Malnutrition in Relation with Dietary, Geographical, and Socioeconomic Factors among Older Chinese / 生物医学与环境科学（英文）

Objective@#Nutrition is closely related to the health of the elderly population. This study aimed to provide a comprehensive picture of the nutrition status of elderly Chinese and its related dietary, geographical, and socioeconomic factors.@*Methods@#A total of 13,987 ≥ 60-year-old persons from the 2010-2013 Chinese National Nutrition and Health Survey were included to evaluate various aspects of malnutrition, including underweight, overweight or obesity, and micronutrient inadequacy.@*Results@#Overall, the prevalence of obesity, overweight, and underweight was 12.4%, 34.8%, and 5.7%, respectively, with disparities both geographically and socioeconomically. The prevalence of underweight was higher among the older old (≥ 75 years), rural residents and those with low income, with low education status, and residing in undeveloped West areas. More than 75% of the elderly do not meet the Dietary Reference Intakes for vitamins A, B @*Conclusions@#Obesity epidemic, inadequacy of micronutrient intake, and high prevalence of underweight and anemia in susceptible older people are the major nutrition challenges for the rapidly aging population in China.

Trends in Lipids Level and Dyslipidemia among Chinese Adults, 2002-2015 / 生物医学与环境科学（英文）

OBJECTIVE To investigate the trends of lipid profiles and dyslipidemia among Chinese adults from 2002 to 2015. METHODS Data were collected from three nationally representative cross-sectional surveys. Fasting venous blood samples were collected and serum lipids were tested by biochemical analysis and enzymatic determination. Lipid levels and the prevalence of dyslipidemia among adults were analyzed with complex sampling weighting adjustment for age and gender. RESULTS The weighted means of TC, TG, and LDL-c significantly increased linearly from 3.93, 1.12, and 2.12 mmol/L in 2002 to 4.59, 1.41, and 2.78 mmol/L in 2010 and then to 4.63, 1.47, and 2.87 mmol/L in 2015, respectively; by contrast, HDL-c levels decreased significantly from 1.30 mmol/L to 1.26 mmol/L over the same period. Similar trends in mean non-HDL-c and lipid-related ratios were observed. The weighted dyslipidemia prevalence linearly increased; in particular, hypercholesterolemia increased from 1.6% to 5.6% and then to 5.8%, hypertriglyceridemia increased from 5.7% to 13.6% and then to 15.0%, low HDL-c increased from 18.8% to 35.5% and then to 24.9%, and high LDL-c increased from 1.3% to 5.6% and then to 7.2% (P for trend < 0.001). CONCLUSION Dyslipidemia increased among Chinese adults from 2002 to 2015. Development of a comprehensive strategy to decrease lipid levels in this population is urgently required.

Prevalence of Undernutrition and Related Dietary Factors among People Aged 75 Years or Older in China during 2010-2012 / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Undernutrition is highly prevalent among older people. The aim of this study was to estimate the prevalence of undernutrition in elderly Chinese residents and explore the relationship between undernutrition and dietary factors.</p><p><b>METHODS</b>Data were collected from 2,552 elderly people aged 75 years and over from the Chinese Nutrition and Health Surveillance during 2010-2012 using questionnaires, anthropometric measurement, and individual consecutive 3-day 24-hour dietary records.</p><p><b>RESULTS</b>The present study showed that 10.5% of participants had undernutrition. The prevalence was higher among the population living in rural areas, those living in the South region, those who smoked, and those with low income levels. Most participants failed to meet the Chinese Dietary Reference Intakes for energy (66.1%) and protein (72.1%). When comparing quartiles of food intake, high rice consumption [odds ratio (OR) = 2.44, 95% confidence interval (CI): 1.35-4.40)], animal oil intake (OR = 1.60, 95% CI: 1.18-2.17), and high fat intake from animal sources (OR = 1.56, 95% CI: 1.06-2.31) were positively associated with underweight whereas high wheat consumption (OR = 0.44, 95% CI: 0.26-0.74), a proper proportion (24%-32%) of energy intake from fat (OR = 0.54, 95% CI: 0.35-0.83), and high fat intake from plant sources (OR = 0.67, 95% CI: 0.46-0.99) were inversely related.</p><p><b>CONCLUSION</b>The prevalence of undernutrition was high among elderly Chinese people, especially in rural areas. Dietary factors, such as high consumption of rice, were associated with undernutrition.</p>

Risk factors on anemia among rural elderly women aged 50-75 y in Xiuning county, Anhui province,China / 中华流行病学杂志

Objective To study the risk factors on anemia among elderly women in rural areas of Xiuning county, Anhui province, China. Methods Xiuning county was selected as working field and elderly women aged 50-75y were selected as subjects. Finger hemoglobin (Hb) was measured and basic health survey was face-to-face interviewed. 220 elderly women with anemia entered into the ease group; and matched by age, another 220 women with normal Hb concentration entered the control group. Survey on diet, questionnaire regarding health and lifestyle and related blood indexes were studied and tested. Results When comparing the data from both case and control groups, weight was (49.4±7.3) kg vs. (52.5±8.4) kg (t= 3.97,P<0.01 ), waist circumference was (75.8±7.8) cm vs. (79.1±9.3) cm (t=3.85,P<0.01), BMI was (21.8±2.6) kg/m2 vs. ( 22.9±3.2) kg/m2 (t = 3.775, P< 0.01 ), respectively. The total protein was ( 76.4± 5.0) g/L vs. (78.4±5.6)g/L (t=3.83 ,P<0.01 ), albumin was (45.7±3.1 ) g/L vs. (47.3±2.9)g/L (t=5.24, P<0.01 ), serum iron was ( 10.3±4.1 ) μmol/L vs. ( 12.7±4.6) μmol/L (t=5.48, P<0.01 ), and saturation of transferrin was ( 19.0±7.6)% vs. (23.1±9.1 )% (t=4.90, P<0.01 ), respectively. Results from multifactor conditioned logistic regression analysis showed that the odd ratios (OR) for anemia with staple food, BMI and vitamin A were 1.54, 1.89, 1.69, and the OR for anemia with BMI, staple food, animal food, carbohydrate and vitamin A were 2.0, 1.6, 1.6, 1.4, 1.6, with their confidence intervals (CI) as 1.3-2.9, 1.1-2.3,1.0-2.3,1.0-2.1, 1.1-2.4, respectively. Conclusion The quality of diet, health status and related blood indexes on anemia among elderly women were lower than that in control group. Lower BMI, less staple food and animal food, less carbohydrate and vitamin A intake appeared to be risk factors of anemia.

Risk factors analysis on anemia among rural women aged 50 - 75 years in Huangling county, Shanxi, northwest of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the related risk factors of anemia of rural elderly women in Huangling county, Shanxi, northwest of China.</p><p><b>METHODS</b>Elderly women aged 50-75 years in Huangling (northwest of China) were selected as study objects. Finger hemoglobin (Hb) was measured and basic health survey was face-to-face questioned. Two-hundred anemia elderly women were entered into the case group; and by age-matching, 200 with normal Hb concentration were entered into the control group. Dietary survey, health and lifestyle questionnaire were undertaken, and related blood indexes were tested.</p><p><b>RESULTS</b>In case and control group, annual income was (446.1 +/- 107.9) vs (903.8 +/- 179.1) yuan (t = 3.06, P < 0.01), daily average physical active time was (9.6 +/- 3.2) vs (10.3 +/- 3.1) hours (t = 1.94, P < 0.05), proportion of experiencing food scarce period was 31.8% vs 22.6% (chi2 = 4.14, P < 0.05), waist circumference was (76.2 +/- 7.3) vs (79.5 +/- 8.9) cm (t = 4.08, P < 0.01), respectively; the total protein was (78.0 +/- 5.8) vs (81.9 +/- 6.0) g/L(t = 5.94, P < 0.01), serum iron was (13.9 +/- 5.7) vs (16.1 +/- 5.0) micromol/L (t = 4.19, P < 0.01), serum ferritin was (94.9 +/- 76.4) vs (116.6 +/- 85.2) microg/L (t = 2.58, P < 0.01), saturation of transferrin was 22.9% +/- 10.0% vs 25.6% +/- 8.7% (t = 3.16, P < 0.01), respectively. Multifactor conditioned logistic regression analysis showed that the odd ratio (OR) for anemia with annual income, whether experiencing food scarce period, daily average physical active time, staple food, soybean products, energy was 0.57, 4.74, 0.06, 0.59, 0.55, 0.65, respectively; their confidence interval (CI) was 0.45 - 0.71, 0.73 - 30.56, 0.01 - 0.52, 0.38 - 0.91, 0.34 - 0.87, 0.44 - 0.98, respectively.</p><p><b>CONCLUSION</b>The quality of diet, health status and related blood indexes in anemia elderly women were lower than those in control group; lower income, less active time, less staple food, soybean products and energy intake should be risk factors of anemia.</p>

Study on the distribution of prevalence of hypercholesterolemia and borderline high cholesterol in Chinese adults / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the distribution of prevalence on hypercholesterolemia and borderline high cholesterol of Chinese residents aged 20 years and above.</p><p><b>METHODS</b>To detect the total fasting plasma cholesterol in 48 299 subjects among 20 year-olds and above.</p><p><b>RESULTS</b>Within a certain age range, the prevalence of both hypercholesterolemia and borderline high cholesterol increased with age, but there was a decreasing trend after 60-years of age in some regions. The prevalence of hypercholesterolemia increased to 12.53% in over 70 year-olds group from 1.36% in urban 20-year-olds, and increased to 5.15% from 60-year-olds group comparing to 0.98% of the 20-year-old group in rural areas. When comparing to the 20-year-old age group, the prevalence of borderline high cholesterol of the 70 age group in urban and rural increased by 4.4 and 4.2 times, respectively. The prevalence of hypercholesterolemia in each age group in urban were higher than that of in rural areas. In Rural I, it was higher than that of in Rural II , Rural III and Rural IV. The prevalence rates of both hypercholesterolemia and borderline high cholesterol of the males in the less than 50 year-olds group were higher than that in females, which was quite different from the group older than 50 years of age. As to borderline high cholesterol, similar result was also noticed.</p><p><b>CONCLUSION</b>Within a certain age range, there was a trend that the prevalence of both hypercholesterolemia and borderline high cholesterol increased with age and related to regions which were classified by economic status. A distinct difference between males and females also existed.</p>

Blood lipid profile and prevalence of dyslipidemia in Chinese adults / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the plasma lipid levels in a national representative sample of subjects and to determine the prevalence of dyslipidemia in the Chinese population.</p><p><b>METHODS</b>Plasma lipid profile was analyzed using the data obtained during the Chinese national nutrition and health survey (CNHS) in 2002 which involved 14 252 participants at the age of 18 years or older.</p><p><b>RESULTS</b>The mean levels of total cholesterol (TC), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) in the participants were 3.81 mmol/L, 1.10 mmol/L, and 1.30 mmol/L, respectively. In the groups of participants at the age of 18-44 years, 45-59 years, and over 60 years the mean TC level was 3.70 mmol/L, 4.09 mmol/L and 4.21 mmol/L, respectively, and the mean TG level was 07 mmol/L, 1.21 mmol/L, 1.20 mmol/L, 1.29 mmol/L, 1.33 mmol/L, and 1.33 mmol/L, respectively. The prevalence of dyslipidemia in Chinese adults was 18.6% and 22.2% in males and 15.9% in females. Dyslipidemia prevalence was higher in urban districts than in rural areas (21.0% vs. 17.7%). The prevalence of hypercholesterolemia, hypertriglyceridemia, and low HDL cholesterol was 2.9%, 11.9%, and 7.4% respectively among the participants.</p><p><b>CONCLUSION</b>Dyslipidemia has become one of the important health risk factors in the Chinese population. There is no significantly difference in the prevalence of dyslipidemia between the groups of participants at the age of 45-59 years and over 60 years. This study provides important lipid profile data for policy making and guideline development for the prevention of dyslipidemia in the Chinese population.</p>

Quality Control of Plasma Lipids Measurement in CNHS 2002 / 中国慢性病预防与控制

Objective To describe the work of quality control for lipids measurement in CNHS 2002.Methods The quality control was applied over the whole project including staff training,making standard operating procedure(blood collection,separation,temporary storage,transportation,final storage),lab materials assignment,internal quality control in central lab and participating US Disease Control Center's Lipids Standard Program(LSP)as external quality control.Results Seven times of national training programs were held and 326 technicians from CDCs in 31 provinces,autonomous regions, municiplalities and 132 surveyed counties received related trainings.During the program,321 persons passed examination (98.5%)and among them 205 got the A score(62.9%);The field work was implemented strictly according to the procedure. Three automatic biochemical instruments were used in the measurement and there is no significant difference between means of serum TC,TG and HDL-C from several batches of quality control serum.Parallel measurements were conducted in five percent randomly selected samples,the ratio of bias less than 3% was 99.05%,96.40% and 98.30% for TC,TG and HLD-C, respectively.Compared with means of LSP control sera,the results showed that all bias was less than 5% except one bias of TG result(7.02%)in one batch of LSP controls.Conclusion The work of quality control in this survey guaranteed the accuracy of plasma lipids measurement,and provided the basic data for the epidemiological description of dyslipidemia status among Chinese and the further analysis.

The plasma lipids level in adults among different areas in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study plasma total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) levels of Chinese adults among different areas in China.</p><p><b>METHODS</b>Analysis of fasting plasma lipid in 49,252 subjects aged 18 years and above was made.</p><p><b>RESULTS</b>The mean TC, TG and HDL-C were 3.81 mmol/L, 1.10 mmol/L and 1.30 mmol/L, respectively. The mean TC, TG and HDL-C is 3.96 mmol/L, 1.16 mmol/L, 1.30 mmol/L in adults in urban and 3.75 mmol/L, 1.07 mmol/L and 1.30 mmol/L in adults in rural areas. In age groups of 18 - 44 years, 45 - 59 years and 60 years above, the mean values were 3.70 mmol/L, 4.09 mmol/L, 4.21 mmol/L for TC; 1.07 mmol/L, 1.21 mmol/L, 1.20 mmol/L for TG; and 1.29 mmol/L, 1.33 mmol/L, 1.33 mmol/L for HDL-C.</p><p><b>CONCLUSION</b>The results of this study might provide the national representative data of plasma lipid level. TC and TG levels of adults in urban might be higher than those adults in rural. With increasing of age, the plasma TC level should be increased. There is no significant difference in TG levels between the adults aged 45-49 years and over 60 years, while the TG level of both age groups should be higher than those of adults aged 18-44 years.</p>

Epidemiologic characteristics of dyslipidemia in people aged 18 years and over in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the difference in prevalence of dyslipidemia, hypercholesterolemia, hypertriglyceridemia and low blood high-density lipoprotein cholesterol (HDL-C) between the residents of urban and rural areas of varied regions in China.</p><p><b>METHODS</b>Fasting plasma levels of total cholesterol, triglyceride and HDL-C were determined with the enzyme methods for 49,252 subjects aged 18 and over during August to December, 2002.</p><p><b>RESULTS</b>Prevalence of dyslipidemia in Chinese adults aged 18 and over was 18.6%, with 17.0%, 22.9% and 23.4% in the groups of 18-44, 45-59 and over 60 years old, respectively, 22.2% and 15.9% in males and females, respectively, and 21.0% and 17.7% in urban and rural areas, respectively. Prevalence of hypercholesterolemia, hypertriglyceridemia and low blood HDL-C in those aged 18 and over was 2.9%, 11.9% and 7.4%, respectively.</p><p><b>CONCLUSIONS</b>Dyslipidemia has become one of important risk factors threatening health of Chinese people, with hypertriglyceridemia and low blood HDL-C as two major types in those aged 18 and over. Prevalence of dyslipidemia was nearly the same in the middle-aged and in the elderly people, and not significantly different in those living in urban areas from those in rural areas. It is very important to pay more attention to earlier comprehensive prevention and control of dyslipidemia.</p>