Association of Tibetan Habitual Food and Metabolic Syndrome Among Tibetan People in China: A Cross-Sectional Study.

Background: The association between habitual food intake in Tibet and metabolic syndrome (MetS) is largely unclear. Objective: To examine the association between Tibetan habitual food intake and MetS among Tibetan adults. Methods: A population-based cross-sectional study, named the China Multi-Ethnic Cohort (CMEC) study, was conducted between 2018 and 2019. We used data from all Tibetans in the CMEC in the current study. The participants, 1,954 men and 3,060 women aged 18-79 years, were from Lhasa, Tibet Autonomous Region, Tibet. The habitual dietary intake was assessed using a food frequency questionnaire (FFQ). MetS was defined according to ATP III guidelines. Multivariate logistic regression was used to estimate the association between five Tibetan habitual foods and MetS. Results: Tsampa, butter tea, and Qing cha intake were associated with reduced prevalence of MetS. Compared with the lowest quartile of each food, odds ratios (ORs) and their 95% confidence intervals (95% CIs) of medium and high Tsampa intake were 0.59 (0.41-0.85) and 0.53 (0.36-0.77), ORs (95% CIs) of butter tea were 0.67 (0.52-0.88) and 0.61 (0.46-0.81), and Qing cha were 0.85 (0.71-1.03) and 0.75 (0.60-0.93), respectively. When exploring the joint effects of these three foods on MetS, the adjusted ORs and their 95% CIs were 0.65 (0.49-0.87) for the middle intake group and 0.59 (0.42-0.83) for the high intake group as compared with the never/rarely group (p = 0.022 for trend). Associations of MetS with Tibetan noodles and raw beef were not observed. Conclusion: Tsampa, butter tea, and Qing cha were negatively associated with MetS. The recommendation of increasing the intake of these foods may be beneficial for MetS prevention.

Comorbid Depressive and Anxiety Symptoms and Their Correlates Among 93,078 Multiethnic Adults in Southwest China.

Background: Depressive symptoms and anxiety symptoms commonly coexist and severely increases the disease burden worldwide. Little is known about the patterns and correlates of comorbid depressive and anxiety symptoms among the multiethnic populations of China. Methods: This population-based study investigated the comprehensive associations of comorbid depressive and anxiety symptoms with lifestyles, stressful life events, chronic diseases, and physical and mental well-being among 93,078 participants (37,193 men, 55,885 women) aged 30-79 years across seven ethnic groups in Southwest China. Multivariable logistic regression models were used to estimate associations. Results: Overall, 2.9% (2.1% in men and 3.5% in women) participants had comorbid depressive and anxiety symptoms; there was considerable heterogeneity among multiethnic populations. Participants with chronic diseases were more likely to have comorbidity than those without them; people with rheumatic heart disease reported the highest risk, with an odds ratio (OR) of 6.25 and 95% confidence interval (CI) of 4.06-9.62. Having experienced 3 or more stressful life events (OR, 8.43, 95% CI: 7.27-9.77), very poor self-rated health status (OR, 33.60, 95%CI: 25.16-44.87), and very unsatisfied life (OR, 33.30, 95% CI: 23.73-46.74) had strong positive associations with comorbid depressive symptoms and anxiety symptoms, with a dose-response relationship (P < 0.05). High frequency of physical activity had negative associations. All the associations were stronger than depressive symptoms alone or anxiety symptoms alone. Conclusions: Our findings emphasize the need to focus on the vulnerable ethnic groups with comorbid depressive and anxiety symptoms, ultimate for help early prevention and improvement of health equity in the underdevelopment and high urbanization areas.

Association of Daytime Napping with chronic diseases among Tibetan people in China: a cross-sectional study.

BACKGROUND: Obesity, diabetes, and hypertension, as three of the most prevalent chronic diseases, remain a daunting health challenge. However, to our knowledge, no study has made a thorough examination of the association between the three chronic diseases and daytime napping, a widely accepted behavior in many countries. This is especially necessary among Tibetan populations, whose lifestyles and health outcomes may be unique, yet patterns of chronic diseases and napping are under-examined. Thus, we sought to explore the aforementioned association in the Tibetan population of China. METHODS: A total of 2902 participants aged 45-79 in 2019 were included. Multivariate logistic regressions were conducted in 2020. The sex disparity was examined through interaction and stratified analyses. RESULTS: Hypertension (40.7%) was more prevalent than obesity (20.2%) and diabetes (21.6%). Comparing to non-nappers, those who napped were more likely to have any conditions (OR = 1.30, 95% CI = 1.04-1.62 for 1-59 min/day group and OR = 1.40, 95% CI = 1.10-1.80 for ≥60 min/day group). Participants who had 1-59 min/day of napping were more likely to develop obesity (OR = 1.37, 95% CI = 1.07-1.75), and ≥ 60 min/day of napping was associated with diabetes (OR = 1.33, 95% CI = 1.01-1.74). The interactions between napping and sex were not statistically significant in the models. CONCLUSIONS: The study revealed napping was unfavorably associated with obesity, diabetes, and any conditions in Tibetan people living on the Tibetan Plateau. Future interventions regarding the three chronic diseases may pay more attention to napping. TRIAL REGISTRATION: Not applicable.

Determinants of self-rated health among an older Tibetan population in a Chinese plateau area: analysis based on the conceptual framework for determinants of health.

BACKGROUND: Self-rated health (SRH) has been frequently used in population health surveys. However, most of these studies only focus on specific factors that might directly affect SRH, so only partial or confounding information about the determinants of SRH is potentially obtained. Conducted in an older Tibetan population in a Chinese plateau area, the aim of our study is to assess interrelationships between various factors affecting SRH based on the conceptual framework for determinants of health. METHODS: Between May 2018 and September 2019, 2707 Tibetans aged 50 years or older were recruited as part of the China Multi-Ethnic Cohort Study (CMEC) from the Chengguan District of Lhasa city in Tibet. The information included SRH and variables based on the conceptual framework for determinants of health (i.e., socioeconomic status, health behaviors, physical health, mental health, and chronic diseases). Structural equation modeling (SEM) was used to estimate the direct and indirect effects of multiple factors in the conceptual framework. RESULTS: Among all participants, 5.54% rated their health excellent, 51.16% very good, 33.58% good, 9.12% fairly poor and 0.59% poor. Physical health (ß = - 0.23, P <  0.001), health behaviors (ß = - 0.44, P <  0.001), socioeconomic status (ß = - 0.29, P <  0.001), chronic diseases (ß = - 0.32, P <  0.001) and gender (ß = 0.19, P <  0.001) were directly associated with SRH. Socioeconomic status, physical health and gender affected SRH both directly and indirectly. In addition, there are potential complete mediator effects in which age and mental health affect SRH through mediators, such as physical health, health behaviors and chronic diseases. CONCLUSIONS: The findings suggested that interventions targeting behavioral changes, health and chronic disease management should be attached to improve SRH among older populations in plateau areas without ignoring gender and socioeconomic disparities.