Cross-sectional association between diet quality and cardiometabolic risk by education level in Mexican adults

Objective: Understanding the association between diet quality and cardiometabolic risk by education level is important for preventing increased cardiometabolic risk in the Mexican population, especially considering pre-existing disparities in diet quality. The present study examined the cross-sectional association of overall diet quality with cardiometabolic risk, overall and by education level, among Mexican men and women.Design: Cardiometabolic risk was defined by using biomarkers and diet quality by the Mexican Diet Quality Index. We computed sex-specific multivariable logistic regression models.Setting: Mexico.Participants: Mexican men (n 634) and women (n 875) participating in the Mexican National Health and Nutrition Survey 2012.Results: We did not find associations of diet quality with cardiometabolic risk factors in the total sample or in men by education level. However, we observed that for each 10-unit increase in the dietary quality score, the odds of diabetes risk in women with no reading/writing skills was 0·47 (95 % CI 0·26, 0·85) relative to the odds in women with ≥10 years of school (referent). Similarly, for each 10-unit increase of the dietary quality score, the odds of having three v. no lipid biomarker level beyond the risk threshold in lower-educated women was 0·27 (95 % CI 0·12, 0·63) relative to the odds in higher-educated women.Conclusions: Diet quality has a stronger protective association with some cardiometabolic disease risk factors for lower- than higher-educated Mexican women, but no association with cardiometabolic disease risk factors among men. Future research will be needed to understand what diet factors could be influencing the cardiometabolic disease risk disparities in this population

An exercise on transition systems

Labelled transition systems admit different but equivalent characterizations either as relational structures or coalgebras for the powerset functor, each of them with their own merits. Notions of simulation and bisimulation, for example, are expressed in the pointfree relational calculus in a very concise and precise way. On the other hand, the coalgebraic perspective regards processes as inhabitants of a final universe and allows for an intuitive definition of the semantics of process’ combinators. This paper is an exercise on such a dual characterisation. In particular, it discusses how a notion of weak bisimilarity can be lifted from the relational to the coalgebraic level, to become an effective reasoning tool on coinductively defined process algebras.(undefined

Waist Circumference Change is Associated with Blood Pressure Change Independent of BMI Change

Objective: This study aimed to understand how an increase in abdominal adiposity relative to overall adiposity is associated with blood pressure (BP) change. Methods: A sex-stratified mixed linear model was used to examine the association (95% CI) between annual changes in waist circumference (WC) and systolic blood pressure and diastolic blood pressure, estimated from two to eight repeated measures across the 1993-2015 China Health and Nutrition Survey, among 5,742 men and 5,972 women (18-66 years) with no history of antihypertension medication use. Results: The association between annual WC change and BP change remained statistically significant but was attenuated after controlling for annual BMI change, regardless of baseline abdominal obesity or overweight status. Each 10-cm annual WC gain in men and women was associated with a 0.98-mm Hg (95% CI: 0.61-1.35) and a 0.97-mm Hg (95% CI: 0.62-1.32) annual increase in systolic blood pressure and a 1.13-mm Hg (95% CI: 0.87-1.38) and a 0.74-mm Hg (95% CI: 0.51-0.97) annual increase in diastolic blood pressure, respectively, independent of annual BMI change. Conclusions: WC gain may elevate BP even in the absence of BMI gain. BP management that addresses only BMI gain could overlook individuals at risk of elevated BP who have increased WC but not BMI

Is a Hypertension Diagnosis Associated With Improved Dietary Outcomes Within 2 to 4 Years? A Fixed-Effects Analysis From the China Health and Nutrition Survey

Background: Evidence shows that dietary factors play an important role in blood pressure. However, there is no clear understanding of whether hypertension diagnosis is associated with dietary modifications. The aim of this study is to estimate the longitudinal association between hypertension diagnosis and subsequent changes (within 2–4 years) in dietary sodium, potassium, and sodium-potassium (Na/K) ratio. Methods and Results: We included adults (18–75 years, n=16 264) from up to 9 waves (1991–2015) of the China Health and Nutrition Survey. Diet data were collected using three 24-hour dietary recalls and a household food inventory. We used fixed-effects models to estimate the association between newly self-reported diagnosed hypertension and subsequent within-individual changes in sodium, potassium, and Na/K ratio. We also examined changes among couples and at the household level. Results suggest that on average, men who were diagnosed with hypertension decreased their sodium intake by 251 mg/d and their Na/K ratio by 0.19 within 2 to 4 years after diagnosis (P<0.005). Among spouse pairs, sodium intake and Na/K ratio of women decreased when their husbands were diagnosed (P<0.05). Household average sodium density and Na/K ratio decreased, and household average potassium density increased after a man was diagnosed. In contrast, changes were not statistically significant when women were diagnosed. Conclusions: Our findings suggest that hypertension diagnosis for a man may result in modest dietary improvements for him, his wife, and other household members. Yet, diagnosis for a woman does not seem to result in dietary changes for her or her household members

Sociodemographic disparity in the diet quality transition among Chinese adults from 1991 to 2011

Background/objectives:This study investigates secular trends in diet quality distribution and related socioeconomic disparity from 1991 to 2011 in the Chinese adult population.Subjects/methods:The analysis uses the 1991-2011 China Health and Nutrition Survey data on 13 853 participants (6876 men and 6977 women) aged 18-65 with 56 319 responses. Dietary assessment was carried out over a 3-day period with 24-h recalls combined with a household food inventory. We tailored Alternative Healthy Eating Index 2010 (named as tAHEI) to measure diet quality and performed quantile regression to investigate shifts in tAHEI scores at different percentiles and used mixed-effect linear regression to examine average diet quality trend and potential sociodemographic disparity.Results:The energy-adjusted mean tAHEI scores increased from 36.9 (36.7-37.1) points in 1991 to 50.3 (50.1-50.5) in 2011 for men (P<0.001) and from 35.6 (35.4-35.8) to 46.9 (46.7-47.1) for women (P<0.001). The covariate-adjusted score of polyunsaturated fatty acids increased by 6.8 (6.6, 7.0) and 7.0 (6.9, 7.2), and the score of long-chain (ω-3) fats increased by 5.3 (5.2, 5.4) and 5.3 (5.2, 5.5) in men and women, respectively, whereas the cereal fiber and red meat scores decreased slightly. Increasing tAHEI score occurred across the entire distribution, and diet quality transition varied across sociodemographic groups.Conclusions:Chinese diet quality is far from optimal, with moderate improvement over a 21-year period. Findings suggest that nutritional intervention should give priority to low-income, low-urbanized communities and southern provincial adults with low diet quality in China

Diet quality is linked to insulin resistance among adults in China

Background: Little is known about the impact of Chinese diet quality changes on diabetes-related markers. Objective: The present study examined the association of changes in overall diet quality with various biomarkers of diabetes among adults in China. Methods: The current analysis used longitudinal diet data from 1991 to 2006 and fasting blood samples from 2009 for 4734 adults aged 18-65 y from the China Health and Nutrition Survey. Dietary intake was assessed by using 3 consecutive 24-h recalls and household food weighing. The tailored Alternative Healthy Eating Index (tAHEI) was adapted from the 2010 Harvard Alternative Healthy Eating Index to measure overall diet quality. We categorized baseline tAHEI scores into tertiles and annual changes in the scores into 5 levels (high decrease, low decrease, maintain, low increase, and high increase). We performed mixed-effects regressions to assess the associations between baseline scores and changes in the tAHEI scores and diabetes or insulin markers. Results: Adults with high baseline tAHEI scores tended to be male, older, of lower socioeconomic status, and with higher physical activity levels. After adjustment for all of the covariates, insulin and homeostasis model assessment of insulin resistance (HOMA-IR) values were 5.1% (95% CI:-0.100,-20.002) and 5.7% (95% CI:-0.113,-0.001) lower, respectively, for adults with high compared with low baseline tAHEI scores and 8.6% (95% CI:-0.155,-0.017) and 9.8% (95% CI:-0.177,-0.018) lower, respectively, for adults with a high increase in score compared with the ''maintain'' category. Null associations were observed between baseline scores and changes in the scores and fasting blood glucose, glycated hemoglobin (HbA1c), and diabetes prevalence. Conclusions: Baseline and changes in diet quality were independently associated with lower HOMA-IR and plasma insulin but not with fasting blood glucose and HbA1c in Chinese adults. Prospective studies on overall diet quality in relation to diabetes markers and risk of diabetes are needed

Environmental horticulture for domestic and community gardens—An integrated and applied research approach

Societal Impact Statement Daunting global challenges of climate change and biodiversity loss may seem overwhelming. However, gardeners have a secret weapon—gardens, balconies, indoor planting, yards and allotments are mini-ecosystems that offer opportunities to counter perceptions of helplessness, inadequacy and resultant inaction by using those spaces to ‘Do what we can, with what we have, where we are’. Minimising gardening ‘footprints’ to mitigate harmful impacts, whilst maximising gardening ‘handprints’ to enhance benefits, is readily achievable. With this in mind, the Royal Horticultural Society is leading research into environmental horticulture for gardens, and benefits for individual wellbeing. Summary This article presents an integrated and applied research approach to the unique and multi-disciplinary area of science referred to here as environmental horticulture. It does this by: (a) providing an institutional perspective (The Royal Horticultural Society) on a research approach for this particular area, emphasising why domestic and community gardens are important in the context of global environmental threats; (b) presenting four primary research focus areas and project examples; and (c) highlighting interdisciplinary linkages, future research needs, public engagement/knowledge sharing opportunities, and ‘Green Skills’ development in the area of environmental horticulture. Research focus areas discussed are: (1) responding to the changing climate (adaptation, mitigation and resilience solutions in gardens); (2) ‘plants for purpose’ (harnessing the potential of horticultural plant diversity, and gardening, to help regulate environmental conditions); (3) sustainability and climate risk reduction through effective and efficient resource management (reduction, re-use, recycling and repurposing); and (4) gardening and cultivated plant choice for human health and wellbeing. We argue that a key research priority is improving our understanding of the linkages and interactions between soil, water, plants, weather and people. These crucial linkages affect above and below ground processes, for both outdoor and indoor plants. They impact the effectiveness with which water and nutrient cycling takes place, the extent to which ecosystem services may be delivered, and the resultant capacity of gardens and gardening to provide environmental and human health benefits

Six-Year Incidence of Cardiometabolic Risk Factors in a Population-Based Cohort of Chinese Adults Followed From 2009 to 2015

Background: China faces a substantial burden from cardiometabolic diseases, but longitudinal studies on a wide range of cardiometabolic risk factors are limited. We examined the 6-year incidence of 8 cardiometabolic risk factors in a diverse, population-based cohort. Methods and Results: In the China Health and Nutrition Survey, anthropometry, blood pressure, and fasting blood samples were collected from 9621 adults (47.6% men) aged 18 to 99 years in 2009 who were followed into 2015. Using inverse probability weights to account for loss to follow-up, we estimated the 6-year incidence of 8 cardiometabolic risk factors and compared the incidence of each risk factor across age groups using inverse probability–weighted sex-stratified logistic regression models. Incidence was noted for the following cardiometabolic risk factors during 2009–2015: hypertension (systolic/diastolic blood pressure ≥140/90 mm Hg; men: 29.2%; women: 24.9%), high waist circumference/height ratio (≥0.5; men: 42.4%; women: 43.8%), and high total to HDL (high-density lipoprotein) cholesterol ratio (≥5; men: 17.0%; women: 14.5%). Older men and women (aged ≥65 years) had the highest incidence of hypertension. Incidence of high waist circumference/height ratio and high LDL (low-density lipoprotein) cholesterol (≥130 mg/dL) was highest among older (aged ≥65 years) women, whereas incidence of overweight (body mass index ≥25) and high triglycerides (≥150 mg/dL) was highest among younger (aged 18–35 and 35–50 years) men. Conclusions: We found increases in cardiometabolic risk among Chinese adults during this recent, short, 6-year period that are higher than previous studies in China. The higher incidence of overweight and elevated dyslipidemia markers in younger versus older men portends an increasing burden of cardiometabolic diseases in China as the younger population ages