Risk for type 2 diabetes mellitus death attributed to insufficient whole grain intake in seven regions of China, 2005-2018 / 中华流行病学杂志

Objective: To estimate the risk for type 2 diabetes mellitus (T2DM) death attributed to insufficient whole grain intake in seven regions of China from 2005 to 2018. Methods: Based on China National Nutrition and Health Surveys and China Adult Chronic Disease and Nutrition Surveillance, ordinary Kriging method and locally weighted regression were used to estimate the level of whole grain intake of Chinese residents from 2005 to 2018. Based on the results of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 and Chronic Diseases Risk Factors Surveillance in China, we calculated the population attributable fraction (PAF), attributable death number and attributable mortality rate of T2DM due to insufficient whole grain intake in people aged ≥20 years in different regions of China, and we used the 2010 Chinese census data to compare the changes in T2DM deaths attributed to insufficient intake of whole grains in seven regions of China. Results: The whole grain intake levels of Chinese people over 20 years old in 2002, 2010 and 2015 were 19.0 g/d, 14.3 g/d and 19.8 g/d, respectively. The estimated overall whole grain intake level was 20.1 g/d in Chinese residents in 2018, and the intake level was 19.4 g/d in men and 20.8 g/d in women. Among the seven regions, the intake level was highest in northern China (47.4 g/d) and lowest in southwestern China (6.0 g/d). In 2018, the PAF was lowest in northern China (12.8%) and highest in southwestern China (19.3%). From 2005 to 2018, the PAF varied in the seven regions, and the PAF in northeastern China fluctuated around 18.5%. Other regions showed downward trends, especially in northern China and northwestern China, decreased by 26.4% and 21.2%, respectively. Over the past 14 years, the number of attributable deaths in the seven regions showed upward trends, with the highest annual average growth rate of 6.7% in southern China and the lowest annual average growth rate of 2.4% in northern China. In 2018, the standardized T2DM mortality rate attributed to insufficient whole grain intake in China was 3.13/100 000, and the attributable mortality was 3.21/100 000 in men and 3.05/100 000 in women. The standardized attributable mortality rate was highest in southwestern China (3.97/100 000) and lowest in northern China (1.78/100 000). From 2005 to 2018, the standardized attributable mortality rate increased by 11.5% in men and decreased by 8.1% in women. The standardized attributable mortality rate in southwestern, southern and central China increased by 23.7%, 21.3% and 4.2%, respectively. The standardized attributable mortality rate in northern, northwestern, eastern and northeastern China decreased by 20.9%, 11.0%, 4.5% and 3.9%, respectively. Conclusion: The whole grain intake level of Chinese residents was low, and the whole grain intake of residents in all seven regions should be increased, especially in the southwest, and men should have more whole grain intake than women to reduce the death risk in patients with T2DM.

Association between high fat-low carbohydrate diet score and newly diagnosed type 2 diabetes in Chinese population / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the association between high fat-low carbohydrate diet score and newly diagnosed type 2 diabetes in Chinese population.</p><p><b>METHODS</b>Data about 20 717 subjects aged 45-59 years from the cross-sectional 2002 China National Nutrition and Health Survey were analyzed. High fat-low carbohydrate diet was scored according to the energy of carbohydrate, fat, and protein.</p><p><b>RESULTS</b>Of the 20 717 subjects, 1 332 were diagnosed with hyperglycemia and 662 were newly diagnosed with type 2 diabetes. Multivariate adjusted analysis showed that the highest score of type 2 diabetes patients was 2.75 (95% CI: 2.09-3.61). The score of type 2 diabetes patients was 1.87 (95% CI: 1.35-2.58) after further adjustment for their socioeconomic status and physical activity. No significant difference was found in the odds ratio after further adjustment for BMI, blood pressure, lipid level, and energy intake. No evidence was observed for the relation between high fat-low carbohydrate-diet score in type 2 diabetes patients due to high family income, less education, physical activity, overweight, hypertension, high TG, or low HDL level.</p><p><b>CONCLUSION</b>High fat-low carbohydrate diets, far different from traditional Chinese diets, are associated with the high incidence of type 2 diabetes in Chinese population.</p>

Dietary iodine intake in the Chinese population / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To evaluate dietary iodine intake and its potential risks among the Chinese population.</p><p><b>METHODS</b>Individual dietary iodine intake was calculated using food consumption data multiplying by iodine concentration in foods, table salt and drinking water, followed by summing, and then compared with the corresponding age-specific reference values, including Upper Intake Level (UL) and Recommended Nutrient Intake (RNI).</p><p><b>RESULTS</b>In areas with water iodine concentration (WI) lower than 150 μg/L, 80.8% of residents had iodine intake between the RNI and UL, 5.8% higher than UL, and the remaining (13.4%) lower than RNI if iodized salt was consumed. However, in the uniodized salt consumption scenario, only 1.0% of residents between RNI and UL, 1.4% higher than UL, and a large part of residents (97.6%) lower than RNI. In areas with WI higher than 150 μg/L, all residents had iodine intake between RNI and UL if iodized salt was consumed, except 10.5% and 24.9% of residents higher than UL in areas with WI at 150-300 μg/L and higher than 300 μg/L respectively. However, in the uniodized salt consumption scenario, only 1.5% and 1.7% of residents had higher iodine intake than UL respectively.</p><p><b>CONCLUSION</b>The findings suggested that in general, the dietary iodine intake by the Chinese population was appropriate and safe at the present stage. People in areas with WI lower than 150 μg/L were more likely to have iodine deficiency. While people in areas with WI higher than 150 μg/L were more likely to have excessive iodine intake if iodized salt was consumed.</p>

Correlation between birth defects and dietary nutrition status in a high incidence area of China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the association between birth defects and dietary nutrient intake in a high risk area of China.</p><p><b>METHODS</b>A dietary survey was performed and serum folic acid was measured in women whose pregnancy was affected by neural tube defects (NTDs) or unaffected by any birth defects (BDs) in Zhongyang and Jiaokou Counties in Shanxi Province of China.</p><p><b>RESULTS</b>The local average consumption of foods including dark green vegetables, fruits, fat and meat, and nutrient intake (e.g., energy, protein, retinol, riboflavin, vitamin E, and selenium) were lower than the national average level. In women of childbearing age, these regions, the intake of nutrients was much lower than the recommended nutrient intake (9%-77%). The case-control dietary nutrition study of women whose pregnancy was affected by BDs (including NTDs and congenital heart defects) demonstrated that, in early pregnancy, adequate nutrition (i.e., eating meat, fresh vegetables, fruit more than once a week) was a protective factor, while eating germinated potatoes was a risk factor. The geometrical mean (p5-p95) of serum folic acid in women with NTD birth defects was 9.6 nmol/L (3.6, 23.03), which was significantly lower than that in normal women (14.03 nmol/L).</p><p><b>CONCLUSION</b>Women of childbearing age in the two counties of Shanxi Province, China, have a marked insufficient intake of some nutrients, especially folic acid, zinc, vitamins A and B12. This nutrient deficiency may be an important risk factor for the high prevalence of birth defects in these regions. Therefore, adequate dietary nutrition in early pregnancy can prevent BDs.</p>

Analysis on influence factors of dietary supplement used in population aged above 45 years in Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore influence factors of dietary supplement used in population aged above 45 years in Beijing.</p><p><b>METHODS</b>Utilizing the data of the survey of dietary supplement (DS) used in Beijing in 2006 was to investigate the influence factors by using multi-factorial logistic regression analysis.</p><p><b>RESULTS</b>All 2487 samples were included in the analysis. Sex, age, average income of each month for each member of the family, experiences of deficiency of nutrition, attitude to nutrition knowledge, attitude to the need of DS and city-or-rural resident had shown effects on DS using. The percentage of using DS in female was higher than that in male being 19.3% and 11.8% respectively. The percentage grew up as the age became older. The same trend appeared as the economic-status going up, but not as education level change. Use of DS was greater in urban population (16.9%) than in rural population (14.6%). The percentage of using DS in people who had or just been diagnosed as malnutrition/deficiency disease or chronic disease, or those who thought themselves having got these diseases only by their own feeling were higher than those did not.</p><p><b>CONCLUSION</b>People the female, the elder, or those having higher income, having experiences of deficiency of nutrition, are more interested in nutrition knowledge, and more positive in need of DS and those living in rural should be the target population of nutrition education for DS use.</p>

Study on food and antioxidant intake in smokers and non-smokers in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the differences in food and antioxidant vitamin intake in current non-smokers,light smokers,and heavy smokers.</p><p><b>METHODS</b>51 115 people (24 077 male, 27 038 female) aged above 15 years who had completed providing information on smoking habit and dietary intake, were selected from 2002 national health and nutrition survey.</p><p><b>RESULTS</b>After adjustment for geographic areas and age, data showed the smokers ate more light vegetable and alcohol, less dark vegetable and fruit than non-smokers. Male smokers consumed more energetic stuff and macronutrients than non-smokers, but female smokers had opposite trends. Light smokers (LS) consumed less antioxidant than non-smokers (NS) after adjusted for area, age, BMI and energy, with carotene (Male LS = 1824.7 microg, NS = 1964.8 microg; Female LS = 1565.4 microg, NS = 2127.4 microg), thiamin (Male LS = 0.84 mg, NS = 0.85 mg; Female LS = 0.72 mg, NS = 0.74 mg), vitamin E (alpha) (Male LS = 9.2 mg, NS = 9.3 mg; Female LS = 7.4 mg, NS = 8.1 mg), vitamin C (Male LS = 91.2 mg, NS = 94.2 mg; Female LS = 76.9 mg, NS = 87.5 mg).</p><p><b>CONCLUSION</b>Smokers had a significantly lower overall mean dietary antioxidant vitamin intake than non-smokers. Increasing the daily consumption of variety of fruits and vegetables had been recommended to reduce the risk of chronic diseases.</p>

Comparison of assessment of food intakes by using 3 dietary survey methods / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the difference and correlation of food intakes assessed by Food Weighted Record, 24 Hours Recall and Food Frequency Questionnaire (FFQ) methods.</p><p><b>SUBJECTS</b>The data of 2002 China National Nutrition and Health Survey were used. All 23,198 subjects (male 11,107, female 12,091) finished all three dietary survey methods. Food Weighted Record method weighted all food items consumed at home by all family members in last 3 days; 24 Hours Recall recorded all food items the subjects consumed at and out home in last 3 days; FFQ recorded the main 33 categories food items that the subjects consumed at and out home in last year.</p><p><b>RESULTS</b>Compared to Food Weighted Record method, food intakes assessed by 24 hours recall were similar, and the relative differences were less than 10% of most food items. The proportion of over-report and under-report (+/- 25%) by 24 Hours Recall were less than 40%. The correlation coefficients of food intakes between Food Weighted Record and 24 Hours Recall methods ranged from 0.58 to 0.88. The results from Food Weighted Record and FFQ were similar among the high frequently consumed food items. The relative differences of the food intakes investigated between Food Weighted Record and FFQ were less than 15% and the proportion of over-report and under-report (+/- 25%) by FFQ were more than 50%. The correlation coefficients of food intakes between Food Weighted Record and FFQ ranged from 0.08 to 0.76.</p><p><b>CONCLUSION</b>Food intakes might be assessed accurately by the Food Weighted Record revised 24 Hours Recall method, and FFQ method be also used to assess the food intakes, especially for the frequently consumed food items, as to studying the relationship between food consumption and health.</p>

Study on the current status and trend of food consumption among Chinese population / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the current status and trend of food consumption among Chinese residents.</p><p><b>METHODS</b>23,470 households including 68,962 subjects were randomly sampled from 132 counties in 31 provinces, autonomous regions and municipalities. A 24-hour dietary recall method for 3 consecutive days was used to collect information on food intake, but the condiment intake was collected by weighting method.</p><p><b>RESULTS</b>The average food consumption per reference man per day of Chinese people included 402 g (urban/rural: 366 g/ 416 g) cereals; 276 g (urban/rural: 252 g/ 286 g) vegetables; 45 g (urban/rural:69 g/36 g) fruits; 79 g (urban/rural: 105 g/69 g) meats; 30 g (urban/rural:45 g/24 g) fishery products; 24 g (urban/rural: 33 g/20 g) eggs; 27 g(urban/rural: 66 g/ 11 g) dairy; 16 g legume; 42 g (urban/rural:44 g/41 g) edible oil; 12 g (urban/rural: 11 g/12 g) salt; 9 g (urban/rural: 11 g/8 g) soy sauce.</p><p><b>CONCLUSIONS</b>For Chinese residents, the quality of diet had been improved and consumptions of animal products, milk, and edible oil had been increased, but the consumptions of dairy and legume products intake was still low which called for improvement. The unbalance was characterized as the downward trend in cereal, vegetable and fruit consumption but significant increased in animal products and oil intake among urban people. Dietary pattern of some subjects adopted a "high energy density" diet. Double burdens from under-nutrition and over-nutrition should both be considered as problems which asked for attention by the government and researchers.</p>