Abstract
BACKGROUND: China's rapid economic development and urbanisation have led to significant shifts in dietary habits, moving from home-cooked meals to ready foods. This transition may exacerbate the burden of non-communicable diseases. OBJECTIVE: This study aimed to (i) assess the overall nutritional quality and quantities of specific nutrients of ready foods available from Chinese online stores, (ii) evaluate whether these foods comply with national dietary recommendations, and (iii) determine whether the nutritional quality of ready foods differs across manufacturers. METHODS: This cross-sectional study analysed ready foods from four major Chinese online stores: Taobao, JD.com, Suning, and Vipshop. Ready foods include pre-packaged, partially processed foods requiring minimal cooking or reheating before consumption. The nutritional quality was calculated based on the amount of dietary fibre, saturated fat, protein, sugar, sodium, and energy of the product by using the Health Star Rating (HSR) scoring algorithm. Continuous and categorical variables are described using means (standard deviation [SD]) or median (inter-quartile range [IQR]) and proportions respectively. RESULTS: We identified 109 419 products from the four major online stores, with 2 087 products included in analyses after conducting eligibility checks and removing duplicates. Median nutritional values for all ready foods were as follows: energy content 2203.3 kJ (IQR 2055.6-3222.5), protein content 29.2 g (IQR 14.9-51.5), fat content 35.5 g (IQR 17.0-57.4), carbohydrate content 15.5 g (IQR 5.8-45.6), and sodium content 1733.6 mg (IQR 995.7-3287.1). Only 25.3% of products met the estimated energy recommended range according to the Chinese dietary reference intakes and more than 85.6% exceeded the recommended sodium intake according to Chinese dietary guidelines. The mean HSR was 2.7 (SD = 0.9), and less than half (32.9%) were classified as healthy products (HSR ≥ 3.5). CONCLUSIONS: Many of the assessed Chinese ready foods failed to meet national dietary recommendations for nutrient composition and exhibited overall low overall nutritional quality. Potential strategies to combat the growing burden of diet-related non-communicable diseases include (i) enhancing consumer awareness about the nutritional aspects of ready foods, (ii) encouraging the food industry to reformulate products, and (iii) supporting consumers to choose healthier options.