Epidemiological characteristics of cardio-metabolic risk factors among children and adolescents aged 7-17 years in 4 provinces of China / 中华流行病学杂志

Objective: This study aimed to investigate the epidemiological characteristics of cardio-metabolic risk factors among children and adolescents aged 7-17 years in (Hebei, Zhejiang, Shaanxi, Hunan) 4 provinces of China and the influence of demographic and economic characteristics on them. Methods: A total of 1 747 children and adolescents aged 7-17 from a Community-based Cohort Study on Nervous System Disease in 2018 were selected. High waist circumference, central obesity, elevated TG, elevated TC, elevated LDL-C, decreased HDL-C, elevated blood pressure, elevated blood glucose, and clustering of risk factors was analyzed. χ2 test was used for univariate analysis, multivariate logistic regression was used to analyze the correlation between demographic and economic factors and risk factors, and the Cochran-Armitage trend test was used for trend analysis. Results: The detection rates of high waist circumference, decreased HDL-C, elevated blood pressure, elevated TG, elevated blood glucose, central obesity, elevated TC, and elevated LDL-C were 29.08%, 15.28%, 13.17%, 13.05%, 11.79%, 7.33%, 6.53%, and 5.15%, respectively. The rate of clustering of risk factors was 18.37%. Multivariate logistic regression analysis showed that the risk of high waist circumference in girls was higher than that in boys (OR=1.67, 95%CI: 1.26-2.22), and the risk of elevated blood glucose and clustering of risk factors was lower than that in boys (OR=0.69, 95%CI: 0.49-0.99; OR=0.72, 95%CI: 0.53-0.99). The risk of high waist circumference, decreased HDL-C, and clustering of risk factors in 13-17 years old group was higher than that in the 7-year-olds group (OR=2.24, 95%CI: 1.65-3.04; OR=1.59, 95%CI: 1.20-2.11; OR=1.75, 95%CI: 1.26-2.44), but the risk of central obesity was lower (OR=0.54, 95%CI: 0.37-0.78). The risk of elevated TC, elevated TG, and decreased HDL-C in children and adolescents in southern was higher than that in northern parts of China (OR=1.88, 95%CI: 1.25-2.83; OR=1.61, 95%CI: 1.17-2.22; OR=1.55, 95%CI: 1.19-2.04), but the risk of high waist circumference and central obesity was lower than that in northern China (OR=0.57, 95%CI: 0.43-0.75; OR=0.62, 95%CI: 0.42-0.90). The risk of decreased HDL-C in rural children and adolescents was higher than in urban children and adolescents (OR=1.36, 95%CI: 1.02-1.83). The risk of multiple risk factors increased with the increase in average monthly household income per capita and BMI level. Conclusions: High waist circumference, decreased HDL-C and elevated blood pressure were prominent cardio-metabolic risk factors among children and adolescents aged 7-17 years in 4 provinces of China in 2018. The region, average monthly household income per capita, and BMI were the main influencing factors of cardio-metabolic risk factors.

Comparison of clinical efficacy of two different pin arrangements for external fixation of femoral neck fracture / 中国骨伤

OBJECTIVE@#To retrospectively analyze the clinical efficacy of external fixation in the treatment of femoral neck fracture with two different pin layout.@*METHODS@#From April 2000 to April 2018, 140 cases of femoral neck fracture were treated with closed reduction and percutaneous pin external fixation, among them 121 cases were followed up for more than 1 year, including 31 cases in traditional group, 12 males and 19 females, aged 45 to 74(65.4±8.4) years;90 cases in modified group, 39 males and 51 females, aged 12 to 75 (64.5±7.8) years. In traditional group, the first needle was put on the femoral talus, the second and third needles were put under the tension line, and the three needles were not on the same line in the lateral phase; in modified group, the first needle was drilled into the lateralcortex of the femur, obliquely penetrating the distal and proximal end of the femoral talus fracture, and the other two needles were drilled into the medial cortex of the femoral neck and the femoral talus, respectively. The operation time, hospital stay, postoperative ambulation time, femoral neck shortening rate, fracture healing time, fracture healing rate and femoral head necrosis rate of the two groups were observed and compared. Harris hip function score was used one year after operation.@*RESULTS@#These 121 patients were followed-up, the follow up time of traditional group was 13 to 45(30.5±11.4) months;the follow-up time of modified group was 14 to 120(34.5±12.5) months. There was no significant difference in operation time, hospital stay and femoral head necrosis rate between two groups (@*CONCLUSION@#Compared with the traditional group, the modified group has the advantages of lower femoral neck shortening rate, shorter fracture healing time, higher fracture healing rate and higher Harris hip function score.

Trend in dietary calcium intake among Chinese children and adolescents aged 4 to 17 years in nine provinces from 1991 to 2009 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the daily calcium intake, food sources and the trends among Chinese children and adolescents aged 4 to 17 years from 1991 to 2009.</p><p><b>METHODS</b>Consecutive 3-day-24-hour dietary recall data from the seven waves of the China Health and Nutrition Survey(CHNS)was used to describe the status and trends of daily calcium intake and related food sources.</p><p><b>RESULTS</b>Between 1991 and 2009, the daily intake of calcium in Chinese children and adolescents showed an increasing trend. In 2009, the average intakes of calcium in Chinese boys and girls were 311.2 mg/d and 294.6 mg/d, respectively. 81.5%-87.6% of boys and 87.0%-91.0% of girls had their calcium intakes less than half of the recommended amount of adequate intakes. Only 0.2%-0.8% of boys and 0.1%-0.8% of girls had their calcium intakes equal or higher than the recommended amount of adequate intakes. The sources of dietary calcium were mainly from vegetables, legumes, cereals and milk products for Chinese children and adolescents, accounting for more than 70% of the average daily intakes.</p><p><b>CONCLUSION</b>During the past two decades, the dietary calcium intake of Chinese children and adolescents still remained at lower level, suggesting that the optimal food sources of calcium were under-consumed.</p>

Trend in vegetable and fruit intake among Chinese children and adolescents aged 6 to 17 years from 1991 to 2009 and related socio-demographic factors / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the long-term shifts in fruit and vegetable intakes in Chinese children and adolescents between 1991 and 2009 and related impact from socio-economic factors on such dynamics.</p><p><b>METHODS</b>Data was from the seven waves of the China Health and Nutrition Survey. 12 596 children and adolescents aged 6 to 17 years with full data of 3-day-24-hour dietary recall, together with related demographic and socioeconomic factors were chosen as the study subjects.</p><p><b>RESULTS</b>The consumption rates of fruits and vegetables showed an significant increasing trend, from 58.3% in 1991 to 82.4%, on dark-color vegetables(χ(2) = 213.2, P < 0.01), from 94.4% to 96.9% on light-color vegetable(χ(2) = 11.6, P < 0.0001)and from 12.6% to 45.4% for fruits(χ(2) = 571.2, P < 0.0001)in 2009. The median intake of total vegetables decreased from 250.0 g/d in 1991 to 225.8 g/d in 2009(χ(2) = 72.4, P < 0.0001) and the light-color vegetable decreased by 36.6 g/d. However, among the corresponding consumers, the fruit intake increased about 50.0 g/d (χ(2) = 104.2, P < 0.01)and the dark-color vegetable intake decreased about 40.0 g/d (χ(2) = 92.8, P < 0.0001 ). The proportion of children who reached the minimum intake of vegetable(300 g/d)recommended by Dietary Guidelines for Chinese 2007 decreased from 38.9% in 1991 to 26.8% in 2011 and the proportion of children who had met the minimum intake(200 g/d)increased from 2.0% to 13.9% . 25.1% of the children consumed dark-color vegetables more than half of the total vegetable intake. Schooling of the mother and family income had important impact on fruit consumption of the children.</p><p><b>CONCLUSION</b>Rates on fruit and vegetable consumption showed an increasing trend among Chinese children and adolescents over the past 20 years. However, the vegetable intake significantly decreased and the fruit intake increased slightly. Chinese Children posed a greater risk on insufficient intake on both vegetables and fruits. Comprehensive and effective programs should be taken to increase vegetable and fruit intakes in order to improve the nutritional status of children.</p>

Situation on 'eating out' and its related risk factors among 1013 Chinese adults in 3 provinces / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the characteristics of 'eating out' behavior among Chinese adults and to explore it related risk factors.</p><p><b>METHODS</b>Data in the present study was from the China Health and Nutrition Study(CHNS), including those from Liaoning, Henan and Hunan as sample provinces. 2 cities and 2 counties from each province and 2 urban communities and 2 suburban communities from each city plus communities from 1 township and 3 villages from each county were chosen. A final 1013 Chinese adults aged 18 to 59 years old who participated in the 2011 CHNS with complete individual information and were available in the present study period were involved in the study. 'Eating out behavior' was estimated through face-to-face interview on the items as:frequency, cost, ways of transportation and distance between restaurants, eating at fast food restaurants/Chinese full service restaurants/Chinese fast food restaurants/mobile food carts/cafes/canteens or other restaurants during the last week. Information on the amount of food intake was collected through three '24 h recalls'. We described the eating out behaviors by types of restaurants they had gone to and comparing eating out eaters and non-eating out eaters for a set of nutritional indicators in order to explore the risk factors related to 'eating out' behaviors.</p><p><b>RESULTS</b>'Eating out' was defined as individuals who consumed at least once in restaurants per week. In all the 1013 adults, 51.72% from urban and 39.14% from rural were defined as having 'eating out' experiences. Proportions of eating out in western fast food restaurants, Chinese full service restaurants, Chinese fast food restaurants, mobile food carts, cafes, canteens and other restaurants were 1.68%, 23.49%, 12.93%, 10.37%, 1.09%, 10.07% and 4.34%, respectively. Energy, Ca, Fe and Zn intake were substantially higher among eaters eating at Chinese full service restaurants than those who had not,Energy, protein, fibers, Ca and Zn intake were higher among canteens eaters than those who did not. Age, gender, education, income and residential areas were associated with eating out behaviors.</p><p><b>CONCLUSION</b>Eating out is a significant nutritional issue among Chinese adults. Education related to nutrition should be taken into account to guide healthy food choices for adults who eat out.</p>

Trend in meat consumption patterns among Chinese children in nine provinces(autonomous region) aged 6 to 17 years between 1991 and 2011 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To examine the trend in meat consumption patterns between 1991 and 2011 in Chinese children in nine provinces(autonomous region) aged 6 to 17 years.</p><p><b>METHODS</b>A multistage, random cluster sampling process was used to investigate 2720, 2702, 2525, 2405, 1509, 1238, 1085, and 936 children and adolescents aged 6-17 years in 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011 respectively in 9 provinces (autonomous region) in China. Their consecutive 3 d 24 h dietary recall data were analyzed to compare meat intake pattern in children and adolescents with different characteristics and different years.</p><p><b>RESULTS</b>The consumption rate increased from 60.9% (1657/2720) in 1991 to 87.2% (816/936) in 2011 for livestock meat (χ(2) = 458.23, P < 0.01), from 9.4% (257/2720) to 33.3% (312/936) for poultry (χ(2) = 446.07, P < 0.01) and from 27.3% (743/2720) to 40.6% (380/936) for seafood (χ(2) = 89.89, P < 0.01). The median of total meat intake increased from 47.4 g/d in 1991 to 100.0 g/d in 2011 (χ(2) = 516.77, P < 0.01), poultry intake from 33.3 g/d to 60.0 g/d (χ(2) = 420.13, P < 0.01), pork intake from 26.7 g/d to 50.0 g/d (χ(2) = 380.50, P < 0.01). The percentage of children whose livestock meat and poultry intakes higher than the recommended amount increased from 32.9% (896/2720) in 1991 to 59.8% (560/936) in 2011 (χ(2) = 392.97, P < 0.01); the percentage of children whose seafood intakes meeting the recommended amount increased from 6.9% (187/2720) in 1991 to 8.8% (82/936) in 2011 (χ(2) = 21.52, P < 0.01). The consumption rates of livestock meat in urban and rural children increased from 81.2% (536/660) and 54.4% (1121/2060) in 1991 to 94.7% (234/247) (χ(2) = 38.34, P < 0.01) and 84.5% (582/689) (χ(2) = 429.26, P < 0.01) in 2011. The intakes of livestock meat in rural children increased from 16.7 g/d in 1991 to 56.7 g/d in 2011 (χ(2) = 472.46, P < 0.01).</p><p><b>CONCLUSION</b>The overall pattern of meat consumption in Chinese children in nine provinces(autonomous region) was unreasonable between 1991 and 2011. There was a significant improvement in meat consumption in rural children over time.</p>