2024

Jump to: 2023, 2022, 2021

13 pages, 281 KiB

Open AccessArticle

Longitudinal Relationship between the Percentage of Energy Intake from Macronutrients and Overweight/Obesity among Chinese Adults from 1991 to 2018

by Xiaorong Yuan, Yanli Wei, Hongru Jiang, Huijun Wang, Zhihong Wang, Mengru Dong, Xiaohui Dong and Jiguo Zhang

Nutrients 2024, 16(5), 666; https://doi.org/10.3390/nu16050666 - 27 Feb 2024

Viewed by 700

Abstract

To investigate the prospective relationship between macronutrient intake and overweight/obesity, data were collected in the China Health and Nutrition Survey (CHNS) from 1991 to 2018. Adults who participated in at least two waves of the survey and were not obese at baseline were [...] Read more.

To investigate the prospective relationship between macronutrient intake and overweight/obesity, data were collected in the China Health and Nutrition Survey (CHNS) from 1991 to 2018. Adults who participated in at least two waves of the survey and were not obese at baseline were selected as the study subjects. A total of 14,531 subjects were finally included with complete data. Overweight/obesity was defined as a body mass index (BMI) ≥ 24.0 kg/m². The generalized estimating equation (GEE) was used to analyze the relationship between the percentage of energy intake from macronutrients and BMI and overweight/obesity. The percentages of energy intake from protein and fat showed an increasing trend (p < 0.01), and the percentage of energy intake from carbohydrate showed a decreasing trend (p < 0.01) among Chinese adults between 1991 and 2018. Adjusting for covariates, the energy intake from fat was positively correlated with BMI, while the energy intake from carbohydrates was negatively correlated with BMI. The percentage of energy intake from non-high-quality protein and polyunsaturated fatty acids (PUFA) were positively correlated with overweight/obesity. In contrast, monounsaturated fatty acids (MUFA) and high-quality carbohydrates were negatively correlated with overweight/obesity. In short, fat, non-high-quality protein, saturated fatty acids (SFA), and PUFA were positively correlated with the risk of obesity, whereas higher carbohydrate, MUFA, and high-quality carbohydrate intake were associated with a lower risk of obesity. Obesity can be effectively prevented by appropriately adjusting the proportion of intake from the three major macronutrients. Full article

2023

Jump to: 2024, 2022, 2021

16 pages, 1612 KiB

Open AccessArticle

Variation Patterns of Hemoglobin Levels by Gestational Age during Pregnancy: A Cross-Sectional Analysis of a Multi-Center Retrospective Cohort Study in China

by Mengxing Sun, Tingfei Gu, Tianchen Wu, Xiaoli Gong, Xiaona Li, Jiaqi Huang, You Li, Yangyu Zhao, Huifeng Shi and Yuan Wei

Nutrients 2023, 15(6), 1383; https://doi.org/10.3390/nu15061383 - 13 Mar 2023

Cited by 1 | Viewed by 2629

Abstract

Background: Pregnancy anemia is a global health concern. However, to our knowledge, there still has little consensus on the reference value of hemoglobin levels. Particularly, little evidence from China was accessible in most existing guidelines. Objective: To evaluate hemoglobin levels and anemia prevalence [...] Read more.

Background: Pregnancy anemia is a global health concern. However, to our knowledge, there still has little consensus on the reference value of hemoglobin levels. Particularly, little evidence from China was accessible in most existing guidelines. Objective: To evaluate hemoglobin levels and anemia prevalence of pregnant women in China and offer evidence for anemia and its reference values in China. Methods: A multi-center retrospective cohort study was conducted among 143,307 singleton pregnant women aged 15–49 at 139 hospitals in China, with hemoglobin concentrations routinely tested at each prenatal visit. Subsequently, a restricted cubic spline was performed to reveal a non-linear variation of hemoglobin concentrations during the gestational week. The Loess model was used to describe the changes in the prevalence of different degrees of anemia with gestational age. Multivariate linear regression model and Logistic regression model were applied to explore influencing factors of gestational changes in hemoglobin level and anemia prevalence, respectively. Results: Hemoglobin varied nonlinearly with gestational age, and the mean hemoglobin levels decreased from 125.75 g/L in the first trimester to 118.71 g/L in the third trimester. By analyzing hemoglobin levels with gestational age and pregnancy period, we proposed new criteria according to 5th percentile hemoglobin concentration in each trimester as a reference for anemia, with 108 g/L, 103 g/L, and 99 g/L, respectively. According to WHO’s criteria, the prevalence of anemia sustainably increased with gestational age, with 6.2% (4083/65,691) in the first trimester, 11.5% (7974/69,184) in the second trimester and 21.9% (12,295/56,042) in the third trimester, respectively. In subsequent analysis, pregnant women in non-urban residents, multiparity, and pre-pregnancy underweight tended to have lower hemoglobin levels. Conclusions: This research, the first large-sample study to present a set of gestational age-specific reference centiles for hemoglobin levels in China, could be used to obtain a better understanding of the overall levels of hemoglobin in Chinese healthy pregnant women and ultimately offer clues for a more precise hemoglobin reference value of anemia in China. Full article

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2022

Jump to: 2024, 2023, 2021

16 pages, 2301 KiB

Open AccessReview

Dietary Patterns and Obesity in Chinese Adults: A Systematic Review and Meta-Analysis

by Karen Jiang, Zhen Zhang, Lee Ann Fullington, Terry T. Huang, Catherine Kaliszewski, Jingkai Wei, Li Zhao, Shuyuan Huang, Amy Ellithorpe, Shenghui Wu, Xinyin Jiang and Liang Wang

Nutrients 2022, 14(22), 4911; https://doi.org/10.3390/nu14224911 - 20 Nov 2022

Cited by 8 | Viewed by 2848

Abstract

Certain dietary patterns are associated with an increased risk of obesity and its comorbidities. However, these associations vary across populations. The prevalence of obesity has been rising amid a drastic nutrition transition in China during the country’s rapid economic growth. This systematic review [...] Read more.

Certain dietary patterns are associated with an increased risk of obesity and its comorbidities. However, these associations vary across populations. The prevalence of obesity has been rising amid a drastic nutrition transition in China during the country’s rapid economic growth. This systematic review and meta-analysis were conducted to summarize how dietary patterns are associated with obesity in the Chinese population. We searched for articles from 1 January 2000 to 1 February 2022 in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus that assessed the relationship between dietary patterns and obesity outcomes. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random effects model. From the 2556 articles identified from the search, 23 articles were included in the analysis. We found that the traditional Chinese dietary pattern was associated with a lower risk of overweight/obesity (OR = 0.69, 95% CI: 0.57, 0.84, p < 0.001), whereas the Western dietary pattern was associated with a higher OR of overweight/obesity, but not reaching statistical significance (OR = 1.34, 95% CI: 0.98, 1.84, p = 0.07). There were inconsistent results for other dietary patterns, such as meat/animal protein and plant/vegetarian patterns. In conclusion, the traditional Chinese diet characterized by vegetables, rice, and meat was associated with a lower risk of obesity. The heterogeneity in characterizing dietary patterns contributes to the inconsistency of how dietary patterns are associated with obesity in the Chinese population. Full article

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13 pages, 828 KiB

Open AccessArticle

Urinary Antibiotics and Dietary Determinants in Adults in Xinjiang, West China

by Lei Chu, Hexing Wang, Deqi Su, Huanwen Zhang, Bahegu Yimingniyazi, Dilihumaer Aili, Tao Luo, Zewen Zhang, Jianghong Dai and Qingwu Jiang

Nutrients 2022, 14(22), 4748; https://doi.org/10.3390/nu14224748 - 10 Nov 2022

Cited by 2 | Viewed by 1199

Abstract

The Xinjiang autonomous region, located in west China, has a unique ethnic structure and a well-developed livestock industry. People in this region have a high risk of exposure to antibiotics, but the exposure level to antibiotics in relation to dietary determinants is unknown. [...] Read more.

The Xinjiang autonomous region, located in west China, has a unique ethnic structure and a well-developed livestock industry. People in this region have a high risk of exposure to antibiotics, but the exposure level to antibiotics in relation to dietary determinants is unknown. In this study, 18 antibiotics, including four human antibiotics (HAs), four veterinary antibiotics (VAs), and 10 preferred veterinary antibiotics (PVAs) were detected in the urine of approximately half of the 873 adults in Xinjiang, including Han Chinese (24.6%), Hui (25.1%), Uighur (24.6%), and Kazakh (25.7%). Logistic regression was used to analyze the association between antibiotic exposure levels and adult diet and water intake. The detection percentage of antibiotics in the urine of adults in Xinjiang ranged from 0.1% to 30.1%, with a total detection percentage of all antibiotics of 49.8%. HAs, VAs and PVAs were detected in 12.3%, 10.3%, and 40.5%, respectively. Fluoroquinolones were the antibiotics with the highest detection percentage (30.1%) and tetracyclines were the antibiotics with the highest detected concentration (17 ng/mL). Adults who regularly ate pork, consumed fruit daily, and did not prefer a plant-based diet were associated with thiamphenicol, norfloxacin, and fluoroquinolones, respectively. These results indicated that adults in the Xinjiang autonomous region were extensively exposed to multiple antibiotics, and some types of food were potential sources of exposure. Special attention should be paid to the health effects of antibiotic exposure in humans in the future. Full article

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14 pages, 1281 KiB

Open AccessArticle

Joint Associations of Food Groups with All-Cause and Cause-Specific Mortality in the Mr. OS and Ms. OS Study: A Prospective Cohort

by Jingli Yang, Aimin Yang, Suey Yeung, Jean Woo and Kenneth Lo

Nutrients 2022, 14(19), 3915; https://doi.org/10.3390/nu14193915 - 21 Sep 2022

Cited by 4 | Viewed by 2009

Abstract

Despite continuous growth in dietary pattern research, the relative importance of each dietary component in the overall pattern and their joint effects on mortality risk have not been examined adequately. We explored the individual and joint associations of multiple food groups with all-cause [...] Read more.

Despite continuous growth in dietary pattern research, the relative importance of each dietary component in the overall pattern and their joint effects on mortality risk have not been examined adequately. We explored the individual and joint associations of multiple food groups with all-cause and cause-specific mortality (cardiovascular disease (CVD) or cancer), by analyzing data from a cohort of 3995 Hong Kong Chinese older adults in the Mr. Osteoporosis (OS) and Ms. OS Study. Cox proportional hazards models were used to examine the associations of food groups with mortality risk. The individual and joint contribution of food groups to mortality risk has been quantified by a machine learning approach, i.e., the Quantile G-Computation. When comparing the highest with the lowest quartile of intake, dark green and leafy vegetables (hazard ratio (HR) = 0.82, 95% confidence interval (CI) = 0.70 to 0.96, P_trend = 0.049), fruit (HR = 0.79, 95% CI = 0.68 to 0.93, P_trend = 0.006), legumes (HR = 0.75, 95% CI = 0.63 to 0.87, P_trend = 0.052), mushroom and fungi (HR = 0.76, 95% CI = 0.65 to 0.88, P_trend = 0.023), soy and soy products (HR = 0.77, 95% CI = 0.66 to 0.90, P_trend = 0.143), and whole grains (HR = 0.76, 95% CI = 0.65 to 0.89, P_trend = 0.008) were inversely associated with all-cause mortality. Legume intake was associated with a lower risk of CVD mortality, while fruit, nuts, soy and soy products were associated with a lower risk of cancer mortality. From the Quantile G-Computation, whole grains, legumes, fruits, mushroom and fungi, soy and soy products had a higher relative weighting on mortality risk, and the joint effect of food groups was inversely associated with the mortality risk due to all-causes (HR = 0.39, 95% CI = 0.27 to 0.55), CVD (HR = 0.78, 95% CI = 0.67 to 0.91), and cancer (HR = 0.31, 95% CI = 0.15 to 0.65). From a sex-stratified analysis, most associations between food groups (whole grains, legumes, fruits, mushroom and fungi, soy and soy products) and mortality risk remained significant among men. In conclusion, whole grains, legumes, fruits, mushroom and fungi, soy and soy products were the main contributors to a reduction in mortality risk, and their joint effects were stronger than individual food groups. Moreover, the sex-specific association of sweets and desserts with cancer mortality may be worth further investigation. Full article

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9 pages, 859 KiB

Open AccessArticle

Association between Serum Spermidine and TyG Index: Results from a Cross-Sectional Study

by Rui Zhang, Jiahui Xu, Ruixue Li, Zhecong Yu, Wei Yuan, Hanshu Gao, Wenjing Feng, Cuiying Gu, Zhaoqing Sun and Liqiang Zheng

Nutrients 2022, 14(18), 3847; https://doi.org/10.3390/nu14183847 - 17 Sep 2022

Cited by 3 | Viewed by 1890

Abstract

Background: Although animal experiments have shown that spermidine (SPD) affects insulin resistance (IR), the evidence for this in humans is still scarce. We aimed to investigate the associations between serum SPD levels and the TyG index in the adult population. Methods: A cross-sectional [...] Read more.

Background: Although animal experiments have shown that spermidine (SPD) affects insulin resistance (IR), the evidence for this in humans is still scarce. We aimed to investigate the associations between serum SPD levels and the TyG index in the adult population. Methods: A cross-sectional study was carried out with 4336 participants, all of whom were adults aged 35+ years. The SPD levels in serum were detected using high performance liquid chromatography with a fluorescence detector (HPLC-FLD). The triglyceride-glucose (TyG) index was calculated as Ln [fasting triglycerides (TG) (mg/dL) × fasting glucose (mg/dL)/²]. Results: After multivariable adjustment, including demographic characteristics, behavioral factors associated with heath, and a history of taking medicine, SPD was inversely associated with the TyG index (β = −0.036; SE: 0.009; p < 0.001). Furthermore, each increase of 1 lnSPD significantly decreased the risk of IR with an odds ratio (ORs) (95% confidence intervals (CIs)) of 0.89 (0.83–0.96). Relative to the first quintile, the multivariate-adjusted ORs (95% CIs) for the third and fourth quartile group were 0.80 (0.65, 0.99) and 0.71 (0.57, 0.88), respectively. Conclusions: In conclusion, SPD was inversely associated with the TyG index. Our findings inform future exploratory research on the further mechanism of the association between spermidine and IR. Full article

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14 pages, 476 KiB

Open AccessArticle

The Association between Sugar-Sweetened Beverages and High-Energy Diets and Academic Performance in Junior School Students

by Yan Ren, Chan Peng, Yanming Li, Feng Zhou, Mei Yang, Bing Xiang, Liping Hao, Xuefeng Yang and Jing Zeng

Nutrients 2022, 14(17), 3577; https://doi.org/10.3390/nu14173577 - 30 Aug 2022

Cited by 1 | Viewed by 2282

Abstract

This study aimed to understand the consumption frequency of sugar-sweetened beverages (SSBs) and high-energy diets in junior school students in China and to explore the relationship between SSBs and high-energy diets and academic performance. Information about 9251 junior school students was retrieved from [...] Read more.

This study aimed to understand the consumption frequency of sugar-sweetened beverages (SSBs) and high-energy diets in junior school students in China and to explore the relationship between SSBs and high-energy diets and academic performance. Information about 9251 junior school students was retrieved from the China Education Panel Survey (CEPS) database. The Mann–Whitney U test and the Kruskal–Wallis test were used to compare differences in academic performance based on the variables of interest. Generalized linear mixed models were used to analyze the association between the consumption frequency of SSBs and high-energy diet and student academic performance, fixed and random effects were included to control for confounding factors. The proportions of the “often” consumption group of SSBs and high-energy diets were 21.5% and 14.6%, respectively. For SSBs, the total score of the “often” consume group was 4.902 (95%CI: −7.660~−2.144, p < 0.001) points lower than that of the “seldom” consume group. Scores of Chinese math, and English were 0.864 (95%CI: −1.551~−0.177, p = 0.014), 2.164 (95%CI: −3.498~−0.831, p = 0.001), and 1.836 (95%CI: −2.961~−0.710, p = 0.001) points lower, respectively. For high-energy diets, the scores of total, Chinese and English in the “sometimes” consume group were 2.519 (95%CI: 0.452~4.585, p = 0.017), 1.025 (95%CI: 0.510~1.540, p < 0.001) and 1.010 (95%CI: 0.167~1.853, p = 0.019) points higher than that of the “seldom” consume group, respectively. Our findings suggested that consumption of SSBs was often negatively associated with academic performance in junior school students, while medium consumption of high-energy diets had a positive correlation. The positive association between high-energy diets and academic performance may be related to the food items included in the high-energy diets consumed by Chinese students. Schools and families should pay more effort to reduce the consumption of SSBs, and for high-energy diets, the focus should be on food selection and avoiding excessive intake. Longitudinal studies are needed to further test these findings among adolescents. Full article

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15 pages, 300 KiB

Open AccessArticle

Prevalence and Correlates of Metabolic Syndrome and Its Components in Chinese Children and Adolescents Aged 7–17: The China National Nutrition and Health Survey of Children and Lactating Mothers from 2016–2017

by Jia Shi, Li He, Dongmei Yu, Lahong Ju, Qiya Guo, Wei Piao, Xiaoli Xu, Liyun Zhao, Xiaolin Yuan, Qiuye Cao and Hongyun Fang

Nutrients 2022, 14(16), 3348; https://doi.org/10.3390/nu14163348 - 16 Aug 2022

Cited by 10 | Viewed by 1959

Abstract

This descriptive study aimed to determine the prevalence of metabolic syndrome (MetS) and its components among Chinese children and adolescents aged 7–17 from 2016–2017 according to the Cook’s criteria modified for age on the basis of the National Cholesterol Education Program-Adult Treatment Panel [...] Read more.

This descriptive study aimed to determine the prevalence of metabolic syndrome (MetS) and its components among Chinese children and adolescents aged 7–17 from 2016–2017 according to the Cook’s criteria modified for age on the basis of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) and to evaluate the associations between the factors of interest (especially vitamin A, vitamin D and hyperuricemia) of MetS and its components, using data from the China National Nutrition and Health Survey of Children and Lactating Mothers from 2016–2017. A total of 54,269 school-aged children and adolescents were ultimately included in this study. Anthropometric measurements and laboratory examinations of the subjects and their relevant information were also collected. A multivariate logistic regression analysis model was applied to analyze the relationships between relevant factors associated with MetS and its components. In the present study, the prevalence of MetS in children and adolescents was 5.98%. Among the five components of MetS, elevated blood pressure (BP) and abdominal obesity were the most prevalent (39.52% and 17.30%), and 58.36% of the subjects had at least one of these components. In the multivariate logistic regression, an overweight condition, obesity and hyperuricemia were positively correlated with the incidence of MetS and all five components. There was also a positive association observed between vitamin A and the risk of MetS and some components of MetS (abdominal obesity and high triglycerides (TG)) and vitamin A was negatively associated with the risk of low high-density lipoprotein cholesterol (HDL-C). Subjects with vitamin D inadequacy had a higher risk of MetS (OR = 1.364, 95%CI: 1.240–1.500) and four of its components, excepting elevated FBG (fast blood glucose). Vitamin D deficiency was positively associated with MetS (OR = 1.646, 95%CI: 1.468–1.845) and all five of its components. Well-designed, large-scale prospective studies are also needed in the future. Full article

11 pages, 1426 KiB

Open AccessArticle

Vitamin A Nutritional Status of Urban Lactating Chinese Women and Its Associated Factors

by Chenlu Yang, Ai Zhao, Zhongxia Ren, Jian Zhang, Peiyu Wang and Yumei Zhang

Nutrients 2022, 14(15), 3184; https://doi.org/10.3390/nu14153184 - 03 Aug 2022

Cited by 1 | Viewed by 1694

Abstract

We aimed to investigate dietary vitamin A (DVA) intake, serum vitamin A (SVA) concentrations, and breast milk vitamin A (BMVA) concentrations of urban lactating Chinese women and explore the associated factors. We recruited 326 lactating women from ten cities in China and collected [...] Read more.

We aimed to investigate dietary vitamin A (DVA) intake, serum vitamin A (SVA) concentrations, and breast milk vitamin A (BMVA) concentrations of urban lactating Chinese women and explore the associated factors. We recruited 326 lactating women from ten cities in China and collected their dietary information, blood samples, and breast milk samples. SVA and BMVA were assessed with high-performance liquid chromatography. Mann–Whitney U tests, Kruskal–Wallis H tests, Chi-square tests, Spearman correlation tests, and multiple regression analyses were conducted. The median (25th, 75th) of DVA, SVA and BMVA were 372.36 (209.12, 619.78) μg RAE/day, 1.99 (1.71, 2.35) μmol/L, and 1.67 (1.13, 2.15) μmol/L, respectively. Only 3.1% of lactating women met the recommended nutrient intake of Vitamin A (VA), and 20.6% had a BMVA level below 1.05 μmol/L. Compared to underweight or normal weight women, overweight or obese lactating women had lower DVA and BMVA but higher SVA (p = 0.022; p = 0.030; p = 0.003). Multiparous women had a higher risk of inadequate BMVA (p = 0.023) than primiparous women. SVA and BMVA were positively associated with DVA, especially for lactating women not using VA supplements (β = 0.174, 95%CI = 0.025, 0.324, p = 0.022; β = 0.501, 95%CI = 0.208, 0.795, p = 0.001). There was no association between SVA and BMVA (β = 0.165, 95%CI = −0.037, 0.366, p = 0.109). In conclusion, VA nutritional status among Chinese urban lactating women needs more attention, especially for those who are obese, overweight, or higher parity. Increased DVA may contribute to increased BMVA. Full article

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10 pages, 824 KiB

Open AccessArticle

Sex Differences in the Relationship between Excessive Alcohol Consumption and Metabolic Abnormalities: A Community-Based Study in Taiwan

by Liang-Jen Wang, Chih-Lang Lin, Yi-Chih Chen, Chemin Lin, Yu-Chiau Shyu and Chih-Ken Chen

Nutrients 2022, 14(14), 2957; https://doi.org/10.3390/nu14142957 - 19 Jul 2022

Cited by 1 | Viewed by 1816

Abstract

Excessive alcohol consumption, as part of an unhealthy lifestyle, can contribute to metabolic abnormalities. This study investigated the sex differences in the relationship between excessive drinking and the risk of metabolic abnormalities. This community-based study included 3387 participants (age range: 30–103 years, mean [...] Read more.

Excessive alcohol consumption, as part of an unhealthy lifestyle, can contribute to metabolic abnormalities. This study investigated the sex differences in the relationship between excessive drinking and the risk of metabolic abnormalities. This community-based study included 3387 participants (age range: 30–103 years, mean age ± SD: 57 ± 13.5 years, 38.2% males) from the northeastern region of Taiwan. All participants completed a demographic survey and were subjected to blood tests. The risks of excessive drinking were evaluated using the Alcohol Use Disorder Identification Test (AUDIT). The results showed that males were at higher risks of obesity, hypertension, and hypertriglyceridemia, but at a lower risk of abdominal obesity than females. Males with hazardous drinking were at greater risks of hypertension, hyperglycemia, low serum levels of high-density lipoprotein cholesterol, and hypertriglyceridemia compared to those with no drinking. Females with hazardous drinking were at a greater risk of hypertension than those with no drinking. There was no interaction effect of sex and excessive drinking on the risks of metabolic abnormalities after controlling for demographics and lifestyle-related habits. Future studies are warranted to explore the sex-specific risk factors for metabolic abnormalities and to elucidate the mechanism underlying this association between alcohol consumption and metabolic abnormalities. Full article

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10 pages, 1248 KiB

Open AccessArticle

Plasma Transthyretin Levels and Risk of Type 2 Diabetes Mellitus and Impaired Glucose Regulation in a Chinese Population

by Xiaoli Hu, Qianqian Guo, Xiaoqian Wang, Qiang Wang, Liangkai Chen, Taoping Sun, Peiyun Li, Zhilei Shan, Liegang Liu, Chao Gao and Ying Rong

Nutrients 2022, 14(14), 2953; https://doi.org/10.3390/nu14142953 - 19 Jul 2022

Cited by 2 | Viewed by 1379

Abstract

Plasma transthyretin may be engaged in glucose regulation. We aimed to investigate the association between plasma transthyretin levels and the risk of newly diagnosed T2DM and impaired glucose regulation (IGR) in a Chinese population. We conducted a case-control study including 1244 newly diagnosed [...] Read more.

Plasma transthyretin may be engaged in glucose regulation. We aimed to investigate the association between plasma transthyretin levels and the risk of newly diagnosed T2DM and impaired glucose regulation (IGR) in a Chinese population. We conducted a case-control study including 1244 newly diagnosed T2DM patients, 837 newly diagnosed IGR patients, and 1244 individuals with normal glucose tolerance (NGT) matched by sex and age. Multivariate logistic regression analysis was utilized to estimate the independent association of plasma transthyretin concentrations with the risk of T2DM and IGR. Plasma transthyretin concentrations were significantly higher in T2DM and IGR patients compared with control subjects (p < 0.005). After multiple adjustment and comparison with the lowest quartile of plasma transthyretin concentrations, the odds ratios (95% confidence intervals) of T2DM and IGR in the highest quartile were 2.22 (1.66, 2.98) and 2.29 (1.72, 3.05), respectively. Plasma transthyretin concentrations also showed a great performance in predicting the risk of T2DM (AUC: 0.76). Moreover, a potential nonlinear trend was observed. Our results demonstrated that higher plasma transthyretin concentrations, especially more than 290 mg/L, were associated with an increased risk of T2DM and IGR. Further studies are warranted to confirm our findings and elucidate the potential mechanisms. Full article

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11 pages, 1951 KiB

Open AccessArticle

Validation of 4 Estimating Methods to Evaluate 24-h Urinary Sodium Excretion: Summer and Winter Seasons for College Students in China

by Weiyi Gong, Yuxia Ma, Zechen Zhang, Jufeng Liang, Jiguo Zhang and Gangqiang Ding

Nutrients 2022, 14(13), 2736; https://doi.org/10.3390/nu14132736 - 30 Jun 2022

Cited by 2 | Viewed by 1251

Abstract

Twenty-four-hour urine sample collection is regarded as the gold standard for sodium intake evaluation, but the implementation can be difficult. The objective was to validate and evaluate the accuracy and feasibility of estimating sodium intake by four methods. A group of 268 healthy [...] Read more.

Twenty-four-hour urine sample collection is regarded as the gold standard for sodium intake evaluation, but the implementation can be difficult. The objective was to validate and evaluate the accuracy and feasibility of estimating sodium intake by four methods. A group of 268 healthy volunteers aged 18–25 years was enrolled in this study. Twenty-four-hour urine samples as well as timed (morning, afternoon, evening, and overnight) urine samples were randomly collected in summer and winter. The sodium intake was estimated by four published methods—Kawasaki, INTERSALT, Tanaka, and Sun’s. The consistencies between estimated sodium intake and real measured values of 24-h urinary sodium excretion were compared by Bland–Altman plots in each of the methods. The 24-h urinary sodium analysis result indicated that average daily sodium intake was 3048.4 ± 1225.9 mg in summer and 3564.7 ± 1369.9 mg in winter. At the population level, the bias (estimated value-measured value) was the least with the INTERSALT method with afternoon (−39.7 mg; 95%CI: −164.7, 85.3 mg) and evening (−43.5 mg; 95%CI: −166.4, 79.5 mg) samples in summer. In winter, the Kawasaki method (162.1 mg; 95%CI: 13.5, 310.7 mg) was superior to others. Estimation of sodium intake using the four methods is affected by the time and temperature. In summer, the INTERSALT method provides the best estimation of the population’s mean sodium intake. The Kawasaki method is superior to other methods in winter. Full article

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12 pages, 1074 KiB

Open AccessArticle

Elevation of Serum Spermidine in Obese Patients: Results from a Cross-Sectional and Follow-Up Study

by Hanshu Gao, Qianlong Zhang, Jiahui Xu, Wei Yuan, Ruixue Li, Hui Guo, Cuiying Gu, Wenjing Feng, Yanan Ma, Zhaoqing Sun and Liqiang Zheng

Nutrients 2022, 14(13), 2613; https://doi.org/10.3390/nu14132613 - 24 Jun 2022

Cited by 7 | Viewed by 2347

Abstract

Background: Spermidine, a natural polyamine, appears to be a promising intervention for the treatment of obesity in animal studies, but epidemiological studies on the association between spermidine and obesity are inadequate. Methods: In the cross-sectional study, a total of 4230 eligible Chinese rural [...] Read more.

Background: Spermidine, a natural polyamine, appears to be a promising intervention for the treatment of obesity in animal studies, but epidemiological studies on the association between spermidine and obesity are inadequate. Methods: In the cross-sectional study, a total of 4230 eligible Chinese rural participants aged ≥ 35 years at baseline were recruited, of whom 1738 completed the two-year follow-up. Serum spermidines were measured using high-performance liquid chromatography with a fluorescence detector. Obesity and change in BMI were used as outcomes. Multivariable logistic regression analysis was applied to obtain the odds ratios (ORs) and 95% confidence intervals (CIs). Results: Participants who were obese had higher serum spermidine concentrations than those who were of normal weight (median (IQR), 27.2 ng/mL (14.8–53.4 ng/mL) vs. 23.8 ng/mL (12.8–46.6 ng/mL), p = 0.002). Compared with participants in the first quartile, those in the third quartile (OR 1.327, 95% CI 1.050 to 1.678) and the fourth quartile (OR 1.417, 95% CI 1.121 to 1.791) had a significantly increased risk of prevalent obesity after adjustment for confounding factors. In the follow-up study, participants in the third quartile (OR 0.712, 95% CI 0.535 to 0.946) and the fourth quartile (OR 0.493, 95% CI 0.370 to 0.657) had significantly lower risks of an increase in BMI after adjustment for confounding factors, with the lowest quartile as the reference. Meanwhile, we found a nonlinear relationship between spermidine and BMI in the follow-up study (p < 0.001). Conclusions: Serum spermidine was positively associated with increased odds of obesity in the cross-sectional study but reduced odds of an increase in BMI in the follow-up study among Chinese adults. Future studies are warranted to determine the exact mechanism underlying the association between spermidine and obesity and the scope for interventions. Full article

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14 pages, 830 KiB

Open AccessArticle

Metabolic Dysfunction-Associated Fatty Liver Disease Is Associated with the Risk of Incident Cardiovascular Disease: A Prospective Cohort Study in Xinjiang

by Yanbo Guo, Jing Yang, Rulin Ma, Xianghui Zhang, Heng Guo, Jia He, Xinping Wang, Boyu Cao, Remina Maimaitijiang, Yu Li, Xinyu Peng, Shijie Zhang and Shuxia Guo

Nutrients 2022, 14(12), 2361; https://doi.org/10.3390/nu14122361 - 07 Jun 2022

Cited by 9 | Viewed by 2340

Abstract

In 2020, a group of international experts proposed a new term ‘metabolic dysfunction-associated fatty liver disease’ (MAFLD) to replace ‘non-alcoholic fatty liver disease’. This study aimed to describe the epidemic characteristics of MAFLD, incidence of cardiovascular disease (CVD), and relationship between MAFLD and [...] Read more.

In 2020, a group of international experts proposed a new term ‘metabolic dysfunction-associated fatty liver disease’ (MAFLD) to replace ‘non-alcoholic fatty liver disease’. This study aimed to describe the epidemic characteristics of MAFLD, incidence of cardiovascular disease (CVD), and relationship between MAFLD and incident CVD. In 2016, 12,794 Uyghur adults from Kashgar, Xinjiang, were grouped according to the presence or absence of MAFLD. The primary outcome was the occurrence of CVD events. Fatty liver was diagnosed using ultrasound. The prevalence of MAFLD was 16.55%. After excluding patients with previous CVD, 11,444 participants were followed up for a median period of 4.7 years. During the follow-up period, the overall CVD incidence was 10.40% (1190/11,444). The incidence of CVD in the patients with MAFLD was significantly higher than that in the non-MAFLD patients (18.38% vs. 9.02%, p < 0.001; multivariable-adjusted hazard ratio = 1.37, 95% CI = 1.20–1.56). The prevalence of MAFLD was relatively low, whereas the incidence of CVD was relatively high among the Uyghur adults in rural Xinjiang. Individuals with MAFLD have a higher risk of developing CVD independent of traditional cardiovascular risk factors, obesity, type 2 diabetes mellitus (T2DM), and dyslipidaemia. Full article

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11 pages, 898 KiB

Open AccessArticle

The SNP rs516946 Interacted in the Association of MetS with Dietary Iron among Chinese Males but Not Females

by Zhenni Zhu, Zhengyuan Wang, Jiajie Zang, Ye Lu, Ziyi Xiao, Guangyong Zheng and Fan Wu

Nutrients 2022, 14(10), 2024; https://doi.org/10.3390/nu14102024 - 12 May 2022

Cited by 1 | Viewed by 1854

Abstract

This study aimed to explore the role of the single nucleotide polymorphism (SNP) rs516946 of the Ankyrin 1 (ANK1) gene in the relationship between dietary iron and metabolic syndrome (MetS) in the Chinese population. A total of 2766 Chinese adults (1284 males and [...] Read more.

This study aimed to explore the role of the single nucleotide polymorphism (SNP) rs516946 of the Ankyrin 1 (ANK1) gene in the relationship between dietary iron and metabolic syndrome (MetS) in the Chinese population. A total of 2766 Chinese adults (1284 males and 1482 females) were recruited. A 3-day 24-h dietary recall and weighing of household condiments were used to assess dietary intake. Anthropometric and laboratory measurements were obtained. After adjusting for age, region, years of education, intentional physical exercise, physical activity level, smoking, alcohol use and energy intake, dietary iron and the SNP rs516946 were both correlated with MetS risk and interacted among the male participants. The trend between dietary iron and MetS risk remained among T allele non-carriers of males but not among T allele carriers of males. Both the SNP rs516946 and the ferritin level correlated positively with the aspartate aminotransferase (AST) level. ANK1 SNP rs516946 interacted in the association of MetS with dietary iron among Chinese males while no association was found among females. Periodic blood loss might prevent females from these associations. The SNP rs516946 might correlate with liver function. Full article

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Graphical abstract

13 pages, 682 KiB

Open AccessArticle

Associations between Meat and Vegetable Intake, Cooking Methods, and Asthenozoospermia: A Hospital-Based Case–Control Study in China

by Ya-Shu Liu, Yi-Xiao Zhang, Xiao-Bin Wang, Qi-Jun Wu, Fang-Hua Liu, Bo-Chen Pan and Yu-Hong Zhao

Nutrients 2022, 14(9), 1956; https://doi.org/10.3390/nu14091956 - 07 May 2022

Cited by 7 | Viewed by 1946

Abstract

Background: The role of meat and vegetable intake in the development of asthenozoospermia has been controversial, and the role of cooking methods for meat and vegetables in the association has yet to be determined. The present study aimed to illuminate the relationship between [...] Read more.

Background: The role of meat and vegetable intake in the development of asthenozoospermia has been controversial, and the role of cooking methods for meat and vegetables in the association has yet to be determined. The present study aimed to illuminate the relationship between the consumption and cooking methods of meat and vegetables and the risk of asthenozoospermia. Methods: In this hospital-based case–control study, we enrolled 552 patients with asthenozoospermia and 585 healthy controls. Dietary information was assessed using a validated self-administered food frequency questionnaire. Asthenozoospermia was diagnosed according to the fifth edition of the WHO laboratory manual for the examination and processing of human semen. Results: Participants in the highest tertile of total meat and unprocessed meat intake had a 44% and 39% lower risk of asthenozoospermia than those in the lowest tertile (OR = 0.56, 95% CI: 0.37, 0.87 and OR = 0.61, 95% CI: 0.40, 0.93), respectively. Participants with the highest processed meat consumption showed higher risk (OR = 1.44, 95% CI: 1.01, 2.06). Raw vegetable consumption was negatively associated with the risk of asthenozoospermia (OR = 0.67, 95% CI: 0.45, 0.98). The stir-frying cooking method for meat was associated with increased risk of asthenozoospermia (OR = 1.58, 95% CI: 1.02, 2.46). Conclusions: Intake of total meat, unprocessed meat, and raw vegetable may reduce asthenozoospermia risk, while higher consumption of processed meat may increase the risk. Cooking methods may play a role in these associations. These findings need to be confirmed in large and prospective cohort studies. Full article

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11 pages, 865 KiB

Open AccessArticle

Nationwide Prevalence and Outcomes of Long-Term Nasogastric Tube Placement in Adults

by Chung Y. Hsu, Jung-Nien Lai, Woon-Man Kung, Chao-Hsien Hung, Hei-Tung Yip, Yu-Chen Chang and Cheng-Yu Wei

Nutrients 2022, 14(9), 1748; https://doi.org/10.3390/nu14091748 - 22 Apr 2022

Cited by 3 | Viewed by 2293

Abstract

Tube feeding (TF) is commonly used for patients with severe swallowing disturbance, and patients with chronic dysphagia are often provided with a long-term nasogastric tube (NGT). However, nationwide epidemiological data on long-term NGT placement are limited. The present study identified the prevalence and [...] Read more.

Tube feeding (TF) is commonly used for patients with severe swallowing disturbance, and patients with chronic dysphagia are often provided with a long-term nasogastric tube (NGT). However, nationwide epidemiological data on long-term NGT placement are limited. The present study identified the prevalence and outcomes of patients with long-term NGT placement in Taiwan. Data were obtained from the Longitudinal Health Insurance Database. Patients with NGT placement for more than 3 months between 2000 and 2012 were enrolled in this cohort study. An NGT cohort of 2754 patients was compared with 11,016 controls matched for age, sex, residential area, and comorbidities. The prevalence rate of long-term NGT reached 0.063% in 2005 and then remained stable at 0.05–0.06%. The major causes of NGT placement were stroke (44%), cancer (16%), head injury (14%), and dementia (12%). Men (63%) were more likely to have long-term NGT placement than women (37%). The adjusted hazard ratios were 28.1 (95% CI = 26.0, 30.3) for acute and chronic respiratory infections; 26.8 (95% CI = 24.1, 29.8) for pneumonia, 8.84 (95% CI = 7.87, 9.93) for diseases of the esophagus, stomach, and duodenum; and 7.5 (95% CI = 14.7, 20.8) for mortality. Patients with NGT placement for more than 6 months had a higher odds ratio (1.58, 95% CI = 1.13, 2.20) of pneumonia than those with NGT placement for less than 6 months. Only 13% and 0.62% of the patients underwent rehabilitation therapy and percutaneous endoscopic gastrostomy, respectively. Long-term NGT use was associated with a higher risk of comorbidities and mortality. Stroke was the main illness contributing to long-term NGT use. Further interventions are necessary to improve the negative effects of long-term TF. Full article

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16 pages, 863 KiB

Open AccessFeature PaperArticle

Association between Dairy Product Intake and Risk of Fracture among Adults: A Cohort Study from China Health and Nutrition Survey

by Xiaona Na, Yuandi Xi, Sicheng Qian, Jian Zhang, Yucheng Yang and Ai Zhao

Nutrients 2022, 14(8), 1632; https://doi.org/10.3390/nu14081632 - 14 Apr 2022

Cited by 6 | Viewed by 2828

Abstract

Background: The current literature reports inconsistent associations between dairy product intake and fracture. This study assessed the association between dairy product intake and the risk of fracture among Chinese adults and examined the mediation effects of height and body mass index (BMI) on [...] Read more.

Background: The current literature reports inconsistent associations between dairy product intake and fracture. This study assessed the association between dairy product intake and the risk of fracture among Chinese adults and examined the mediation effects of height and body mass index (BMI) on the association. Methods: Data in 1997–2015 from the China Health and Nutrition Survey were used. Dietary data were collected by a 24-hour dietary recall, and occurrences of fracture were obtained by self-report of participants. Cumulative average intake of daily dairy products was calculated by the sum of the dairy product intake and divided by the total waves of participating in the surveys before fracture. Cox proportion hazard regressions were performed to explore the associations between dairy product intake and the risk of fracture. Mediation analysis models were established to examine the mediation effects of height and BMI on the associations. Results: A total of 14,711 participants were included. Dairy product intake of 0.1–100 g/day was associated with a decreased risk of fracture, while no association was observed among participants with dairy product intake of >100 g/day. The indirect effects of dairy product intake on the fracture mediated by height and BMI were much smaller than the direct effects. Conclusions: Dairy product intake with 0.1–100 g/day is associated with a lower risk of fracture, and the association is mainly a direct result of nutrients in dairy products and much less a result of the mediation effects of height or BMI. Dairy product intake of 0.1–100 g/day might be a cost-effective measure for Chinese adults to decrease fracture incidence. Full article

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12 pages, 563 KiB

Open AccessArticle

Distinct Roles of Distress and Coping Capacity in the Effects of Psychological Stress on Energy Intake and Percentage of Energy from Macronutrients

by Feifei Huang, Huijun Wang, Wenwen Du, Xiaofan Zhang, Shufa Du and Bing Zhang

Nutrients 2022, 14(3), 577; https://doi.org/10.3390/nu14030577 - 28 Jan 2022

Viewed by 2116

Abstract

The aim of this study was to explore the association of perceived stress on energy intake and percentage of energy from macronutrients. We examined cross-sectional data from the China Health and Nutrition Survey among Chinese adults. Perceived stress scale was used to assess [...] Read more.

The aim of this study was to explore the association of perceived stress on energy intake and percentage of energy from macronutrients. We examined cross-sectional data from the China Health and Nutrition Survey among Chinese adults. Perceived stress scale was used to assess psychological stress, and confirmatory factor analysis was used to calculate the two latent variable scores: distress factor and coping factor of perceived stress. Combined two-level random effect model and structural equation modeling were used to explore the association between distress, coping, and energy intake. The study involved 6865 adults with an average age of 46.9 years. The intake of energy was 2047.9 ± 666.6 kcal/d, 51.1% from carbohydrate and 35.2% from fat. Neither distress nor coping capacity had an association with energy intake. The coping factor score was positively associated with the sum of percentage of energy intake from carbohydrate and fat (%C&F) in females (β = 0.149, p = 0.015) but not in males. Compared to the lowest tertile, %C&F of females with a coping factor score in the medium and top tertiles were 0.44 and 0.81 significantly higher, respectively (p_medium = 0.0013, p_top < 0.0001). Psychological stress was positively associated with %C&F in females. It was insufficient capacity to cope with stress that led to unhealthy eating behavior. Full article

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11 pages, 270 KiB

Open AccessFeature PaperArticle

Care Their Diet and Mind: Association between Eating Habits and Mental Health in Chinese Left-behind Children

by Kaixin Liang, Sitong Chen and Xinli Chi

Nutrients 2022, 14(3), 524; https://doi.org/10.3390/nu14030524 - 25 Jan 2022

Cited by 9 | Viewed by 3115

Abstract

Studies have shown that the prevalence of mental health problems is high among left-behind children (LBC). Modifiable eating habits may play an important role in promoting mental health among these adolescents. This study aimed to investigate the situation of dietary habits and their [...] Read more.

Studies have shown that the prevalence of mental health problems is high among left-behind children (LBC). Modifiable eating habits may play an important role in promoting mental health among these adolescents. This study aimed to investigate the situation of dietary habits and their association with mental health problems in a sample of Chinese LBC. We conducted this cross-sectional study in an economically disadvantaged area of China in May 2020. Information on socio-demographic factors, eating habits (the frequency of eating carbohydrates, fruits, vegetables, protein, and breakfast), and mental health problems (insomnia, depression, and anxiety) were collected among local adolescents. Among 8939 adolescents were recruited, a total of 3314 LBC (1455 males and 1859 females, aged 12–17 years) were identified and included in the current study. Associations between dietary habits and mental health were analyzed by generalized linear models. Results indicated that the dietary pattern was unhealthy among LBC and even worse in females. Compared to routinely eating breakfast and fruits, lower frequencies of eating breakfast and fruits were identified as two significant factors with higher risks of mental health problems. Moreover, the association was more pronounced in females. Therefore, improving diet quality, particularly the frequency of eating breakfast and fruit intake may be an effective approach in the mental health promotion for LBC, especially for females. Full article

25 pages, 929 KiB

Open AccessSystematic Review

Exploring the Determinants of Food Choice in Chinese Mainlanders and Chinese Immigrants: A Systematic Review

by Yixi Wang-Chen, Nicole J. Kellow and Tammie S. T. Choi

Nutrients 2022, 14(2), 346; https://doi.org/10.3390/nu14020346 - 14 Jan 2022

Cited by 12 | Viewed by 4334

Abstract

Determinants of food choice in Chinese populations have not been systematically synthesised using a cultural lens. This study reviewed qualitative studies exploring food choice determinants of both Chinese mainlanders and Chinese immigrants living in Western countries. Ovid Medline, CINAHL Plus, Web of Science, [...] Read more.

Determinants of food choice in Chinese populations have not been systematically synthesised using a cultural lens. This study reviewed qualitative studies exploring food choice determinants of both Chinese mainlanders and Chinese immigrants living in Western countries. Ovid Medline, CINAHL Plus, Web of Science, ProQuest, and China National Knowledge Infrastructure database (CNKI) were searched from database inception to 1 April 2021. Studies were included if they involved qualitative research methods, were written in English or Chinese, investigated the factors influencing food choices, and targeted Chinese mainlanders or Chinese immigrants living in Western countries. Twenty-five studies (24 in English, 1 in Chinese) were included, involving 2048 participants. Four themes were identified; (1) the principles of traditional Chinese medicine (TCM), (2) perceptions of a healthy diet in Chinese culture (e.g., regular eating, eating in moderation, and emphasis on food freshness), (3) the desire to maintain harmony in families/communities, and (4) physical/social environmental factors all significantly influenced Chinese people’s food choices. It is important to acknowledge these factors when developing culturally appropriate nutrition programs for promoting health in Chinese mainlanders and Chinese immigrants. Full article

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15 pages, 20663 KiB

Open AccessReview

Low-Glycemic Index Diets as an Intervention in Metabolic Diseases: A Systematic Review and Meta-Analysis

by Chunxiao Ni, Qingqing Jia, Gangqiang Ding, Xifeng Wu and Min Yang

Nutrients 2022, 14(2), 307; https://doi.org/10.3390/nu14020307 - 12 Jan 2022

Cited by 17 | Viewed by 4539

Abstract

We aimed to investigate the effects of a low-glycemic index (GI) diet on the body mass and blood glucose of patients with four common metabolic diseases by conducting a systematic review and meta-analysis of studies comparing a low-GI diet (LGID) and other types [...] Read more.

We aimed to investigate the effects of a low-glycemic index (GI) diet on the body mass and blood glucose of patients with four common metabolic diseases by conducting a systematic review and meta-analysis of studies comparing a low-GI diet (LGID) and other types of diet. Search terms relating to population, intervention, comparator, outcomes, and study design were used to search three databases: PubMed, Embase, and the Cochrane Library. We identified 24 studies involving 2002 participants. Random-effects models were used for 16 studies in the meta-analysis and stratified analyses were performed according to the duration of the intervention. The systematic review showed that LGIDs slightly reduced body mass and body mass index (BMI) (p < 0.05). BMI improved more substantially after interventions of >24 weeks and there was no inter-study heterogeneity (I² = 0%, p = 0.48; mean difference (MD) = −2.02, 95% confidence interval (CI): −3.05, −0.98). Overall, an LGID had superior effects to a control diet on fasting blood glucose (FBG) and glycosylated hemoglobin. When the intervention exceeded 30 days, an LGID reduced FBG more substantially (MD = −0.34, 95% CI: −0.55, −0.12). Thus, for patients with metabolic diseases, an LGID is more effective at controlling body mass and blood glucose than a high-GI or other diet. Full article

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14 pages, 752 KiB

Open AccessArticle

Association between Milk Intake and All-Cause Mortality among Chinese Adults: A Prospective Study

by Xiaona Na, Hanglian Lan, Yu Wang, Yuefeng Tan, Jian Zhang and Ai Zhao

Nutrients 2022, 14(2), 292; https://doi.org/10.3390/nu14020292 - 11 Jan 2022

Cited by 3 | Viewed by 2304

Abstract

Background: Little is known about the effect of milk intake on all-cause mortality among Chinese adults. The present study aimed to explore the association between milk intake and all-cause mortality in the Chinese population. Methods: Data from 1997 to 2015 of the China [...] Read more.

Background: Little is known about the effect of milk intake on all-cause mortality among Chinese adults. The present study aimed to explore the association between milk intake and all-cause mortality in the Chinese population. Methods: Data from 1997 to 2015 of the China Health and Nutrition Survey (CHNS) were used. A total of 14,738 participants enrolled in the study. Dietary data were obtained by three day 24-h dietary recall. All-cause mortality was assessed according to information reported. The association between milk intake and all-cause mortality were explored using Cox regression and further stratified with different levels of dietary diversity score (DDS) and energy intake. Results: 11,975 (81.25%) did not consume milk, 1341 (9.10%) and 1422 (9.65%) consumed 0.1–2 portions/week and >2 portions/week, respectively. Milk consumption of 0.1–2 portions/week was related to the decreased all-cause mortality (HR: 0.59, 95% CI: 0.41–0.85). In stratified analysis, consuming 0.1–2 portions/week was associated with decreased all-cause mortality among people with high DDS and energy intake. Conclusions: Milk intake is low among Chinese adults. Consuming 0.1–2 portions of milk/week might be associated with the reduced risk of death among Chinese adults by advocating health education. Further research is required to investigate the relationships between specific dairy products and cause-specific mortality. Full article

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12 pages, 799 KiB

Open AccessArticle

The Association between Trajectories of Anthropometric Variables and Risk of Diabetes among Prediabetic Chinese

by Fang Li and Lizhang Chen

Nutrients 2021, 13(12), 4356; https://doi.org/10.3390/nu13124356 - 03 Dec 2021

Cited by 2 | Viewed by 1916

Abstract

In order to explore the association between trajectories of body mass index (BMI) and mid-upper arm circumference (MUAC) and diabetes and to assess the effectiveness of the models to predict diabetes among Chinese prediabetic people, we conducted this study. Using a national longitudinal [...] Read more.

In order to explore the association between trajectories of body mass index (BMI) and mid-upper arm circumference (MUAC) and diabetes and to assess the effectiveness of the models to predict diabetes among Chinese prediabetic people, we conducted this study. Using a national longitudinal study, 1529 cases were involved for analyzing the association between diabetes and BMI trajectories or MUAC trajectories. Growth mixture modeling was conducted among the prediabetic Chinese population to explore the trajectories of BMI and MUAC, and logistic regression was applied to evaluate the association between these trajectories and the risk of diabetes. The receiver operating characteristic curve (ROC) and the area under the curve (AUC) were applied to assess the feasibility of prediction. BMI and MUAC were categorized into 4-class trajectories, respectively. Statistically significant associations were observed between diabetes in certain BMI and MUAC trajectories. The AUC for trajectories of BMI and MUAC to predict diabetes was 0.752 (95% CI: 0.690–0.814). A simple cross-validation using logistic regression indicated an acceptable efficiency of the prediction. Diabetes prevention programs should emphasize the significance of body weight control and maintaining skeletal muscle mass and resistance training should be recommended for prediabetes. Full article

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16 pages, 679 KiB

Open AccessArticle

Current Assessment of Weight, Dietary and Physical Activity Behaviors among Middle and High School Students in Shanghai, China—A 2019 Cross-Sectional Study

by Jingfen Zhu, Yinliang Tan, Weiyi Lu, Yaping He and Zhiping Yu

Nutrients 2021, 13(12), 4331; https://doi.org/10.3390/nu13124331 - 30 Nov 2021

Cited by 5 | Viewed by 2353

Abstract

Poor nutrition or insufficient physical activity (PA) are risk factors for obesity and chronic diseases. This 2019 cross-sectional study from the school health survey examined the dietary and PA behaviors of Chinese adolescents. A total of 12,860 adolescents aged 11–18 participated through multistage [...] Read more.

Poor nutrition or insufficient physical activity (PA) are risk factors for obesity and chronic diseases. This 2019 cross-sectional study from the school health survey examined the dietary and PA behaviors of Chinese adolescents. A total of 12,860 adolescents aged 11–18 participated through multistage and stratified cluster random sampling. A questionnaire collected data on weight, PA, sedentary lifestyle, and eating habits. Unhealthy behaviors were identified and summed up for each behavior. Participants were then classified into high and low amounts of risk behaviors. Weight status was defined using Body Mass Index (BMI) cutoff points for Chinese individuals aged 6–18. Multinomial logistic regression was used to assess effects of lifestyle behaviors on weight status. The prevalence of overweight and obesity was 22.3% among all participants (30.6% in boys, 13.2% in girls). Females engaged in more risk physical activities (4.12 vs. 3.80, p < 0.05), while males engaged in more risk dietary activities (2.20 vs. 2.02, p < 0.05). Higher number of risk dietary, PA, and sedentary behaviors were all significantly correlated with higher BMI (dietary: r = 0.064; PA: r = 0.099; sedentary: r = 0.161; p < 0.001 for all) and body weight (dietary: r = 0.124; PA: r = 0.128; sedentary: r = 0.222; p < 0.001 for all). Risk sedentary behaviors was a significant risk factor for overweight/obesity (Adjusted Odds Ratio AOR = 1.30, 95% Confidence Interval CI 1.11–1.52). Obesity and unhealthy lifestyle behaviors remain a concern among Chinese adolescents. These results provide an update on the factors contributing to overweight/obesity among adolescents and call for efforts to address obesity among adolescents. Full article

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16 pages, 2367 KiB

Open AccessReview

Associated Factors of Sarcopenia in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

by Qianqian Gao, Kaiyan Hu, Chunjuan Yan, Bing Zhao, Fan Mei, Fei Chen, Li Zhao, Yi Shang, Yuxia Ma and Bin Ma

Nutrients 2021, 13(12), 4291; https://doi.org/10.3390/nu13124291 - 27 Nov 2021

Cited by 72 | Viewed by 13159

Abstract

(1) Background: To review the associated factors of sarcopenia in community-dwelling older adults. (2) Methods: PubMed, Embase, Web of Science, and four Chinese electronic databases were searched for observational studies that reported the associated factors of sarcopenia from inception to August 2021. Two [...] Read more.

(1) Background: To review the associated factors of sarcopenia in community-dwelling older adults. (2) Methods: PubMed, Embase, Web of Science, and four Chinese electronic databases were searched for observational studies that reported the associated factors of sarcopenia from inception to August 2021. Two researchers independently selected the literature, evaluated their quality, and extracted relevant data. The pooled odds ratio (OR) and its 95% confidence interval (CI) were calculated for each associated factors of sarcopenia using random-effects/fixed-effects models. Publication bias was assessed using funnel plot and the Eggers test. We performed statistical analysis using Stata 15.0 software. (3) Results: A total of 68 studies comprising 98,502 cases were included. Sociodemographic associated factors of sarcopenia among community-dwelling older adults included age (OR = 1.12, 95% CI: 1.10–1.13), marital status (singled, divorced, or widowed) (OR = 1.57, 95% CI: 1.08–2.28), disability for activities of daily living (ADL) (OR = 1.49, 95% CI: 1.15–1.92), and underweight (OR = 3.78, 95% CI: 2.55–5.60). Behavioral associated factors included smoking (OR = 1.20, 95% CI: 1.10–1.21), physical inactivity (OR = 1.73, 95% CI: 1.48–2.01), malnutrition/malnutrition risk (OR = 2.99, 95% CI: 2.40–3.72), long (OR = 2.30, 95% CI: 1.37–3.86) and short (OR = 3.32, 95% CI: 1.86–5.93) sleeping time, and living alone (OR = 1.55, 95% CI: 1.00–2.40). Disease-related associated factors included diabetes (OR = 1.40, 95% CI: 1.18–1.66), cognitive impairment (OR = 1.62, 95% CI: 1.05–2.51), heart diseases (OR = 1.14, 95% CI: 1.00–1.30), respiratory diseases (OR = 1.22, 95% CI: 1.09–1.36), osteopenia/osteoporosis (OR = 2.73, 95% CI: 1.63–4.57), osteoarthritis (OR = 1.33, 95% CI: 1.23–1.44), depression (OR = 1.46, 95% CI: 1.17–1.83), falls (OR = 1.28, 95% CI: 1.14–1.44), anorexia (OR = 1.50, 95% CI: 1.14–1.96), and anemia (OR = 1.39, 95% CI: 1.06–1.82). However, it remained unknown whether gender (female: OR = 1.10, 95% CI: 0.80–1.51; male: OR = 1.50, 95% CI: 0.96–2.34), overweight/obesity (OR = 0.27, 95% CI: 0.17–0.44), drinking (OR = 0.92, 95% CI: 0.84–1.01), hypertension (OR = 0.98, 95% CI: 0.84–1.14), hyperlipidemia (OR = 1.14, 95% CI: 0.89–1.47), stroke (OR = 1.70, 95% CI: 0.69–4.17), cancer (OR = 0.88, 95% CI: 0.85–0.92), pain (OR = 1.08, 95% CI: 0.98–1.20), liver disease (OR = 0.88, 95% CI: 0.85–0.91), and kidney disease (OR = 2.52, 95% CI: 0.19–33.30) were associated with sarcopenia. (4) Conclusions: There are many sociodemographic, behavioral, and disease-related associated factors of sarcopenia in community-dwelling older adults. Our view provides evidence for the early identification of high-risk individuals and the development of relevant interventions to prevent sarcopenia in community-dwelling older adults. Full article

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15 pages, 327 KiB

Open AccessArticle

Association between Free Sugars Intake and Excessive Daytime Sleepiness among Chinese Adolescents

by Yue Xi, Qian Lin, Qiping Yang, Fang Li, Hanmei Liu, Jing Luo, Yufeng Ouyang, Minghui Sun, Cuiting Yong, Caihong Xiang and Wenya Zheng

Nutrients 2021, 13(11), 3959; https://doi.org/10.3390/nu13113959 - 05 Nov 2021

Cited by 5 | Viewed by 2376

Abstract

This study aimed to investigate the prevalence of excessive daytime sleepiness (EDS) and explore the association between free sugars intake and EDS. In this cross-sectional study, a total of 1517 middle school students (808 boys and 707 girls) aged 12~14 years were recruited. [...] Read more.

This study aimed to investigate the prevalence of excessive daytime sleepiness (EDS) and explore the association between free sugars intake and EDS. In this cross-sectional study, a total of 1517 middle school students (808 boys and 707 girls) aged 12~14 years were recruited. The study was conducted in Changsha city, China. Adolescents completed an online questionnaire, including the Epworth Sleepiness Scale (ESS), sleep characteristics, a 12-item Food Frequency Questionnaire (FFQ), and other self-reported information. The ESS score ≥ ten was defined as EDS. The anthropometric indices, including height, weight, and waist circumference, were measured and recorded by uniformly trained assistants. Statistical analyses included the Chi-square test and binary logistic regression model. The mean ESS score and free sugars consumption were 6.8 ± 3.9 points and 53.1 ± 44.7 g/d, respectively. The prevalence of EDS among adolescents was 22.5%, and more girls than boys had EDS (26.1% vs. 19.4%, p < 0.05). An exceeded free sugars intake was positively associated with EDS, with the adjusted Odds Ratio (OR) with its 95% Confident Interval (95% CI) of 1.366 (1.060~1.761, p < 0.05). EDS and excessive consumption of free sugars are commonly found among Chinese adolescents. Further studies are needed to confirm whether free sugars restriction can be meaningful to improve daytime drowsiness in those with EDS. Full article

9 pages, 416 KiB

Open AccessArticle

Dietary Sodium Intake Is Positively Associated with Sugar-Sweetened Beverage Consumption in Chinese Children and Adolescents

by Zhenni Zhu, Xueying Cui, Xiaohui Wei, Jiajie Zang, Jingyuan Feng, Zhengyuan Wang and Zehuan Shi

Nutrients 2021, 13(11), 3949; https://doi.org/10.3390/nu13113949 - 05 Nov 2021

Cited by 4 | Viewed by 1904

Abstract

Sugar-sweetened beverage (SSB) consumption among children and adolescents is steadily increasing in China, while the main taste of Chinese food is salty. The present study aimed to determine the relationships between SSB and total fluid consumption and dietary sodium and salt intake among [...] Read more.

Sugar-sweetened beverage (SSB) consumption among children and adolescents is steadily increasing in China, while the main taste of Chinese food is salty. The present study aimed to determine the relationships between SSB and total fluid consumption and dietary sodium and salt intake among children and adolescents in China. The data were obtained from a cross-sectional investigation in 2015. A total of 3958 participants were included. A 24-h dietary record for three consecutive days was collected to determine the SSB intake and food consumption across school days and rest days. After adjusting for age, sex, yearly household income, maternal education, intentional physical exercise, and instances of eating out in the last week, the dietary sodium intake was positively associated with the SSB consumption (p < 0.05), but salt was not. After stratifying by sex, grades, and puberty status, the associations between dietary sodium intake and SSB consumption were significant in girls, in grades 1–5 and before puberty (p < 0.05). Dietary sodium intake was positively associated with SSB consumption in Chinese children and adolescents, particularly in young children. A reduction of the sodium intake might help reduce SSB consumption among children and adolescents. Full article

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13 pages, 1320 KiB

Open AccessArticle

Dietary Protein Intake Dynamics in Elderly Chinese from 1991 to 2018

by Yifei Ouyang, Tingyi Tan, Xiaoyun Song, Feifei Huang, Bing Zhang, Gangqiang Ding and Huijun Wang

Nutrients 2021, 13(11), 3806; https://doi.org/10.3390/nu13113806 - 26 Oct 2021

Cited by 10 | Viewed by 2303

Abstract

Unique rapid urbanization-related changes in China may affect the dietary protein intake of the aging population. We aimed to evaluate trends in dietary protein intake and major food sources of protein and estimate conformity to the dietary reference intakes (DRIs) in the elderly [...] Read more.

Unique rapid urbanization-related changes in China may affect the dietary protein intake of the aging population. We aimed to evaluate trends in dietary protein intake and major food sources of protein and estimate conformity to the dietary reference intakes (DRIs) in the elderly Chinese population. A sample of 10,854 elderly adults aged 60 years or older, drawn from 10 waves of the China Health and Nutrition Survey (CHNS) between 1991 and 2018, was included. Protein intake data were obtained on the basis of 3-day, 24 h dietary recalls. The dietary protein intake among elderly Chinese individuals declined from 63.3 g/day to 57.8 g/day over the 28-year period, with a −0.032 ± 0.0001 g/day change per year (p < 0.05). There was a significant increase in the proportion of subjects with a protein intake level below the estimated averaged requirement (EAR) and a reduction in the proportion of subjects consuming protein above the recommended nutrient intake (RNI) across all population subgroups. Cereals ranked as the major sources of dietary protein, although their contribution to dietary protein gradually decreased as time went on. The contribution from meat steadily rose from 18.2% in 1991 to 28.7% in 2018. The proportion of energy gained from fat increased notably, reaching 34.2% in 2018. The elderly Chinese population experienced a significant reduction in dietary protein intake. Although the transformation of dietary patterns had positive effects on improving protein quality due to increases in animal source food, some elderly Chinese individuals currently face the risk of inadequate dietary protein intake. Full article

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14 pages, 623 KiB

Open AccessArticle

Association between Parents’ Perceptions of Preschool Children’s Weight, Feeding Practices and Children’s Dietary Patterns: A Cross-Sectional Study in China

by Caihong Xiang, Youjie Zhang, Cuiting Yong, Yue Xi, Jiaqi Huo, Hanshuang Zou, Jiajing Liang, Zhiqian Jiang and Qian Lin

Nutrients 2021, 13(11), 3767; https://doi.org/10.3390/nu13113767 - 25 Oct 2021

Cited by 8 | Viewed by 2170

Abstract

Parental perception of children’s weight may influence parents’ feeding practices, and in turn, child dietary intake and weight status; however, there is limited evidence generated for preschoolers. The aim of this cross-sectional study was to investigate associations between Chinese parents’ perceptions of child [...] Read more.

Parental perception of children’s weight may influence parents’ feeding practices, and in turn, child dietary intake and weight status; however, there is limited evidence generated for preschoolers. The aim of this cross-sectional study was to investigate associations between Chinese parents’ perceptions of child weight, feeding practices and preschoolers’ dietary patterns. Participants (1616 parent-child pairs) were recruited from six kindergartens in Hunan, China. Parents’ misperception, concern, and dissatisfaction on child weight were collected through a self-administered caregiver questionnaire. Parental feeding practices and children’s dietary intake were, respectively, assessed using the Child Feeding Questionnaire and a Food Frequency Questionnaire. Linear regression models were applied to analyze associations between parental weight perceptions, feeding practices, and preschooler’s dietary patterns. Associations between parents’ weight perceptions and dietary patterns were significant only among underweight children. Regardless of child weight status, parental weight underestimation and preference for a heavier child were positively associated with pressure-to-eat. Parental weight concern was positively associated with restriction in normal weight child, but this was not found in other weight groups. In conclusion, Parents’ misperception, concern, and dissatisfaction about child weight are associated with parents’ feeding practices and may influence preschoolers’ dietary quality, but the relationships vary by children’s actual weight status. Full article

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19 pages, 576 KiB

Open AccessReview

A Systematic Review of Diet Quality Index and Obesity among Chinese Adults

by Isma’il Kadam, Sudeep Neupane, Jingkai Wei, Lee Ann Fullington, Tricia Li, Ruopeng An, Li Zhao, Amy Ellithorpe, Xinyin Jiang and Liang Wang

Nutrients 2021, 13(10), 3555; https://doi.org/10.3390/nu13103555 - 11 Oct 2021

Cited by 14 | Viewed by 3885

Abstract

Diet quality scores are designed mainly based on Western-style dietary patterns. They were demonstrated to be good indicators of obesity in developed but not developing countries. Several diet quality scores were developed based on the Chinese dietary guidelines, yet no systematic review exists [...] Read more.

Diet quality scores are designed mainly based on Western-style dietary patterns. They were demonstrated to be good indicators of obesity in developed but not developing countries. Several diet quality scores were developed based on the Chinese dietary guidelines, yet no systematic review exists regarding how they were related to obesity. We searched research articles published between 2000 and 2021 in PubMed, CINAHL, and Scopus databases. Both cross-sectional and prospective studies that examined the relationship between a diet quality score and weight, body mass index, obesity, or waist circumference conducted in a Chinese population were selected. From the 602 articles searched, 20 articles were selected (12 are cross-sectional studies and 8 are prospective cohort studies). The relationship between internationally used scores and obesity was inconsistent among studies. Scores tailored to the Chinese diet demonstrated a strong relationship with both being underweight and obesity. The heterogeneity of the populations and the major nutrition transition in China may partially explain the discrepancies among studies. In conclusion, diet quality scores tailored to the Chinese diet may be associated with both undernutrition and overnutrition, as well as being underweight and obesity outcomes. Full article

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7 pages, 248 KiB

Open AccessArticle

by Huidi Zhang, Yang Cao, Pengkun Song, Qingqing Man, Deqian Mao, Yichun Hu and Lichen Yang

Nutrients 2021, 13(9), 3287; https://doi.org/10.3390/nu13093287 - 20 Sep 2021

Cited by 5 | Viewed by 2178

Abstract

Background: Magnesium and calcium play a variety of biological roles in body functions. Reference values of these elements have not yet been systematically determined in China, especially in childbearing women. We proposed to establish the reference range of Mg, Ca, and Ca/Mg ratio [...] Read more.

Background: Magnesium and calcium play a variety of biological roles in body functions. Reference values of these elements have not yet been systematically determined in China, especially in childbearing women. We proposed to establish the reference range of Mg, Ca, and Ca/Mg ratio in plasma and whole blood for 18–44 years healthy childbearing women in China. Method: A total of 1921 women of childbearing age (18–44 years) were randomly selected from the 2015 China National Nutrition and Health Survey by taking into account the regional types and monitoring points. Among them, 182 healthy women were screened out with a series strict inclusion criteria to study the reference ranges of elements. Fundamental indicators (weight, height, waist, blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein, fast glucose, HbA1c, blood pressure, uric acid) and elements concentrations in plasma and whole blood were collected. The 2.5th to 97.5th was used to represent the reference range of Mg, Ca, and Ca/Mg ratio. Results: The reference range of Mg, Ca, and Ca/Mg ratio in plasma were 0.75–1.13 mmol/L, 2.27–3.43 mmol/L, and 2.41–3.44, respectively. Additionally, the reference range of Mg, Ca, and Ca/Mg ratio in whole blood were 1.28–1.83 mmol/L, 1.39–2.26 mmol/L, and 0.90–1.66, respectively. According to the established reference range, the prevalence of magnesium deficiency was 4.79% in 1921 childbearing women, 21.05% in type 2 diabetes, and 5.63% in prediabetes. Conclusion: The reference values of Mg, Ca and Ca/Mg proportion in plasma and entire blood of healthy childbearing women can be utilized as a pointer to assess the status of component lack and over-burden. The lower limit of plasma Mg is in good agreement with the recommended criteria for the determination of hypomagnesemia. Full article

7 pages, 248 KiB

Open AccessArticle

Zinc Nutritional Status and Risk Factors of Elderly in the China Adult Chronic Disease and Nutrition Surveillance 2015

by Jiaxi Lu, Yichun Hu, Min Li, Xiaobing Liu, Rui Wang, Deqian Mao, Xiaoguang Yang and Lichen Yang

Nutrients 2021, 13(9), 3086; https://doi.org/10.3390/nu13093086 - 02 Sep 2021

Cited by 7 | Viewed by 2602

Abstract

Objectives: To analyze the serum zinc nutrition status of the Chinese elderly, and to assess the risk factor for zinc deficiency. Methods: 3727 elderly people over 60 years old were randomly selected from 302 monitoring points in 31 provinces of China Adult Chronic [...] Read more.

Objectives: To analyze the serum zinc nutrition status of the Chinese elderly, and to assess the risk factor for zinc deficiency. Methods: 3727 elderly people over 60 years old were randomly selected from 302 monitoring points in 31 provinces of China Adult Chronic Disease and Nutrition Surveillance (CACDNS) 2015. Blood samples were selected from the biological sample bank of CACDNS 2015 and the basic information were collected by questionnaires. The criteria of serum zinc deficiency recommended by the International Zinc Nutrition Consulting Group (IZiNCG) were adopted, and the related factors were also analyzed. Results: The median serum zinc concentration of Chinese elderly was 99.2 (84.3~118.7) μg/dL. The overall adjusted prevalence of zinc deficiency was 8.68%, with a 95% confidence interval (CI) of 7.74% and 9.61%. Significant differences were found in different sex, age groups, Body Mass Index (BMI), residence region, race and education level in terms of serum zinc status in the elderly (p < 0.05). Participants who are males, aged above 70y, with BMIs of less than 18.5 kg/m², living in rural areas, minority, and with the lowest income had a higher prevalence of zinc deficiency in the subgroups under different classifications. The risk of zinc deficiency in the elderly over 70y was 1.44 higher than those aged 60–69y (OR = 1.44, 95%CI 1.14–1.82), and the minority elderly has a 1.39 higher risk than Han nationality (OR = 1.39, 95%CI 1.01–1.91), while overweight/obesity and female elderly were at lower risk (OR < 1, p < 0.05). Conclusions: The overall prevalence of zinc deficiency in the elderly was highest in all adults in the CACDNS. It is recommended that the male elderly, over 70 years, and the minority elderly should pay more attention to the zinc nutrition status of their own. Full article

15 pages, 615 KiB

Open AccessArticle

The Association between Free Sugars Consumption and Laryngopharyngeal Reflux: A Cross-Sectional Study among Chinese Adolescents

by Fang Li, Qian Lin, Qiping Yang, Yue Xi, Hanmei Liu, Jing Luo, Yufeng Ouyang, Minghui Sun, Cuiting Yong, Caihong Xiang and Jing Deng

Nutrients 2021, 13(9), 3012; https://doi.org/10.3390/nu13093012 - 28 Aug 2021

Cited by 5 | Viewed by 2087

Abstract

There is a lack of evidence to show prevalence of laryngopharyngeal reflux (LPR) and the association between LPR and dietary factors. Adolescents consume the most amount of free sugars among the Chinese population. We conducted this study to investigate the prevalence of LPR [...] Read more.

There is a lack of evidence to show prevalence of laryngopharyngeal reflux (LPR) and the association between LPR and dietary factors. Adolescents consume the most amount of free sugars among the Chinese population. We conducted this study to investigate the prevalence of LPR in Chinese adolescents and explore the association between free sugars consumption and LPR. A cross-sectional study was conducted on 1517 middle school students in Hunan, China. An online questionnaire was applied to collect data on the condition of LPR, consumption of free sugars and other self-reported covariates. Height, weight and waist circumference were collected by anthropometric measurements. Logistic regression was applied to assess the association between LPR and free sugars consumption. The mean and standard deviation of free sugars consumption was 53.14 ± 44.75 (g/d). The prevalence of LPR was 8.11%. A positive association was observed between LPR and higher free sugars consumption after adjusted multiple covariates, with adjusted odds ratio (95% confident interval) of 1.656 (1.125–2.438). The prevalence of LPR among Chinese adolescents was high. Further analytic studies with strict design are required to test the association between LPR and free sugar consumption. Systematic strategies and policies should to be developed to reduce the intake of free sugars in order to prevent LPR. Full article

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8 pages, 433 KiB

Open AccessArticle

Trajectories of Dietary Patterns and Their Associations with Overweight/Obesity among Chinese Adults: China Health and Nutrition Survey 1991–2018

by Jiguo Zhang, Huijun Wang, Zhihong Wang, Feifei Huang, Xiaofan Zhang, Wenwen Du, Chang Su, Yifei Ouyang, Li Li, Jing Bai, Bing Zhang, Shufa Du and Gangqiang Ding

Nutrients 2021, 13(8), 2835; https://doi.org/10.3390/nu13082835 - 18 Aug 2021

Cited by 21 | Viewed by 3069

Abstract

It is essential to understand the impact of different dietary pattern trajectories on health over time. Therefore, we aimed to explore the long-term trajectories of dietary patterns among Chinese adults and examine the prospective association between different trajectory groups and the risk of [...] Read more.

It is essential to understand the impact of different dietary pattern trajectories on health over time. Therefore, we aimed to explore the long-term trajectories of dietary patterns among Chinese adults and examine the prospective association between different trajectory groups and the risk of overweight/obesity. The sample was 9299 adults aged 18 years or older from the China Health and Nutrition Survey (CHNS) between 1991 and 2018. We used factor analysis to identify dietary patterns and group-based trajectory modeling to identify dietary pattern trajectories. Three trajectories of a southern pattern and a modern pattern and four trajectories of a meat pattern were identified. Participants who followed the highest initial score and a slight decrease trajectory (OR = 1.63; 95% CI: 1.04, 2.54) of the meat dietary pattern were positively associated with risk of overweight/obesity when compared with the lowest initial score trajectory. The southern dietary pattern and the modern dietary pattern trajectories of participants in Group 2 (OR = 0.64; 95% CI: 0.51, 0.81; OR = 0.76; 95% CI: 0.63, 0.91) and Group 3 (OR = 0.71; 95% CI: 0.54, 0.91; OR = 0.64; 95% CI: 0.44, 0.90) were associated with lower risk of overweight/obesity when compared with Group 1. We observed that dietary pattern trajectories have different associations with overweight/obesity among Chinese adults. Full article

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10 pages, 618 KiB

Open AccessArticle

Ultra-Processed Food Consumption Associated with Overweight/Obesity among Chinese Adults—Results from China Health and Nutrition Survey 1997–2011

by Ming Li and Zumin Shi

Nutrients 2021, 13(8), 2796; https://doi.org/10.3390/nu13082796 - 15 Aug 2021

Cited by 34 | Viewed by 4809

Abstract

The association between the consumption of ultra-processed food (UPF) with overweight/obesity in Chinese adults has not been investigated. This study included a cohort of 12,451 adults aged >20 years who participated at least twice in the China Nutrition and Health Survey (CNHS) during [...] Read more.

The association between the consumption of ultra-processed food (UPF) with overweight/obesity in Chinese adults has not been investigated. This study included a cohort of 12,451 adults aged >20 years who participated at least twice in the China Nutrition and Health Survey (CNHS) during 1997–2011. Food intake at each survey was assessed using a 3-day 24-h dietary recall. Body weight (kg), height (m), and waist circumference (WC) were measured during the survey. UPF was defined by the NOVA classification. Mixed effect logistic regression analyses were used. The mean UPF consumption of the study population (baseline mean age 43.7 years) increased from 12.0 g in 1997 to 41.5 g in 2011 with the corresponding proportion of UPF in daily diet from 1.0% to 3.6%. The adjusted odds ratios (95% CI) for BMI ≥ 25 kg/m² for those with mean UPF consumption of 1–19 g/d, 20–49 g/d, and ≥50 g/d were 1.45 (1.26–1.65), 1.34 (1.15–1.57), and 1.45 (1.21–1.74), respectively (p-trend = 0.015), compared with the non-consumers. Similarly, the corresponding adjusted ORs (95% CI) for central obesity were 1.54 (1.38–1.72), 1.35 (1.19–1.54), and 1.50 (1.29–1.74). Higher long-term UPF consumption was associated with increased risk of overweight/obesity among Chinese adults. Full article

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12 pages, 459 KiB

Open AccessArticle

The Impact of Lifestyle Intervention on Dietary Quality among Rural Women with Previous Gestational Diabetes Mellitus—A Randomized Controlled Study

by Mingshu Li, Qian Lin, Jingcheng Shi, Yue Xi, Caihong Xiang, Cuiting Yong and Jia Guo

Nutrients 2021, 13(8), 2642; https://doi.org/10.3390/nu13082642 - 30 Jul 2021

Cited by 3 | Viewed by 2727

Abstract

Healthy diet is essential to type 2 diabetes mellitus (T2DM) prevention for women with previous gestational diabetes mellitus (GDM). To evaluate the effect of a lifestyle intervention program on diet quality for rural women who were previously diagnosed with GDM, we conducted a [...] Read more.

Healthy diet is essential to type 2 diabetes mellitus (T2DM) prevention for women with previous gestational diabetes mellitus (GDM). To evaluate the effect of a lifestyle intervention program on diet quality for rural women who were previously diagnosed with GDM, we conducted a randomized controlled study in two counties located in south-central China. A total of 404 eligible women were allocated into an intervention group and control group. Participants in the intervention group received 6-month lifestyle intervention including six group seminars and eight telephone consultations. Dietary data were collected at baseline and 18 months via a 24 h dietary recall, and dietary quality was measured by two indicators, Chinese Healthy Eating Score (CHEI) and Minimum Dietary Diversity for Women (MDD-W). Baseline CHEI scores (54.4 vs. 53.5, p = 0.305) and the proportions of participants who met MDD-W (73.8% vs. 74.5%, p = 0.904) were comparable between the two groups. The intervention group achieved a higher CHEI score (62.2 vs. 58.9, p = 0.001) and higher MDD-W proportion (90.6% vs. 81.2%, p = 0.023) at 18 months. Lifestyle intervention was associated with the change of CHEI (p = 0.049) but not with MDD-W (p = 0.212). In conclusion, compared with usual care, lifestyle intervention resulted in greater improvement of dietary quality among rural women with previous GDM. Full article

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15 pages, 849 KiB

Open AccessArticle

Plasma Sphingolipid Profile in Association with Incident Metabolic Syndrome in a Chinese Population-Based Cohort Study

by Huan Yun, Qi-Bin Qi, Geng Zong, Qing-Qing Wu, Zhen-Hua Niu, Shuang-Shuang Chen, Huai-Xing Li, Liang Sun, Rong Zeng and Xu Lin

Nutrients 2021, 13(7), 2263; https://doi.org/10.3390/nu13072263 - 30 Jun 2021

Cited by 4 | Viewed by 2347

Abstract

Although bioactive sphingolipids have been shown to regulate cardiometabolic homeostasis and inflammatory signaling pathways in rodents, population-based longitudinal studies of relationships between sphingolipids and onset of metabolic syndrome (MetS) are sparse. We aimed to determine associations of circulating sphingolipids with inflammatory markers, adipokines, [...] Read more.

Although bioactive sphingolipids have been shown to regulate cardiometabolic homeostasis and inflammatory signaling pathways in rodents, population-based longitudinal studies of relationships between sphingolipids and onset of metabolic syndrome (MetS) are sparse. We aimed to determine associations of circulating sphingolipids with inflammatory markers, adipokines, and incidence of MetS. Among 1242 Chinese people aged 50–70 years who completed the 6-year resurvey, 76 baseline plasma sphingolipids were quantified by high-throughput liquid chromatography-tandem mass spectrometry. There were 431 incident MetS cases at 6-year revisit. After multivariable adjustment including lifestyle characteristics and BMI, 21 sphingolipids mainly from ceramide and hydroxysphingomyelin subclasses were significantly associated with incident MetS. Meanwhile, the baseline ceramide score was positively associated (RR_{Q4 versus Q1} = 1.31; 95% CI 1.05, 1.63; p_trend = 0.010) and the hydroxysphingomyelin score was inversely associated (RR_{Q4 versus Q1} = 0.60; 95% CI 0.45, 0.79; p_trend < 0.001) with incident MetS. When further controlling for clinical lipids, both associations were attenuated but remained significant. Comparing extreme quartiles, RRs (95% CIs) of MetS risk were 1.34 (95% CI 1.06, 1.70; p_trend = 0.010) for ceramide score and 0.71 (95% CI 0.51, 0.97; p_trend = 0.018) for hydroxysphingomyelin score, respectively. Furthermore, a stronger association between ceramide score and incidence of MetS was evidenced in those having higher inflammation levels (RR_{Q4 versus Q1} 1.57; 95% CI 1.16, 2.12; p_interaction = 0.004). Our data suggested that elevated ceramide concentrations were associated with a higher MetS risk, whereas raised hydroxysphingomyelin levels were associated with a lower MetS risk beyond traditional clinical lipids. Full article

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13 pages, 605 KiB

Open AccessArticle

Vitamin D Nutritional Status of Chinese Pregnant Women, Comparing the Chinese National Nutrition Surveillance (CNHS) 2015–2017 with CNHS 2010–2012

by Yichun Hu, Rui Wang, Deqian Mao, Jing Chen, Min Li, Weidong Li, Yanhua Yang, Liyun Zhao, Jian Zhang, Jianhua Piao, Xiaoguang Yang and Lichen Yang

Nutrients 2021, 13(7), 2237; https://doi.org/10.3390/nu13072237 - 29 Jun 2021

Cited by 10 | Viewed by 2432

Abstract

Optimal vitamin D (vitD) status is beneficial for both pregnant women and their newborns. The aim of this study was to evaluate the vitamin D status of Chinese pregnant women in the latest China Nutrition and Health Surveillance (CNHS) 2015–2017, analyze the risk [...] Read more.

Optimal vitamin D (vitD) status is beneficial for both pregnant women and their newborns. The aim of this study was to evaluate the vitamin D status of Chinese pregnant women in the latest China Nutrition and Health Surveillance (CNHS) 2015–2017, analyze the risk factors of vitamin D deficiency (VDD), and compare them with those in CNHS 2010–2012. Serum 25 hydroxyvitamin D (25(OH)D) was measured by ELISA method. City type, district, latitude, location, age, vitamin D supplements intake, education, marital status, annual family income, etc., were recorded. The median 25(OH)D concentration was 13.02 (10.17–17.01) ng/mL in 2015–2017, and 15.48 (11.89–20.09) ng/mL in 2010–2012. The vitamin D sufficient rate was only 12.57% in 2015–2017, comparing to 25.17% in 2010–2012. The risk factors of vitamin D inadequacy (25(OH)D < 20 ng/mL) in 2015–2017 were not exactly consistent with that in 2010–2012. The risk factors included season of spring (p < 0.0001) and winter (p < 0.001), subtropical (p < 0.001), median (p < 0.0001) and warm temperate zones (p < 0.0001), the western (p = 0.027) and the central areas (p = 0.041), while vitD supplements intake (p = 0.021) was a protective factor in pregnant women. In conclusion, vitD inadequacy is very common among Chinese pregnant women. We encourage pregnant women to take more effective sunlight and proper vitD supplements, especially for those from the subtropical, warm and medium temperate zones, the western and the central, and in the seasons of spring and winter. Full article

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13 pages, 282 KiB

Open AccessArticle

Sugar-Sweetened Beverages Consumption and Associated Factors among Northeastern Chinese Children

by Xuxiu Zhuang, Yang Liu, Joel Gittelsohn, Emma Lewis, Shenzhi Song, Yanan Ma and Deliang Wen

Nutrients 2021, 13(7), 2233; https://doi.org/10.3390/nu13072233 - 29 Jun 2021

Cited by 7 | Viewed by 3364

Abstract

(1) Background: The present study aimed to investigate the association between home-related factors, community environmental factors, and sugar-sweetened beverages (SSBs) intake among Northeastern Chinese children. (2) Methods: Cross-sectional. Children with complete data were included in the analysis (n = 901). A questionnaire [...] Read more.

(1) Background: The present study aimed to investigate the association between home-related factors, community environmental factors, and sugar-sweetened beverages (SSBs) intake among Northeastern Chinese children. (2) Methods: Cross-sectional. Children with complete data were included in the analysis (n = 901). A questionnaire modified according to BEVQ-15 measured the intake of SSBs. Logistic regression was applied to determine the factors associated with the consumption of SSBs. IBM SPSS Statistics 23.0 was applied to perform all statistical analyses. (3) Results: The mean total amount of SSBs consumed on a weekly basis was 2214.04 ± 2188.62 mL. Children’s weekly pocket money, frequency of SSBs purchase, SSBs availability at home, the number of accessible supermarkets, and frequency of weekly visits to convenience stores were all found to be associated with a high intake of SSBs among all children. Among children of normal weight, the findings indicated that weekly pocket money, SSBs availability at home, and number of accessible supermarkets were associated with a high SSBs intake. At the same time, frequency of SSBs purchase, mother’s SSBs intake, and frequency of weekly visits to convenience stores were associated with a high SSBs intake among children with obesity. (4) Conclusions: Given the potential negative health effects of high SSBs intake, it is crucial to pay attention to home-related factors and community environment. Full article

14 pages, 287 KiB

Open AccessArticle

Association of Maternal Dietary Patterns during Pregnancy and Offspring Weight Status across Infancy: Results from a Prospective Birth Cohort in China

by Jiajin Hu, Izzuddin M. Aris, Pi-I D. Lin, Ningyu Wan, Yilin Liu, Yinuo Wang and Deliang Wen

Nutrients 2021, 13(6), 2040; https://doi.org/10.3390/nu13062040 - 15 Jun 2021

Cited by 4 | Viewed by 2085

Abstract

Literature on maternal dietary patterns during pregnancy and offspring weight status have been largely equivocal. We aimed to investigate the association of maternal dietary patterns with infant weight status among 937 mother–infant dyads in a Chinese birth cohort. We assessed maternal diet during [...] Read more.

Literature on maternal dietary patterns during pregnancy and offspring weight status have been largely equivocal. We aimed to investigate the association of maternal dietary patterns with infant weight status among 937 mother–infant dyads in a Chinese birth cohort. We assessed maternal diet during pregnancy using food frequency questionnaires (FFQ) and three-day food diaries (TFD) and examined infants’ body weight and length at birth, 1, 3, 6, 8 and 12 months. Maternal adherence to the “protein-rich pattern (FFQ)” was associated with lower infant body mass index z-scores (BMIZ) at birth, 3 and 6 months and lower odds of overweight and obesity (OwOb) across infancy (quartile 3 (Q3) vs. quartile 1 (Q1): odds ratio (OR): 0.50, (95% confidence interval: 0.27, 0.93)). Maternal adherence to the “vegetable–fruit–rice pattern (FFQ)” was associated with higher BMIZ at birth, 3 and 6 months and higher odds of OwOb across infancy (Q3 vs. Q1: OR: 1.79, (1.03, 3.12)). Maternal adherence to the “fried food–bean–dairy pattern (TFD)” was associated with lower BMIZ at 3, 6, 8 and 12 months and lower odds of OwOb (Q3 vs. Q1: OR: 0.54, (0.31, 0.95)). The study results may help to develop interventions and to better define target populations for childhood obesity prevention. Full article

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12 pages, 761 KiB

Open AccessArticle

Regional Difference in the Association between the Trajectory of Selenium Intake and Hypertension: A 20-Year Cohort Study

by Changxiao Xie, Jinli Xian, Mao Zeng, Zhengjie Cai, Shengping Li, Yong Zhao and Zumin Shi

Nutrients 2021, 13(5), 1501; https://doi.org/10.3390/nu13051501 - 29 Apr 2021

Cited by 11 | Viewed by 2519

Abstract

The effect of selenium on hypertension is inconclusive. We aimed to study the relationship between selenium intake and incident hypertension. Adults (age ≥20 years) in the China Health and Nutrition Survey were followed up from 1991 to 2011 (N = 13,668). The [...] Read more.

The effect of selenium on hypertension is inconclusive. We aimed to study the relationship between selenium intake and incident hypertension. Adults (age ≥20 years) in the China Health and Nutrition Survey were followed up from 1991 to 2011 (N = 13,668). The latent class modeling method was used to identify trajectory groups of selenium intake. A total of 4039 respondents developed hypertension. The incidence of hypertension was 30.1, 30.5, 30.6, and 31.2 per 1000 person-years among participants with cumulative average selenium intake of 21.0 ± 5.1, 33.2 ± 2.8, 43.8 ± 3.6, and 68.3 ± 25.2 µg/day, respectively. Region and selenium intake interaction in relation to hypertension was significant. In the multivariable model, cumulative intake of selenium was only inversely associated with the incident hypertension in northern participants (low selenium zone), and not in southern participants. Compared to selenium intake trajectory Group 1 (stable low intake), all three trajectory groups had a low hazard ratio for hypertension among the northern participants. However, Group 4 (high intake and decreased) showed an increasing trend of hypertension risk in the south. In conclusion, the association between selenium intake and the incidence of hypertension varied according to regions in China. In the low soil selenium zone, high selenium intake might be beneficial for hypertension prevention. Full article

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