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With the expansion of aging population in China, the increasingly serious situation of Parkinson's disease (PD) threatens the physical and mental health and quality of life of middle-aged and elderly people, posing a great challenge to increase healthy life expectancy and realize the Healthy China Strategy. Previous studies showed some connections between dietary and lifestyle factors and PD and suggested that excessive intake of red meat might increase the risk of PD; however, coffee and tea, dietary antioxidants, n-3 polyunsaturated fatty acids, vitamin D, and vitamin B were associated with reducing the risk of PD or delaying the progression of PD, and dietary patterns with high intakes of fresh vegetables and fruits, legumes, whole grains, fish, and poultry meat were also associated with a reduced risk of PD. In addition, physical activity was a protective factor for PD, and smoking was also associated with a reduced risk of PD, but the related mechanisms were still unclear. This paper evaluated the relationships of factors like foods, nutrients, dietary patterns, and lifestyle with PD based on published literature, summarized the limitations of relevant studies, and provided useful enlightenment for PD prevention and control.
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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.
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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.
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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.
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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.
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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.
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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.