[Contamination and dietary exposure assessment of 2-chloropropanol esters in vegetable oils available on Zhejiang market during 2016-2020].

OBJECTIVE: To investigate the occurrence data for 2-chloropropanol(2-MCPD) ester in edible vegetable oils purchased in Zhejiang Province during 2016-2020, and to estimate dietary exposures of 2-MCPD ester via vegetable oil. METHODS: A total of 404 samples of edible oils were collected from markets, stores, online shopping in Zhejiang Province, the occurrence of 2-MCPD ester was detected by gas chromatography mass spectrometry from 2016-2020. Data of vegetable oils consumption was obtained from the survey result of urban and rural residents in Zhejiang Province in 2008. The exposure levels of 2-chloropropanol ester was calculated for people aged 4-6, 7-10, 11-17, 18-59 and 60 years old and older from the consumption of vegetable oils. RESULTS: The detection rate of 2-MCPD esters in 404 samples was 82.7%(334/404) with the mean level of 0.32 mg/kg. Among them, the mean content of camellia oil was the highest with 1.23 mg/kg, followed by rice oil(0.69 mg/kg); sunflower oil, olive oil and soybean oil have relatively low average values, respectively with 0.11, 0.12 and 0.13 mg/kg. There are significant differences in 2-MCPD ester content in different types of edible oils of the same brand(P<0.05), the content of 2-MCPD ester in different brands of peanut oil was significant(P<0.05), but in different brands of corn oil was not statistically significant. Among the edible vegetable oil consumers, the average exposure of 2-MCPD esters in different age groups ranged from 0.21 to 0.69 µg/(kg·BW·d). CONCLUSION: 2-MCPD esters pollution is widespread in vegetable oils, the severity of pollution was affected by the type and brand of the edible vegetable oil, and the intake of 2-MCPD esters was relatively high among people with high vegetable oil consumption and the general population of 4-10 years old.

[Cost-benefit analysis on the intervention of application iron-fortified soy sauce for anemia in Deqing 15-54 years women, Zhejiang].

OBJECTIVE: To make a cost-benefit analysis on anemia intervention with iron-fortified soy sauce in 15-54 years old women. METHODS: The study was conducted in Deqing county, Zhejiang province in 2012-2013. A total 585 women as sampling size were estimated with statistical model and randomly selected by probability proportionate to size sampling. Hemoglobin were measured before intervention and after 15 months. The cost of the intervention project were collected with manpower, communication and other invest. The benefit was estimated with profiling model. RESULTS: After the intervention, the anemia prevalence of sampled women decreased from 31.1% to 21.9%(P<0.01). The major cost of the project was 156 400 RMB, and total benefits result ing from projects were 1 448 485 RMB. The cost-benefit ratio of the project is 1∶9.49. If investing one yuan can produce economic benefits of nearly 9.49 yuan, therefore, the intervention projectis worth to be scaling up. Sensitivity analysis showed the result of this study was stable. CONCLUSION: The intervention can significantly reduce the prevalence of anemia in women, and reduce the economic burden of the diseases. .

Intake of Vitamin B12 and Folate and Biomarkers of Nutrient Status of Women within Two Years Postpartum.

Background: Little is known about variation in vitamin B12 and folate status among Chinese women 2 years postpartum. This study assessed intake of vitamin B12 and folate and biomarkers of nutrient status among Chinese women postpartum. Methods: Demographic information, multi-/single-nutrient supplementation, dietary data, serum vitamin B12 and serum folate were assessed in 982 women within 2 years postpartum, using ten investigation sites in Zhejiang Province from the National Nutritional Study 2016−2017, which is a nationally representative cross-sectional study, to form a representative provincial sample of Zhejiang Province. The dietary diversity score (DDS) was used for assessing the dietary pattern. Results: Vitamin B12 increased slightly at the early stage of postpartum and then dropped over time. Serum folate level elevated with postpartum time. The median serum vitamin B12 concentration was 494.59 (373.21−650.20) pg/mL, and folate was 7.58 (5.02−10.34) ng/mL. Correspondingly, vitamin B12 levels suggesting marginal deficiency (200−300 pg/mL) and deficiency (<200 pg/mL) resulted as 9.27% and 3.26%, respectively, and folate level suggesting deficiency (<3 ng/mL) was 9.16%. Multi-/single-nutrient supplementation during pregnancy was associated with log-transformed serum vitamin B12 and folate level after adjusting for potential confounders (vitamin B12: ß (SE) = 0.124 (0.028), p < 0.001; folate: 0.128 (0.035), <0.001). Additionally, postpartum nutrient supplementation was associated with log-transformed serum folate level, especially for lactating women (ß (SE) = 0.204 (0.062), p = 0.001). Increased DDS was significantly associated with elevated serum vitamin B12 and folate levels (vitamin B12: ß (SE) = 0.028 (0.011), p = 0.011; folate: 0.030 (0.014), 0.031). In addition, age and educational level were influencing factors for serum vitamin B12 and folate concentrations among postpartum women. Conclusion: Serum vitamin B12 level decreased and folate level increased with postpartum age among Chinese women. Nutrient supplementation during pregnancy was related to elevated serum vitamin B12 and folate concentrations. Postpartum nutrient supplementation was associated with the increased serum folate level of lactating women. Dietary diversity was related to increased serum vitamin B12 and folate levels, especially among postpartum women with younger age and lower educational level.

Serum levels of vitamin D, retinol, zinc, and CRP in relation to obesity among children and adolescents.

BACKGROUND: The aim of this study was to examine the possible association between serum micronutrients (vitamin D, retinol, zinc), C-reactive protein (CRP), and obesity among children and adolescents. METHODS: Weight and height were measured and serum 25-hydroxy vitamin D, serum retinol, serum zinc, and CRP were measured in 2818 children and adolescents (6-17 years of age), and the data of 10 investigation sites in Zhejiang Province were used. The difference of micronutrients (vitamin D, retinol, zinc) and CRP among different nutritional status were explored by ANOVA and Chi-square test. The associated factors of micronutrients and CRP of overweight and obesity were explored by multifactor analysis. RESULTS: There were significant differences between male students and female students on BMI, 25(OH)D3, and CRP, and there were significant differences between children and adolescents and between students living in urban area and rural area on BMI, 25(OH)D3, retinol, and zinc(t > 1.96, p < 0.05). There were significant differences on 25(OH)D3 and CRP level among children and adolescents with different nutritional conditions (F = 2.612, 15.022, p < 0.05). In multifactor analysis, we found that female [odds ratio (OR) = 0.68, 95% CI 0.49-0.81], living in rural area (OR = 0.68, 95% CI 0.56-0.82), age (OR = 0.95, 95% CI 0.92-0.98), high CRP concentration (OR = 1.08, 95% CI 1.04-1.12) and appropriate retinol level (OR = 1.32, 95% CI 1.09-1.59) were associated with obesity compared to low/normal BMI. CONCLUSION: Gender, living area, age, CRP concentration, and vitamin A status were associated with children and adolescents with overweight and obesity compared to low/normal BMI. More attention in the intervention of overweight and obesity should be paid to boys living in urban areas, and high serum concentration of CRP should also be concerned.

The Current Status of Insufficient Sleep Duration and Its Influencing Factors Among Children and Adolescents: A Household Based Cross-Sectional Study in Zhejiang Province, China.

PURPOSE: Insufficient sleep duration is common among children and adolescents worldwide, and the decline of sleep duration during the recent years is troubling. This study aimed to learn the status of insufficient sleep duration and to explore its influencing factors among children and adolescents in Zhejiang Province, China. DESIGN AND METHODS: A stratified sampling technique was employed in the present cross-sectional study. Demographic characteristics, sports time as well as sedentary behavior were investigated. RESULTS: A greater proportion of children than adolescents reported insufficient sleep duration (36.4% versus 19.2%, p = 0.001). For children, insufficient sleep duration was associated with age (OR = 1.290, 95%CI: 1.069-1.557), watching movies or TV shows with smartphones after school (OR = 3.098, 95%CI: 1.293-7.420), surf the internet after school (OR = 0.113, 95%CI: 0.013-0.969), walk to school (OR = 0.289, 95%CI: 0.105-0.793). For adolescents, insufficient sleep duration was associated with watch TV after school (OR = 0.379, 95%CI: 0.148-0.970), watching movies or TV shows with smartphones after school (OR = 4.744, 95%CI: 1.799-12.507), do homework after school (OR = 0.265, 95%CI: 0.086-0.813). CONCLUSIONS: An unhealthy sedentary screen lifestyle profile may have influence on insufficient sleep duration. Urgent actions are needed to improve sleep duration among children and adolescents.

Sociodemographic disparity in the nutritional status among children and adolescents in Zhejiang Province.

OBJECTIVE: To explore the sociodemographic disparity in the nutritional status including BMI, vitamin D and vitamin A status among children and adolescents in Zhejiang Province. METHODS: Weight, height serum 25-hydroxyvitamin D, and serum retinol were assessed in 2818 children and adolescents (6-17 years of age), using ten investigation sites in Zhejiang Province including urban and rural areas data from the China National Nutritional Study 2016-2017, which is a nationally representative cross-sectional study, to form provincial representative sample of Zhejiang Province. Sociodemographic disparity was explored. RESULTS: The prevalence of low weight, eutrophic, overweight and obese were 6.7%, 70.4%, 11.6%, and 11.2%, respectively. Significant difference was observed on BMI between males and females (P < 0.05), and between urban and rural areas (P < 0.05). The prevalence of vitamin D deficiency, inadequacy, normal and appropriate were 1.8%, 34.9%, 46.4% and 16.9%, respectively. Significant difference was observed on the concentration of 25-hydroxyvitamin D (25(OH)D) both between genders and between living areas (P < 0.05). The prevalence of vitamin A deficiency, marginal deficiency and appropriate were 4.5%, 24.7%, and 70.9%, respectively. Significant difference was observed on the concentration of retinol between living area (P < 0.05). CONCLUSIONS: Overweight and obesity, deficiency and inadequacy of vitamin D, deficiency and marginal deficiency of vitamin A were prevalent among children and adolescents. There were disparities between genders and between living areas on the nutritional status. Regional and sex-specific guidelines and public health policies for children and adolescent nutrition are needed.

Adult breakfast habits and nutritional status: A household based cross-sectional study in Zhejiang Province, China.

BACKGROUND AND OBJECTIVES: Although Dietary Guidelines for Chinese Residents offers advice for breakfast in China, current breakfast consumption habits are unclear. The aim of this study was to describe the frequency of breakfast consumption among adults and explore its associations with daily food consumption and daily nutrient intake. METHODS AND STUDY DESIGN: A stratified cluster sampling technique was employed in this cross-sectional study. Demographic characteristics, breakfast consumption, and daily food and nutrient intake were investigated. RESULTS: Dietary data were collected for 3251 adult residents through interviews. We determined that residents with an annual income of

[Comparative study on burden of diet-related chronic diseases in China between 1990 and 2016].

OBJECTIVE: To compare the disease burden of diet-related chronic diseases in China between 1990 and 2016. METHODS: Based on the Global Burden of Disease 2016, we extracted the absolute number of deaths and disability-adjusted life years( DALYs) of diet-related chronic diseases and the corresponding age-standardized rates in China in 1990 and 2016. Subgroup analyses were conducted in various gender, dietary risk factors and categories of diseases. RESULTS: In 2016, the total number and rate of diet-related NCDs deaths was 2493 thousand and 182. 4/100000. The corresponding number and rate of DALYs was 54995 thousand person-year and 4023. 0/100000. Compared with those in 1990, the rates of death and DALYs in 2016 increased by19. 5% and 9. 3%, respectively. Both death rate and DALYs rate increased with the age. Death rate( 214. 6/100000) and DALYs rate( 4961. 1/100000) in males were 1. 4-fold and 1. 6-fold as that in females( 148. 2/100000 and 3028. 2/100000, respectively). High intake in sodium, low intake in whole grains and low intake in fruits were the three leading dietary risk factors and cardiovascular diseases accounted for 88. 1% DALYs in all chronic diseases. CONCLUSION: The burden of diet-related chronic diseases in China is severe and it continues increasing over years.

[Analysis on the dietary survey results of 60 years old and over population in different economic area of Zhejiang Province in 2010-2012].

OBJECTIVE: To analyze the dietary energy and pattern of the elderly in different economic area of Zhejiang Province. METHODS: Data was from Chinese National Nutrition and Health Survey from 2010 to 2012 in Zhejiang Province. The 24 h dietary recall method for 3 consecutive days was used in dietary survey and weighing method was used for condiment intake. RESULTS: There were 793 elderly( age≥60 years) attended in the survey. The intake of beans and nuts, fish and shrimps, eggs, cereals and vegetables respectively were 30. 26, 54. 07, 20. 56, 300. 27 and 277. 78 g. The livestock and poultry meat( 92. 69 g), salt( 9. 14 g), and cooking oil( 33. 60 g) intake was higher than that recommended. Dietary pattern of the urban was better than that of the rural areas. The proportion of energy providing in protein and fat was 14. 17% and 34. 46%, respectively. The proportion of protein from grain and animal food was 31. 51% and 37. 48%. The proportion of fat from plant food was 66. 44%. CONCLUSION: The major problems areirregular diet, imbalanced diet, and unreasonable food sources of protein in Zhejiang province. Because the level of each localities economic development is different, each region's dietary problems are different. We need to research in different areas to analyze specific issues of nutrition interventions, and improving the elders' life quality.

Effect of Low-Dose Vitamin D Supplementation on Serum 25(OH)D in School Children and White-Collar Workers.

OBJECTIVE: Our study aimed to investigate the nutritional vitamin D status of school children aged 9-15 years and white-collar workers in Zhejiang province, and evaluate the efficacy of low-dose-oral vitamin D supplementation in both populations. METHODS: We conducted a prospective controlled trial during March 2014 to November 2015, comparing the efficacy of vitamin D supplements (400 IU/day) with non-intervention for 18 months in school children aged 9-15 years. Meanwhile, a before-after study was conducted among white-collar workers for 1 year. Serum 25(OH)D concentration was measured at baseline and after vitamin D supplementation, respectively. RESULTS: At the baseline, 95% of school children and 84% of adult participants had vitamin D deficiency (<20 ng/mL). In school children, no difference was observed between the intervention and control groups with regard to anthropometric data. Serum 25(OH)D concentrations of the school children intervention group, school children control group and white-collar workers were 12.77 ± 3.01 ng/mL, 14.17 ± 3.59 ng/mL and 16.58 ± 3.66 ng/mL at baseline and increased to 17.34 ± 3.78 ng/mL, 18.04 ± 4.01 ng/mL and 17.75 ± 5.36 ng/mL after vitamin D supplementation, respectively. Although, after adjusting for potential confounders, the 400 IU oral vitamin D supplementation increased serum 25(OH)D concentration in school children (ß = 0.81, p = 0.0426) as well as in white-collar workers (p = 0.0839), the prevalence of vitamin D deficiency was still very high among school children (79.23% in intervention group and 72.38% in control group) and white-collar workers (76.00%). CONCLUSIONS: High prevalence of vitamin D deficiency was common in these two study populations. Daily doses of 400 IU oral vitamin D supplementation was not able to adequately increase serum 25(OH)D concentrations. A suitable recommendation regarding the level of vitamin D supplementation is required for this Chinese population.

Dietary Patterns and Obesity among Chinese Adults: Results from a Household-Based Cross-Sectional Study.

The key dietary pattern other than dietary factors influencing obesity has been reported by several large epidemiological studies. This study was carried out between 2010 and 2012 including 1613 adult residents in Zhejiang Province. Dietary patterns were extracted by factor analysis based on 24-h dietary recall. Associations with dietary patterns and obesity were examined and adjusted for age and gender by logistic regression. Five dietary patterns were identified by factor analysis with their eigenvalues greater than 1: 'cereal, animal, and plant food', 'high protein food', 'plant food', 'poultry', and 'beverage'. After adjustment for age and gender, the 'cereal, animal, and plant food' and 'beverage' pattern was associated with obesity (OR = 2.924, 3.257; 95% CI = 1.147-7.463, 1.372-7.692). In conclusion, 'cereal, animal, and plant food' and 'beverage' dietary patterns may be associated with increased risk of obesity. 'Cereal, animal, and plant food' dietary patterns may be associated with increased risk of obesity resulting from increased total energy intake by increased protein and fat intake; while a 'beverage' dietary pattern may be associated with increased risk of obesity resulting from increased total energy intake by increased carbohydrate intake. The findings are valuable in targeting future nutrition education.

The Rural-Urban Difference in BMI and Anemia among Children and Adolescents.

There is growing concern over the double burden of over- and under-nutrition in individuals, especially in children and adolescents, which could dwarf their growth and development. This study aims to explore the rural-urban difference in BMI and anemia among children and adolescents. A stratified cluster sampling technique was employed. Dietary data were collected through interviews, and anthropometric values were measured. There were 1534 children and adolescents who participated in this study, including 775 male and 759 female participants. The prevalence of obesity among children living in a city, township and rural area was 10.3%, 8.5% and 5.5%, and that among adolescents was 1.4%, 2.9% and 2.8%. The prevalence of anemia among children and living in a city, township and rural area was 4.3%, 2.5% and 4.5%, while that among adolescents was 6.1%, 3.7% and 11.3%, respectively, with significant difference (χ² = 10.824, p = 0.004). The prevalence of being overweight, obesity and anemia was significant when comparing children with adolescents (χ² = 37.861, p = 0.000; χ² = 19.832, p = 0.000; χ² = 8.611, p = 0.003). Findings of this study indicate the double burden of malnutrition in Zhejiang province, characterized by a high prevalence of being overweight, obesity and anemia among children and a high prevalence of anemia among adolescents living in townships.

A comparison study on the prevalence of obesity and its associated factors among city, township and rural area adults in China.

OBJECTIVES: To explore the association of dietary behaviour factors on obesity among city, township and rural area adults. SETTING: A stratified cluster sampling technique was employed in the present cross-sectional study. On the basis of socioeconomic characteristics, two cities, two townships and two residential villages were randomly selected where the investigation was conducted. PARTICIPANTS: A total of 1770 city residents, 2071 town residents and 1736 rural area residents participated in this survey. PRIMARY AND SECONDARY OUTCOME MEASURES: Dietary data were collected through interviews with each household member. Anthropometric values were measured. Participants with a body mass index (BMI) of ≥28.0 kg/m(2) were defined as obesity. RESULTS: The prevalence of obesity was 10.1%, 7.3% and 6.5% among city, township and rural area adults, respectively. Correlation analysis showed that for adults living in cities, the daily intake of rice and its products, wheat flour and its products, light coloured vegetables, pickled vegetables, nut, pork and sauce was positively correlated with BMI (r=0.112, 0.084, 0.109, 0.129, 0.077, 0.078, 0.125, p<0.05), while the daily intake of tubers, dried beans, milk and dairy products was negatively correlated with BMI (r=-0.086, -0.078, -0.116, p<0.05). For township residents, the daily intake of vegetable oil, salt, chicken essence, monosodium glutamate and sauce was positively correlated with BMI (r=0.088, 0.091, 0.078, 0.087, 0.189, p<0.05). For rural area residents, the daily intake of pork, fish and shrimp, vegetable oil and salt was positively correlated with BMI (r=0.087, 0.122, 0.093, 0.112, p<0.05), while the daily intake of dark coloured vegetables was negatively correlated with BMI (r=-0.105, p<0.05). CONCLUSIONS: The prevalence of obesity was higher among city residents than among township and rural area residents. The findings of this study indicate that demographic and dietary factors could be associated with obesity among adults. Healthy dietary behaviour should be promoted and the ongoing monitoring of population nutrition and health status remains crucially important.

[Exposure assessment on dietary lead and cadmium of residents in three areas of Zhejiang province from 2009 to 2010].

OBJECTIVE: To assess the safety of dietary lead and cadmium intake in 3 areas of Zhejiang province. METHODS: Using the total dietary study method, the study was conducted in 3 regions which represented coastal, city and rural areas in Zhejiang province from 2009 to 2010. The dietary survey was conducted on the residents (512 subjects) and the categories and volume of food consumption were obtained. The analytical food samples were obtained by food consumption survey, food aggregation, food sampling and preparation. The food samples were detected by inductively coupled plasma mass spectrometry (ICP-MS). The safety of dietary lead and cadmium intake was evaluated. RESULTS: The median dietary lead intake (P50) in Zhejiang province was 37.8 µg/d. The 97.5% dietary lead intake (P97.5) was 72.3 µg/d. The P50 dietary lead intakes of different age and gender groups ranged from 23.2 to 44.2 µg/d. The P97.5 dietary lead intakes of different age and gender groups ranged from 34.2 to 88.1 µg/d. The P50 dietary cadmium intake in Zhejiang province was 9.6 µg/d. The P97.5 dietary cadmium intake was 15.7 µg/d. The P50 dietary cadmium intakes of different age and gender groups ranged from 6.4 to 11.4 µg/d, accounting 15.6% - 42.6% of PTMI (provisional tolerable monthly intake, 25 µg/kg). The P97.5 dietary cadmium intakes of different age and gender groups ranged from 10.5 to 21.4 µg/d, accounting 27.5% - 77.6% of PTMI. Vegetable (11.3 µg), cereal (11.0 µg) and meat (9.8 µg) were the first three food sources which accounted for 84.9% of dietary lead (P50: 37.8 µg/d). Cereal (3.6 µg), vegetable (2.1 µg) and legume (0.9 µg) were the first three food sources which accounted for 68.8% of dietary cadmium (P50: 9.6 µg/d). CONCLUSION: Dietary lead and cadmium intakes of most residents in 3 areas of Zhejiang province as well as the average level are safe.