The Association of Folic Acid, Iron Nutrition during Pregnancy and Congenital Heart Disease in Northwestern China: A Matched Case-Control Study.

Background: The purpose of this study was to investigate the relationship between folic acid and iron nutrition during pregnancy and congenital heart disease (CHD) in the offspring. Methods: Conditional logistic regression models and nonlinear mixed-effects models were used to analyze the effects of folic acid and iron nutrition during pregnancy on CHD in offspring. Results: After adjusting for confounders, folic acid or iron supplementation during pregnancy reduced the risk for fetal CHD (OR = 0.60 (0.45, 0.82) or 0.36 (0.27, 0.48)). Similarly, dietary iron intake during pregnancy (≥29 mg/d) was associated with a reduced risk of fetal CHD (OR = 0.64 (0.46, 0.88)). Additionally, compared with women who only supplemented folic acid (OR = 0.59 (0.41, 0.84)) or iron (OR = 0.32 (0.16, 0.60)), women who supplemented both folic acid and iron had lower risk for newborns with CHD (OR = 0.22 (0.15, 0.34)). Similarly, compared with women who only supplemented folic acid (OR = 0.59 (0.41, 0.84)) or higher dietary iron intake (≥29 mg/d) (OR = 0.60 (0.33, 1.09)), women who supplemented both folic acid and higher dietary iron intake (≥29 mg/d) had lower risk for the newborn with CHD (OR = 0.41 (0.28, 0.62)). The combined effects were significant in the multiplication model (OR = 0.35 (0.26, 0.48) or 0.66 (0.50, 0.85)) but not in the additive model. Conclusions: Our study found that folic acid and iron nutrition during pregnancy were associated with a reduced risk of CHD in the offspring and confirmed a statistically significant multiplicative interaction between folic acid and iron nutrition on the reduced risk of CHD in offspring.

[Association between the distribution of feeding index and physical development of infants and young children aged 6-35 months in rural areas of Lhasa in 2010].

OBJECTIVE: Using infant and child feeding index (ICFI) to evaluate the relationship between infant feeding and physical development indicators in rural areas of Lhasa. METHODS: In July and August 2010 in the rural areas of Lhasa, the multi-stage cluster random sampling method was adopted to select 540 Tibetan children who were between 6 to 35 months of age. There were 70, 79 and 391 cases in 6 to 8, 9 to 11 and 12 to 35-month-old group respectively. The basic status of infants, information about breastfeeding and complementary feeding were collected by using designed questionnaires. Their height and weight were measured to calculate the children's weight for age Z-score (WAZ), height for age Z-score (HAZ) and weight for height Z-score (WHZ) and assess feeding index score (out of 17 scores) and analyze the relationship between feeding index and HAZ, WAZ and WHZ. RESULTS: The mean ICFI score of 540 cases was 8.90 ± 2.82.It was 6.84 ± 3.16, 8.16 ± 2.78 and 9.41 ± 2.55 for 6 to 8, 9 to 11 and 12 to 35-month-old infants respectively. There was significant difference between the different month group (F = 30.99, P < 0.05).For the three month groups, the scores of WAZ were 0.10 ± 1.18, -0.09 ± 1.20 and -0.38 ± 0.96; HAZ were -0.60 ± 1.68, -1.02 ± 1.72 and -1.30 ± 1.30; WHZ were 0.62 ± 1.23, 0.69 ± 0.96 and 0.43 ± 0.95 respectively. The ICFI scores of 9 to 11, 12 to 35 and 6 to 35-month-old infants were positively correlated with HAZ (correlation coefficients were 0.25,0.12 and 0.09 respectively, all P values <0.05). There was no correlation with WAZ (correlation coefficients were 0.15,0.08 and 0.03 respectively, all P values >0.05) and WHZ (correlation coefficients were -0.08, -0.02, and -0.07 respectively, all P values >0.05). There were no correlation between ICFI score with HAZ, WAZ and WHZ for 6 to 8 month-old infants (correlation coefficient were 0.06,0.16 and -0.07 respectively, all P values >0.05). CONCLUSION: To some extent, the feeding index can effectively reflect the growth status of these infants and can serve as a comprehensive assessment of feeding situations among Tibetan children in rural areas of Lhasa.

[Survey on the prevalences of overweight and obesity in 9 rural areas in Hanzhong, Shaanxi province].

OBJECTIVE: To investigate the prevalences of overweight and obesity in the rural communities in Hanzhong, Shaanxi Province. METHODS: A total of 3030 residents in the rural areas of Hanzhong city were selected by stratified random sampling method to take questionnaire-based survey and physical examinations. RESULTS: The data of 3017 valid subjects (1048 men and 1969 women) entered the final analysis. The average body mass index was (22.9±4.2) kg/m(2) [(23.0±5.5) kg/m(2) in men and (22.9±3.2) kg/m(2) in women]. The prevalence rates of overweight and obesity were 27.9% and 5.9% respectively, and the standardized rates were 23.4% and 5.4%, respectively. More specifically, prevalence rates of overweight and obesity were 28.3% and 6.1% in men (standardized rates were 24.7% and 7.5%, respectively) and 27.6% and 5.8% (standardized rate were 22.8% and 4.5% respectively) in women. The overweight/obesity was more often in young and mid-aged married men with higher education and socioeconomic status and in middle-aged and older women with less education from wealthier households. CONCLUSION: The prevalences of overweight and obesity are relatively high in the rural areas of Hanzhong, and therefore effective interventions are warranted.

[Study on the prevalence rate of abdominal obesity in 9 rural communities from Hanzhong area of Shaanxi province].

OBJECTIVE: The objective of this study was to investigate the prevalence rate of abdominal obesity and to explore the associated risk factors in rural communities from Hanzhong area, Shaanxi province, and to provide baseline data for further targeted intervention programs. METHODS: A cross-sectional study was conducted among all the participants with questionnaires, interview and physical examination. Nine townships were selected in Hanzhong area, followed by one village randomly chosen from the selected township, using the stratified random sampling method. RESULTS: There were 3030 participants in this survey, among which 3021 samples were valid, including 1048 males and 1973 females. The overall prevalence rate of abdominal obesity was 38.9% (standardized rate as 33.4%) in rural communities of Hanzhong, and the prevalence rate on males abdominal obesity (35.0%) was significantly lower than that of females (40.9%). It was found that following factors as: being male, married, having more household wealth, frequent consumption of fried food, non-engagement of agricultural labor work, being nonsmoker or ex-smoker, spending longer time on watching-TV etc. were positively associated with the bigger odds of having abdominal obesity when using the logistic regression analysis. Meanwhile, data from this study indicated that factors as: at younger age, frequent participation in agricultural labor, under artificial feeding, with more years of education, less frequency of pregnancy etc. were negatively related to the prevalence of female abdominal obesity. CONCLUSION: The prevalence rate of abdominal obesity in Hanzhong area, Shaanxi province was significantly higher than the national average level which called for the development of related intervention programs to prevent chronic diseases associated with gender related-obesity in Hanzhong.

[Relationships between smoking behavior and obesity in men from 9 rural districts of Hanzhong in Shaanxi province].

OBJECTIVE: To examine the relationship between cigarette smoking and body mass index (BMI) as well as waist circumference (WC) of men from 9 rural districts of Hanzhong, Shaanxi province. METHODS: Cross-sectional data was analyzed from Hanzhong Health Survey on rural residents in 2010. Quantile regression mode was used to compare the results using the BMI (WC) and smoking status (degree) as the dependent variables and independent variable and confounding factors were also controlled. RESULTS: 1039 male residents of rural areas of Hanzhong city were investigated. The prevalence rates on overweight and obesity among the males were 28.0% and 5.9%, with central obesity as 35.0% and the rate of current cigarette smoking was 63.6% in the areas. RESULTS: from the quantile regression showed that the relationship between smoking status and BMI beyond 80 percentile in men (BMI = 24.4) which was not significantly different BMI among the heavy smokers, was much higher than those mild smokers beyond 90 percentile (BMI = 24.9). WC of the current smokers was significantly higher than those ex-smokers beyond the 95 percentile (WC = 96.7 cm). WCs of the moderate and heavy smokers had an increase along with the increase of WCs beyond the 85 percentiles (WC = 89.9 cm). CONCLUSION: The effect of smoking status and BMI (WC) were inconsistent, however, with BMI and WC increased among the subjects whose BMI or WC were at the high extreme end of the distribution. Thus, we should advise the obese subjects to quit smoking.

[Analysis on growth and malnutrition status of Tibetan children aged 0 to 35 months in rural Lhasa in 2010].

OBJECTIVE: To understand the growth and malnutrition status of Tibetan children aged 0 to 35 months in rural Lhasa in 2010. METHODS: Cross-sectional study and multistage sampling design were used to randomly select sampling units. A total of 640 children were studied. Height and weight were measured and nutritional status was evaluated with WHO reference in 2006 using Z-scores. Z-scores of weight-for-age (WAZ), Z-scores of height-for-age (HAZ) and Z-scores of weight-for-height (WHZ) were analyzed. RESULTS: At the age of 18 - 35 months, the children in rural Lhasa were 3.0 cm shorter as compared to the China national length reference. At the age of 6 - 11, 12 - 17 months, weight ((8.84 ± 1.23) and (10.20 ± 1.08) kg) and length ((70.45 ± 4.46) and (76.73 ± 4.78) cm) of boys were significantly higher than girls (weight: (8.42 ± 1.30) and (9.59 ± 1.26) kg; length: (67.61 ± 3.98) and (74.25 ± 4.50) cm) (all P values < 0.05). WAZ and HAZ were -0.17 ± 1.11 and -1.11 ± 1.46, respectively. The HAZ of 18 - 23 months children (-1.51 ± 1.24) was significantly different from the HAZ of 0 - 5, 6 - 11, 12 - 17 months children (HAZ: -0.75 ± 1.50, -0.83 ± 1.72, -1.07 ± 1.55, respectively) (all P values < 0.05), comparison with the HAZ of 24 - 29, 30 - 35 months children (HAZ: -1.41 ± 1.25, -1.24 ± 1.05), the results showed that there were no significant difference (all P values > 0.05), HAZ of 18 - 23 months children was the lowest. The prevalence of stunting, underweight, and wasting were 24.6% (155/630), 5.4% (33/616) and 1.0% (6/608), respectively. The malnutrition of boys was more serious than that of girls, the stunting of 18 - 23 and 24 - 29 months children had reached 35.0% (36/103) and 29.1% (25/86), respectively. CONCLUSION: The growth and development status of children in rural Lhasa under 3 years old was poor, and the malnutrition of local children should not be ignored with variations by gender and months of age.