Breast-milk scientific research contributes to improvement of breast milk quality and development of human civilization / 中华围产医学杂志

Breast milk, the product of mammalian evolution, provides infants with not only vital nutrients, but also an array of nourishing contents, including bioactive substances, microorganisms, and cells. Being a crucial stage of reproductive health, breastfeeding serves as the primary means of nutrient absorption during early life. However, the scientific evaluation of its health effects remains inaccurate. The study of breast milk has emerged as a new interdisciplinary research hotspot, offering a new paradigm for explorations in life health, disease prevention, clinical treatment, social ethics, and economic advancement. This paper reviewed and discussed the research progress of breast milk science both domestically and internationally and the gap in between, and proposed a promising perspective for future research and development.

Vegetarian diet and vitamin B 12 level in Chinese pregnant women / 中华围产医学杂志

Objective:To explore the relationship between vegetarian diets and vitamin B 12 levels in Chinese pregnant women. Methods:A cross-sectional survey was used to explore the relationship between vegetarian diets and vitamin B 12 levels in Chinese pregnant women based on data from the Chinese National Nutrition and Health Surveillance (2015-2017). Maternal serum vitamin B 12 concentration was determined by electrochemiluminescence. Background and diet information of all subjects were collected using general and food frequency questionnaires. General Linear Model was used to analyze the difference in serum vitamin B 12 levels between vegetarian and non-vegetarian pregnant women and multivariate logistic regression for examining the relationship between vegetarian diets and vitamin B 12 deficiency (vitamin B 12<150 pmol/L) in pregnant women. Results:A total of 8 366 pregnant women were included in the analysis, and vegetarians accounted for 1.2% (102/8 366). The median serum vitamin B 12 concentrations were 155.8(93.6-212.4) pmol/L and 187.2(127.4-267.6) pmol/L ( Z=－4.22, P<0.001), and the vitamin B 12 deficiency rates were 48.0% (49/102) and 35.0% (2 896/8 264) in vegetarian and non-vegetarian women, respectively. The vitamin B 12 deficiency rate in vegetarian women was 0.89-fold higher than in non-vegetarians (95% CI: 1.24-2.89). Among the vegetarian and non-vegetarian pregnant women, vitamin B 12 deficiency rates during the first, second, and third trimesters were 34.8%(16/46), 54.3%(19/35), 66.7%(14/21), and 20.4%(521/2 559), 32.6%(941/2 886), 50.9%(1 430/2 807), noting for an increasing trend ( Z=23.54 and 2.57, P=0.010 and P<0.001). Conclusions:Vegetarian pregnant women are at high risk of vitamin B 12 deficiency. Compared with non-vegetarian women, vegetarian pregnant women in China have lower vitamin B 12 levels and a higher risk of vitamin B 12 deficiency. Moreover, the risk of vitamin B 12 deficiency will gradually increase during pregnancy.

Scientific research on breast milk underpins breastfeeding promotion actions / 中华围产医学杂志

This article is a summary of the Second China Breast Milk Science Conference, which was held in Beijing from August 5 to 7, 2022, with the theme of "Data sharing, method sharing and science sharing". The purpose of the conference is to summarize the latest progress in breast milk research, identify the unresolved issues, and jointly discuss the direction of future breast milk research. Firstly, we summarize the contents and purpose of breast milk scientific research and prospect of breast milk science. The second part focuses on the research status of breast milk composition and its health effects, and puts forward the future research direction. The third section focuses on the health effects of breastfeeding and scientific support and key aspects of breastfeeding promotion actions. The fourth part elaborates the specific methods of current scientific research of breast milk and emphasize the importance of method standardization and the idea of future methodological research. The fifth part consists of the strategy of feeding infants with medical conditions and ways to better promote the growth and development of these infants. The last part introduces the innovation, deficiencies, and future research directions of infant formula production technology in China. This conference demonstrate the importance of multidisciplinary communication, discussions and collaborations in clinical medicine, nutrition, perinatal health, food science, and policy-making in the scientific research of breast milk, and provides guidance for future multidisciplinary research on the physiology of lactation, the composition of breast milk, breastfeeding, and infants and young children nutrition.

History and current situation of research on human milk components in China / 中华围产医学杂志

Human milk is the optimal food for infants. We described the history of human milk research both in China and abroad, the gap between domestic and international research, and the future direction in this area. Human milk needs to be studied as a biological system in the future. Reference values for human milk components of Chinese healthy mother-infant dyad should be established. Factors associated with human milk components variations and relationships between human milk components and maternal and child health also need to be investigated to achieve the best nutrition and health status for mother and child pairs.

Exploring miracles and obtaining a better understanding of breast milk: a long way to go / 中华围产医学杂志

Breast milk and breastfeeding are the main focus of scientific research on breast milk. Previous studies in the past two centuries have shown that breast milk is the product of human evolution over 200 million years; that breast milk is a gold standard for infant feeding to meet their nutritional requirement, and human milk can also be used clinically for life-saving or health promotion of infants. Breastfeeding is the best way to achieve normal growth and development of infants and maintain their health. The challenges of breastfeeding behavior and the influence of social-economic or other possible factors have contributed to the poor improvement of exclusive breastfeeding rate of infants up to the age of 6 months in the world. Noting the preciseness and urgency of scientific research on human milk, research in the future should focus on the construction of national standard and monitoring system for human milk composition, the establishment of national basic strategic data resources, updating the latest evidence and technological innovation in human milk science, and propose a practical plan to resolve problems in breastfeeding in China.

Introduction to Guidelines for Salt Reduction in Chinese Food Industry / 中华预防医学杂志

Excessive salt intake is an important risk factor of diseases such as hypertension, stroke, and stomach cancer. China is one of countries with high salt intake in the world. Recently, the intake of sodium from pre-packaged foods in China has been increasing, and the situation of salt control is rigorous. Based on the summary of the domestic and international experience of salt reduction, the "Guidelines for Salt Reduction in Chinese Food Industry" presents the basic principles, targets at different stages within various categories, technical routes, steps and measures, and social environment co-construction of salt reduction in Chinese food industry. This article focuses on the background, basis, process, key content and promotion of the guideline. The implementation of this guideline will contribute to the vigorous advancement of salt reduction action in Chinese food industry.

Gestational weight gain and optimal ranges in Chinese mothers giving singleton and full-term births in 2013 / 中华预防医学杂志

Objective@#To analyze the status of gestational weight gain (GWG) among Chinese mothers who gave singleton and full-term births, and to look at optimal GWG ranges.@*Methods@#In 2013, using the multi-stage stratified and population proportional cluster sampling method, we investigated 8 323 mother-child pairs at their 0-24 months postpartum from 55 counties (cities/districts) of 30 provinces (except Tibet) in mainland China. Questionnaire was used to collect data on body weight before pregnancy and delivery, diseases during gestation, hemorrhage or not at postpartum, child birth weight and length, and other information about pregnant outcomes. We measured mother's body weight and height, and child's body weight and length. Based on 'Chinese Adult Body Weight Standard’, we divided mothers into four groups according to their body weight before pregnancy: low weight (BMI<18.5 kg/m2), normal weight (BMI 18.5-23.9 kg/m2), overweight (BMI 24.0-27.9 kg/m2) and obesity (BMI≥28.0 kg/m2). The status of GWG was assessed by IOM optimal GWG guidelines. Chinese optimal GWG ranges were calculated according to the association of GWG with pregnant outcomes and anthropometry of mothers and children, and according to P25-P75 of GWG among mothers who had good pregnant outcomes and good anthropometry, and whose children had good anthropometry. The status of GWG was assessed by the new optimal ranges.@*Results@#P50 (P25-P75) of GWG among the 8 323 mothers was 15.0 (10.0-19.0) kg. According to the proposed optimal GWG ranges of IOM, the proportions of inadequate, optimal and excessive GWG accounted for 27.2% (2 263 mothers), 36.2% (3 016 mothers) and 36.6% (3 044 mothers). The optimal GWG ranges for low weight, normal weight, overweight and obesity were 11.5-18.0, 10.0-15.0, 8.0-14.0 and 5.0-11.5 kg. Based on these optimal GWG ranges established in this study, the rates of inadequate, optimal and excessive GWG were 15.7% (1 303 mothers), 45.0% (3 744 mothers) and 39.3% (3 276 mothers), and these rates were significantly different from that defined by the IOM standards (χ2=345.36, P<0.001).@*Conclusion@#The median of GWG among Chinese mothers is 15.0 kg, which is at a relatively higher level. This study suggests the optimal GWG ranges for Chinese women who give singleton and full-term babies, which appears lower than IOM's.

Status and related factors for gestational weight gain of Chinese pregnant women during 2010-2012 / 中华预防医学杂志

Objective@#To examine the status and related factors for gestational weight gain of Chinese pregnant women at different trimesters in 2010-2012.@*Methods@#Participants were from Chinese National Nutrition and Health Surveillance in 2010-2012. Using a multi-stage stratified cluster random sampling method, we recruited 2 805 singleton pregnant women with gestational age 13 weeks or more from 31 provinces of China. A standard questionnaire was used to collect general information and pre-pregnancy weight; body weight and height of pregnant women were measured using a unified weighing scale and stadiometer, dietary intake during the previous year was collected using a food frequency questionnaire. A multiple logistic regression was used to analyze potential factors associated with appropriate gestational weight gain.@*Results@#Among 2 805 pregnant women, 1 441 were in the second (13-27 weeks) and 1 364 in the third trimesters (≥28 weeks) . In the 2nd trimester, 229 cases (15.9%), 440 cases (30.5%) and 772 cases (53.6%) were insufficient gestational weight gain, appropriate gestational weight gain and excessive gestational weight gain respectively. So were 256 cases (18.8%), 474 cases (34.8%), 634 cases (46.5%) in the 3rd trimester respectively. In the multivariate unconditional logistic model, less fruit intake was associated with insufficient weight gain for women in the 2nd trimester (OR (95%CI): 1.58 (1.06-2.34)). Pregnant women with Han ethnicity who live in the small/medium city had lower risk of insufficient weight gain in the 3rd trimester (OR (95%CI): 0.58 (0.34-0.98)). Those pregnant women with physical activity <1 hour/day had a higher risk of excessive weight gain (OR (95%CI): 1.33 (1.02-1.73)).@*Conclusion@#The prevalence of appropriate gestational weight gain was low in China. Our study suggests that pregnant weight gain is associated with fruit intake, types of residential area and physical activity.

Analysis on maternal anemia rate and related factors in Taicang of Jiangsu Province in 2014-2016 / 中华预防医学杂志

Objective@#To investigate anemia rate and to analyze related factors in maternal women in Taicang of Jiangsu province.@*Methods@#There were 13 278 pregnant women who had prenatal care and gave birth in 25 hospitals during 2014-2016 in Taicang of Jiangsu Province. We excluded 1 179 women who registered after 12 weeks of gestation, 144 women who did not test hemoglobin during gestation, and 25 women whose gestational weeks were incorrect. Finally, data from 11 930 pregnant women were analyzed. From the electronical medical record system of maternal and child health care, we obtained basic information of these pregnant women, their hemoglobin levels and related data during gestation and postpartum. Anemia rate was descripted, and factors associated with anemia were identified using multiple unconditional logistic regression.@*Results@#Age of the 11 930 pregnant women was (27.0±4.5) years old, and the P50 (P25-P75) of BMI at the first trimester was 21.4 (19.6-23.7) kg/m2. The anemia rate during gestation was 37.2% (4 434/11 930). The anemia rate was 5.5% (276/5 035), 24.4% (1 802/7 377), and 47.8% (3 328/6 966) at the first, second and third trimesters, respectively. Anemia rate at 42 days postpartum was 19.9% (680/3 418). Multiple unconditional logistic regression indicated that anemia during gestation was related with maternal age <21 years old at prenatal registration (OR (95%CI): 1.28 (1.07-1.53)), body mass index(BMI) <18.5 kg/m2 at the first trimester (OR (95%CI): 1.14 (1.00-1.29)), non-local residence (OR (95%CI): 1.35 (1.20-1.52)), education of middle school and lower (OR (95%CI): middle school: 1.24 (1.05-1.47), primary school: 1.36 (1.01-1.82)), occupation of housewife or farmer (OR (95%CI): housewife: 1.21 (1.06-1.38), farmer: 1.21 (1.03-1.44)). Anemia at 42 days postpartum was associated with multipara (OR(95%CI): 1.59 (1.12-2.27)), anemia at the first trimester (OR(95%CI): 3.26 (1.92-5.55)), no folic acid supplementation at the first trimester (OR(95%CI): 1.34 (1.00-1.80)), and hemorrhage≥500 ml during 24 h postpartum (OR(95%CI): 2.26 (1.02-4.97)).@*Conclusion@#Anemia rate was low for maternal women in Taicang of Jiangsu Province. The factors associated with gestational anemia included pregnant women's age, BMI, local or non-local residence, occupation, and education. The factors associated with postpartum anemia included multipara, anemia at the first trimester, no folic acid supplementation at the first trimester, and hemorrhage 24 h postpartum.

A guide module for placement of posterior column lag screws in anterior-posterior column acetabular plate — design by three-dimensional models / 中华创伤骨科杂志

Objective To report our self-designed guide module for placement of posterior column lag screws in anterior-posterior column acetabular plate using CT reconstruction data.Methods The CT scan data of 50 normal adult pelves were collected from February 2012 to April 2013,involving 30 males and 20 females with an average age of 46.4 years(range,from 25 to 69 years).The data were imported into Mimics 10.01 software for reconstruction of semi-pelvic models.Virtual cylindrical implants were placed intraosseously in both the left and the right posterior columns.The perpendicular distance (OP) from the insertion point O of the virtual cylindrical implant to the arcuate margin (P) and the distance (PI) from the point P to the point I,the crosspoint of the extension line of the ischial ramus and the arcuate margin were measured respectively.The angle (∠φ) between the direction of screws and the plane of guide module and the angle (∠θ) between the direction of screws and the long axis of guide module were also measured respectively.Results The average length of PI was 0.98 ± 0.13 cm,with 1.08 ± 0.22 cm in females and 0.95 ± 0.27 cm in males.The difference between genders was not statistically significant (P ＞ 0.05).The average length of OP was 1.09 ± 0.26 cm,with 1.06 ± 0.29 cm in females and 1.12 ± 0.24 cm in males.The gender difference was not statistically significant either (P ＞ 0.05).The mean value of ∠ φ was 55.43° ± 3.64°,with 55.33° ± 4.00° in females and 55.50° ±3.43° in males.The difference between genders was not statistically significant (P ＞ 0.05).The ∠θ value in females was 39.21 ° ± 2.45° and 35.58° ± 2.31 ° in males.The gender difference was statistically significant (P ＜ 0.05).Conclusions In design of the guide module,the nail holes should be located about 1 cm away from both the posterior edge and the medial edge,the angle between the screw direction and the module plane should be approximately 39° in females and 35° in males,and the angle between the screw direction and the long axis of the module approximately 55°.

DIETARY INTAKES OF CAROTENOIDS IN CHINESE ADULTS FROM URBAN, SUBURBAN AND RURAL COMMUNITIES / 营养学报

Objective To explore the dietary intakes of carotenoids in Chinese adults.Method One hundred and eighty four 30-60 year-old adults(84 males and 100 females) from three different communities were recruited in the investigation.The dietary samples were collected by double-servings in every season of the year respectively.The double sample comprised all the foods of continuous 3 d at equal variety and quantity,and were analyzed by HPLC for the contents of ?-carotene,?-carotene,?-cryptoxanthin,lycopene,and lutein/zeaxanthin.Results The dietary samples were collected and analyzed from 184,184,169,and 161 subjects in summer,autumn,winter and spring respectively.The dietary intakes of ?-carotene,?-carotene,?-cryptoxanthin,lycopene,and lutein+zeaxanthin in the investigated subjects in summer were 2.48?2.71mg,276.6?469.4 ?g,86.9?241.4 ?g,2.16?3.38 mg,and 1.48?1.65 mg respectively.Those in autumn were 3.39?4.10 mg,271.7?462.8 ?g,339.9?1016.8 ?g,0.25?1.34 mg and 2.07?3.00 mg respectively.Those in winter were 2.85?3.76 mg,302.7?622.6 ?g,108.8?142.3 ?g,0.36?1.46 mg and 1.97?3.00 mg.and those in spring were 3.76?3.35 mg,162.4?413.9 ?g,42.1?93.8 ?g,0.86?1.39 mg and 6.10?6.26 mg respecfively.The lycopene intakes were relatively higher in summer,?-cryptoxanthin higher in autumn,and lutein/ zeaxanthin higher in spring.The intakes of ?-and ?-carotene were relatively less fluctuated by seasons.Generally,the subjects from the central urban community consumed more carotenoids than those from the outskirt community and the rural village,with the only exception of lutein/zeaxanthin intake in spring.Conclusion The dietary carotenoids intakes in Chinese adults were studied,and the data would be helpful for further researches about carotenoids nutrition among Chinese population.

DIFFERENT FEEDING PRACTICES OF CHINESE INFANTS WITHIN FOUR MONTHS OF AGE IN 2002 / 营养学报

Objective:To study the different feeding practices of Chinese infants within four months of age in 2002. Method:The method of multi-steps cluster sampling was adopted. In order to ensure the sample size sufficient additional subjects were included in this survey. Results:More than two thirds (71.6%) of infants within four months of age had been almost exclusively breastfed, 65.5% and 74.4% in urban and rural areas respectively. The average percentage of mixed feeding was 23.0% (27.0% in urban and 21.2% in rural areas); and that of artificial feeding was 5.4% (7.5% in urban and 4.4% in rural areas). The rate of breastfeeding decreased with the increase of family income. Conclusion:Although the rate of almost exclusive breastfeeding is increasing, there is still far away from the aim of 85% in 2001-2010 National Outline for Children.