New insight into air pollution-related cardiovascular disease: an adverse outcome pathway framework of PM2.5-associated vascular calcification.

Despite the air quality has been generally improved in recent years, ambient fine particulate matter (PM2.5), a major contributor to air pollution, remains one of the major threats to public health. Vascular calcification is a systematic pathology associated with an increased risk of cardiovascular disease. Although the epidemiological evidence has uncovered the association between PM2.5 exposure and vascular calcification, little is known about the underlying mechanisms. The adverse outcome pathway (AOP) concept offers a comprehensive interpretation of all of the findings obtained by toxicological and epidemiological studies. In this review, reactive oxygen species generation was identified as the molecular initiating event (MIE), which targeted subsequent key events (KEs) such as oxidative stress, inflammation, endoplasmic reticulum stress, and autophagy, from the cellular to the tissue/organ level. These KEs eventually led to the adverse outcome, namely increased incidence of vascular calcification and atherosclerosis morbidity. To the best of our knowledge, this is the first AOP framework devoted to PM2.5-associated vascular calcification, which benefits future investigations by identifying current limitations and latent biomarkers.

Immunotoxicity Evaluation of Trihalophenolic Disinfection By-Products in Mouse and Human Mononuclear Macrophage Systems: The Role of RNA Epitranscriptomic Modification in Mammalian Immunity.

BACKGROUND: 2,4,6-Trichlorophenol (TCP), 2,4,6-tribromophenol (TBP) and 2,4,6-triiodophenol (TIP) are three widely detected trihalophenolic disinfection by-products (DBPs). Previous studies have mainly focused on the carcinogenic risk and developmental toxicity of 2,4,6-trihalophenols. Very little is known about their immunotoxicity in mammals. OBJECTIVES: We investigated the effects of 2,4,6-trihalophenols on mammalian immunity using a mouse macrophage model infected with bacteria or intracellular parasites and aimed to elucidate the underlying mechanisms from an epitranscriptomic perspective. The identified mechanisms were further validated in human peripheral blood mononuclear cells (PBMCs). METHODS: The mouse macrophage cell line RAW264.7 and primary mouse peritoneal macrophages were exposed to different concentrations of TCP, TBP, and TIP. The pro-inflammatory marker Ly6C, the survival of the bacterium Escherichia coli (E. coli), and the parasite burden of Toxoplasma gondii (T. gondii) were assessed. Furthermore, the global gene expression profiling of macrophages following exposure to 2,4,6-trihalophenols was obtained through RNA-sequencing (RNA-seq). The effects of 2,4,6-trihalophenols on RNA N6-methyladenosine (m6A) methyltransferases and total RNA m6A levels were evaluated using Western blotting and dot blot, respectively. Transcriptome-wide m6A methylome was analyzed by m6A-seq. In addition, expression of m6A regulators and total RNA m6A levels in human PBMCs exposed to 2,4,6-trihalophenols were detected using quantitative reverse transcriptase polymerase chain reaction and dot blot, respectively. RESULTS: Mouse macrophages exposed to TCP, TBP, or TIP had lower expression of the pro-inflammatory marker Ly6C, with a greater difference from control observed for TIP-exposed cells. Consistently, macrophages exposed to such DBPs, especially TIP, were susceptible to infection with the bacterium E. coli and the intracellular parasite T. gondii, indicating a compromised ability of macrophages to defend against pathogens. Intriguingly, macrophages exposed to TIP had significantly greater m6A levels, which correlated with the greater expression levels of m6A methyltransferases. Macrophages exposed to each of the three 2,4,6-trihalophenols exhibited transcriptome-wide redistribution of m6A. In particular, the m6A peaks in genes associated with immune-related pathways were altered after exposure. In addition, differences in m6A were also observed in human PBMCs after exposure to 2,4,6-trihalophenols. DISCUSSION: These findings suggest that 2,4,6-trihalophenol exposure impaired the ability of macrophages to defend against pathogens. This response might be associated with notable differences in m6A after exposure. To the best of our knowledge, this study presents the first m6A landscape across the transcriptome of immune cells exposed to pollutants. However, significant challenges remain in elucidating the mechanisms by which m6A mediates immune dysregulation in infected macrophages after 2,4,6-trihalophenol exposure. https://doi.org/10.1289/EHP11329.

The impact of lockdown on air pollution: Evidence from an instrument.

This paper studies the impact of lockdown measures in response to the outbreak of COVID-19 on a prefecture's air pollution in China. To avoid potential endogenous problems, we exploit the bilateral population flow from the Baidu Migration Index to predict prefectures' probability to undertake lockdown measures. Our results using difference-in-differences with the instrumental variable show that a prefecture's lockdown measures significantly reduce its air quality index (AQI) by around 35%, and yet the result for difference-in-differences with OLS is only around 11%. We also find that a prefecture under lockdown reduces its PM 10 and PM 2.5 by around 25% and 35% respectively, and the results of diff-in-diff with OLS are only around 11% and 12%. The sharp difference between these two approaches seems to imply that there is a strong heterogeneity in lockdown stringency across prefectures.

The Phytochemical Rhein Mediates M6A-Independent Suppression of Adipocyte Differentiation.

Adipogenesis is mediated by the complex gene expression networks involving the posttranscriptional modifications. The natural compound rhein has been linked to the regulation of adipogenesis, but the underlying regulatory mechanisms remain elusive. Herein, we systematically analyzed the effects of rhein on adipogenesis at both the transcriptional and posttranscriptional levels. Rhein remarkably suppresses adipogenesis in the stage-specific and dose-dependent manners. Rhein has been identified to inhibit fat mass and obesity-associated (FTO) demethylase activity. Surprisingly, side-by-side comparison analysis revealed that the rhein treatment and Fto knockdown triggered the differential gene regulatory patterns, resulting in impaired adipocyte formation. Specifically, rhein treatment mildly altered the transcriptome with hundreds of genes dysregulated. N 6-methyladenosine (m6A) methylome profile showed that, although the supply of rhein induced increased m6A levels on a small subset of messenger RNAs (mRNAs), few of them showed dramatic transcriptional response to this compound. Moreover, the specific rhein-responsive mRNAs, which are linked to mitotic pathway, are barely methylated or contain m6A peaks without dramatic response to rhein, suggesting separate regulation of global m6A pattern and adipogenesis mediated by rhein. Further identification of m6A-independent pathways revealed a positive regulator, receptor expressing-enhancing protein 3 (REEP3), in guidance of adipogenesis. Hence, this study provides the mechanistic view of the cellular actions of rhein in the modulation of adipogenesis and identifies a potential novel target for obesity therapeutic research.

Low-Dose Cyclophosphamide Induces Nerve Injury and Functional Overactivity in the Urinary Bladder of Rats.

Aim: This research aimed to investigate the neurotoxicity of low-dose cyclophosphamide (CYP) on the urinary bladder of rats by in vivo and in vitro studies. Methods: To establish CYP-induced cystitis rat model, rats were treated with three intraperitoneal injections of CYP (25 mg/kg) in a week. During treatment, the up-down method was used to assess the mechanical withdrawal threshold. On day 8, urodynamic test and bladder smooth muscle contractility study, including the contraction of bladder strips to electrical field stimulation (EFS, 2-64 Hz), carbachol (CCh, 10-8-10-5 M) and KCl (120 mM), were performed to evaluate the function of bladder function. Body weight and bladder weight were also recorded. Morphometric analysis using an optical microscope and transmission electron microscope was performed to observe the changes of microstructure and submicrostructure of the bladder. The major pelvic neurons were isolated and treated with acrolein (the main CYP metabolite) to assess apoptosis in vitro. RT-PCR assays were used to quantify the mRNA expression levels of Nlrp6, Asc, Casp11 and Casp1 in bladder tissues and primary neurons. Results: After CYP injections, the body weights decreased, but the bladder weights increased in the model group. The mechanical withdrawal threshold of the cystitis model remained at a low level. The morphometric analysis suggested bladder inflammation and neuroinflammation in the bladder of the cystitis rat model. Urodynamic test revealed that, the amplitude, the pressure baseline, the peak pressure and pressure threshold of model rats significantly increased after CYP treatment. The muscle strips of model rats exhibited significantly higher contractility caused by EFS and CCh than the controls. Apoptotic cells appeared at the highest concentration group (100 µM acrolein) after 6 h of acrolein incubation in apoptosis assay of primary neurons. The mRNA expression levels of Nlrp6 and Casp11 were significantly increased in the cystitis rat model and in the acrolein-treated neurons. Conclusions: Low-dose CYP treatment was confirmed to induce nerve injury, which leading to bladder pain and overactive bladder in female rats, and the up-regulation of Nlrp6 and Casp11 may contribute to these pathological changes.

Household and schooling rather than diet offset the adverse associations of height with school competence and emotional disturbance among Taiwanese girls.

OBJECTIVE: Short stature may reflect health in early life and be an enduring disability. How birth weight, gender, household, elementary schooling and diet play a role in associations between stature and overall school competence (OSC) have been assessed. DESIGN: The 2001-2002 Nutrition and Health Survey in Taiwan (NAHSIT) for elementary schoolchildren (n 2274, 52·1 % boys) was linked to birth records. It provided sociodemographic, dietary quality, body compositional and school performance (as Scale for Assessing Emotional Disturbance, SAED; OSC as an SAED subscale) data. Lower birth weight was ≤15th percentile: 2850 g for boys and 2700 g for girls, and stature as z-scores for Taiwanese. Multivariable linear regression was used for relationships between OSC and stature. Trends in OSC by stature and school grade were assessed. SETTING: The 2001-2002 NAHSIT for elementary schoolchildren. PARTICIPANTS: Totally, 2274 schoolchildren aged 6-13 years. RESULTS: Compared to normal height (-2< height for age z-score (HAZ) <2), shorter girls (HAZ ≤ -2) had a lower OSC (8·87 v. 10·5, P < 0·05) and taller girls (HAZ ≥ 2) had a better OSC (12·3 v. 10·5, P < 0·001). Maternal education and household income each contributed more than 5 % of OSC variance. OSC and HAZ among girls were positively associated and emotional disturbance negatively associated. Shortness-associated lower OSC underwent remediation with advancing school grade. Stature and OSC were not evidently related in boys. CONCLUSIONS: Shorter stature can compromise OSC among school girls. The major determinants in shorter girls are less household income and limited parental education.

Identification and Target-Modification of SL-BBI: A Novel Bowman-Birk Type Trypsin Inhibitor from Sylvirana latouchii.

The peptides from the ranacyclin family share similar active disulphide loop with plant-derived Bowman-Birk type inhibitors, some of which have the dual activities of trypsin inhibition and antimicrobial. Herein, a novel Bowman-Birk type trypsin inhibitor of the ranacyclin family was identified from the skin secretion of broad-folded frog (Sylvirana latouchii) by molecular cloning method and named as SL-BBI. After chemical synthesis, it was proved to be a potent inhibitor of trypsin with a Ki value of 230.5 nM and showed weak antimicrobial activity against tested microorganisms. Modified analogue K-SL maintains the original inhibitory activity with a Ki value of 77.27 nM while enhancing the antimicrobial activity. After the substitution of active P1 site to phenylalanine and P2' site to isoleucine, F-SL regenerated its inhibitory activity on chymotrypsin with a Ki value of 309.3 nM and exhibited antiproliferative effects on PC-3, MCF-7 and a series of non-small cell lung cancer cell lines without cell membrane damage. The affinity of F-SL for the ß subunits in the yeast 20S proteasome showed by molecular docking simulations enriched the understanding of the possible action mode of Bowman-Birk type inhibitors. Further mechanistic studies have shown that F-SL can activate caspase 3/7 in H157 cells and induce apoptosis, which means it has the potential to become an anticancer agent.

Evaluating the Bioactivity of a Novel Antimicrobial and Anticancer Peptide, Dermaseptin-PS4(Der-PS4), from the Skin Secretion of Phyllomedusa sauvagii.

Dermaseptins belonging to a large family of cationic membrane-disruption antimicrobial peptides display extensive antibacterial and antiproliferative activities depending on a coil-to-helix transition and the specific structural parameters. Herein, a novel dermaseptin peptide named Der-PS4 was discovered from the skin secretion of the waxy monkey tree frog, Phyllomedusa sauvagii. The complementary DNA (cDNA)-encoding precursor was obtained relying on "shotgun" cloning, and afterwards, a mature peptide amino acid sequence was identified by reverse-phase high performance liquid chromatography (RP-HPLC) and MS/MS. Specimens were chemically synthesized and applied for further functional studies. Structural analysis demonstrated a higher α-helical content in the membrane-mimetic environment compared with that in the ammonium acetate/water circumstance. Der-PS4 displayed a broad spectrum of antimicrobial activities against tested pathogenic microorganisms, however, exhibiting slight membrane-damaging effectiveness towards horse red blood cells. Coincident with the inhibitory activities on pathogens, Der-PS4 also showed considerable biofilm eradicating impact. Also, Der-PS4 penetrated cell membrane in a relative short period under each minimum bactericidal concentration. In addition, Der-PS4 possessed antiproliferative capacity against five cancer cell lines, while presenting slight suppressing effect on human microvascular endothelial, HMEC-1. These findings provide a promising insight for the discovery and development of novel drugs from a natural source.

Dietary quality linkage to overall competence at school and emotional disturbance in representative Taiwanese young adolescents: dependence on gender, parental characteristics and personal behaviors.

BACKGROUND: Child school performance during puberty may be at increased risk through emotional disturbance. It is hypothesized that this may be mitigated by dietary quality. METHODS: In a nationally representative sample (Nutrition and Health Survey in Taiwan, NAHSIT), 1371 Taiwanese aged 11-16 years, overall competence at school, (OCS) and emotional status have been assessed by teachers with the SAED (Scale for Assessing Emotional Disturbance). Parents provided family socio-demographics and students completed a behavioral and dietary questionnaire (Youth Healthy Eating Index - Taiwan, YHEI-TW). Associations between emotional disturbance (ED), OCS and dietary quality (YHEI-TW) were assessed in multiple linear regression models with adjustments for covariates including parental characteristics, personal behaviors, body fatness and puberty. RESULTS: Boys or girls with ED had a less favorable OCS (p < 0.001), minimally dependent on YHEI-TW. On multivariable analysis there was a more positive association between OCS and YHEI-TW among boys (ß = 0.05, p < 0.01) and girls (ß = 0.07, p < 0.001). Poor dietary quality was associated with ED, especially in girls (ß = - 0.06, p < 0.001). Additionally, parental characteristics, body fatness, and personal behaviors are associated with OCS. Puberty is associated with ED and may be indirectly linked to OCS. CONCLUSIONS: Unsatisfactory food intake is associated with the link between emotional disturbance and impaired school performance, as assessed by OCS, especially among girls. For both genders, socio-economic and behavioral factors including parenteral income, reading, screen viewing and smoking are modulators of this association. Puberty was a modifying factor in girls. Dietary quality is a relevant factor for health (ED) as well as education (OCS) during early adolescence.

Dermaseptin-PH: A Novel Peptide with Antimicrobial and Anticancer Activities from the Skin Secretion of the South American Orange-Legged Leaf Frog, Pithecopus (Phyllomedusa) hypochondrialis.

The dermaseptin peptides, mainly derived from the skin secretions of Hylidae frogs, belong to a superfamily of antimicrobial peptides and exhibit diverse antimicrobial and anticancer activities with low cytotoxicity. Here, we reported a novel dermaseptin peptide, from the South American orange-legged leaf frogs, Pithecopus (Phyllomedusa) hypochondrialis, processing the shortest peptide length, namely Dermaseptin-PH. The complementary DNA (cDNA) encoding biosynthetic precursor of Dermaseptin-PH was initially identified by the rapid amplification of cDNA ends PCR (RACE-PCR) technique from the skin secretion. The predicted primary structure was confirmed by a combination of reverse-phase high performance liquid chromatography (RP-HPLC) and MS/MS fragmentation from the skin secretion. Chemically-synthetic Dermaseptin-PH was investigated using a range of bioactivity assessment assays to evaluate the biological activities and cytotoxicity of Dermaseptin-PH. Dermaseptin-PH inhibited the growth of Gram-negative bacteria, Gram-positive bacteria, and pathogenic yeast Candidaalbicans. In addition, Dermaseptin-PH showed a broad-spectrum of anticancer activities against several cancer cell lines including MCF-7, H157, U251MG, MDA-MB-435S, and PC-3. The potent antimicrobial and anticancer activities of Dermaseptin-PH make it a promising candidate in the discovery of new drugs for clinical applications, and the relatively short sequence of Dermaseptin-PH can provide new insight for the research and structural modification of new peptide drugs.

Fitness and food environments around junior high schools in Taiwan and their association with body composition: Gender differences for recreational, reading, food and beverage exposures.

School environments may contribute to adolescent behavior, reproductive physiology and body composition (BC). The Nutritional and Health Survey in Taiwan (2010) for 1458 junior high school students was geo-mapped for 30 school environs. Facilities for physical activity (fitness centers, gymnasia and sports stadiums, activity centers and parks), sedentary activities (reading material rental shops (RMRS), internet cafes) and food and beverage outlets (FBOs) were calculated as weighted numbers within 1000m of schools. Multiple linear regressions were used to predict BC variable z-scores. For boys, higher fitness center densities and, for girls, gymnasia and sports stadiums were associated with less abdominal fatness. For girls, body mass index, waist circumference (WC) and triceps skinfold thickness (TSF) were greater when RMRS density was higher as was TSF with internet café density. Where there were no FBOs, boys' WC and TSF were less with more parks, but girls were shorter and WC more adverse. With greater RMRS density and no FBOs, girls still had increased WC/Hip ratio, and less mid-arm muscle circumference. Boys' findings were more evident after considering puberty. Physical activity facilities (differently by gender), food and beverage outlets absence for boys and low reading material rental shop density for girls increase the likelihood of healthier body composition.

Anxiolytic effects of orcinol glucoside and orcinol monohydrate in mice.

CONTEXT: Anxiety is a common psychological disorder, often occurring in combination with depression, but therapeutic drugs with high efficacy and safety are lacking. Orcinol glucoside (OG) was recently found to have an antidepressive action. OBJECTIVE: To study the therapeutic potential of OG and orcinol monohydrate (OM) as anxiolytic agents. MATERIALS AND METHODS: Anxiolytic effects in mice were measured using the elevated plus-maze, hole-board, and open-field tests. Eight groups of mice were included in each test. Thirty minutes before each test, mice in each group received one oral administration of OG (5, 10, or 20 mg/kg), OM (2.5, 5, or 10 mg/kg), the positive control diazepam (1 or 5 mg/kg), or control vehicle. Each mouse underwent only one test. Uptake of orcinol (5 mg/kg) in the brain was qualitatively detected using the HPLC-MS method. RESULTS: OG (5, 10, and 20 mg/kg) and OM (2.5 and 5 mg/kg) increased the time spent in open arms and the number of entries into open arms in the elevated plus-maze test. OG (5 and 10 mg/kg) and OM (2.5 and 5 mg/kg) increased the number of head-dips in the hole-board test. At all tested doses, OG and OM did not significantly affect the locomotion of mice in the open-field test. Orcinol could be detected in the mouse brain homogenates 30 min after oral OM administration, having confirmed that OM is centrally active. DISCUSSION AND CONCLUSION: The results demonstrated that OG and OM are anxiolytic agents without sedative effects, indicating their therapeutic potential for anxiety.

Optimal dairy intake is predicated on total, cardiovascular, and stroke mortalities in a Taiwanese cohort.

OBJECTIVE: Dairy foods help achieve essential nutrient adequacy. This role may be conflicted where so-called chronic diseases prevail. We have examined associations between dairy intake and mortality where dairy foods have not been traditional. METHODS: A representative Taiwanese cohort of 3810 subjects, aged 19-64 years, derived from the Nutrition and Health Survey in Taiwan (NAHSIT, 1993-1996) was linked to death registration (1993-2008). Participants were categorized by 4 dairy weekly intake frequencies from 0 to >7 times. Mortality hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional-hazards models. RESULTS: Nonconsumers of dairy products included 30.7% of the men and 22.1% of the women. Adverse sociodemographic and personal behaviors were generally significantly associated with lower dairy consumption. After adjustment for covariates, together with body mass index (BMI) and supplement use, those with 3-7 times/week intakes had an HR (95% CI) for all-cause mortality of 0.61 (0.39-0.96) with a significant dose-response trend (p = 0.043). Similarly, the HR for cardiovascular disease (CVD) mortality with dairy weekly intake frequency >7 was 0.14 (0.02-0.97) with a significant linear trend (p = 0.007). For stroke, the corresponding HR (95% CI) was 0.03 (0.00-0.28) with a linear trend. By age and with adjustment for dietary quality, food, and calcium or vitamin D intake, significance and dose-response relationships remained. Dairy intake and cancer mortality were not associated. CONCLUSION: In a Chinese food culture, a dairy foods intake in adults up to 7 times a week does not increase mortality and may have favorable effects on stroke.

Dietary quality of elders and children is interdependent in Taiwanese communities: a NAHSIT mapping study.

Dietary quality may exhibit intergenerational associations in Taiwanese communities. Nutrition and Health Surveys in Taiwan (NAHSIT) for children and elders (1999-2002) were mapped for coincident locality and ethnicity with Geo-Gadget. Communities were characterized ecologically. Dietary quality was assessed by the Youth Healthy Eating Index-Taiwan (YHEI-TW) for children and Overall Dietary Index-Revised (ODI-R) for elders. Hierarchical regression analysis was used. Elderly ODI-R was linked with the overall child YHEI-TW (p < .001). When ODI-R increased 1 unit, the child YHEI-TW improved 0.232 and 0.134 YHEI-TW units with men and women, respectively. Dietary quality of community elders is related to that of children.

Leisure time physical activities and dietary quality of the general and indigenous Taiwanese populations are associated with fat distribution and sarcopenia.

Indigenous peoples are at greater risk of obesity-related health problems for various reasons. These have been explored in the adulthood (>=19 yrs) section of the nationally-representative Nutrition and Health Survey in Taiwan (NAHSIT) for 2005-2008 in Indigenous mountain-dwelling (IndT) (n=226) and general (mainly Han Chinese) (GenT) (n=1486) Taiwanese. Physical activity, BMI, fat distribution (waist circum-ference (WC) and triceps skinfold (TSF)) and mid arm muscle circumference (MAMC) have been com-pared. Leisure-time physical activities (LTPA) were assigned metabolic equivalents (METs). Comparisons were made by ethnicity-locality. Indigenous men and women were 3.81 and 5.47 times more obese (WHO criteria BMI>=30 kg/m2) than the GenT, respectively. Some 55% of the IndT and 34% of the GenT reported no LTPA. All LTPA types were less evident in the IndT. Multivaiable adjusted ORs (95% CIs) against inactivity as referent were, for sarcopenic MAMC, in Indigenes with MVI-LTPA 0.13 (0.03-0.67) and in the GenT 0.61 (0.37-1.01); in the GenT with LTPA for BMI >=30 kg/m2 and obese TSF, they were 0.53 (0.31-0.91) and 0.77 (0.60-0.98), respectively. Without dietary quality adjustment, the sarcopenia risk in GenT with LTPA was significant (OR=0.60, 95% CI: 0.37-0.97). Having adjusted for dietary quality, the significance disappeared. Less sarcopenia was found with ambulation in the GenT (OR=2.07, 95% CI: 1.26-3.43). More over-fatness in an IndT than GenT is associated with less LTPA. LTPA reduces sarcope-nic risk irrespective of ethnicity, is partly dependent on diet, and reduces obesity indices in the GenT.

Bidirectionality and gender differences in emotional disturbance associations with obesity among Taiwanese schoolchildren.

Childhood obesity is associated with psychological problems, but little is known about its association with emotional disturbance (ED) in the educational setting, especially by gender. In the population representative Elementary School Children's Nutrition and Health Survey in Taiwan 2001-2002 of children aged 6-13 (n=2283), we have considered whether ED is associated with obesity by gender. Schoolchildren were assessed with the modified scale for assessing emotional disturbance questionnaires. For some subscales, boys and girls had ED associations with obesity which were bidirectional. With normal weight as referent and relevant adjustments, the significant ED subscales predictable by obesity were relationship problems (RP) in boys (odds ratio, OR=1.89 with 95% CI: 1.08-3.30) and inappropriate behavior (IB) in girls (OR=2.88: 95% CI: 1.47-5.61). Conversely, with 'no-specific-ED' as referent, obesity was predictable by fully-adjusted specific-EDs in the same subscales, namely RP in boys (OR=1.88 with 95% CI: 1.13-3.13) and IB in girls (OR=3.03: 95% CI: 1.57-5.85). Child obesity prevalence showed no trend with school grade from 1 to 6, but for aggregate ED and most of its subscales the prevalence increased with grade (P for trend <0.01). Thus, there is some dissociation of obesity and ED as judged by their trend presence with school grade. Where obesity and ED occurred together (for inability-to-learn and unhappiness or depression), there were upward trends with grade (P<0.01). There are probably some selected bidirectional pathogenicities for obesity-ED associations with different expression in boys and girls and during elementary education. This provides some policy direction while mechanisms and causality require elucidation.

Lower birth weight and diet in Taiwanese girls more than boys predicts learning impediments.

Possible links between lower birth weight, childhood diet, and learning in Taiwan are evaluated. The population representative Elementary School Children's Nutrition and Health Survey in Taiwan 2001-2002 and the national birth registry were used to examine school and social performance using the modified Scale for Assessing Emotional Disturbance questionnaires in relation to diet quality by the Youth Healthy Eating Index-Taiwan and birth weight of children aged 6-13 years (n=2283). Lower birth weight (≤15th percentile: ≤2850 g for boys and ≤2700 g for girls) children were mostly from mountainous areas and of indigenous descent. Compared to normal birth weight, lower birth weight girls experienced greater inability to learn and weaker overall competence. Better diet quality predicted more favorable emotional and behavioral outcomes in lower birth weight girls, and this persisted with adjustment for covariates. None of these findings were evident among boys. Girls' cognitive and social development appears to be susceptible to diet quality and birth weight, such that the adverse risk of lower birth weight on school performance may be offset by improved diet.

Fast-food outlets and walkability in school neighbourhoods predict fatness in boys and height in girls: a Taiwanese population study.

OBJECTIVE: There is increasing evidence that the school food environment contributes to childhood obesity and health in various locations. We investigated the influence of fast-food stores and convenience food stores (FS and CS, respectively) on growth and body composition in a range of residential densities for North-east Asian food culture. DESIGN: Anthropometrics and birth weight of schoolchildren were obtained. Geocoded mapping of schools and food outlets was conducted. Multivariable linear regression models, adjusted for father's ethnicity and education, as well as for household income, pocket money, birth weight, physical activity, television watching, food quality and region, were used to predict body composition from school food environments. SETTING: Elementary schools and school neighbourhoods in 359 townships/districts of Taiwan. SUBJECTS: A total of 2283 schoolchildren aged 6-13 years from the Elementary School Children's Nutrition and Health Survey in Taiwan conducted in 2001-2002. RESULTS: Remote and socially disadvantaged locations had the highest prevalence of lower weight, BMI, waist circumference and triceps skinfold thickness. Food store densities, FS and CS, were highest in urban Taiwan and lowest in remote Taiwan. In the fully adjusted models, FS densities predicted weight and BMI in boys; there was a similar association for waist circumference, except when adjusted for region. FS densities also predicted height for girls. Except for weight and BMI in boys, CS did not have effects evident with FS for either boys or girls. CONCLUSIONS: A high FS density, more than CS density, in Taiwan increased the risk of general (BMI) and abdominal (waist circumference) obesity in boys and stature in girls. These findings have long-term implications for chronic disease in adulthood.

The demography of food in health security: current experience with dairy consumption in Taiwan.

To establish a food guide, the "total diet" needs to be considered, based on prevailing patterns of food and nutrient intake; these will be culturally acceptable and recognize the prevailing social and economic conditions that affect food availability. Dairy produce is a good source of high quality protein, and provides significant amounts of vitamins and minerals. People who consume more dairy have higher intakes of calcium and vitamin B2 with less chance of deficiency. We used four National Nutrition Surveys in Taiwan (NAHSITs) to establish the current demographic predictors of dairy intakes, an indicator of food security in an affluent society. There was a U shape relationship between dairy consumption practices (whether or not) and age. In Taiwanese, the practice is higher in school children (49.3%), adolescents (32.1%) and elderly (43.6%) than it is in middle age (22.2-25.9%). Average daily dairy intake decreases with age; in the elderly, the intake is less than half a serving. Forty seven percent of first grade children consumed a serving or more of dairy while the 6th graders dropped to 37%. Less than 20% adults consume one serving or more a day. The rate increases to 40% for elderly. Physiologic limitation and dietary habit account for 25% and 50% of dairy avoidance, respectively. Education, financial status, ethnicity, regionality and health seeking behaviors are determinants of dairy consumption in all age groups. There is a need for alternative Food Guides for non-dairy consumers. Attention to dairy intake for socio-economically disadvantaged groups is required.