Association of changes in plant-based diet consumption with all-cause mortality among older adults in China: a prospective study from 2008 to 2019.

OBJECTIVES: To examine the association of changes in plant-based diet consumption with all-cause mortality among older adults in China. DESIGN: Cohort study. SETTING: This cohort study of 11 years used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a long-term, nationwide survey covering 23 provinces in China. PARTICIPANTS: A total of 7843 older participants aged ≥60 years were included in this study. MEASUREMENTS: Changes in plant-based diets consumption (2008-2011) were assessed by 3 graded plant-based diet indices, including an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). The main outcome was all-cause mortality. Multivariable-adjusted Cox proportional-hazards models were fitted to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) of mortality for changes in PDI, hPDI, and uPDI. RESULTS: A total of 7843 participants (mean [SD] age, 82.2 [10.9] years; 3588 [45.7%] men) were included in this study. During a median (IQR) of 9 (5-10) years of follow-up, 3749 deaths were documented. Compared with older adults whose plant-based diet indices were relatively stable, older adults with the greatest decrease (quintile 1) in PDI, hPDI, and uPDI had respectively 32% (95% CI, 19%-47%) higher, 21% (95% CI, 9%-33%) higher, and 10% (95% CI, 4%-21%) lower risk of death. Compared with older adults whose diet indices were relatively stable, older adults with the greatest increase (quintile 5) in uPDI had a 13% higher risk of death (95% CI, 1%-21%), while no significant associations of the increased PDI and hPDI with all-cause mortality were observed. CONCLUSION: Maintaining the consumption of overall and healthful plant-based diets, and decreasing the consumption of an unhealthful plant-based diet can be beneficial in preventing or delaying premature death among Chinese older adults.

Association of social isolation and loneliness with the risk of hypertension in middle aged and older adults: Findings from a national representative longitudinal survey.

BACKGROUND: Social isolation and loneliness have been proved to be associated with many adverse health outcomes, but their influence on hypertension remains unclear. This study aimed to assess the relationship of social isolation and loneliness with hypertension risk among middle-aged and older adults in China. METHODS: We used data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were assessed for social isolation and loneliness at baseline, and hypertension was identified by self-report and blood pressure measurement at follow-up in 2015. Binary logistic regression analyses were conducted to assess the association of social isolation and loneliness with the risk of hypertension. RESULTS: A total of 3711 residents were included. 13.7 % of the participants had high level of social isolation and 18.1 % felt lonely. During the four-year follow up period, 651 participants developed hypertension. People with high level of social isolation had an increased risk of hypertension (odds ratio [OR]: 1.40, 95 % confidence interval [CI]: 1.09-1.79). Similar results were found between social isolation score and hypertension risk (OR: 1.14, 95 % CI: 1.04-1.26). No significant association between loneliness and hypertension or any interaction effect of social isolation and loneliness on hypertension were observed. LIMITATIONS: Limited by the structure of questionnaire, some of the information was derived by self-report, which may lead to recalling bias. CONCLUSION: Social isolation, rather than loneliness was associated with hypertension for middle aged and older adults. Social support needs to be strengthened for hypertension prevention in community.

The Association Between Solid Fuel Use and Visual Impairment Among Middle-Aged and Older Chinese Adults: Nationwide Population-Based Cohort Study.

BACKGROUND: Indoor air pollution has been reported to have adverse effects on the eye; however, the health effects of exposure to cooking with solid fuels on visual impairment remain unclear in China. OBJECTIVE: We aimed to examine the association between cooking with solid fuels and visual impairment, including distance visual impairment (DVI) and near visual impairment (NVI). METHODS: Data were obtained from the China Health and Retirement Longitudinal Study, a nationwide survey of adults aged over 45 years who were enrolled in 2011 (Wave 1) and followed up in Wave 2 (2013), Wave 3 (2015), and Wave 4 (2018). We used Cox proportional hazards models to determine the association between solid fuels use and visual impairment. Additionally, the impact of switching cooking fuel types on vision function were examined through wave-specific data analysis (Wave 1 and Wave 4). Interaction and subgroup analyses were performed to explore the potential effect modifiers. Data were collected using the stratified multistage random sampling method and further analyzed using SPSS 27.0 and R 4.2.1 statistical software packages. RESULTS: A total of 9559 middle-aged and older Chinese adults without visual impairment at baseline were included in the study, with 51.2% (n=4914) of the participants reporting that they cooked with solid fuels. During the follow-up period, 2644 (27.5%) and 3130 (32.6%) participants developed DVI and NVI, respectively. Compared with the clean fuel users, participants who cooked with solid fuels had a higher risk of DVI (hazards ratio [HR] 1.38, 95% CI 1.28-1.50) and NVI (HR 1.18, 95% CI 1.10-1.27). In addition, switching the cooking fuel type from clean to solid fuels was associated with an elevated risk of DVI (HR 1.51, 95% CI 1.15-1.98) and NVI (HR 1.39, 95% CI 1.06-1.82) compared to persistently using clean fuels during the follow-up period, although no protective effect of switching from solid to clean fuels on NVI was found (P=.52). In subgroup analysis, we found that cooking with solid fuels increased the risk of DVI in participants younger than 65 years (HR 1.41, 95% CI 1.28-1.55), men (HR 1.45, 95% CI 1.28-1.65), urban residents (HR 1.41, 95% CI 1.08-1.75), and smokers (HR 1.43, 95% CI 1.25-1.64). By contrast, negative effects of cooking with solid fuels on NVI were found in nonsmokers (HR 1.21, 95% CI 1.11-1.33) and urban residents (HR 1.20, 95% CI 1.10-1.37). CONCLUSIONS: Cooking with solid fuels was associated with an increased risk of visual impairment among middle-aged and older Chinese adults. These findings indicate that promoting the utilization of clean fuels is conducive to reducing the burden of visual impairment for the public.

Association of social participation and psychological resilience with adverse cognitive outcomes among older Chinese adults: A national longitudinal study.

BACKGROUND: Limited epidemiological evidence exists regarding the association of social participation and psychological resilience with cognitive health. This study aimed to comprehensively investigate the effects of social participation and psychological resilience on adverse cognitive outcomes among older adults in China. METHODS: We used two waves (2011 and 2014) of data from the Chinese Longitudinal Survey of Health and Longevity (CLHLS), and 9765 respondents were eligible for the subsequent screening for the present prospective analysis. The Cox proportional hazards model was utilized to examine the association of social participation and psychological resilience with cognitive impairment, cognitive decline and greater cognitive decline. The restricted cubic spline plots were applied to clarify the dose-response relationships between them. RESULTS: Compared to those with low social participation, participants with high social participation had a lower hazard ratio (HR) of 0.72 (95 % confidence interval [CI]: 0.59-0.89) for cognitive impairment, 0.85 (95 % CI: 0.76-0.94) for cognitive decline and 0.78 (95 % CI: 0.67-0.90) for greater cognitive decline. Participants with high psychological resilience had an HR of 0.77 (95 % CI: 0.63-0.95) for cognitive impairment 0.85 (95 % CI: 0.76-0.94) for cognitive decline and 0.85 (95 % CI: 0.73-0.98) for greater cognitive decline compared with those with low psychological resilience. Similar effects were observed for social participation score and psychological resilience score. The dose-response analysis also showed that the risk of adverse cognitive outcomes decreased gradually with increasing social participation scores and psychological resilience scores. Additionally, the multiplicative interaction between social participation and psychological resilience was not significant. LIMITATION: All information was collected by self-report, which may lead to biases in the process of information collection. CONCLUSION: In this study, social participation and psychological resilience were independently associated with a lower risk of adverse cognitive outcomes, and therefore both need to be considered as broader measures to preserve cognitive health among older Chinese adults.

Miscarriage, stillbirth and the risk of diabetes in women: A systematic review and meta-analysis.

AIMS: Whether women with a history of miscarriage or stillbirth have an increased risk of diabetes is inconclusive. We aimed to systematically assess the association between them. METHODS: We searched PubMed, Web of Science and Scopus through November 2022. Random-effect model for meta-analysis was applied to calculate pooled odds ratios and corresponding 95 % confidence intervals (CIs) when heterogeneity was > 40 %. RESULTS: Thirteen cohort studies and eight case-control studies with a total of 529,990 participants were included. Women ever experiencing a miscarriage had a 1.15-fold risk of non-gestational diabetes (95% CI: 1.02-1.28) and a 1.62-fold risk of gestational diabetes (95% CI: 1.32-1.98) compared to those never experiencing a miscarriage. Of them, women with three or more miscarriages had a 1.99-fold risk of non-gestational diabetes (95% CI: 1.36-2.91). The risk of non-gestational diabetes among women ever experiencing a stillbirth was 1.21 times compared with those never experiencing a stillbirth (95% CI: 1.03-1.41). Pooled results did not support a stable association between stillbirth and gestational diabetes risk (odds ratio:1.91, 95% CI: 1.00-3.64). CONCLUSIONS: A history of miscarriage or stillbirth was associated with an increased risk of diabetes in women. Future studies are needed to explore whether prediabetic metabolic conditions contribute to this association.

Consideration of future consequences and self-control mediate the impact of time perspectives on self-rated health and engagement in healthy lifestyles among young adults.

The study investigated how different time perspectives predict people's self-rated health and engagement in healthy lifestyles, and explored the mediating effects of consideration of future consequences (CFC) and self-control as the underlying mechanisms. Young adults (n = 299, M age = 23.65, ranges from 18 to 30 years old) completed measures of time perspectives, CFC, self-control and engagement in daily health behaviors. Generalized linear regression models showed that Past-Negative time perspective negatively predicted sleep quality; Future time perspective negatively predicted unhealthy eating patterns; Future time perspective was the only protective factor of risky drinking, while both Past-Positive and Future time perspective were protective factors of smoking. Mediation analyses showed that CFC-Immediate and self-control mediated the relationship between Future time perspective and eating patterns. Results suggested that consideration of future consequences and self-control partially explained how time perspectives affect engagement in healthy lifestyles among young Chinese adults. Implications of the current research for promoting healthy living and directions for future research are discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-022-03135-6.

Adherence to the Chinese Food Pagoda in the High-Risk Population of Non-communicable Diseases Aged 35-59 in Central China.

Objectives: A healthy dietary habit is essential for preventing non-communicable diseases (NCDs). We aimed to assess the adherence to the Chinese Food Pagoda (CFP) proposed in the Chinese Dietary Guidelines 2016 in the high-risk population of NCDs in central China. Methods: A cross-sectional study was conducted in two large enterprises (totally 3,016 employees) from October to December 2019 in Hubei Province (central China). The high-risk population of NCDs was identified by physical examination, laboratory test and face-to-face questionnaire survey according to the National Norms for Prevention and Control of Non-communicable Diseases issued by the Chinese government. We assessed the deviation of real diet from the CFP recommended diet in the high-risk population of NCDs. Results: A total of 821 participants aged 35-59 years old with at least one high-risk factor of NCDs were enrolled in our study. Of them, 53.8% were daily smokers, 49.6% had elevated blood cholesterol, 31.4% were centrally obese, 23.3% had high normal blood pressure, and 3.5% had impaired fasting glucose. Significant disparity was detected in the high-risk population of NCDs between real food consumption and the CFP's recommendation (P < 0.05), such as the deficient intake of nuts and milk and dairy products, and the over-consumption of cereals, meat and poultry, oil, and salt. Participants with impaired fasting glucose had the highest intake of cereals and vegetables on average. Participants with central obesity were more likely to consume meat and poultry (P < 0.05). The lowest average intake of eggs and the highest average intake of milk and dairy products were found in participants with high blood cholesterol (P < 0.05). The daily smokers were more likely to consume beans and nuts (P < 0.05). The lowest average intake of fruits and the highest average intake of tubers were found in participants with high normal blood pressure (P < 0.05). Conclusion: Adherence to CFP in the high-risk population of NCDs appeared to be challenging. It is necessary to adopt dietary education campaign focusing on the high-risk population of NCDs to prevent or delay the occurrence of NCDs.

Maternal long working hours and offspring's weight-related outcomes: A systematic review and meta-analysis.

It is unclear whether maternal working time has an impact on offspring's weight-related outcomes especially obesity; the objective of this study is to conduct the first meta-analysis to focus on this topic. We searched PubMed, Ovid, and Web of Science databases through August 2021. A random-effect model was used to assess the pooled odds ratios (ORs) and regression coefficients (ß) with their corresponding 95% confidence intervals (95% CIs). Subgroup analyses were conducted to explore sources of heterogeneity. Publication bias was evaluated by the Egger's tests. Twenty-two observational studies were included with a total of 191,420 participants. Compared with children whose mothers worked less than 35 h/week, we found that children whose mothers worked more than 35 to 40 h/week had a 2.24-fold increased risk of childhood overweight/obesity (OR = 2.24, 95% CI: 1.61-3.11). An increment of 10 h/week in maternal working was associated with an approximately 1.0 percentage points in the probability of childhood overweight/obesity (ß = 0.008, 95% CI: 0.004-0.012). The pooled OR also indicated a similar result (OR = 1.09, 95% CI: 1.04-1.15). In addition, an increment of 10 h/week in maternal working was associated with 0.029 units increase in offspring's BMI z score (ß = 0.029, 95% CI: 0.016-0.042). Maternal long working hours is a potential risk factor for offspring's weight-related outcomes. Measures should be taken to protect the work welfare of females, thus facilitating the positive interaction of individual-family-society.

Association of the Time to First Cigarette and the Prevalence of Chronic Respiratory Diseases in Chinese Elderly Population.

BACKGROUND: Increasing number of studies have suggested the time to first cigarette after waking (TTFC) have significant positive effect on respiratory diseases. However, few of them focused on the Chinese population. This study aims to estimate the impact of TTFC on the prevalence of chronic respiratory diseases (CRD) in Chinese elderly and explore the association in different sub-populations. METHODS: Cross-sectional data of demographic characteristics, living environment, smoking-related variables, and CRD were drawn from the Chinese Longitudinal Healthy Longevity Survey in 2018. Multivariate stepwise logistic regression analyses were conducted to examine the association of the TTFC with the prevalence of CRD. RESULTS: This study includes 13,208 subjects aged 52 years and older, with a mean age of 85.3 years. Of them, 3,779 participants were ex- or current smokers (44.9% had the TTFC ≤30 minutes, 55.1% >30 minutes) and 1,492 had suffered from CRD. Compared with non-smokers, participants with TTFC ≤30 minutes seemed to have higher prevalence of CRD (OR 1.97; 95% CI, 1.65-2.35) than those with TTFC >30 minutes (OR 1.70; 95% CI, 1.44-2.00), although the difference was statistically insignificant (Pinteraction = 0.12). Compared with TTFC >30 minutes, TTFC ≤30 minutes could drive a higher prevalence of CRD among female participants, those aged 90 years and older, urban residents, and ex-smokers (Pinteraction < 0.05). CONCLUSION: Shorter TTFC relates to higher prevalences of CRD in Chinese older females, those aged 90 years and older, urban residents, and ex-smokers. Delaying TTFC might partially reduce its detrimental impact on respiratory disease in these specific subpopulations.

Association between alcohol consumption and the risk of stroke in middle-aged and older adults in China.

OBJECTIVE: This study aimed to investigate the association between alcohol consumption and the prevalence of stroke in Chinese adults aged 40 years and over. METHOD: We conducted a cross-sectional analysis among 113,573 Chinese adults aged ≥ 40 years in the China National Stroke Prevention Project (2014-2015) to examine correlations of alcohol consumption with the prevalence of stroke. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), controlling for various confounders, e.g., gender, age, smoking, physical activity and other health conditions. RESULTS: Within the study population, a total of 12,753 stroke survivors were identified. The prevalence of light to moderate and of heavy alcohol consumption was 10.1% and 5.7% respectively. The multivariate logistic regression results show that light to moderate alcohol consumption was associated with reduced risk of stroke of all types [0.91 (95%CI: 0.85-0.97)] and of ischemic stroke [0.90 (0.84-0.97)]. No association was found between alcohol consumption and hemorrhagic stroke. Compared with abstainers, the adjusted ORs of all stroke were 0.83 (0.75-0.92) for those who drank 11-20 years, and no association was found between 1 and 10 years or over 20 years of drinking and risk of stroke. CONCLUSIONS: These results indicate that light to moderate alcohol consumption may be protective against all and ischemic stroke, and heavy drinking was not significantly associated with risk of all stroke in China. No association between alcohol consumption and hemorrhagic stroke was found.

Effects of environmental factors on the removal of heavy metals by sulfide-modified nanoscale zerovalent iron.

Sulfide-modified nanoscale zerovalent iron (S-nZVI) has excellent reducing performance for heavy metals in water. The influence of environmental factors on the reactivity can be used to explore the practical feasibility of S-nZVI and analyze the reaction mechanism in depth. This study compared the removal effect and mechanism of Cu2+ and Ni2+ by nanoscale zerovalent iron (nZVI), S-nZVI, and carboxymethyl cellulose-modified nanoscale zerovalent iron (CMC-nZVI). The results show that the pseudo-first-order kinetic constant of Cu2+ removal by nZVI, S-nZVI, and CMC-nZVI was 1.384, 1.919, and 2.890 min-1, respectively, and the rate of Ni2+ removal was 0.304, 0.931, and 0.360 min-1, respectively. The removal mechanism of S-nZVI was similar to that of nZVI and CMC-nZVI. Specifically, Cu2+ was predominantly removed by reduction, while Ni2+ removal included adsorption and reduction. Environmental factors had a specific inhibitory effect on the removal of Cu2+ but had a negligible impact on Ni2+. The condition of low pH, the presence of Cl- and humic acid (HA) promoted the corrosion consumption of Fe0, in which H+ directly corroded Fe0 at low pH. At the same time, Cl- and HA inhibited the adsorption or binding of heavy metal ions on the particle surface, thereby reducing the electron transfer and utilization efficiency. The passivation of NO3- reduced the anaerobic corrosion of the material in water but suppressed the release of electrons, thereby reducing the reduction efficiency of the three types of materials. The anaerobic corrosion of S-nZVI was less affected by environmental factors, and it can still maintain more than 80% of the electronic utilization efficiency under different environmental factors, which illustrates that S-nZVI has broad prospects for practical applications in heavy metal polluted water.

Adsorption and degradation in the removal of nonylphenol from water by cells immobilized on biochar.

To investigate the role of adsorption by biochar and biodegradation by bacteria in the wastewater treatment system of microorganisms immobilized on biochar, Nonylphenol (NP) removal (adsorption + degradation) rates and degradation rates from water by NP degrading bacteria immobilized on bamboo charcoal (BC) and wood charcoal (WC) were examined in a short-term and long-term. Results showed that cells immobilized on different biochar had different NP removal effects, and cells immobilized on bamboo charcoal (I-BC) was better. After eight rounds of long-term reuse, the cumulative removal rate and the degradation rate of NP in water by I-BC were 93.95% and 41.86%, respectively, significantly higher than those of cells immobilized on wood charcoal (69.60%, 22.78%) and free cells (64.79%, 19.49%) (P < 0.01). The rise in the ratio of the degradation rate to the removal rate indicated that the long-term NP removal effect is more dependent on biodegradation. The amount of residual NP in I-BC still accounted for about 50%, indicating that the secondary pollution in the disposal of carrier could not be ignored. In addition, promotion effect of biochar on microorganisms were observed by SEM, quantitative PCR and 16S rRNA. Pseudomonas, Achromobacter, Ochrobactrum and Stenotrophomonas were predominant bacteria for NP degradation. The addition of biochar (especially bamboo charcoal) also effectively delayed the transformation of their community structure.

Interaction between pollutants during the removal of polychlorinated biphenyl-heavy metal combined pollution by modified nanoscale zero-valent iron.

Modified nanoscale zero-valent iron (nZVI) is a promising functional material for the remediation of combined pollutants involving polychlorinated biphenyls (PCBs) and heavy metals. However, the interaction between the two types of pollutants has not been systematically studied for this method of treatment. In this study, 2,2',4,4',5,5'-hexachlorobiphenyl (PCB153), Cu2+, and Ni2+ were selected as the target pollutants. To understand the interaction between pollutants, the efficiencies of nZVI, sulfidated nZVI (S-nZVI), and carboxymethylcellulose stabilized nZVI (CMC-nZVI) were investigated for removal of PCB153, Cu2+/Ni2+, and combined pollution system (PCBs-Cu2+/Ni2+). Results showed that the removal kinetics of the two types of pollutants by the three materials fitted a pseudo-first-order model well and that the reaction mechanisms were similar. Among the three materials, CMC-nZVI showed the highest reactivity to degrade PCB153 (pseudo-first-order kinetic constants (kobs) = 2.7 × 10-4 min-1) and remove Cu2+ (kobs = 2.890 min-1), while S-nZVI showed higher affinity for the removal of Ni2+ (kobs = 0.931 min-1). For the combined pollution system, PCB153 had little effect on the removal of heavy metals by the three materials, while the effect of heavy metals on PCB153 degradation was related to the types of heavy metals and the materials. Cu2+ had no significant effect on PCB153 degradation by the three materials, while the coexistence of Ni2+ promoted PCB153 degradation by nZVI and CMC-nZVI. XPS and electrochemical analysis showed that Cu0 and Ni0 were produced on the surface of the three materials. Ni is a more effective catalyst and promoted the electron transfer efficiency of the materials and had a positive impact on the dechlorination reaction.

Comparison of carbonized materials from wastes of different origin for nonylphenol removal by adsorption.

The application of carbonized materials (CMs) from solid wastes for the control of hydrophobic organic contaminants is a promising way to treat wastes. In this paper, the physicochemical properties of CMs prepared from industry (fly ash and sewage sludge), plant (rice straw and bamboo fragments), and livestock (chicken manure) were analyzed, their adsorption capacities for nonylphenol were studied, and the relationship between the adsorption capacity and the physicochemical properties of different types of CMs was investigated. The results showed that the adsorption capacities of CMs prepared from plant solid wastes (rice straw and bamboo fragments) far exceeded those of the industrial and livestock solid wastes. The parameter Kf obtained by the Freundlich model showed a significant and positive correlation with carbon content (C%), carboxyl content, specific surface area (SSA), and pore volume, and a negative correlation with ash content (ash%). Compared with CMs produced by the other two types of solid wastes, CMs from the plant solid wastes had the characteristics of a large SSA, rich pore structure (especially mesoporous) and high aromaticity (high C%), which were the main reasons for their superior adsorption capacity. The results could provide a scientific basis for the utilization of solid wastes.