China’s food consumption patterns and eating and cooking behaviors changed dramatically between 1991 and 2011. Macronutrient composition has shifted toward fats, and protein and sodium intakes remain high and potassium intake low. The rapid decline in intake of coarse grains and, later, of refined grains and increases in intake of edible oils and animal-source foods accompanied by major eating and cooking behavior shifts are leading to what might be characterized as an unhealthy Western type of diet, often based on traditional recipes with major additions and changes. The most popular animal-source food is pork, and consumption of poultry and eggs is increasing. The changes in cooking and eating styles include a decrease in the proportion of food steamed, baked, or boiled and an increase in snacking and eating away from home. Prior to the last decade there was essentially no snacking in China except for hot water or green tea. Most recently the intake of foods high in added sugar has increased. The dietary shifts are affected great by the country’s urbanization. The future, as exemplified by the diet of the 3 mega cities, promises major growth in consumption of processed foods and beverages.