Objectives: Determination of trends in diet-related behaviors and their interactions with cardio-metabolic diseases is an important research endeavor. Methods: We analyzed food categories, weight, eating frequency, eating location, cooking methods, time of food intake, dietary knowledge, food preference, nutritional structure over time, and their interaction with cardiometabolic risks, using t tests and χ² tests, based on the China Health and Nutrition Survey packages from 1997 to 2011. Results: Consumption of fruits, dairy products, snacks, fast food, and beverages has increased significantly, as a concomitant and marked decrease in rice consumption has occurred. Food categories, eating frequency, cooking methods, and at-home eating are gradually increasing and diversifying. Persons not only prefer to consume carbohydrate-rich foods like fruits and vegetables, but also enjoy energy-dense foods like meat, snacks, and beverages. There has been a switch from a predominantly plant-based diet to a Western style diet high in fat and animal-based foods. People have undergone significant changes in reducing the intake of energy, carbohydrates, and protein, but significantly increased their fat intake. Conclusion: Chinese dietary patterns and diet-related behaviors have undergone significant transition in the past few decades, trending towards diversification and modernization.