Abstract
BACKGROUND: The global burden of early-onset chronic diseases, especially early-onset type 2 diabetes, is increasing, particularly in China. Diet is a key factor and emerging evidence highlights substantial inter-individual variability in metabolic responses to diets, highlighting the need for precision nutrition. METHODS: The China Precision Nutrition Biobank (CPNB) is a prospective, longitudinal, cohort study designed to investigate diet-phenotype/genotype interactions and develop precision dietary strategies for early prevention and intervention of chronic diseases, with a particular focus on early-onset diseases. CPNB consists of three phases: the alpha (pilot cohort), beta (transition cohort), and gamma (main cohort) phases. Approximately 200, 1450, and 20,000 adults aged 18-40 years from urban and rural areas in China including Beijing, one city each in Heilongjiang, Shandong, Zhejiang, Guangxi, and Hainan provinces, and one or more villages each in Henan, Gansu, Sichuan, Zhejiang, and Hunan provinces will be recruited during the alpha, beta, and gamma phases, respectively, between 2025 and 2035. Sociodemographic information, medical records, read-time weighed food records and corresponding continuous glucose monitor (CGM) readings, objective physical activity, food challenges, genes, gut and oral microbiota, metabolites from blood, stool, urine, saliva, and hair, and questionnaires will be collected at baseline survey. The follow-up survey will be conducted every five years to repeat these assessments until participants' death (the follow-up period may extend up to 80 years). Outcomes of interest are common early- and late-onset chronic diseases and their preclinical stages. DISCUSSION: The CPNB data can be used to develop prediction models for personalized metabolic responses and risks of early-onset chronic diseases among Chinese people. It will also provide new evidence on interactions of diet with human phenotypes/genotypes during preclinical stage, onset, and progression of early-onset diseases. CPNB aims to inform the development of precision nutrition strategies aligned with the principles of predictive, personalized, preventive, and participatory medicine in the Chinese population. TRIAL REGISTRATION: CPNB was registered at Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ) on June 3rd, 2025, under the registration number ChiCTR2500103621.