ABSTRACT
Background Changes in cognitive function exist before the onset of clinical Parkinson's disease. However, studies on association between cognitive function and prodromal Parkinson's disease (pPD) are limited. Objective To estimate probability of pPD and assess its association with global and domain cognitive function in Chinese elders. Methods Data were drawn from the Community-based Cohort Study on Nervous System Disease 2018 (baseline) and 2020 (follow-up). We selected 3911 residents aged 55 and above who participated the two waves, without Alzheimer's disease and Parkinson's disease, and with completed information on demographics, disease history, cognitive function test, and risk factors of Parkinson's disease. Cognitive function was assessed using the Chinese version of Montreal Cognitive Assessment Scale. Calculation of probability of pPD and assessment of possible (probability between 30% and <80%) or probable (probability ≥80%) pPD were performed according to the criteria published by the International Parkinson and Movement Disorder Society. Multiple linear regression model was employed to analyze the association between baseline cognitive function and follow-up probability of pPD. Results The medians of scores of baseline global cognitive function and cognitive domains in terms of memory, execution, visuospatial function, language, attention, and orientation were 23, 12, 9, 6, 5, 14, and 6, respectively. The median of follow-up probability of pPD was 0.87%, and the proportion of participants with possible or probable pPD was 0.4%. The differences in the distribution of follow-up probability of pPD were significant in groups by baseline global cognitive score quartiles (χ2=21.68, P<0.001). A higher baseline global cognitive score was considerably related to a lower follow-up probability of pPD, b(95%CI)=0.994(0.988~0.999), P=0.040. After adjusting for selected confounders, the results of multiple linear regression analyses showed that the probability of pPD in the highest quartile group was decreased by 10.7% (b=0.893, 95%CI: 0.794-0.992, P=0.034) relative to the lowest quartile group, and the trend was significant (trend P=0.031). Higher baseline index scores of execution, attention, and orientation were highly related to a lower follow-up probability of pPD (all P<0.05). Conclusion Declines in global cognitive function and cognitive domains of execution, attention, and orientation may associate with a higher probability of pPD in middle-aged and elderly population, which suggests the significance of cognitive intervention in early stage for pPD prevention.
ABSTRACT
Background It has been reported that a high intake of dairy products might be associated with an increased risk of Parkinson's disease (PD) in foreign studies, but no such study has yet been conducted on prodromal Parkinson's disease (pPD) and the Chinese population. Objective To investigate the prospective relationship between the intake of dairy products and pPD among people aged 55 and above in four provinces of China. Methods The research data were obtained from the baseline 2018 and follow-up 2020 surveys of Community-based Cohort Study on Nervous System Disease. A total of 9984 residents were selected who participated in both waves of surveys and had complete data on demographics, dietary products intake, and risk factors for PD. We evaluated the risk level and the numbers of related risk/prodromal markers of pPD in the participants based on a criteria recommended by the International Parkinson and Movement Disorder Society (MDS). Food Frequency Questionnaire was used to obtain food consumption data in the past 12 months, and the intake of dairy products was calculated and divided into non-consumption and tertiles of consumption (T1, T2, and T3 from low to high). Multiple linear regression was used to analyze the association between baseline dairy intake and risk level of follow-up pPD. Poisson regression and multinomial logit regression models were used to analyze the relationship of baseline dairy products and the number of risk/prodromal markers of follow-up pPD in the population, and multiple logistic regression was used to analyze each risk/prodromal marker of follow-up pPD according to baseline levels of dairy products intake. Results The percentage of residents without dairy products consumption was 58.02% in 2018, and the dairy products intakes were relatively high among residents being female, aged 55 to 74 years, with an education level of middle school and above, with a per capita monthly household income ≥ 1000 yuan, living in urban areas, and without active employment (P<0.05). The median risk level of pPD was 0.74% in 2020, and the proportion of residents with 3 to 5 markers was 66.74%. The multiple linear regression analysis results suggested no association between baseline dairy intake and follow-up risk level of pPD. The Poisson regression model showed that the high dairy products intake group at baseline (T3, median=250.00 g·d−1) was found to be 1.159 (95%CI: 1.065~1.261, Ptrend<0.001) times more likely to have the risk/prodromal markers of pPD at follow-up than non-consumers. When the number of markers was grouped, no statistically significant association was found by multiple logistic regression analysis. Conclusion Although high dairy products intake levels might be associated with pPD risk/prodromal markers among people aged 55 and above in four provinces of China, no direct association is found between dairy products intake and pPD risk levels in this study.
ABSTRACT
Background Gastrointestinal microbiota plays an important role in the development of Parkinson's disease (PD), and dietary factors have a great impact on intestinal micro ecology. At present, few studies focus on red meat and PD, especially prodromal PD (pPD). Objective To understand the relationships of the intake of red meat and processed meat products with pPD and the number of risk/prodromal markers, and to explore the association of dietary factors with pPD. Methods Based on the data of Community-based Cohort Study on Nervous System Disease in 2018 and 2020, adults aged 55 years and older with complete demographic information, dietary survey information, and information on risk factors related to PD were selected from four provinces of China. After excluding those reporting abnormal total energy intake or those reporting alcohol drinking or abused drugs for a long period of time, and confirmed mental diseases with prescribed drugs, a total of 10003 subjects were included. Food frequency questionnaire was used to calculate the intake of red meat and processed meat products. The pPD-related risk/prodromal markers were selected following the International Parkinson and Movement Disorder Society criteria for pPD, and the risk level and the number of markers of pPD were then calculated. The relationship between the intake of red meat and processed meat and the risk level of pPD was analyzed by multiple linear regression. The relationship between the intake of red meat and processed meat and the pPD marker number groups was analyzed by multinomial logit regression model. Results In 2018, the intake of red meat and processed meat was 28.57 g·d−1 in the target population. In 2020, the median of the number of risk/prodromal markers was 3, and the median M (P25, P75) of the posterior probability of pPD was 0.74% (0.42%, 1.49%). The multiple linear regression analysis showed that the higher the intake of red meat and processed meat, the higher the risk level of pPD in follow-up (b=0.021, P<0.05). The multiple logit regression model showed that compared with the lowest quartile (Q1), the highest quartile (Q4) group of red meat and processed meat intake were more likely reporting 3−5 risk/prodromal markers than ≤ 2 risk/prodromal markers (OR=1.185, 95%CI: 1.015−1.382). Conclusion The intake level of red meat and processed meat is related to the risk level of pPD, and a higher intake of red meat and processed meat may be a potential risk factor of pPD.
ABSTRACT
Background China is witnessing an accelerated aging process and an increasingly serious situation of Parkinson's disease. Research on the pre-disease stage and its related influencing factors has gained more and more attention. Objective To analyze the current situation of prodromal Parkinson's disease (pPD) of people aged 55 years and above in four provinces of China, and to explore its influencing demographic and socio-economic characteristics. Methods Using the data of Community-based Cohort Study on Nervous System Disease in 2020, a total of 10724 participants with complete data on demographic and socio-economic factors and risk factors on Parkinson's disease were selected. Based on the criteria recommended by the International Parkinson and Movement Disorder Society (MDS), we evaluated risk level (i.e., post-test probability) of pPd, prevalence of possible or probable pPD, and number of pPD-related risk/prodromal markers in the participants. Multiple linear regression and multiple logistic regression models were used to analyze the influencing socio-demographic factors of risk level of pPd and prevalence of possible or probable pPD, and Poisson regression and multinomial logit regression models were used to analyze the influencing socio-demographic factors of the number of pPD-related risk/prodromal markers in the total sample, men, and women, respectively. Results The median (P25, P75) of post-test probability of pPD in 2020 was 0.78% (0.42%, 1.66%), the prevalence rate of possible or probable pPD was 0.34%, and 69.03% of the participants reported 3-5 pPD-related risk/prodromal markers. The post-test probabilities of men, those with older age, lower education level, per capita monthly household income < 1000 yuan, urban residency, or without active employment were higher (P<0.05). Men and being aged ≥ 75 years had a higher prevalence of possible or probable pPD (P<0.05). The OR of possible or probable pPD was 8.404 (95%CI: 2.839−24.879) in subjects aged ≥ 75 years versus those aged 55−64 years. Males, those without active employment, being less educated, with older age, and urban residents were more likely to report pPD-related risk/prodromal markers than those of the opposite groups (P<0.05). Conclusion Men, subjects aged ≥75 years, those with lower education level, urban residents, and those without active employment have higher risk levels of pPD and are more likely to report pPD-related risk/prodromal markers among people aged 55 years and above in the four provinces of China, poor economic situation is also associated with higher risk levels of pPD.
ABSTRACT
Background Diabetes is a major contributor to global burden of disease. The role of magnesium in the prevention of diabetes has aroused concern. However, the research results on the impact of dietary magnesium on the risk of diabetes are hitherto inconsistent. Objective To evaluate the association between dietary magnesium intake and the risk of diabetes through a systematic review. Methods PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang databases were searched for prospective studies that contained risk estimates for magnesium intake-associated diabetes and were published from January 1, 2000 to December 31, 2021. Two researchers independently screened the literature according to a set of pre-prepared inclusion and exclusion criteria, extracted the data according to an unified data extraction table, and evaluated the quality of included articles with Newcastle-Ottawa Scale (NOS). R 4.0.3 software and Stata SE16.0 software were used for meta-analysis and subgroup meta-analysis, and Higgins I2 statistics were used to test the heterogeneity of the included studies. The sources of heterogeneity were analyzed by univariate meta regression. Results A total of 14 articles involving 17 prospective cohort studies (1065267 participants and 40506 patients with diabetes) were included in the study. The NOS scores ranged from 8 to 9, with an average of 8.6, indicating that the included studies were classified as being high quality. The highest quintile of magnesium intake group reduced the risk of diabetes by 22% (RR=0.78, 95%CI: 0.73-0.82) compared with the lowest quintile group. This association was not substantially modified by geographic region, sex, or follow-up length. The highest quintile of dietary magnesium intake in the Americas and Asia were associated with 22% and 26% reductions in the risk of type 2 diabetes respectively compared with the lowest quintile group (the Americas, RR=0.78, 95%CI: 0.73-0.84; Asia, RR=0.74, 95%CI: 0.63-0.88); The highest quintile of dietary magnesium intake in female, male and without gender stratified were associated with 22%, 19% and 46% reductions in the risk of type 2 diabetes respectively compared with the lowest quintile group (Female RR=0.78, 95%CI: 0.73-0.84; Male RR=0.81, 95%CI: 0.74-0.89; Both RR=0.54, 95%CI: 0.42-0.68); Compared with the lowest quintile groups, the groups with the highest quintile of dietary magnesium intake with a follow-up time of less than 10 years and more than 10 years reduced the risk of type 2 diabetes by 26% and 20% respectively (≤10 years, RR=0.74, 95%CI: 0.65-0.83; ＞10 years, RR=0.80, 95%CI: 0.75-0.85). After adjusting for hypertension, the highest quintile of dietary magnesium intake group reduced the risk of type 2 diabetes by 20% compared with the lowest quintile group (RR=0.80, 95%CI: 0.74-0.85). The year of publication (P<0.05) or the sex of the subjects (P<0.05) may be the source of heterogeneity by meta regression test. The results of Egger’s test for funnel plot asymmetry suggested publication bias. Conclusion The combined data supports a role for high magnesium intake in reducing the risk of type 2 diabetes. Because it is difficult to separate the effect of magnesium intake on diabetes risk from other factors, large-scale and clinical randomized controlled trials are needed to directly assess the impact of magnesium on the incidence rate of diabetes.
ABSTRACT
Background At present, domestic and foreign studies on the association between dietary magnesium and diabetes risk are not consistent, and there are relatively few prospective studies in China and the study population is relatively limited. Objective To explore the association between dietary magnesium intake and diabetes risk in Chinese adults in 15 provinces (autonomous regions, municipalities), and to provide a scientific basis for revising dietary magnesium intake reference for Chinese residents. Methods A total of 8061 adults aged 18-64 who participated in at least two follow-up surveys in the China Health and Nutrition Survey in 2009, 2015, and 2018, had complete survey data, and did not report diabetes at baseline were selected as subjects. Food consumption data were collected from 3-day 24-hour dietary recalls and by weighing household cooking oil and condiments. The average daily dietary magnesium intake was calculated based on the food composition table. Multiple Cox proportional risk regression model and restricted cubic spline (RCS) model were used to analyze the association and dose-response relationship between dietary magnesium intake and diabetes risk. Diabetes was defined according to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 edition). Results A total of 47237.46 person-years were followed up, with an average follow-up of 5.86 years. Among 8061 subjects, the incidence rate was 8.86%. Compared with those in the top quintile of magnesium intake (Q5), those with lower dietary magnesium intake were more likely to be female, have higher income, higher education, live in urban areas, and have lower intakes of energy, dietary fiber, and dietary calcium. After adjusting for demographic characteristics, lifestyle, and dietary factors, compared with adults in the lowest quintile of dietary magnesium intake, the results of Cox proportional risk regression model showed that the second (median: 220.96 mg·d−1), third (median: 263.01 mg·d−1), and fourth (median: 312.33mg·d−1) quintile dietary magnesium intake reduced the risk of diabetes by 45% (HR=0.55, 95%CI: 0.43-0.71), 39% (HR=0.61, 95%CI: 0.47-0.78), and 34% (HR=0.66, 95%CI: 0.51-0.78), respectively. The results of RCS analysis showed that dietary magnesium intake and the risk of diabetes were U-shaped overall. Taking the 5th percentile magnesium intake as reference, when dietary magnesium intake was lower than 240 mg·d−1, the risk of diabetes gradually decreased with the increase of magnesium intake; the risk was the lowest at 240 mg·d−1, followed by a slight increase in risk at 240-400 mg·d−1; and no statistical difference presented in the association between dietary magnesium and diabetes risk after 650 mg·d−1. Conclusion The study findings suggest an association between dietary magnesium intake and diebetes risk. The association is negative and non-linear when dietary magnesium intake is below 240 mg·d−1.
ABSTRACT
Background Magnesium plays an important physiological role in human, but the association between dietary magnesium intake and the risk of hypertension is unclear. Few studies have reported the dose-response relationship in Chinese population. Objective To analyze the relationship between dietary magnesium intake and the risk of hypertension in Chinese adults aged 18-64 years, and to explore the dose-response relationship. Methods A total of 13082 adults aged 18-64 years who participated in at least two rounds of the China Health and Nutrition Survey (CHNS) from 2000 to 2018 were selected. Dietary data were obtained by consecutive 3-day 24-hour dietary recall and weighting & bookkeeping method. Blood pressure was measured with a standard mercury sphygmomanometer. Hypertension was diagnosed when systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, or self-reported hypertension history or using antihypertensive drugs. The mean of dietary magnesium intake in all survey years (excluding the last survey) was used as the dietary magnesium intake of the subject, and the mean of dietary magnesium intake was divided into 5 equal groups. Cox proportional risk model with adjustments for socio-demographic factors, body mass index (BMI), smoking and drinking, sleep time, physical activity, and dietary factors, was used to analyze the association between dietary magnesium intake and the risk of hypertension. A sensitivity analysis was conducted by excluding baseline diabetes patients and adjusting for baseline blood pressure. In addition, a restricted cubic spline model was used to analyze the dose-response relationship between them. Results In this study, male participants accounted for 47.70%, and those aged 18-44 years accounted for 72.47%. The mean follow-up time was 12.56 years and the prevalence of hypertension was 13.86%. Dietary magnesium intake was inversely associated with the risk of hypertension at the 4th quintile (median 333.56 mg·d−1) and the 5th quintile (median 420.07 mg·d−1) compared with the 1st quintile (median 189.06 mg·d–1), and the hazard risk (HR) values and associated 95%CIs were 0.81 (0.67-0.97) and 0.81 (0.66-0.99) respectively. After eliminating baseline diabetes and adjusting baseline blood pressure, dietary magnesium intake remained negatively associated with the risk of hypertension, which was consistent with the population-wide HR. The association between dietary magnesium intake and the risk of hypertension was non-linear (χ2=11.07, P=0.01). When dietary magnesium intake was higher than 339 mg·d−1, the risk of hypertension decreased, and the HR value was the lowest in 375-418 mg·d−1 (HR=0.65, 95%CI: 0.45-0.94), and then gradually tended to 1. There was no statistically significant association at 467 mg·d−1 and above. Conclusion Magnesium intake in the range of 339-467 mg·d−1 is negatively associated with the risk of hypertension in Chinese adults, presenting a U-shaped dose-response relationship.
ABSTRACT
Background Magnesium is an important nutrient, and participates in most metabolic processes. Many studies show an association between dietary magnesium intakes and nutrition-related diseases such as diabetes. However, the data of dietary magnesium intakes and secular trends among the whole life cycle of Chinese residents are not available. Objective To investigate the dietary magnesium intakes and associated secular trends over the past three decades in residents of all ages and China, to identify the high-risk residents of magnesium deficiency and plan nutritional interventions, and provide basic data support for the revision of dietary magnesium reference intake. Method The data came from the 10 rounds of the "China Health and Nutrition Survey" from 1991 to 2018, and the participants with complete sociodemographic and dietary data wereselected. The median intakes, insufficient rates, and secular trends of dietary magnesium intakes were analyzed in different survey years. Analysis of multiple linear regression was used to analyze the annual change characteristics of dietary magnesium intakes controlling gender, age, education, urban-rural stratum, and north-south region. Wilcoxon trend test was used to analyze the secular trends of dietary magnesium intakes in different characteristic groups. The trends of insufficient rate were analyzed by Cochran-Armitage trend test among different characteristic groups. Results A total of 127169 residents were included in the present study. The medians of dietary magnesium intakes in 1991, 1993, 1997, 2000, 2004, 2006, 2009, 2011, 2015, and 2018 were 283.70, 283.38, 304.26, 285.50, 283.64, 275.49, 267.92, 242.93, 240.51, and 238.89 mg·d−1, respectively, showing a significant downward trend (F=2931.81, P<0.001). Dietary magnesium intakes showed significant differences in gender, age, education level, income level, urban-rural stratum, and north-south region in almost all survey years, except that there was no significant difference among different income groups in 1991. Insufficient rate of dietary magnesium intake showed a significant upward trend (Z=62.62, P<0.001), approximate 60% of Chinese residents consumed insufficient magnesium. The insufficient rate was 53.94% for male and 65.35% for female, and the insufficient rate in the 14-17 age group was as high as 71.29%. Conclusion The dietary magnesium intake shows a significant downward trend and insufficient intake of dietary magnesium is prevalent among Chinese population. It is necessary to observe the high-risk population and conduct relevant nutritional interventions, as well as to further assess the recommended intake of magnesium.
ABSTRACT
Background Global dietary magnesium insufficiency is widespread and seriously harmful to human health. There are few studies on dietary magnesium intake in China, and associated dietary intervention lacks scientific support. Objective To explore the dietary magnesium intake level and food sources of Chinese adults aged 18-64 in 2018, and to identify the problems of dietary magnesium intake. Methods A total of 9181 residents in the 2018 "China Health and Nutrition Survey" were selected as the study subjects. Types and intake of food collected from consecutive 3-day 24-hour dietary recalls and by household condiment weighing and counting method. The average daily dietary magnesium intake and the composition of main food sources were calculated using the food composition table. Multiple logistic regression was used to analyze the relationship between socioeconomic factors and insufficient dietary magnesium intake. Results In 2018, the daily intake of magnesium in P50 (P25, P75) of adults aged 18-64 in 15 provinces (autonomous regions and municipalities) of China was 252.28 (196.25, 326.27) mg. The proportion of residents with insufficient dietary magnesium intake was 60.9%. The proportions of women, adults aged 18-49, urban residents, southern region residents, and western regions residents with insufficient dietary magnesium intake were 66.4%, 63.4%, 62.4%, 65.2%, and 68.3%, respectively. The results of multiple logistic regression analysis showed that the risks of insufficient dietary magnesium intake were 64.6%, 24.6%, and 43.6% higher in women, urban residents, and southern region residents than those in men, rural residents, and northern region residents, respectively (OR=1.646, 95%CI: 1.509-1.794; OR=1.246, 95%CI: 1.126-1.379; OR=1.436, 95%CI: 1.311-1.573); the risk of insufficient dietary magnesium intake in residents aged 50-64 was 15.7% lower than that in residents aged 18-49 (OR=0.843, 95%CI: 0.771-0.921); the risks of insufficient magnesium intake in residents in middle and western areas were 1.202 times and 1.590 times of that in residents in eastern area (OR=1.202, 95%CI: 1.079-1.340; OR=1.590, 95%CI: 1.424-1.776). The effect of education level and income level on magnesium intake insufficiency was not observed (P>0.05). In addition, 41.4% of dietary magnesium of the subjects came from cereals and products (ranking first in food sources), and only 2.4% from dark vegetables with rich magnesium content (ranking sixth place). The top six dietary magnesium sources of men and women were the same. The proportion of dietary magnesium from cereals and products was 6.3% higher in rural residents than in urban residents, and 9.3% higher in residents living in northern regions than those in southern regions. The proportion of dietary magnesium from livestock meat and products was 1.3% higher in the 18-49 age group than in the 50-64 age group, 0.9% higher in urban residents than in rural residents, and 1.6% higher in western region residents than in eastern region residents. Conclusion The dietary magnesium intake of Chinese residents is generally insufficient, and the source of dietary magnesium is irrational. Women, residents aged 18-49, residents in southern, middle, and western areas are high-risk populations of dietary magnesium insufficiency. Chinese residents are encouraged to eat more dark vegetables and whole grain food; women should improve their dietary quality and intake diverse magnesium-rich food; southern region residents and urban residents should increase the intake of whole grains and avoid over refining food; residents aged 18-49, urban residents, and those in western regions should adjust their dietary structure and reduce meat intake.
ABSTRACT
Background Overweight and obesity are on the rise all over the world and are related to a variety of chronic diseases. There is a lack of such research on the population aged 18-35. Objective To explore the trends of overweight and obesity in adults aged 18-35 from 1989 to 2018 and the epidemiological characteristics in 2018. Methods A total of 22425 adults aged 18-35 enrolled in the China Health and Nutrition Survey in 1989, 1991, 1993, 1997, 2000, 2004, 2006, 2009, 2011, 2015, and 2018 were selected as study subjects. Overweight and obesity were judged in accordance with WST 428-2013 Determination of adult weight. The trend analysis of body mass index (BMI) level adopted a general linear model, and the trend analysis of overweight and obesity rate adopted a chi-square test for trend. A joinpoint regression model was used to calculate the average annual percentage change (AAPC) and annual percentage change (APC). A log-binomial regression model was used to analyze the relationship between socioeconomic factors and overweight/obesity, and a model with sex stratification was also constructed. Results In the period of 1989–2018, the BMI, overweight rate, and obesity rate of adults aged 18-35 all showed an upward trend. The BMI increased from (21.3±2.3) kg·m−2 to (23.3±4.0) kg·m−2, and the rate of overweight and obesity increased from 12.1% to 36.8%. The results of joinpoint regression model showed that 2000 was a joinpoint, and the APCs of overweight rates of 1989–2000 and 2000–2018 were 4.1% and 2.4% respectively (P < 0.05), and the APCs of obesity rates were 15.2% and 7.5% respectively (P < 0.05). From 1989 to 2018, the overweight rate increased at an average annual rate of 3.1% (AAPC=3.1%, 95%CI: 2.4%-3.7%, P<0.05), and the obesity rate increased at an average annual rate of 10.3% (AAPC=10.3%, 95%CI: 7.6%-13.2%, P<0.05). The overweight and obesity rates of men, the 25-35 age group, and northerners were 49.5%, 38.7%, and 45.4% respectively. About 52.6% of men aged 25-35 were overweight and obese. The results of log-binomial regression analysis showed that the risks of overweight and obesity were lower in women (with men as reference, RR=0.54, 95%CI: 0.44-0.65) and in southerners (with northerners as reference, RR=0.74, 95%CI: 0.61-0.91), but was higher in the 25-35 year old group (with the 18-24 year old group as reference, RR=1.41, 95%CI: 1.07-1.87). After stratification by sex, the results of log-binomial regression analysis showed that compared with men aged 18-34, men aged 25-35 had an increased risk of overweight and obesity (RR=1.50, 95%CI: 1.04-2.14), and compared with women in the north, women in the south had a lower risk of overweight and obesity (RR=0.63, 95%CI: 0.46-0.87). Conclusion The problem of overweight and obesity of Chinese adults aged 18-35 is serious. We should give priority to intervene and prevent the overweight and obesity of men, people aged 25-35, and northerners, especially men aged 25-35.
ABSTRACT
Background In recent years, Chinese residents have undergone profound changes in dietary habits and lifestyle, and the increasing prevalence rate of central obesity has become one of the major public health problems. Objective To analyze the changes in waist circumference distribution and central obesity prevalence, and the differences by demographic and socioeconomic factors among Chinese adults aged 18-35 in 15 provinces (autonomous regions and municipalities) from 1993 to 2018, and to provide evidence for further exploration of etiology and control measures. Methods Based on the data of nine follow-up rounds of the China Health and Nutrition Survey from 1993 to 2018, adults aged 18 to 35 were selected as study subjects. After excluding the records of missing demographic information or abnormal physical measurement data, a total of 16008 subjects were included in this study. Central obesity was diagnosed by WS/T 428—2013 Criteria of weight for adults. Spearman rank test was used to analyze the changes of waist circumference; Cochran-Armitage trend test was used to analyze the trends of central obesity prevalence rate; multiple logistic regression analysis was used to analyze the influencing factors of central obesity in the whole population; subgroup analysis on waist circumference and central obesity prevalence rate was also conducted among participants from the 2018 follow-up survey. survey. Results From 1993 to 2018, the waist circumference and prevalence rate of central obesity of adults aged 18-35 in 15 provinces (autonomous regions and municipalities) significantly increased by year (P<0.05). In males, the prevalence rate increased from 4.40% to 35.49% (Ptrend<0.05), while in females, it increased from 6.33% to 18.31% (Ptrend<0.05), and the average growth rates were 8.14% and 2.58% per annum, respectively. The results of multiple model analysis showed that subjects aged 25 to 35 years were more likely to have central obesity than the control group with age 18 to 24 years in both males (OR=1.285, 95%CI: 1.066-1.550) and females (OR=1.558, 95%CI: 1.234-1.967). There were significant associations of central obesity in males with residence, geographical location, and economic zones: urban males were 39.5% (OR=1.395, 95%CI: 1.169-1.165) more likely to suffer from central obesity than rural males; males living in southern China were 37.9% (OR=0.621, 95%CI: 0.519-0.744) less likely to suffer from central obesity than those living in northern China; compared with males living in central economic zone, males living in western economic zone were 27.1% (OR=0.729, 95%CI: 0.567-0.937) less likely and males living in eastern economic zone were 21.8% (OR=1.218, 95%CI: 1.017-1.459) more likely to suffer from central obesity. No significant correlation was found of residence and geographical location with central obesity in females, only in the western economic zone, females were 32.4% (OR=0.676, 95%CI: 0.515-0.886) less likely to suffer from central obesity than those in the central economic zone. With increase of income levels, females were less likely to be central obese, and females of middle income level (OR=0.749, 95%CI: 0.600-0.934) and high income level (OR=0.684, 95%CI: 0.542-0.864) were less likely to suffer from central obesity than those of low income level. In the total population, a higher body mass index (BMI) level was significantly associated with having central obesity; overweight and obese males were found to be 12.207 (95%CI: 10.228-14.568) and 150.418 (95%CI: 111.186-203.492) times more likely to have central obesity, respectively, and the odds ratios for females were 9.014 (95%CI: 7.446-10.912) and 88.215 (95%CI: 61.411-126.717), respectively. Conclusion From 1993 to 2018, waist circumference and the prevalence rate of central obesity in adults aged 18-35 in selected 15 provinces (autonomous regions and municipalities) of China have been increased year by year, the condition of central obesity is more severe in males. Gender, age, economic zones, and BMI are the major influencing factors. It is necessary to take effective early screening and intervention measures targeting central obesity in youth population to reduce health risks.
ABSTRACT
Objective@#To analyze the status of dietary sodium intake of Chinese adult residents in fifteen provinces in 2015.@*Methods@#Data were collected from 2015 China Nutrition Transition Cohort Study. This cohort study used a three consecutive 24-h retrospective method to record food intake and weighing method to record household condiment consumption. In this study, 14 847 residents aged 18 years and over with complete data from 15 provinces in 2015 were selected for the comparison of dietary sodium intake (median) with different characteristics.@*Results@#Among the 14 847 residents, 47.1% were males, and the rural and northern residents accounted for 60.1% and 37.7%, respectively. Median sodium intake was 3 960.0 mg/d among residents in 2015. The sodium intake of males (4 272.1 mg/d) was higher than that of females (3 716.6 mg/d). Across age subgroups, sodium intake was highest among residents aged 45-59 years (4 257.0 mg/d; 18-44 years old, 3 867.1 mg/d; ≥60 years old, 3 799.0 mg/d). Sodium intake was higher in rural area (4 042.9 mg/d) than in urban area (3 866.8 mg/d), higher in north (4 229.2 mg/d) than in south (3 806.8 mg/d) (all P values <0.05). 11.8% of residents with dietary sodium intake were below 2 000 mg/d. The main sources of dietary sodium were condiments (79.4%), regular cooking foods (11.9%) and processed foods (8.7%). Among the condiments, the salt and soy sauce accounted for 63.6% and 10.4%, respectively.@*Conclusion@#In 2015, Chinese adult residents had higher dietary sodium intake with gender and regional differences. Condiments were the main source of dietary sodium.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the association between dietary cholesterol intake and hypercholesterolemia among Chinese adults.</p><p><b>METHODS</b>In 2009, 4 244 adults aged 25-65 years old who participated in both 2004 and 2009 China Health and Nutrition Surveys, and with complete biochemical and dietary data were selected. Hypercholesterolemia were defined as with total cholesterol ≥ 6.22 mmol/L, according to 2007 Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Non-conditional logistic regression was used to investigate association between dietary cholesterol intake and hypercholesterolemia.</p><p><b>RESULTS</b>The average total cholesterol was 4.9 mmol/L, with prevalence of hypercholesterolemia as 9.6%, in 2009. During 2004 to 2009, dietary cholesterol showed a dramatical increase, with lower intake groups the most. Males who consumed middle or lower dietary cholesterol in 2004 and high intake in 2009 had significantly higher risk of having hypercholesterolemia. However, similar findings did not appear in females.</p><p><b>CONCLUSION</b>The associations between dietary cholesterol intake and hypercholesterolemia were different among Chinese males and females. Dramatic increase of dietary cholesterol intake was related to higher risk of hypercholesterolemia in males.</p>