Background. Serum cholesterol (TC) levels and coronary heart disease (CHD) are lower in China than in wester countries. This report examines the role of thet in determining TC.Methods. Data were collected as part of a cross-sectional study of 10 000 men and women, 35-54 years old, conducted in 1983-1984 in four areas in China. A 10% subsample was surveyed for eating patterns and measurement of blood lipids. Six one-day dietary recalls were collected on each participant.Results. Mean daily intake of energy from fat was less than 30% Mean Keys scores ranged from 20.4 to 32.6. In multvariable regression analysis controlling for age, body mass Index (BMI), and alcohol. Keys score was statisticall associated with serum TC. A 10-unit greater Keys score was associated with 6.3 mg/dl higher TC and 4.0 mg/dl higher low density lipoprotein cholesterol.Conclusions. We conclude that in China the relation of dietary lactors to serum llpids is similer to that in population having high senum TC levels.