The nitrogen (N) and phosphorus (P) costs of food production have increased greatly in China during the last 30 years, leading to eutrophication of surface waters, nitrate leaching to groundwater, and greenhouse gas emissions. Here, we present the results of scenario analyses in which possible changes in food production-consumption in China for the year 2030 were explored. Changes in food chain structure, improvements in technology and management, and combinations of these on food supply and environmental quality were analyzed with the NUFER model. In the business as usual scenario, N and P fertilizer consumption in 2030 will be driven by population growth and diet changes and will both increase by 25%. N and P losses will increase by 44 and 73%, respectively, relative to the reference year 2005. Scenarios with increased imports of animal products and feed instead of domestic production, and with changes in the human diet, indicate reductions in fertilizer consumption and N and P losses relative to the business as usual scenario. Implementation of a package of integrated nutrient management measures may roughly nullify the increases in losses in the business as usual scenario and may greatly increase the efficiency of N and P throughout the whole food chain.