–17 years. The sample size for the four exposure groups was 10 814 for children of normal height and weight, 2128 for stunted, 729 for overweight and 99 for stunted overweight.

Compared with children of normal height and weight, stunted and stunted overweight children consumed more high-energy-dense foods with a lower dietary diversity score, less protein, polyunsaturated fat and Fe, and a higher molar ratio of phytate to Ca. On the contrary, overweight children tended to consume significantly less carbohydrates and more protein and fat. Overall, stunted overweight children consumed lower amounts of vegetables, fruit, white meat (poultry and fish) and more milk. The OR for prevalent dyslipidaemia were 1·32 (95 % CI 1·13, 1·53), 1·76 (95 % CI 1·48, 2·09) and 2·59 (95 % CI 1·65, 4·07) among stunted, overweight and stunted overweight children, respectively, compared with children of normal height and weight. In addition, being overweight was significantly associated with high glucose concentrations, whereas stunting was significantly associated with having anaemia.

Limited dietary diversity and intake of high-energy-dense foods were notably observed among stunted overweight children. Furthermore, being stunted and/or overweight was associated with an increased likelihood of unhealthy lipid profiles.

To review the nutrition policies and efforts related to nutrition transition in China.

Design and setting: This paper reviews the nutrition policy and activities of China to prevent and control diet-related non-communicable diseases (DR-NCDs). Data came from the Ministry of Health, the Ministry of Agriculture, the State Council and some cross-sectional surveys.

China is undergoing a remarkable, but undesirable, rapid transition towards a stage of the nutrition transition characterised by high rates of DR-NCDs in a very short time. Some public sector Chinese organisations have combined their efforts to create the initial stages of systematic attempts to reduce these problems. These efforts, which focus on both under- and overnutrition, include the new Dietary Guidelines for Chinese Residents and the Chinese Pagoda and The National Plan of Action for Nutrition in China, issued by the highest body of the government, the State Council. There are selected agricultural sector activities that are laudable and few other systematic efforts that are impacting behaviour yet. In the health sector, efforts related to reducing hypertension and diabetes are becoming more widespread, but there is limited work in the nutrition sector. This paper points to some unique strengths from past Chinese efforts and to an agenda for the next several decades.

China is trying in its efforts to prevent and control the development of DR-NCDs but effects are limited. Systematic multi-sector co-operation is needed to effectively prevent and control DR-NCDs inside and outside the health sector.