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BACKGROUND: With rapid urbanization, massive migration, and non-family-based eldercare involvement, Chinese concepts of eldercare responsibility and filial piety are shifting. We performed age-period-cohort (APC) analyses to assess the transition of old-age pension coverage, eldercare responsibility, and filial piety concepts and its urban-rural differences among Chinese adults using data from the China General Social Survey (2006-2017). METHODS: Old-age pension coverage (yes/no) and primary eldercare responsibility (government/offspring/self/sharing) were investigated in 2010, 2012, 2013, 2015, and 2017. Filial piety was evaluated using customized questionnaires in 2006 and 2017. The APC effects were estimated using mixed effects and generalized additive models. RESULTS: Among 66,182 eligible participants (mean age: 48.8 years, females: 51.7%) in the six waves, APC analyses indicated that old-age pension coverage increased with aging and over time. Across cohort groups, it grew as the cohort was younger in urban residents but decreased in rural residents. The concept of offspring-based (> 50%) and government/self/offspring-shared eldercare (> 30%) predominated. APC analyses revealed that the offspring-based concept declined with aging (OR = 0.81, 95% CI: 0.79-0.84), whereas the government-based (OR = 1.37, 95% CI: 1.33-1.41) and self-based (OR = 1.55, 95% CI: 1.47-1.63) concepts increased with aging. People born around the 1940s have a comparatively higher possibility to perceive that the primary eldercare responsibility should be undertaken by the government and elder parents. In contrast, people born in the younger cohort were more likely to perceive that adult children are responsible for their parents' primary eldercare. Filial piety score slightly increased with aging (ß = 0.18, SD: 0.05) but decreased as the birth cohort was younger. In addition, rural participants were more likely to perceive offspring-based eldercare and maintain filial piety, and the related urban-rural difference was intensified by aging. CONCLUSIONS: The traditional concept that eldercare solely relies on offspring has changed to relying on multiple entities, including the government and self-reliance. Diluted filial piety in people born in the young cohort requires reinforcement. Moreover, future healthy aging policies need to focus more on urban-rural disparities to promote equity in social well-being.
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População Rural , População Urbana , Humanos , China , Feminino , Masculino , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Idoso , População Urbana/estatística & dados numéricos , Adulto , Estudos de Coortes , Relação entre Gerações , Pensões/estatística & dados numéricos , Inquéritos e Questionários , Responsabilidade SocialRESUMO
Background: Diabetes is more prevalent among overweight/obese individuals, but has become a significant public health challenge among normal weight populations. In this meta-analysis, we aimed to estimate diabetes/prediabetes incidence and its temporal trends by weight status. Methods: PubMed, Embase, Web of Science, and Cochrane Library were searched until 8 December 2021. Prospective cohort studies reporting diabetes incidence by baseline body mass index (BMI) categories in adults were included. The median year of data collection was used to assess the temporal trends. Subgroup analyses and meta-regression were also performed. Results: We included 94 studies involving 3.4 million adults from 22 countries. The pooled diabetes incidence in underweight, normal-weight, and overweight/obese adults was 4.5 (95% confidence interval (CI) = 2.8-7.3), 2.7 (95% CI = 2.2-3.3), and 10.5 (95% CI = 9.3-11.8) per 1000 person-years, respectively. The diabetes incidence in low- and middle-income countries (LMICs) was higher than in high-income countries among normal-weight (5.8 vs 2.0 per 1000 person-years) or overweight/obese (15.9 vs 8.9 per 1000 person-years) adults. European and American regions had a higher diabetes incidence than the non-Western areas, regardless of weight status. Underweight diabetes incidence decreased significantly from 1995-2000 to 2005-2010. Diabetes incidence in normal-weight populations has increased continuously since 1985 by an estimated 36% every five years. In overweight/obese adults, diabetes incidence increased between 1985-1990 and 1995-2000, stabilised between 2000 and 2010, and spiked suddenly after 2010. Conclusions: Diabetes incidence and its temporal trends differed by weight status. The continuous upward trend of diabetes incidence among overweight/obese individuals requires urgent attention, particularly in LMICs. Furthermore, diabetes among normal-weight individuals is becoming a significant public health problem. Registration: PROSPERO (CRD42020215957).
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Diabetes Mellitus Tipo 2 , Adulto , Humanos , Diabetes Mellitus Tipo 2/epidemiologia , Sobrepeso/epidemiologia , Incidência , Estudos Prospectivos , Magreza , Obesidade/epidemiologiaRESUMO
AIMS: Diabetes development mechanisms vary by weight status. We aimed to compare cardiometabolic risk and characterize fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) trajectories before diagnosing type 2 diabetes in individuals with/without obesity. METHODS: Data from the China Health and Retirement Longitudinal Study (CHARLS) and English Longitudinal Study of Ageing (ELSA) were analysed. Participants without diabetes and with a body mass index of 18.5-40 kg/m2 at baseline were included. Incident diabetes was ascertained by self-reported physician diagnosis and/or antidiabetic drug use, FPG ≥126 mg/dl and/or HbA1c ≥6.5%. The difference in the FPG/HbA1c trajectory before the diabetes diagnosis in participants with/without obesity was examined using mixed-effects models. RESULTS: Among 11 925 eligible participants, 1361 incident diabetes cases (mean age: 61.4 years; male: 46.2%) were identified within 15 years of follow-up. Obese diabetes showed higher levels of diastolic blood pressure and C-reactive protein at diagnosis than non-obese diabetes. Mixed-effects models indicated the difference in the FPG trajectory before diagnosis by weight status was non-significant with a slope difference of 0.149 mg/dl (SE = 0.642, p = .816, CHARLS) and 0.013 mg/dl (SE = 0.013, p = .337, ELSA). However, obese diabetes showed a steep increase in HbA1c before diagnosis with a slope difference of 0.036% (SE = 0.016, p = .021) in the CHARLS and 0.032% (SE = 0.014, p = .027) in the ELSA, respectively. Sex-stratified analyses showed that the difference in HbA1c trajectory before the diabetes diagnosis by weight status was only significant in males. CONCLUSIONS: Obese and non-obese diabetes developments may share a similar FPG but distinct HbA1c trajectory. Obese diabetes interventions require more attention to cardiometabolic risks. Moreover, studies addressing weight/sex-related differences in diabetes aetiologies and treatments are warranted.
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Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Masculino , Humanos , Pessoa de Meia-Idade , Hemoglobinas Glicadas , Glucose , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Glicemia/metabolismo , Estudos Longitudinais , Estudos de Coortes , Jejum , Obesidade/complicações , Obesidade/epidemiologiaRESUMO
AIM: To assess the association of telomere length (TL) with prediabetes/diabetes and to explore the potential factors affecting TL among individuals with prediabetes/diabetes by weight status. METHODS: This study included 3,379 eligible adults (aged 45-85 years, males: 42%) from the US Health and Retirement Study in 2008. TL was assayed using quantitative PCR of saliva (T/S ratio). Linear and nonlinear associations between TL and prediabetes/diabetes were assessed using the logistic regression and restricted cubic spline model, respectively, adjusting for TL-plate numbers, age, sex, race, body mass index, lifestyles, diabetes medications, and cardiometabolic parameters (blood pressure, C-reactive protein, and total cholesterol). Multiple linear regression was used for testing any factors associated with TL. RESULTS: Among 3,379 participants, 868 (25.7%) had prediabetes with a mean TL of 1.34 ± 0.37 (T/S ratio) and 858 (25.4%) had diabetes with a mean TL of 1.36 ± 0.43 (T/S ratio). Neither linear nor nonlinear association of TL with prediabetes/diabetes was significant by weight status. Age was negatively associated with TL in both normal-weight (ß = - 0.002, p = 0.025) and overweight/obese (ß = - 0.002, p = 0.006) prediabetes, but non-significant in normal-weight and overweight/obese diabetes. BMI and cardiometabolic parameters were not associated with TL in prediabetes/diabetes by weight status. CONCLUSIONS: Salivary TL was not associated with prediabetes/diabetes among the US middle-aged and older adults. Further longitudinal studies are required to establish the link between TL and diabetes development and to identify potential factors affecting TL shortening, particularly in normal-weight diabetic patients.
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Doenças Cardiovasculares , Diabetes Mellitus , Estado Pré-Diabético , Masculino , Pessoa de Meia-Idade , Humanos , Idoso , Aposentadoria , Sobrepeso , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/genética , Obesidade/complicações , Obesidade/epidemiologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/genética , Encurtamento do Telômero , Telômero/genéticaRESUMO
Adverse childhood experience (ACE) is a powerful risk factor for long-term sleep health. However, the degree to which ACE and its subtypes contribute to adulthood sleep problems remains unknown. For this systematic review and meta-analysis, PubMed, Embase, Web of Sciences, Cochrane library, and CNKI (Chinese) were searched from inception to 1 December 2021. Cohort studies that examined the association between ACEs (aged <18 y) and adulthood sleep outcomes (aged ≥18 y) were included. The most fully adjusted odds ratios (ORs) were extracted and pooled using the random-effects model. A total of nine articles involving 108 330 participants from five high-income countries were identified. Individuals with at least one ACE subtype were more likely to report adulthood sleep problems (OR = 1.14, 1.09-1.20, I2 = 77.5%, n = 9 studies) compared with those without ACE. The pooled ORs were approximately 1.20 for sexual, physical, and emotional abuse with high heterogeneity (I2 > 80%), 1.09 (95% CI: 0.99-1.19, I2 = 0%, n = 2) for neglect, and 1.21 (95% CI: 1.14-1.30, I2 = 73.6%, n = 3) for family dysfunction. Individuals with multiple ACEs were associated with a higher magnitude of the risk for sleep problems (OR = 1.33, 95% CI: 1.18-1.49, I2 = 87.3%, n = 3). In conclusion, the magnitude of the risk for sleep problems was similar across ACE subtypes except for childhood neglect. ACE may have cumulative detrime ntal effects on sleep health. More longitudinal evidence regarding ACE-sleep relationships, particularly in low- and middle-income countries, is needed. Furthermore, more policy efforts and evidence-based preventions are warranted to address ACEs among children.
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Experiências Adversas da Infância , Maus-Tratos Infantis , Transtornos do Sono-Vigília , Adulto , Criança , Maus-Tratos Infantis/psicologia , Estudos de Coortes , Humanos , Sono , Transtornos do Sono-Vigília/epidemiologiaRESUMO
Obesity is a known risk factor for type 2 diabetes mellitus (T2DM); however, the associations between underweight and T2DM and between weight status and prediabetes have not been systematically reviewed. We aimed to estimate the relative risks (RRs) of prediabetes/T2DM in underweight/overweight/obesity relative to normal weight. PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to December 8, 2021. Prospective cohort studies with a minimum 12-month follow-up period reporting the association between baseline body mass index (BMI) categories and risk of prediabetes/T2DM in adults were included. Study quality was assessed using the Newcastle-Ottawa Scale. The main analyses of T2DM risk were performed using the ethnic-specific (Asian/non-Asian) BMI classification and additional analyses of prediabetes/T2DM risk by including all eligible studies. Random-effects models with inverse variance weighting were used. Subgroup analyses and meta-regression were conducted to explore the potential effects of pre-specified modifiers. The study protocol was registered with PROSPERO (CRD42020215957). Eighty-four articles involving over 2.69 million participants from 20 countries were included. The pooled RR of prediabetes risk was 1.24 (95% CI: 1.19-1.28, I2 = 9.7%, n = 5 studies) for overweight/obesity vs. normal weight. The pooled RRs of T2DM based on the ethnic-specific BMI categories were 0.93 (95% CI: 0.75-1.15, I2 = 55.5%, n = 12) for underweight, 2.24 (95% CI: 1.95-2.56, I2 = 92.0%, n = 47) for overweight, 4.56 (95% CI: 3.69-5.64, I2 = 96%, n = 43) for obesity, and 22.97 (95% CI: 13.58-38.86, I2 = 92.1%, n = 6) for severe obesity vs. normal weight. Subgroup analyses indicated that underweight is a protective factor against T2DM in non-Asians (RR = 0.68, 95% CI: 0.40-0.99, I2 = 56.1%, n = 6). The magnitude of the RR of T2DM in overweight/obesity decreased with age and varied by region and the assessment methods for weight and T2DM. Overweight/obesity was associated with an increased prediabetes/T2DM risk. Further studies are required to confirm the association between underweight and prediabetes/T2DM, particularly in Asian populations.
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Diabetes Mellitus Tipo 2 , Estado Pré-Diabético , Adulto , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Sobrepeso/complicações , Sobrepeso/epidemiologia , Estado Pré-Diabético/complicações , Estado Pré-Diabético/epidemiologia , Estudos Prospectivos , Magreza/complicações , Magreza/epidemiologiaRESUMO
BACKGROUND: Suicide has become a severe public health issue worldwide. Body weight has been put forward as a potentially modifiable element for suicide thought and behavior. However, there are discrepancies across previous studies. Furthermore, the relationships of body weight with suicidal ideation and suicide attempt among low- and middle-income countries (LMICs) remain unclear. Therefore, we addressed this issue among 104,907 adolescents of 12-15 years old in 45 LMICs. METHODS: The present study used data from the Global School-based Student Health Survey (GSHS). Suicidal ideation and suicide attempt during the last year were self-reported. Participants were classified intro underweight, normal weight, overweight and obesity according to their body mass index classification. Multivariable logistic regression and meta-analyses based on country-wise estimates were conducted. RESULTS: The prevalence of suicidal ideation and suicide attempt were 11.8% and 13.0%, respectively. Countrywide meta-analysis demonstrated that overweight and obesity were significantly associated with increased risks of suicidal ideation (For overweight: OR = 1.10; 95% CI = 1.01-1.20; for obesity: OR=1.17; 95%CI: 1.01-1.35) and suicide attempt (For overweight: OR = 1.12; 95% CI = 1.02-1.23; for obesity: OR=1.12; 95%CI: 1.00-1.25). Subgroup analyses showed that the associations between overweight/obesity and suicide attempt were significant for girls but not for boys. LIMITATIONS: The cross-sectional design cannot explore causality; mental health factors were not assessed; suicidal behaviors were self-reported; significant heterogeneity across countries; only students attending school were included. CONCLUSIONS: Overweight/obesity was significantly associated with the risk of suicidal ideation and suicide attempt among adolescents in LMICs.
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Países em Desenvolvimento , Ideação Suicida , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Tentativa de SuicídioRESUMO
Child neglect (CN) has been associated with eating disorders, but little is known about its prospective association with the eating habits (EHs) of children. This study aimed to assess the cross-sectional and prospective associations of baseline CN with six common EHs in Chinese primary schoolchildren. We analyzed two-wave data of 1102 children (aged 9.1 ± 0.5 years) in Wuhan, China. Baseline CN was investigated by the Child Neglect Scale. Baseline and follow-up EHs, including fruit, vegetables, milk, sugar-sweetened beverages, and high-calorie snack and breakfast consumption frequency, were assessed by the Food Frequency Questionnaires. The association of baseline CN with baseline/follow-up EHs was analyzed by the generalized linear model (GLM). The association of baseline CN with the change of EHs from baseline to follow-up was examined by the Generalized estimating equation (GEE) model. After adjusting for demographic characteristics, pubertal stage, and body mass index, GLM indicated that higher baseline CN was associated with lower frequency of consuming fruit/vegetables/milk/breakfast and higher frequency of consuming sugar-sweetened beverages and high-calorie snacks at baseline, while it was only associated with lower frequency of vegetables/breakfast consumption and higher frequency of sugar-sweetened beverages consumption at follow-up. GEE results indicated that children with higher CN had a more rapid increase for the frequency of fruit/milk/breakfast consumption and a steeper decrease for the frequency of sugar-sweetened beverages consumption. In conclusion, higher CN was associated with unhealthy EHs. Yet simultaneously, children with higher CN have more scope to promote the health of their EHs. Targeting and reducing CN may be a promising approach for future interventions to improve subsequent EHs.
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Maus-Tratos Infantis , Comportamento Alimentar , Bebidas , Criança , Estudos Transversais , Frutas , Humanos , Estudos Prospectivos , VerdurasRESUMO
The study aimed to investigate the individual and combined association of health-risk behaviors with mental health among Chinese children. A cross-sectional study was conducted in Wuhan, China, from May to June 2018. Participants self-reported the information on physical activity (PA), screen time (ST), fruit and vegetable (FV) intake, and sleep duration. Mental health, including depression, social anxiety and self-esteem, was assessed using standard questionnaires. A total of 1296 children (704 males and 592 females) aged 9.2 ± 0.4 years were included in the present study. The prevalence of low PA, high ST, low FV intake, and inadequate sleep duration was 45.6%, 18.0%, 69.7%, and 64.7%, respectively. Overall, significant associations were found between individual health-risk behavior and increased risks of mental health. Furthermore, children with three or four health-risk behaviors showed significantly increased risks of anxiety (OR: 3.18, 95%CI: 1.63-6.21), depression (OR: 4.55, 95%CI: 2.28-9.09) and low self-esteem (OR: 3.59, 95%CI: 2.20-5.88) compared with those without health-risk behavior. Results of this study revealed a high prevalence of health-risk behaviors among Chinese children. Furthermore, the clustering of health-risk behavior was associated with significantly increased risks of mental health in this population. Considering these findings, it is important to perform early interventions to reduce children's health-risk behavior and prevent mental health problems.
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Exercício Físico , Saúde Mental , Criança , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Assunção de RiscosRESUMO
Introduction: Body weight perception (BWP) directly determines weight management behaviors. Although child neglect is a well-established risk factor for managing body weight, little is known about its association with the accuracy of BWP. This study aimed to assess the cross-sectional and longitudinal associations between child neglect and BWP accuracy in primary schoolchildren, and explore how these differ based on the sex of the child. Methods: The sample included 1,063 primary schoolchildren (557 boys and 506 girls, aged 8-10 years) from a two-wave observational study between 2018 and 2019 in Wuhan, China. Child neglect and BWP were investigated using self-administered questionnaires. The accuracy of BWP was defined by comparing the BWP and actual body weight, and it was categorized into three groups-consistent, underestimated, and overestimated. Multinomial logistic regression analysis was conducted with fitting child neglect as the independent variable and the accuracy of BWP as the dependent variable. Results: The prevalence of weight misperception was ~44% at baseline (underestimation 40%; overestimation 4%) in Chinese primary schoolchildren. In the cross-sectional analysis, children with a higher level of neglect were more likely to misperceive their body weight. Moreover, there was an apparent sex-related difference that boys who experienced a higher level of neglect significantly reported more underestimation, while girls reported more overestimation. There was no significant longitudinal association between child neglect and the change in BWP accuracy. Conclusions: This study revealed that a higher level of neglect was significantly associated with underestimated BWP in boys and overestimated BWP in girls. The mechanisms of sex-related difference and whether child neglect is involved in the change in BWP, merit further investigations.
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Maus-Tratos Infantis , Percepção de Peso , Índice de Massa Corporal , Peso Corporal , Criança , China , Estudos Transversais , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Multiple chronic diseases (MCDs) and social isolation are independent risk factors related to stroke and disability, but it is unknown whether the combination of these two conditions resulted from aging-related to functional disability in stroke patients. This study aimed to probe the relationship between the combination of MCDs, social isolation, and functional disability after stroke in elderly patients. METHODS: A multicenter and cross-sectional study was conducted in the Departments of Rehabilitation of 103 hospitals located in 23 cities across China. Stroke patients aged 60-90 years were selected for analysis. Demographic characteristics, lifestyles, and clinical information were investigated by questionnaires and medical records. MCDs (hypertension/ diabetes/ hyperlipidemia/heart disease/kidney disease) were categorized into three levels: 0, 1, and ≥ 2. Functional disability was assessed by the Barthel Index and categorized into four groups: no, mild, moderate, and severe disability. The multi-nominal logistic regression model was used to explore the independent and combined association of MCDs and social isolation with functional disability. RESULTS: A total of 4046 elderly stroke patients (55 % males) were included in the final analysis. The prevalence of social isolation, MCDs ≥ 2, and severe disability increased with aging. In the fully adjusted model, patients with social isolation or MCDs had a higher risk of functional disability significantly than those without. Patients with social isolation combined MCDs ≥ 2 were 35 times (95 % CI: 18.89-64.69) more likely to suffer severe disability after stroke, and 8 times (95 % CI: 18.89-64.69) for moderate disability than those without social isolation and MCDs. CONCLUSIONS: MCDs, social isolation, and their combination were associated with a higher risk of functional disability after stroke in Chinese elderly patients. The elderly population should be encouraged to participate in more social activities, particularly in those with MCDs. Future secondary prevention and rehabilitation treatments to the functional ability of elderly stroke patients should underscore both social activity and the combined treatments of MCDs. TRIAL REGISTRATION: NO: ChiCTR2000034067 .
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Pessoas com Deficiência , Múltiplas Afecções Crônicas , Acidente Vascular Cerebral , Atividades Cotidianas , Idoso , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Isolamento Social , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologiaRESUMO
Child neglect robustly predicts many behavioral problems and adulthood mental disorders, but little is known about its association with daily lifestyles and psychological development during childhood, particularly in the longitudinal study. We aimed to examine the association of child neglect with physical activity (PA), screen time (ST), eating habits (EHs), and depression/self-esteem using a two-wave follow-up study of primary schoolchildren in Wuhan, China. Data of 1085 schoolchildren aged 8-10 years (boys: 53.5%) were analyzed. Child neglect, lifestyles, and depression/self-esteem were collected in 2018 (T1) and 2019 (T2). Autoregressive cross-lagged models (ARCLMs) were fitted to explore the interrelationships among these variables. In ARCLM including child neglect and lifestyles, higher child neglect at T1 was significantly associated with higher ST and more risky EHs at T2, while insignificantly associated with PA. In ARCLM including child neglect and depression/self-esteem, lower T1 child neglect significantly predicted a higher T2 depression, but insignificantly for T2 self-esteem. In ARCLM including all variables, child neglect still significantly predicted later ST and depression, but insignificantly predicted EHs. Our study underscores that child neglect is strongly intertwined with ST, EHs, and depression during childhood. The prevention of child neglect may promote some healthy lifestyles and depression in children.
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Maus-Tratos Infantis , Depressão , Adulto , Criança , Seguimentos , Humanos , Estilo de Vida , Estudos Longitudinais , Masculino , AutoimagemRESUMO
Emerging evidence shows an association between protein intake during infancy and later obesity risk, and that association may differ by protein sources. This systematic review summarized and evaluated prospective cohort studies assessing the long-term association of total protein intake and protein sources during infancy (from birth to 2 y) with subsequent obesity outcomes in childhood or adolescence. Literature searches were conducted in Embase, Medline, Scopus, and Web of Science. Sixteen studies that reported associations between total protein intake and/or protein intake from different sources from birth to 2 y and ≥1 obesity outcomes in childhood or adolescence from 9 cohorts were identified. Most studies (11/16) were rated as high quality. The most frequently reported association was total protein intake and BMI (up to 10 y) with 6 out of 7 cohorts showing significant positive associations. Similar associations were found for animal protein, but not for plant protein. Limited studies examined the association between protein intake (both total and sources) and body composition (body fat, fat mass, and fat-free mass) and revealed inconsistent findings. Overall, higher intakes of total and animal protein during infancy were associated with higher BMI in childhood and adolescence. Future studies investigating the contribution of protein sources in long-term obesity development are needed. This review was registered at PROSPERO as CRD42020166540.
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Composição Corporal , Obesidade , Tecido Adiposo , Adolescente , Índice de Massa Corporal , Humanos , Estudos ProspectivosRESUMO
BACKGROUND: The link between high protein intake during infancy and obesity later in childhood has been much debated, and the association with differing protein sources remains unclear. OBJECTIVE: This study aimed to examine the associations between total protein intake and protein from different sources (ie, nondairy animal, dairy, and plant) reported at age 9 months and development in body mass index (BMI) z scores until age 5 years. DESIGN: This study involved a secondary data analysis of the Melbourne InFANT (Infant Feeding, Activity and Nutrition Trial) program, an observational prospective cohort study that was conducted from 2008 to 2013. PARTICIPANTS/SETTING: Participants were children (n = 345) who completed both the 9-month and 5-year follow-up visits within the Melbourne InFANT program. MAIN OUTCOME MEASURES: BMI z score was measured at age 5 years. STATISTICAL ANALYSES PERFORMED: Linear mixed models with a random effect for clusters of mother's group and with adjustment for baseline child and maternal covariates were conducted. RESULTS: With adjustment for covariates, every 1 g or 1% energy increase in total protein intake at age 9 months was associated with a 0.016-unit (95% CI 0.003 to 0.029) or 0.034-unit (95% CI 0.005 to 0.063) increase in BMI z score at age 5 years, respectively. With respect to protein sources, associations of similar magnitude were found for nondairy animal protein. No evidence of an association with BMI z score was found for dairy (including milk, yogurt, cheese, breast milk, and infant formula) and plant proteins. CONCLUSIONS: High intakes of total protein, nondairy animal protein, but not dairy or plant proteins, during infancy were associated with higher BMI z score in early childhood. These findings can inform dietary recommendations regarding protein intakes during infancy. CLINICAL TRIAL REGISTRATION: The InFANT program was registered with Current Controlled Trials (ISRCTN81847050); http://www.isrctn.com/ISRCTN81847050.
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Índice de Massa Corporal , Dieta/estatística & dados numéricos , Proteínas Alimentares/análise , Alimentos Infantis/análise , Obesidade Infantil/epidemiologia , Austrália/epidemiologia , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Análise por Conglomerados , Dieta/efeitos adversos , Feminino , Humanos , Lactente , Modelos Lineares , Masculino , Obesidade Infantil/etiologia , Obesidade Infantil/prevenção & controle , Estudos Prospectivos , Recomendações NutricionaisRESUMO
Chromosome 7 plays an important role in lung tumorigenesis. Chromosome 7 copy number changes might be an early event of lung cancer tumorigenesis. Here we investigate whether chromosome 7p copy number gain is a detectable genetic event with plasma cell-free DNA for early lung cancer detection. Eighteen surgical eligible lung cancer patients and eighteen non-cancer controls were recruited. Peripheral blood was collected before surgery. Cell-free DNA was profiled with low coverage whole-genome sequencing. Chromosome 7 copy number gains were defined as chr7 normalized coverage ≥1.0005 and p-value <0.05. Plasma cell-free DNA chr7 copy gains were then compared to pathological examinations on surgical tissues. 83.3% of patients were confirmed as malignancy post-operation, 12 patients with adenocarcinoma, and 3 with squamous-carcinoma. The other 16.7% were benign lesions. Cell-free DNA was successfully extracted from pre-surgical plasma samples, with a concentration range from 0.18 to 0.49 ng/µl. Chromosome 7 short arm copy gains were found in 66.7% (10/15) patients, including 66.7% (4/6) T1aN0M0 and 50.0% (1/2) Tis patients, otherwise, chr7p gain was found in 0% (0/3) benign lesions. The specificity was further examined in 18 volunteers who undergoing routine body examinations. Meanwhile, positive carcinoembryonic antigen (CEA) and cytokeratin-19-fragment (CYFRA21-1) were only found in 1/18 (5.7%) and 4/18 (22.2%), respectively. Taking together, Ultrasensitive- Chromosomal Aneuploidy Detector (UCAD) chr7p or UCAD chr7p and tumor biomarker positivity can predict 12/15 (80%, 95% CI: 49.0-94.3%) early lung cancers. Further analyses showed that chr7p copy number gains tend to be enriched in normal EGFR/KRAS patients (Fisher's test, p-value = 0.077). Chromosome 7p copy gain is a useful peripheral blood tumor biomarker from lung cancer detection.
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Ácidos Nucleicos Livres , Neoplasias Pulmonares , Antígenos de Neoplasias , Ácidos Nucleicos Livres/genética , Cromossomos , Variações do Número de Cópias de DNA , Humanos , Queratina-19 , Pulmão , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/genética , Estudos ProspectivosRESUMO
BACKGROUND: Adverse childhood experiences (ACEs) have been linked to long-term health outcomes, while the impact of such experience has not been investigated among Zambian youth. This study examined the associations of ACEs with individual and clusters of health risk behavior among college students in Zambia. METHOD: A total of 624 college students participated in this cross-sectional study. A self-administered questionnaire was used to collect information on their ACEs and health risk behaviors. RESULTS: There were 58.3% (364) reporting some forms of ACEs, with 27.6% (172), 16.3% (102), and 14.4% (90) being exposed to 1, 2, and ≥ 3 ACEs, respectively. The prevalence of health risk behaviors ranged from 6.0 to 34.2%. Overall, ACEs were associated with increased risk of smoking, binge drinking, suicide attempt, risky sexual behaviors, and illicit drug use. Logistic regression suggested that participants with ≥ 3 ACEs (OR, 3.62; 95% CI, 2.14-6.13) were more likely to engage in the unhealthy cluster, characterized by the presence of any health risk behavior, than those without ACE. CONCLUSION: ACEs were associated with individual and clustering of health risk behaviors among Zambia college students. Our study suggests that early intervention is needed to prevent long-term adverse health consequences in this population.
Assuntos
Experiências Adversas da Infância , Comportamentos de Risco à Saúde , Estudantes/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Assunção de Riscos , Fumar/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Adulto Jovem , ZâmbiaRESUMO
This study aimed to evaluate the effectiveness of a school-based nutrition education and physical activity intervention on cardiovascular risk profile and mental health outcomes among Chinese children with obesity. Two primary schools were randomly allocated to the control group (CG) and the intervention group (IG). We selected children with obesity from 1340 students in the third and fourth grades as participants. The IG received 8 months of nutrition education and physical activity intervention, while the CG was waitlisted. A generalized estimating equation model was applied to assess repeated variables over time. A total of 171 children with obesity (99 IG and 72 CG) aged 9.8 ± 0.7 years completed the post-intervention stage. Compared with baseline, significant reductions were observed within the IG for depression and fasting plasma glucose at post-intervention. After adjusting for confounders, group and time interaction effects showed that the IG achieved improvements in the risk of poor well-being (p = 0.051) and social anxiety (p = 0.029), had decreased diastolic blood pressure (p = 0.020) and fasting plasma glucose (p < 0.001), and had significantly increased high-density lipoprotein (p < 0.001) from baseline to post-intervention relative to the CG. The effects of school-based nutrition education and physical activity intervention on children with obesity are diverse, including not only the improvement of metabolic health but also mental health promotion.
Assuntos
Ciências da Nutrição Infantil/educação , Exercício Físico , Obesidade Infantil/psicologia , Obesidade Infantil/terapia , Serviços de Saúde Escolar , Criança , China , Feminino , Educação em Saúde , Promoção da Saúde , Humanos , Masculino , Saúde MentalRESUMO
BACKGROUND: Fruit and vegetable intake (FVI) has been inversely associated with the risk of depression. However, there is a gap in evidence from low- and middle-income countries (LMICs) and among adolescents. Further, little is known about FVI in relation to the risk of anxiety. Therefore, we examined these associations among adolescents in 25 LMICs. METHODS: Data from the Global School-based Student Health Survey were analyzed in 65267 adolescents aged 12-15 years (mostly nationally representative). Depressive and anxiety symptoms during the past 12 months were self-reported. Frequencies of FVI during the past 30 days were collected. Multivariable logistic regression and meta-analyses of country-wise estimates were undertaken. RESULTS: The prevalence of depressive and anxiety symptoms were 30.3% and 9.8%, respectively. A meta-analysis indicated that FVI of <5 times/d (vs. higher) was associated with an increased risk of depressive symptoms (OR = 1.10; 95% CIâ¯=â¯1.02-1.18). The pooled estimate for anxiety symptoms was insignificant. When examined separately, fruit intake was significantly associated with both lower risks of depressive and anxiety symptoms; vegetable intake was significantly associated with a lower risk of depressive symptoms, but not with anxiety. LIMITATIONS: Only adolescents attending school were included; the cross-sectional design cannot reveal causality; outcomes were not measured against the gold-standard diagnostic criteria. CONCLUSIONS: Our study provides multi-national evidence of the protective effect of FVI against depressive and anxiety symptoms among adolescents in LMICs, enabling key stakeholders to address mental health issues among adolescents globally.