Predictive Equation for Basal Metabolic Rate in Normal-Weight Chinese Adults.

This study aimed to develop a predictive equation for basal metabolic rate (BMR) in normal-weight Chinese adults and provide a reference for establishing the national recommended dietary energy intake. A new equation for BMR was derived from a sample of 516 normal-weight Chinese adults (men = 253, women = 263), and this sample was collected from two previous studies. Furthermore, the accuracy of this new equation and eight other previous predictive equations was reviewed. The agreement and reliability were compared in terms of bias, accuracy, the intraclass correlation coefficient, and Bland-Altman plots between predictive equations. In addition, the newly developed equation was further verified using a small independent sample, which contained 41 healthy Chinese adults (men = 21, women = 20). The measured BMR (mBMR) of all participants, measured using indirect calorimetry, was 1346.2 ± 358.0 kcal/d. Thirty participants were excluded based on Cook's distance criteria (Cook's distance of ≥0.008). Previous equations developed by Henry, Schofield, Harris-Benedict (H-B), Yang, and Hong overestimated the BMR of healthy Chinese adults. The present equation displayed the smallest average bias (0.2 kcal/d) between the mBMR and predicted basal metabolic rate (pBMR). The limits of agreement of the present equation from Bland-Altman plots were -514.3 kcal/d and 513.9 kcal/d, which is the most narrow and balanced limit of agreement. Moreover, in the verification of the testing database, the pBMR of the new equation was not significantly different from the mBMR, and the accuracy was 75.6%. Compared with pre-existing equations, the present equation is more applicable to the prediction of BMR in healthy Chinese adults. However, further studies are required to verify the accuracy of this new equation.

Vitamin D Status and Associated Factors of Older Adults in the Cross-Sectional 2015-2017 Survey.

Vitamin D is beneficial for maintaining good health; however, there is a lack of nationally representative data reported, particularly in older adults. To better understand the nutritional status of vitamin D and its influencing factors on Chinese older adults, we adopted stratified random sampling to select serum samples originating from the Chronic Disease and Nutritional Survey Biobank of Chinese Residents in 2015-2017. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were determined by enzyme-linked immunoassay. The OR and PR of associated factors for vitamin D deficiency and insufficiency were calculated. In the study, a total of 6273 participants were included. Median serum 25(OH)D concentration was 18.48 (13.27-24.71) ng/mL. The overall rate of vitamin D deficiency and insufficiency was 58.27% (<20 ng/mL), and the VDD rate was 22.17%, which is worse than 5 years ago by nearly 20%. The likelihood of vitamin D deficiency and insufficiency is increased in women, people aged and above 70 years, ethnic minorities, people living in urban areas, midlands, or western areas, warm or medium temperate zones, with middle school and above education level, and people with abdominal obesity and anemia would increase the possibility of vitamin D deficiency and insufficiency with latitude having the greatest impact on vitamin D deficiency and insufficiency. Overall, vitamin D deficiency and insufficiency are very common in Chinese older adults. They should be encouraged to improve their vitamin D nutritional status through enough sunshine exposure and increasing vitamin D intake through diet or supplements.

[Protein efficiency ratio of genetically modified pork powder with fat-1 gene].

OBJECTIVE: To evaluate the protein efficiency ratio(PER) of genetically modified pork powder with fat-1 gene(GM group), and thus evaluate whether the nutritional evaluation value of fat-1 gene pork powder has changed. METHODS: Sixty weaned SD rats(60-80 g) were randomly divided into casein group, parental control group and GM group according to sex and weight, 20 rats in each group, half of each sex. The rats in the three groups were fed with corresponding formulated feed containing 10% protein for 28 days. The body weight and food intake of each group were recorded weekly. Blood was collected at the end of the experiment to determine hematology and blood biochemical indexes. The food utilization rate, organ/body weigh indexes, PER and corrected PER were calculated. RESULTS: The weight of rats in all groups increased steadily during the experimental period. Statistically significant differences were found in some hematology and blood biochemical indexes and organ/body weigh indexes. No biologically significant changes were found. The food utilization rate of GM group was higher than that of casein group(P<0.05), which was equivalent to that in the parental control group. The PER of both genetically modified pork powder with fat-1 gene and parental white pork powder were higher than that of casein(P<0.05). CONCLUSION: The PER of genetically modified pork powder with fat-1 gene was equal to that of its parental white pork powder.

[Plasma selenium level and its influencing factors in Chinese child-bearing-aged women in 2015].

OBJECTIVE: To assess the plasma selenium(Se) level of child-bearing-aged women and discuss the influence factor for low-Se level. METHODS: Using the muti-stage stratified and population proportional cluster random sampling method, 1881 child-bearing-aged women aged 18 to 44 years were selected from China Adult Chronic Disease and Nutrition Surveillance(2015) Data. The basic information of the subjects was collected by unified electronic questionnaires and equipments were used for field survey, measurement and record. Plasma Se concentration was detected by inductively coupled plasma mass spectrometry. Plasma low-Se level were assessed using lower limit of plasma/serum Se established by the Mayo Clinic Laboratory and our laboratory, respectively. Influence factors of low-Se level were analyzed by the multivariate logistic regression model. RESULTS: The M(P25, P75) plasma Se concentration for Chinese child-bearing-aged women was 89.52(74.21, 105.03)µg/L. Nationality, location, urban-rural type and education level difference had influence on plasma Se level in this population(P<0.05). According to the lower limit of plasma/serum Se concentration established by the Mayo clinical laboratories(<70 µg/L) and our laboratories(<73.81 µg/L), the low-Se rate were 20.47% and 24.51%, respectively. There were significantly differences in low-Se rate among nationality, location, urban-rural type, education level and marital status(P<0.05). The multivariate logistic regression model showed that location and urban-rural type had significant effects on low-Se rate of child-bearing-aged women(P<0.05). CONCLUSION: The plasma low-Se rate of Chinese women of childbearing age is relatively high and higher prevalence low-Se was found in western and central regions and rural areas in China.

Re-exploration of dietary iodine intake in Chinese adult males using a modified iodine balance study.

There is still controversy about optimal dietary iodine intake as the Universal Salt Iodization policy enforcement in China. A modified iodine balance study was thus conducted to explore the suitable iodine intake in Chinese adult males using the iodine overflow hypothesis. In this study, thirty-eight apparently healthy males (19·1 (sd 0·6) years) were recruited and provided with designed diets. After the 14-d iodine depletion, daily iodine intake gradually increased in the 30-d iodine supplementation, consisting of six stages and each of 5 d. All foods and excreta (urine, faeces) were collected to examine daily iodine intake, iodine excretion and the changes of iodine increment in relation to those values at stage 1. The dose-response associations of iodine intake increment with excretion increment were fitted by the mixed effects models, as well as with retention increment. Daily iodine intake and excretion were 16·3 and 54·3 µg/d at stage 1, and iodine intake increment increased from 11·2 µg/d at stage 2 to 118·0 µg/d at stage 6, while excretion increment elevated from 21·5 to 95·0 µg/d. A zero iodine balance was dynamically achieved as 48·0 µg/d of iodine intake. The estimated average requirement and recommended nutrient intake were severally 48·0 and 67·2 µg/d, which could be corresponded to a daily iodine intake of 0·74 and 1·04 µg/kg per d. The results of our study indicate that roughly half of current iodine intakes recommendation could be enough in Chinese adult males, which would be beneficial for the revision of dietary reference intakes.

Chronic Toxicity of Genetically Modified Maize with Cry1Ab-ma Gene and Its Effect on Serum Metabolites in Rats.

Genetic engineering has inserted the crystallin (Cry) gene of Bacillus thuringiensis into the genes of maize to cultivate a variety of transgenic insect-resistant maizes. At present, genetically modified maize with Cry1Ab-ma gene (maize CM8101) was in the stage of safety verification. In this study, a 1-year chronic toxicity test was carried out to evaluate the safety of maize CM8101. Wistar rats were selected for the experiment. Rats were randomly divided into three groups and fed the corresponding diets: genetically modified maize group (CM8101 group), parental maize group (Zheng58 group), and AIN group. Rat serum and urine were collected at the third, sixth, and twelfth months of the experiment, and viscera were collected at the end of the experiment for detection. Metabolomics was used to analyze the metabolites in the serum of rats at the 12th month. While the CM8101 group rats' diets were supplemented with 60% maize CM8101, no obvious poisoning symptoms were found in rats, and no poisoning death occurred. There were no negative effects on body weight, food intake, blood and urine indices, or organ histopathological examination results. Furthermore, metabolomics results revealed that, when compared to group differences, the gender of rats had a more obvious effect on metabolites. The CM8101 group primarily changed linoleic acid metabolism in female rats, while glyceropholipid metabolism was altered in male rats. In rats, consumption of maize CM8101 did not result in significant metabolic dysfunction.

Re-exploring the requirement of dietary iodine intake in Chinese female adults based on 'iodine overflow theory'.

PURPOSE: We re-explored the basal iodine requirement based on healthy Chinese female and a new iodine overflow theory was proposed for iodine balance study. METHODS: Thirty-six Chinese healthy female adults (age 20.7 ± 1.1) were recruited for this study, which included 40 days low iodine depletion period and six stages of 30 days supplementation period. Uniform diets with low iodine were provided and the content of iodine in the diet was regulated by dairy products. The total iodine intake from food and the total iodine excretion through 24-h urine and staged feces were completely gathered and monitored. The incremental (Δ) intake and excretion over the range were calculated. RESULTS: The iodine intake and excretion were 13.6 µg/day and 48.6 µg/day at the first stage, respectively. The incremental iodine intakes and excretions were 21.1 µg/day to 120.3 µg/day and 25.8 µg/day to 105.4 µg/day for the supplementation stages, respectively. According to the 'iodine overflow theory', the zero iodine balance (Δ iodine intake = Δ iodine excretion) derived from a mixed effect model indicated a mean iodine intake of 52.2 µg/d (1.0 µg/d kg). The RNI for iodine to healthy Chinese female adult was 73.1 µg/d (1.4 µg/d kg). CONCLUSION: A daily iodine intake of 52.2 µg/d may meet the basal iodine requirement for healthy Chinese female adults, and Chinese female may need more than 20% iodine intake than male based on the 'iodine overflow theory'. The trial was registered at the Chinese Clinical Trial Registry in May 2018 (No: ChiCTR1800016184).

Exploration of the lower threshold of iodine intake in Southern Chinese young adults based on 'overflow theory' in an iodine balance study.

BACKGROUND: Appropriate iodine intake for adults is essential to reduce the prevalence of thyroid diseases, but there is little research data on iodine requirement of Chinese population. This study aimed to explore the iodine requirement of young adults to maintain a healthy status based on 'overflow theory'. METHODS: Iodine-balance experiment has been performed in this project. We conducted an 18-day study consisted of a 6-day acclimation period and 3 consecutive experimental stages in 37 Chinese healthy young adults (23 female and 14 male). Each stage was consumed for 4 days. Strictly-controlled low-iodine intake diets were provided for adults in the first period, an egg or 125mL milk was added in the second and third period, respectively. The dietary samples, 24-h urine specimens and faeces of volunteers were collected daily for assessment of iodine intake and excretion in volunteers. RESULTS: Mean values of iodine intake (22.7±3.6, 35.1±3.7, and 52.2±3.8µg/d), excretion (64.7±13.9, 62.3±12.6, and 94.3±14.5µg/d) and iodine balance (-35.2±19.5, -21.0±19.8, and -33.5±26.9µg/d) were significantly different among three periods for male (P<0.001 for all); mean values of iodine intake (16.6±3.1, 29.7±2.7, and 48.0±2.7µg/d), and excretion (47.0±9.9, 55.5±8.1, and 75.7±12.4µg/d) were significantly different among three periods for female (P < 0.001 for all). No significant difference was observed among the 3 periods for female in the iodine balance (-30.5±9.3, -25.9±7.3, and -27.6±12.1µg/d). The linear regression equation of iodine excretion on iodine intake was Y=0.979X+37.04 (male) and Y=0.895X+31.48 (female). Compared with stage 2, iodine excretion increments in stage 3 had exceeded the iodine intake increment for men. The ratio of increment was 1.675 for male when the average iodine intake was 52.2µg/d in stage 3. When the iodine excretion increment equaled to the iodine intake increment, the daily iodine intake of men was 47.0µg. CONCLUSION: We have evaluated the iodine requirement of young adults in southern China based on overflow theory. Our results indicate the lower limit of iodine requirement for Chinese young men is 47.0µg/d. The trial was registered at www.chictr.org.cn as ChiCTR1800014877.

Higher selenium was associated with higher risk of diabetes: Consistent evidence from longitudinal and cross-sectional studies based on nail and serum selenium measures.

Although the association between selenium (Se) and diabetes has been well-discussed in recent years, few studies have focused on the effects of long-term natural Se exposure and rarely concerned the effects of different Se biomarkers. To address this question, we carried out a 7-year longitudinal study on older adults aged over 65 and another cross-sectional study on middle-aged and older adults aged 40 and above from Chinese soil Se-deplete and Se-optimum areas. Cox proportional hazard models were used to evaluate the associations between nail Se levels and incidence risk of diabetes. Unconditional logistic regression models and analysis of variance models were used to examine the associations between serum Se levels and the prevalence risk of diabetes. The nail and serum Se levels were 0.47 ± 0.20 µg/g and 111.09 ± 55.01 µg/L for the two study populations, respectively. For both of the independent studies, higher Se levels were observed to be associated with a higher risk of diabetes and prediabetes. Compared with the Second nail Se quartile (Q2), the adjusted hazard ratios (HRs) and 95 % confidence intervals (95 % CIs) of diabetes for Q1, Q3 and Q4 were 1.24(0.70, 2.21), 1.53(0.98, 2.39) and 1.31(0.76, 2.26), respectively, and the adjusted HRs (95 % CIs) of prediabetes were 1.47(0.77, 2.81), 1.38(0.83, 2.30), and 1.97(1.13, 3.44), respectively. Compared with the first serum Se quintile (Q1), the adjusted odds ratios (ORs) and 95 % CIs of diabetes for higher quintiles were 1.12(0.75, 1.66), 1.05(0.71, 1.57), 1.09(0.73, 1.62) and 1.51(1.02, 2.19), and the adjusted ORs (95 % CIs) of prediabetes were 1.27(0.77, 2.09), 1.70(1.05, 2.74), 1.94(1.21, 3.11) and 1.67(1.03, 2.71). Our findings consistently suggest that higher Se status is associated with a higher risk of diabetes in adults.

[Vitamin A nutrition status of Chinese urban adults aged 18 to 60 years old in 2015].

OBJECTIVE: To investigate the vitamin A nutritional status and its related influencing factors of Chinese 18-60 urban adults by analyzing serum retinol level in 2015. METHODS: Serum samples of 42 people, half male and half female, were randomly selected in each point, from the 302 monitoring sites of Chinese adult chronic diseases and nutrition surveillance in 2015. The serum retinol levels were determined by high pressure liquid chromatography(HPLC). RESULTS: A total of 2571 serum samples were detected. The serum retinol level of Chinese urban adults of 18-60 years old was 1.98(1.56-2.53)µmol/L, the deficiency rate was 0.25%, and the marginal deficiency rate was 4.45%. The serum retinol level of male was 2.19(1.75-2.78)µmol/L, the deficiency rate was 0.05%, and the marginal deficiency rate was 2.48%; The serum retinol level of female was 1.80(1.42-2.25)µmol/L, the deficiency rate was 0.46%, and the marginal deficiency rate was 6.51%. The significant differences in serum retinol was observed deficiency rate and marginal deficiency rate between males and females(P<0.01), the nutritional status of males was better than the females. The deficiency rate and marginal deficiency rate of 18-29 years old were the highest, which were 0.34% and 5.81% respectively. The deficiency rate and marginal deficiency rate of over 50 years old were the lowest, which were 0.15% and 2.60% respectively. The vitamin A deficiency rate and marginal deficiency rate of people with body mass index(BMI)<18.5 were 0.95% and 7.24%, 0.33% and 5.85% for BMI=18.5-23.9, 0.13% and 3.27% for BMI=24.0-27.9, respectively. The differences of vitamin A deficiency rate and marginal deficiency rate among different BMI were significant. CONCLUSION: The vitamin A nutritional status of urban adults in China is good, the vitamin A deficiency rate is very low, and the incidence of vitamin A deficiency is also low. It is basically not a public health problem according the WHO standard.

Reference Ranges of Selenium in Plasma and Whole Blood for Child-Bearing-Aged Women in China.

Selenium (Se) is a "dual-surface" element. Both Se-deficiency and Se-overload have bad effects on humans. The amount of Se in the blood is a good indicator of Se intake, and there are considerable differences in the reference ranges among different regions and populations. The purpose of this study was to establish the age-specific reference interval of blood Se in healthy child-bearing-aged women in China. A total of 187 healthy women aged 18-45 years old were enrolled with strict inclusion criteria from the China Adult Chronic Disease and Nutrition Surveillance (2015 CACDNS) database to establish the reference interval of Se. Plasma and whole-blood Se were detected by inductively coupled plasma mass spectrometry (ICP-MS). The reference range (RR) estimated as P2.5-P97.5 percentiles (geometric mean) was 73.81-140.75 (100.94) µg/L and P2.5-P97.5 percentiles (median) 81.06-164.75 (121.05) µg/L for plasma and whole-blood Se, respectively. The proposed RR of plasma Se in this study was used to evaluate the Se nutritional status of a representative sample of 1950 women of child-bearing age who were randomly selected from 2015 CACDNS. The proportion of Se level lower than P2.5 cut-off value was 24.05%, and there were 5.08% child-bearing-aged women with plasma Se higher than the upper limit of RR. Women in the western and rural areas tend to have lower Se levels.

[Protein efficiency ratio of genetically modified corn with Cry1Ab-ma gene].

OBJECTIVE: To evaluate the protein efficiency ratio(PER) of genetically modified corn with Cry1Ab-Ma gene and parental corn. METHODS: Sixty SD rats(60-80 g) were randomly divided into genetically modified corn group, parental corn group and casein control group, with 20 rats in each group and half male and half female. Casein was added to 10% of the diet in casein control group. When the protein content of the diets in the genetically modified corn group and parental corn group was still less than 10% according to the principle of maximum incorporation, the defective part was supplemented with casein. Rats were free to drink and eat for 28 days. Food intake and body weight of each group were recorded every week. Blood was collected at the end of the experiment to determine hematology and blood biochemical indexes. The main organs were weighed and organ/body weigh indexes were calculated. PER and corrected PER were calculated. RESULTS: The body weight of all the animals in each group showed an increasing trend, and the weight growth was normal. Although there were statistical differences in the individual indexes of end-stage hematology and blood biochemical indexes, there was no biological significance. There were no significant change in the organ/body weigh indexes. PER of genetically modified corn, parental corn and casein were 2.01±0.22, 1.77±0.30 and 3.64±0.48, respectively. The corrected PER of genetically modified corn and parent corn were 1.38 and 1.22, respectively. CONCLUSION: The PER of this batch of genetically modified corn with Cry1Ab-ma gene was better than that of parental corn, but worse than that of casein.

Nutritional components and protein quality analysis of genetically modified phytase maize.

The nutritional components and protein quality of genetically modified maize expressing phytase gene (GM) were analyzed and evaluated in this study. The nutritional components were analyzed by Chinese national standard methods. The ileostomy Bama miniature pigs were utilized to analyze the true digestibility of protein and amino acids. The digestible indispensable amino acid score (DIAAS) was adopted to evaluate the protein quality of GM, its parental maize (PM) and commercial available maize Zhengdan 958 (ZD). Meanwhile, the widely used protein digestibility corrected amino acid score (PDCAAS) was also calculated and compared with DIAAS. The content of protein, fat, vitamins, and minerals of all the strains of maize are in the normal ranges of OECD and/or ILSI. The DIAAS of GM, PM, and ZD were 54.57, 31.75, and 33.91, respectively, and the first limiting amino acid for GM, PM, and ZD was lysine. In conclusion, the introduction of phyA2 gene in GM maize does not disturb the digestion of protein/amino acid, but has the ability to promote the digestion of amino acids.

Zinc Nutritional Status and Risk Factors of Elderly in the China Adult Chronic Disease and Nutrition Surveillance 2015.

OBJECTIVES: To analyze the serum zinc nutrition status of the Chinese elderly, and to assess the risk factor for zinc deficiency. METHODS: 3727 elderly people over 60 years old were randomly selected from 302 monitoring points in 31 provinces of China Adult Chronic Disease and Nutrition Surveillance (CACDNS) 2015. Blood samples were selected from the biological sample bank of CACDNS 2015 and the basic information were collected by questionnaires. The criteria of serum zinc deficiency recommended by the International Zinc Nutrition Consulting Group (IZiNCG) were adopted, and the related factors were also analyzed. RESULTS: The median serum zinc concentration of Chinese elderly was 99.2 (84.3~118.7) µg/dL. The overall adjusted prevalence of zinc deficiency was 8.68%, with a 95% confidence interval (CI) of 7.74% and 9.61%. Significant differences were found in different sex, age groups, Body Mass Index (BMI), residence region, race and education level in terms of serum zinc status in the elderly (p < 0.05). Participants who are males, aged above 70y, with BMIs of less than 18.5 kg/m2, living in rural areas, minority, and with the lowest income had a higher prevalence of zinc deficiency in the subgroups under different classifications. The risk of zinc deficiency in the elderly over 70y was 1.44 higher than those aged 60-69y (OR = 1.44, 95%CI 1.14-1.82), and the minority elderly has a 1.39 higher risk than Han nationality (OR = 1.39, 95%CI 1.01-1.91), while overweight/obesity and female elderly were at lower risk (OR < 1, p < 0.05). CONCLUSIONS: The overall prevalence of zinc deficiency in the elderly was highest in all adults in the CACDNS. It is recommended that the male elderly, over 70 years, and the minority elderly should pay more attention to the zinc nutrition status of their own.

Suggested Reference Ranges of Blood Mg and Ca Level in Childbearing Women of China: Analysis of China Adult Chronic Disease and Nutrition Surveillance (2015).

BACKGROUND: Magnesium and calcium play a variety of biological roles in body functions. Reference values of these elements have not yet been systematically determined in China, especially in childbearing women. We proposed to establish the reference range of Mg, Ca, and Ca/Mg ratio in plasma and whole blood for 18-44 years healthy childbearing women in China. METHOD: A total of 1921 women of childbearing age (18-44 years) were randomly selected from the 2015 China National Nutrition and Health Survey by taking into account the regional types and monitoring points. Among them, 182 healthy women were screened out with a series strict inclusion criteria to study the reference ranges of elements. Fundamental indicators (weight, height, waist, blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein, fast glucose, HbA1c, blood pressure, uric acid) and elements concentrations in plasma and whole blood were collected. The 2.5th to 97.5th was used to represent the reference range of Mg, Ca, and Ca/Mg ratio. RESULTS: The reference range of Mg, Ca, and Ca/Mg ratio in plasma were 0.75-1.13 mmol/L, 2.27-3.43 mmol/L, and 2.41-3.44, respectively. Additionally, the reference range of Mg, Ca, and Ca/Mg ratio in whole blood were 1.28-1.83 mmol/L, 1.39-2.26 mmol/L, and 0.90-1.66, respectively. According to the established reference range, the prevalence of magnesium deficiency was 4.79% in 1921 childbearing women, 21.05% in type 2 diabetes, and 5.63% in prediabetes. CONCLUSION: The reference values of Mg, Ca and Ca/Mg proportion in plasma and entire blood of healthy childbearing women can be utilized as a pointer to assess the status of component lack and over-burden. The lower limit of plasma Mg is in good agreement with the recommended criteria for the determination of hypomagnesemia.

LSM-SEC: Tongue Segmentation by the Level Set Model with Symmetry and Edge Constraints.

Accurate segmentation of the tongue body is an important prerequisite for computer-aided tongue diagnosis. In general, the size and shape of the tongue are very different, the color of the tongue is similar to the surrounding tissue, the edge of the tongue is fuzzy, and some of the tongue is interfered by pathological details. The existing segmentation methods are often not ideal for tongue image processing. To solve these problems, this paper proposes a symmetry and edge-constrained level set model combined with the geometric features of the tongue for tongue segmentation. Based on the symmetry geometry of the tongue, a novel level set initialization method is proposed to improve the accuracy of subsequent model evolution. In order to increase the evolution force of the energy function, symmetry detection constraints are added to the evolution model. Combined with the latest convolution neural network, the edge probability input of the tongue image is obtained to guide the evolution of the edge stop function, so as to achieve accurate and automatic tongue segmentation. The experimental results show that the input tongue image is not subject to the external capturing facility or environment, and it is suitable for tongue segmentation under most realistic conditions. Qualitative and quantitative comparisons show that the proposed method is superior to the other methods in terms of robustness and accuracy.

Vitamin D Nutritional Status of Chinese Pregnant Women, Comparing the Chinese National Nutrition Surveillance (CNHS) 2015-2017 with CNHS 2010-2012.

Optimal vitamin D (vitD) status is beneficial for both pregnant women and their newborns. The aim of this study was to evaluate the vitamin D status of Chinese pregnant women in the latest China Nutrition and Health Surveillance (CNHS) 2015-2017, analyze the risk factors of vitamin D deficiency (VDD), and compare them with those in CNHS 2010-2012. Serum 25 hydroxyvitamin D (25(OH)D) was measured by ELISA method. City type, district, latitude, location, age, vitamin D supplements intake, education, marital status, annual family income, etc., were recorded. The median 25(OH)D concentration was 13.02 (10.17-17.01) ng/mL in 2015-2017, and 15.48 (11.89-20.09) ng/mL in 2010-2012. The vitamin D sufficient rate was only 12.57% in 2015-2017, comparing to 25.17% in 2010-2012. The risk factors of vitamin D inadequacy (25(OH)D < 20 ng/mL) in 2015-2017 were not exactly consistent with that in 2010-2012. The risk factors included season of spring (p < 0.0001) and winter (p < 0.001), subtropical (p < 0.001), median (p < 0.0001) and warm temperate zones (p < 0.0001), the western (p = 0.027) and the central areas (p = 0.041), while vitD supplements intake (p = 0.021) was a protective factor in pregnant women. In conclusion, vitD inadequacy is very common among Chinese pregnant women. We encourage pregnant women to take more effective sunlight and proper vitD supplements, especially for those from the subtropical, warm and medium temperate zones, the western and the central, and in the seasons of spring and winter.

[Zinc status of 18-60 year-old adults in China in 2015].

OBJECTIVE: To estimate the distribution of serum zinc levels, zinc deficiency status and possible influencing factors in 18-60 year-old adults in China. METHODS: Based on the data of China Adult Chronic Disease and Nutrition Surveillance, 3903 blood samples were selected by stratified random sampling. The distribution of serum zinc in adults with different gender, age, regional type and regional distribution were analyzed by inductively coupled plasma mass spectrometry and body mass index(BMI), exercise, smoking, drinking, vitamin A level and other factors on serum zinc concentration and zinc deficiency rate. Multivariate logistic regression model was used to analyze the correlation between zinc deficiency and the influencing factors. RESULTS: In 2015, the median of serum zinc in Chinese adults aged 18-60 years was 103. 44(95%CI 64. 84-186. 12) µg/dL, and the overall zinc deficiency rate was 6. 04%. Serum zinc concentration had statistically significant difference(P<0. 05) in different genders, regional types, regional distribution, vitamin A status, smoking status, drinking status. In the comparison of zinc deficiency rates, ethnic minorities(10. 67 %) was higher than Han(5. 44%), rural area(7. 35%) was higher than urban area(4. 90%), vitamin A deficiency group(9. 12%) was higher than vitamin A normal group(5. 90%), non-exercise group(6. 29%) was higher than sports group(5. 09%). Among different regional distributions, the western region had the highest zinc deficiency rate(7. 33%), and among different BMI groups overweight group had the lowest rate(4. 81%). These differences were statistically significant(P<0. 05). In the analysis of multivariate logistic regression, the risk of zinc deficiency in the vitamin A deficiency group was 1. 89 higher than that of the normal group(OR=1. 89, 95%CI 1. 13-3. 18); and the overweight group had a lower risk of serum zinc deficiency than the normal group(OR=0. 71, 95%CI 0. 52-0. 96). CONCLUSION: The prevalence of serum zinc deficiency among adults aged 18-60 in China is relatively low. Vitamin A deficiency is a risk factor for zinc deficiency and overweight is a protective factor for zinc deficiency.

[Vitamin A nutrition status among pregnant women in rural China in 2015].

OBJECTIVE: To evaluate the nutrition status of vitamin A in Chinese rural pregnant women from the Chinese National Nutrition and Health Survey 2015(CNNHS 2015). METHODS: A total of 3273 Chinese rural pregnant women were recruited in this study. The concentrations of serum retinol were determined using high performance liquid chromatography. The C-reactive protein and α-acid glycoprotein were determined by immunoturbidimetric method. The distribution of serum retinol status in pregnant women was further described for different regions, age groups, nationalities, body mass index(BMI), education levels, gestational weeks, family income per capita and inflammation levels. The prevalence of vitamin A deficiency and the percentage of marginal vitamin A deficiency in pregnant women were compared in different subgroups. RESULTS: The median concentration of serum retinol(M(P25, P75)) was 0. 47(0. 36, 0. 61) mg/L. There were significant differences among different regions, age groups, education levels, gestational age and per capita household income(P<0. 01). The prevalence of vitamin A deficiency was 1. 2% for deficiency and 10. 5% for marginal deficiency, respectively. Significant differences were observed in age groups, gestational weeks and inflammation levels(P<0. 01). In addition, the prevalence of vitamin A deficiency was relatively serious, 2. 1% for deficiency and 14. 2% for marginal deficiency in the third trimester, 2. 0% for deficiency and 12. 2% for marginal in the 30-44 years. CONCLUSION: It should be pay more attention on the vitamin A nutrition status in the third trimester and the 30-44 years old pregnant women, although the vitamin A status had been greatly improved in Chinese rural pregnant women.

[Vitamin A nutrition status and influencing factors of Chinese rural elderly in 2015].

OBJECTIVE: To analyze the level of vitamin A and its influencing factors of Chinese rural elderly. METHODS: The serum samples of the rural elderly were selected by random sampling method from the biological sample bank of Chinese Adults Nutrition and Chronic Diseases Surveillance in 2015(CANCDS2015). The basic information of the subjects was collected by questionnaire survey. High performance liquid chromatography(HPLC) method was used to determine the vitamin A nutritional status of the population according to the standard recommended by WHO. Multiple logistic regression analysis was explored the relationship between vitamin A status with the potential relevant factors. RESULTS: A total of 3134 elderly from Chinese rural were included in this study. The serum vitamin A concentration(M(P25, P75))was 1. 92(1. 50, 2. 45)µmoL/L. The prevalence of vitamin A deficiency was 0. 99%(95%CI 0. 64%-1. 34%), and the prevalence of vitamin A marginal deficiency was 4. 38%(95%CI 3. 65%-5. 10%). The prevalence of vitamin A marginal deficiency was significantly higher in elderly lived in western region than that lived in eastern and central regions of China. The serum vitamin A adequacy rate of rural elderly who were 80 years old and above or thin was relatively low(P<0. 05). Married elderly had significant lower vitamin A deficiency rate. The result from multivariate logistic regression model analysis showed that gender, age and body mass index had significant effects on vitamin A nutritional status of Chinese urban elderly(P<0. 05). CONCLUSION: The nutritional status of vitamin A in rural elderly in China was better, and the deficiency rate was lower.