Dietary Micronutrient Status and Relation between Micronutrient Intakes and Overweight and Obesity among Non-Pregnant and Non-Lactating Women Aged 18 to 49 in China

Women between the ages of 18 and 49 are women of reproductive age, for whom physical health and nutritional status are closely related to successful pregnancy, good pregnancy outcomes and the nurturing of the next generation. Overweight and obesity have become important nutrition and health problems of women aged 18–49 years in China. In social life, non-pregnant and non-lactating Chinese women aged 18–49 are the most vulnerable and neglected group. At present, there are no research data on their dietary micronutrient intake, and the relationship between dietary micronutrient intake and overweight and obesity in China. However, non-pregnant and non-lactating women aged 18–49 are the best window of opportunity to implement strategies, correct nutrition and improve physical health. It remains to be explored whether their overweight and obesity are related to inadequate dietary micronutrient intake. The aim of this study was to evaluate dietary micronutrient intake in non-pregnant and non-lactating Chinese women aged 18–49 years, and to analyze the relationship between dietary micronutrient intake and overweight and obesity. Data were obtained from 2015 China Adult Chronic Disease and Nutrition Surveillance (CACDNS 2015). In CACDNS 2015, 12,872 women aged 18 to 49 years (excluding pregnant women and lactating mothers) were surveyed for a three-day 24 h dietary recall and a three-day household weighing of edible oil and condiments. The average daily dietary intake of micronutrients was calculated according to the Chinese food composition table. In 2015, the median intake of vitamin A, vitamin B1, vitamin B2, vitamin C and folate in non-pregnant and non-lactating women aged 18–49 years in China was 267.0 μg RE/day, 0.7 mg/day, 0.6 mg/day, 63.5 mg/day and 121.0 μg/day, respectively. The median mean intake of vitamin A, niacin, calcium and zinc in overweight/obese group was lower than that in non-overweight/obese group, and the difference was statistically significant (p < 0.05). Multivariate Logistic regression analysis showed that vitamin A intake (Q3 vs. Q1: OR = 0.785, 95% CI: 0.702~0.878; Q4 vs. Q1: OR = 0.766, 95% CI: 0.679~0.865), niacin intake (Q2 vs. Q1: OR = 0.801, 95% CI: 0.715–0.898; Q3 vs. Q1: OR = 0.632, 95% CI: 0.554~0.721; Q4 vs. Q1: OR = 0.662, 95% CI: 0.568~0.772), Zinc intake (Q4 vs. Q1: OR = 0.786, 95% CI: 0.662~0.932) were a protective factor for overweight/obesity in women, while vitamin B2 intake (Q2 vs. Q1: OR = 1.256, 95% CI: 1.120~1.408; Q3 vs. Q1: OR = 1.416, 95% CI: 1.240~1.617; Q4 vs. Q1: OR = 1.515, 95% CI: 1.293–1.776), vitamin E intake (Q2 vs. Q1: OR = 1.114, 95% CI: 1.006–0.235; Q3 vs. Q1: OR = 1.162, 95% CI: 1.048~0.288; Q4 vs. Q1: OR = 1.234, 95% CI: 1.112–1.371) was a risk factor for overweight/obesity in females. The intakes of most dietary micronutrients in non-pregnant and non-lactating women aged 18–49 in China were low. The intakes of dietary vitamin A, niacin and zinc were negatively correlated with the risk of overweight/obesity, while the intakes of vitamin B2 and vitamin E were positively correlated with the risk of overweight/obesity

Quality of Life of People Living with HIV/AIDS: A Cross-Sectional Study in Zhejiang Province, China.

Health-related quality of life (HRQOL) has become a concept commonly used in the related research. Using the World Health Organization Quality of Life Questionnaire for Brief Version (WHOQOL-BREF), this study evaluated the Quality of Life (QOL) of people living with HIV/AIDS (PLWHA) in Zhejiang province, China, and assessed the influences of demographic, laboratory and disease-related variables on QOL. This cross-sectional study was conducted among PLWHA aged ≥ 18 years in Taizhou municipality, Zhejiang province, China, between August 1 and October 31, 2014. A multiple linear regression model was used to analyze the influential factors. Of 403 subjects, 72.48% were male, 72.46% had received a high- school or above education, 94.79% were of Han ethnicity, and 65.51% were non farmers. The total score of QOL was 15.99±1.99. The scores of QOL in physiological, psychological, social relation, and environmental domains were 14.99 ±2.25, 14.25 ±2.12, 13.22 ±2.37, and 13.31 ±1.99 respectively. Except the total score of QOL and the score of environmental domain (p<0.05), the scores in other domains had no significant difference with the results of the national norm level. The multiple linear regression model identified the physical domain related factors to be age (β = -0.045), CD4 count (β = 0.002), and ART adherence(β = 1.231). And it also showed that psychological domain related factors included CD4 count (β = 0.002) and WHO clinical stage (β = -0.437); social domain related factors included WHO clinical stage (β = -0.704) and ART adherence (β = 1.177); while environmental domain related factors included WHO clinical stage (β = -0.538), educational status(β = 0.549) and ART adherence(β = 1.078).Those who are young, with higher level of education, higher CD4 count and good access and adherence of ART, are likely to have better QOL among PLWHA in Zhejiang province. This suggests that in addition to ART, many other factors should be taken into consideration to improve the QOL of PLWHA. The relatively lower scores the subjects received in social relation and environmental domains also suggest that social relation and environmental interventions need to be strengthened

Analysis of the Correlation between Eating Away from Home and BMI in Adults 18 Years and Older in China: Data from the CNNHS 2015

The purpose of this study is to examine the relationship between the frequency of eating away from home (EAFH) and Body mass index (BMI) in adults. The data were collected from 2015 China Adult Chronic Disease and Nutrition Surveillance (CNNHS 2015). Adults aged 18 and above who had complete dietary frequency questionnaire data were recruited as the research objects. The frequency of EAFH among different genders and BMI groups were compared, and multiple linear regression method was used to analyze the correlation between frequency of EAFH and BMI of adults aged 18 years and above with different gender, age, family per capita annual income, education level, marital status, and occupation level. The frequency of EAFH was higher for adults aged 18&ndash;44, eastern region, urban, family per capita annual income of 20,000 RMB or more, highly educated, unmarried, school students, employed people, and obese adults, which were 3.64, 3.30, 3.71, 4.30, 5.92, 5.64, 9.29 and 2.68 times per week, respectively. The highest frequency of EAFH was obese men in urban areas aged 18&ndash;44 years, which was 5.63 times per week. Multiple linear regression analysis showed that the frequency of EAFH for breakfast was not associated with BMI (p &gt; 0.05), the frequency of EAFH for lunch was negatively correlated with BMI (&beta; = &minus;0.024, p = 0.008), and the frequency of EAFH for dinner was positively correlated with BMI (&beta; = 0.040, p = 0.004).The frequency of EAFH of male (&beta; = 0.013, p = 0.008), 60 years old and above (&beta; = 0.022, p = 0.021), family per capita annual income less than 10,000 RMB (&beta; = 0.019, p = 0.005), junior high school education or below (&beta; = 0.012, p = 0.009), and unemployed/retired (&beta; = 0.029, p = 0.003) adults were positively correlated with BMI. While for women, the frequency of EAFH (&beta; = &minus;0.019, p = 0.001) was negatively correlated with BMI. In terms of frequency of EAFH for breakfast, female (&beta; = 0.027, p = 0.041), people aged 45&ndash;59 years (&beta; = 0.042, p = 0.002), aged 60 and above (&beta; = 0.047, p = 0.017), eastern China (&beta; = 0.034, p = 0.010), junior high school education or below (&beta; = 0.045, p = 0.001), married/cohabiting (&beta; = 0.024, p = 0.008) adults&rsquo; frequency of EAFH for breakfast of was positively correlated with BMI. In terms of frequency of EAFH for lunch, female (&beta; = 0.056, p = 0.001), people aged 45&ndash;59 years (&beta; = 0.024, p = 0.005), eastern China (&beta; = 0.034, p = 0.004), rural areas (&beta; = 0.035, p = 0.006), moderate and high family per capita annual income (&beta; = 0.043, p = 0.007; &beta; = 0.029, p = 0.039), high education level (&beta; = 0.039, p = 0.034), married/cohabiting (&beta; = 0.028, p = 0.001), on-the-job personnel (&beta; = 0.033, p = 0.001) frequency of EAFH for lunch were negatively correlated with BMI. In terms of the frequency of EAFH for dinner, the frequency of EAFH for dinner had a significant positive influence on the BMI of males (&beta; = 0.061, p = 0.001). The frequency of dinner EAFH for 18&ndash;44 years old (&beta; = 0.042, p = 0.028), central region (&beta; = 1.000, p &lt; 0.001), rural areas (&beta; = 0.055, p = 0.013), married/cohabiting (&beta; = 0.048, p = 0.001), on-the-job personnel (&beta; = 0.037, p = 0.035) adults were positively correlated with BMI. The frequency of EAFH in urban obese men aged 18&ndash;44 was the highest. The frequency of EAFH for breakfast was not correlated with BMI, the frequency of EAFH for lunch was negatively correlated with BMI, and the frequency of EAFH for dinner was positively correlated with BMI. The analysis between EAFH according to the current definition and health-related outcomes is mixed. It is suggested that relevant authorities redefine EAFH from the perspective of health outcomes

Analysis of the Correlation between Meal Frequency and Obesity among Chinese Adults Aged 18&ndash;59 Years in 2015

This study aimed to investigate the relationship between meal frequency and obesity in Chinese adults aged 18 to 59 years. The data came from the 2015 Chinese Adult Chronic Disease and Nutrition Surveillance (CACDNS 2015) and provincial dietary environment data from the 2015 National Statistical Yearbook. A total of 34,206 adults aged 18 to 59 who took part in the diet survey were selected as the study participants. A two-level multivariate logistic regression model was used to adjust for the socioeconomic and nutritional status of individuals. For parameter estimation, a numerical integral approach was used to analyze the relationship between meal frequency (including meals at home, the workplace or school dining halls, and eating away from home) and obesity. A two-level &ldquo;provincial&ndash;individual&rdquo; logistic multivariate regression analysis was performed with obesity as the dependent variable. The two-level multivariate analysis of variance model fitting results showed that after adjusting for the effects of gender, age, occupation, education, marital status, family per capita annual income, provincial gross domestic product (GDP), restaurant industry turnover, consumer price index of EAFH food, and energy intake, the frequency of eating at home was not associated with obesity (all p &gt; 0.05); the frequency of eating at dining halls &ge;1 to &lt;2 times per day (OR = 0.784, p = 0.0122) showed a negative association with obesity; the frequency of eating away from home &lt; 1 times per day and &ge;1 to &lt;2 times per day were positively correlated with obesity (&lt;1 time per day: OR = 1.123, p = 0.0419; &ge;1 to &lt;2 times per day: OR = 1.249, p = 0.0022). The results of the two-level random-intercept logistic multivariate mixed-effects prediction model for obesity in adults aged 18 to 59 years showed that no statistical association was noticed between the frequency of eating at home and obesity in adults aged 18 to 59 years. However, adults who ate out &lt; 1 time and &ge;1 to &lt;2 times a day showed higher risks of obesity than those who did not eat out, with OR = 1.131 (95% CI 1.012&ndash;1.264) and OR = 1.258 (95% CI 1.099&ndash;1.440), while adults who ate at school and workplace dining halls &ge;1 to &lt;2 times a day may have a reduced risk of obesity, with OR = 0.790 (95% CI 0.656&ndash;0.951). This result could not be found based on the definition of eating out in previous studies. Therefore, it is recommended to exclude nonprofit collective canteens such as school and workplace dining halls from the definition of eating away from home, and to redefine eating out in terms of health effects. At the same time, it is also recommended to strengthen collective nutritional interventions around canteens, improve the nutritious meal system in school and workplace canteens, and create healthy canteens

Association of the Protective Dietary Pattern for Blood Pressure with Elevated Blood Pressure and Hypertension among Chinese Children and Adolescents Aged 6–17 Years Old: Data from China Nutrition and Health Surveillance (2015–2017)

Studies focused on the association between dietary patterns and elevated blood pressure (BP) and hypertension (HTN) among children and adolescents remain insufficient. This study aimed to explore a dietary pattern that could be helpful for the prevention of abnormal BP and to investigate the association between this dietary pattern and elevated BP and HTN among Chinese children and adolescents. A total of 52,080 Chinese children and adolescents aged 6~17 years old from the China Nutrition and Health Surveillance (CNHS) 2015–2017 were included in the current study. The reduced rank regression (RRR) method was applied to derive a dietary pattern that is associated with BP. Multivariable logistic regression was used to assess the association between dietary pattern (DP) and elevated BP and HTN. The Dietary Approach to Stop Hypertension (DASH) score was also calculated for each participant as a comparative method to validate the dietary pattern derived with the RRR method. A protective dietary pattern (PDP) for BP among Chinese children and adolescents was derived, which was characterized by high intakes of dairy products, mushrooms/edible fungi, fresh vegetables, fresh fruits, fresh eggs, aquatic products, mixed legumes, soybeans and related products, offal, dried fruits, and coarse cereals, with low intakes of refined grains. After multiple adjustments, there were significant inverse associations between PDP scores and the odds of elevated BP and HTN (elevated BP: Q5 vs. Q1, OR = 0.849, 95%CI = 0.755–0.931, P-trend 0.05). The current study suggested that greater adherence to the PDP for BP among Chinese children and adolescents might be associated with lower odds of elevated BP and HTN

The Status of Dietary Energy and Nutrients Intakes among Chinese Elderly Aged 80 and Above: Data from the CACDNS 2015

This study analyzed the status of dietary energy and nutrients intakes among the oldest-old in China. Data was obtained from the China Adult Chronic Disease and Nutrition Surveillance in 2015 (CACDNS 2015). We enrolled 1929 Chinese elderly people aged 80 and above who participated in both 3-day 24-h dietary recalls and household condiments weighing. The dietary intakes were calculated based on Chinese Food Composition Tables and assessed using Chinese Dietary Reference Intakes (DRIs). The dietary intakes of energy and most nutrients were all below the EAR or AI, except for fat, vitamin E, niacin, iron and sodium. As a result, daily dietary intakes of energy and most nutrients were inadequate in the oldest-old in China, especially vitamin A, vitamin B1, vitamin B2, folate and calcium, with the prevalence of deficiency more than 90%. Furthermore, the prevalence of inadequacy of vitamin C, zinc, selenium and magnesium was also high with the proportion below the EAR more than 60%. Approximately 30% of the subjects with dietary vitamin E intake did not reach AI, and more than 90% of subjects have reached AI in the intake of sodium, while more than 90% did not reach AI in potassium. The mean intakes of niacin and iron have reached EAR, but around 15% were still faced with the risk of deficiency. In addition, although the dietary energy intake was below EER, the energy contribution from fat in total population and all subgroups (region, age, gender, education level, material status, household income level groups) all exceeded the recommended proportion of 30% from the DRIs and close to or over 35%, is a significant concern. For the majority of nutrients, higher daily dietary intakes and lower prevalence of deficiencies were found in the oldest-old living in urban areas, aged 80–84 years, with high school and above education level, living with spouse and from high household income family. These findings indicates that the dietary intakes of energy and nutrients were inadequate, while the energy contribution from fat and dietary sodium intake were too high among the oldest-old in China. Most oldest-old were at high risk of nutritional deficiency, particularly for those who living in rural areas, with lower education level and from low household income

The Prevalence of Hyperuricemia and Its Correlates among Adults in China: Results from CNHS 2015&ndash;2017

This study aimed to investigate the prevalence of hyperuricemia (HUA) and associated risk factors in Chinese adults aged 18 to 59 years. All the data were collected from the China Nutrition and Health Surveillance during the period 2015&ndash;2017, which adopted a stratified, multistage, random sampling method on a national scale. A total of 52,627 participants aged 18 years or older were included in this study. The definition of hyperuricemia was 420 &mu;mol/L for male and 360 &mu;mol/L for female. The Rao&ndash;Scott chi-square test was used to compare the differences in prevalence between or among the subgroups. A weighted two-level multivariate survey-logistic regression was used to detect the correlations between HUA and demographic, physical, lifestyle and metabolic factors. The total prevalence of HUA was 15.1%, and that was higher in male, current smokers, higher BMI and less physical activities subgroups, and also in noninfectious chronic diseases (NCDs) subgroups. The subgroups of non-vegetarian diet, insufficient vegetable intakes and excessive red meat and alcohol intakes had significantly higher HUA prevalence. After introducing all the variables in the survey-logistic regression, gender, age, BMI, physically active, hypertension, diabetes mellitus, bean and nut intake, vegetable intake, red meat intake, alcohol consumption and vegetarian were associated with HUA. Among the significant variables, age and physical active served as a protective factor, and BMI showed to be a risk factor for HUA. Hypertension and dyslipidemia could increase the risk for HUA, while diabetes mellitus was shown a negative association with it. For dietary factors, vegetarian diet, sufficient beans and nuts and vegetables intake could lower the risk of HUA, but more alcohol could increase the risk of HUA. Dietary factor played a key role in HUA. It suggested that the intervention of dietary factor should receive more attention to ameliorate the high prevalence of HUA in China

Dietary Pattern Associated with the Risk of Hyperuricemia in Chinese Elderly: Result from China Nutrition and Health Surveillance 2015–2017

Our current study aimed to estimate the relationship between dietary patterns and hyperuricemia among the Chinese elderly over 60 years old. All the data were obtained from China Nutrition and Health Surveillance during 2015–2017. A total of 18,691 participants who completed the whole survey were included in our statistical analysis. The definition of hyperuricemia was 420 μmmol/L (7 mg/dL) for male and 360 μmmol/L (6 mg/dL) for female. Exploratory factor analysis was applied to explore posterior dietary patterns in our samples, and five dietary patterns were recognized, namely “Typical Chinese”, “Modern Chinese”, “Western”, “Animal products and alcohol”, and “Tuber and fermented vegetables”. After multiple adjusted logistic regression, participants in the highest quartile of “typical Chinese” (Q4 vs. Q1, OR = 0.32, 95% CI: 0.28–0.37, p-trend p-trend = 0.0021) and “tuber and fermented vegetables” (Q4 vs. Q1, OR = 0.78, 95% CI: 0.69–0.88, p-trend p-trend < 0.0001). We also found that participants who mainly ate a modern Chinese diet tended to meet the RNI/AI of nutrients we discuss in this paper, which may supply some information for hyperuricemia prevention and management by dietary methods

Comparison of mean scores of quality of life according to socio-demographic, clinical and disease-related characteristics.

<p>Note</p><p>*P<0.05 and</p><p>**<i>P</i><0.01</p><p>Comparison of mean scores of quality of life according to socio-demographic, clinical and disease-related characteristics.</p