In this paper we discuss diet and health changes of millet agriculturists in Northern China, Shaanxi province, during the period 7,000-4,000 BP. An episode of intensive climatic oscillations that preceded the onset of colder climate circa the fifth millennium BP divides the period (Shi et al. [1993] Global Planet. Change 7:219-233). The onset of the cooler climate marks the decline of the egalitarian society of Yangshao and the rise of the chiefdom-like society of Longshan. Skeletal materials from the two sites of Beiliu and Jiangzhai are from the earlier phases of Yangshao culture (7,000-6,000 BP), while remains from the Shijia site were excavated from the terminal phase of Yangshao culture (6,000-5,000 BP), a phase that would be expected to show adjustments to strong climatic fluctuations. Human remains from the Longshan culture (5,000-4,000, BP) were found at the Kangjia site. In order to investigate whether the trajectory of diet and health changes persisted beyond the Longshan, a skeletal sample from the Xicun site of the Western Zhao Dynastic period (3,800-2,200 BP) is included in our analyses. All Yangshao sites in our study are characterized by low frequencies of anemia and carious lesions. Some subsistence changes probably occurred during the later phase of Yangshao culture that resulted in elevated masticatory stress and occlusal macrowear among the Shijia people. However, deterioration of community health did not begin until the Longshan, when increased occurrence of porotic hyperostosis and caries is accompanied by decreased adult stature. The transition to softer, more extensively processed food during Longshan is evident in decreased rates of occlusal wear. Increased population density and diminished food values were most likely responsible for these changes. Poor health persisted into the subsequent Dynastic period of Western Zhao.