Chemistries of bifunctional PROTAC degraders.

Proteolysis targeting chimeras (PROTACs) technology is a novel and promising therapeutic strategy using small molecules to induce ubiquitin-dependent degradation of proteins. It has received extensive attention from both academia and industry as it can potentially access previously inaccessible targets. However, the design and optimization of PROTACs present big challenges for researchers, and the general strategy for its development and optimization is a lot of trial and error based on experience. This review highlights the important advances in this rapidly growing field and critical limitations of the traditional trial-and-error approach to developing PROTACs by analyzing numerous representative examples of PROTACs development. We summarize and analyze the general principles and strategies for PROTACs design and optimization from the perspective of chemical structure design, and propose potential future pathways to facilitate the development of PROTACs.

[Evaluate the dietary quality of pregnant women using the adjusted diet balance index for pregnancy].

OBJECTIVE: To update the Chinese diet balance index for pregnancy(DBI＿P), evaluate the dietary quality of pregnant women at different stages of pregnancy and analyze the influencing factors. METHODS: The DBI＿P was adjusted according to the recommended intake of various foods for pregnant women at different stages in the newly released Dietary Guidelines for Chinese Residents(2022) and and the balanced dietary pagoda for pregnant women. A total of 521 pregnant women in Taicang were investigated by questionnaire and 3-day food records method. Their basic information and food intake in the first, second and third trimester were collected. Low bound score(LBS), high bound score(HBS), diet quality distance(DQD) of DBI＿P were used to evaluate the dietary quality of each stage of pregnancy and multiple linear regression method was used to analyze the influencing factors of dietary quality. RESULTS: There was insufficient intake of cereals, vegetables, fruits, dairy products, soy nuts, aquatic products and food categories at all stages of pregnancy. The intake of eggs was sufficient at each stage of pregnancy. The intake of meat and poultry was excessive at all stages of pregnancy. The proportion of pregnant women with insufficient vegetable intake in the first, second and third trimester all exceeded 70%. The proportion with insufficient daily food categories in each term was more than 90%. The proportion with excessive intake of meat and poultry increased from 74.5% in the first trimester to 84.1% in the third trimester. The mean of LBS in each stage of pregnancy were 16.0, 15.5 and 15.1, and the proportion with moderate to severe insufficient intake were 14.2%, 12.2% and 9.2%, respectively. The mean of HBS in each stage of pregnancy were 4.3, 4.8 and 4.9, and the proportion with moderate to severe excessive intake were 4.3%, 5.4% and 4.5%, respectively. The mean of DQD in each stage of pregnancy were 20.3, 20.3 and 20.0, and the proportion with moderate to severe imbalanced intake were 26.9%, 26.1% and 21.7%, respectively. The proportion of pregnant women with low imbalanced intake or balanced diet during the whole pregnancy was 51.1%. Compared with pregnant women under 25 years of age, pregnant women ≥25 years of age had a lower degree of insufficient and unbalanced dietary intake(ß=-0.99, 95%CI-1.94--0.03). With the increase of education level, the degree of insufficient and unbalanced dietary intake of pregnant women showed a downward trend, while the degree of excessive intake increased only in college graduates(ß=0.66, 95%CI 0.11-1.22). Compared with pregnant women living in rural areas, pregnant women living in urban areas had a lower degree of excessive dietary intake(ß=-0.59, 95%CI-0.97--0.21). CONCLUSION: The dietary structure of pregnant women in Taicang is imbalanced, and the dietary quality is affected by sociodemographic characteristics.

[Relationship between sleep duration and hypertension among elderly residents in 15 provinces of China in 2015].

OBJECTIVE: To explore the relationship between the duration of sleep and hypertension among residents aged 60 and above in 15 provinces of China. METHODS: Based on the China Health and Nutrition Survey in 2015, 4078 residents aged 60 and above who provided complete diagnostic information on sleep duration and blood pressure were selected as subjects by stratified multi-stage cluster random sampling. RESULTS: The average age of participants aged 60 and above in 15 provinces was 68.41 years old, with 1915 were male, 2163 were female, 1683 urban participants and 2464 rural participants. After adjusting for gender, age, education, and economic confounding factors, Model 2 found that subjects who slept less than 7 h/d and those who slept more than 8 h/d had an increased risk of developing hypertension compared with the recommended sleep duration, the ORs were 1.24(95%CI 1.03-1.51) and 1.38(95%CI 1.15-1.65). Adding the sitting time, smoking, drinking and obesity to the Model 2, compared with the recommended sleep duration, subjects who slept less than 7 h/d and those who slept more than 9 h/d had an increased risk of hypertension. The ORs values were 1.27(95%CI 1.04-1.56) and 1.40(95%CI 1.16-1.70). CONCLUSION: The proportion of the elder aged 60 and older who sleep less than 7 h/d or more than 9 h/d has increased hypertension.

[Main food intake prediction of Chinese residents based on grey model].

OBJECTIVE: To predict the main food intake trend of the China's urban and rural residents from 2022 to 2030. METHODS: Data was collected from the China Health and Nutrition Survey(CHNS), which was carried out on a stratified, multistage, clustered, and random sampling method. And the average daily food intake in the survey was continuously collected by a 24-hour dietary review method for 3 consecutive days. The sample sizes aged 20 years or older of seven rounds survey were 9794, 9425, 9313, 9726, 12 760, 15 446 and 15 051, respectively. Based on the seven rounds of average food intake, the main food intake of urban and rural residents in China from 2022 to 2030 was predicted by the Grey model. RESULTS: (1)The mean absolute percentage error of average food intake prediction in urban and rural ranged from 1.6% to 38.4%. (2)In terms of the trends of food intake from 2022 to 2030, the grain and vegetable average intake of plant food in urban and rural residents showed a decreasing trend, while the average intake of fruits showed an increasing trend. The average intake of animal food, such as poultry and aquatic products in urban, livestock, poultry, eggs in rural areas showed an upward trend. Meanwhile, the average intake of animal food, such as livestock and eggs in urban and aquatic products in rural showed a downward trend. (3)Compared with the 2018, the fruits, poultry and aquatic product intake of urban and rural residents in 2030 will increase by 60.7%, 29.4% and 6.6%, the intake of grain, vegetables, livestock and eggs in urban areas will decrease by 36.9%, 19.4%, 8.7% and 12.4%, respectively. In 2030, the intake of fruits, livestock, poultry and eggs of rural residents will increase by 88.9%, 31.8%, 71.9% and 9.2%, respectively. While the intake of grain, vegetables and aquatic products of rural residents will decrease by 32.5%, 24.8% and 2.2%, respectively. (4)By 2030, the average intake of poultry in urban and rural areas will be within the recommended range of dietary guidelines. But the average intake of grain, vegetables, fruits, eggs and aquatic products in urban and rural areas will remain below dietary recommendations. While the livestock average intake will be far higher than the recommendations. CONCLUSION: The model accuracy is different when applied to different kinds of food. According to the prediction result of the grey model, residents should be guided to maintain the current grain intake level and increase the intake of vegetables, fruits, poultry, eggs and aquatic products in order to get balanced diet, while reducing the intake of livestock.

Application of the Global Diet Quality Score in Chinese Adults to Evaluate the Double Burden of Nutrient Inadequacy and Metabolic Syndrome.

BACKGROUND: The double burdens of under- and overnutrition are changing the health of individuals and the economic and disease burdens in China. Poor diet plays an important role; however, a valid and easily operationalized metric that could capture the full range of characteristics of the diet that are relevant to both under- and overnutrition is lacking in China. OBJECTIVES: We aimed to examine the application of the Global Diet Quality Score (GDQS) to evaluate nutrient inadequacy and metabolic syndrome in different demographic groups of Chinese adults. METHODS: A total of 35,146 individuals (men 14,978, women 20,168) aged >18 y from the 2010-2012 China National Nutrition and Health Survey were included. We scored the GDQS using average intakes of 25 food groups from 3 d of 24-h dietary recalls. Double burden was defined as coexisting metabolic syndrome and nutrient inadequacy. RESULTS: Diet quality assessed by GDQS was significantly higher in urban than in rural residents (20.8 compared with 18.7), and increased with both educational level and household income (P-trends < 0.0001). A higher GDQS score was inversely associated with metabolic syndrome and nutrient inadequacy, or both (P-trends < 0.0001): multivariate adjusted ORs comparing extreme quintiles of GDQS were 0.79 (95% CI: 0.69, 0.91) for metabolic syndrome, 0.17 (95% CI: 0.14, 0.20) for nutrient inadequacy, and 0.59 (95% CI: 0.50, 0.69) for the double burden. These associations were consistent across different household income levels (P-interaction = 0.26), suggestively stronger in younger (<50 y), females, urban residents, and the more highly educated (P-interaction < 0.05) compared with their counterparts. CONCLUSIONS: A higher GDQS was inversely associated with a double burden of nutrient inadequacy and metabolic syndrome across various subgroups of Chinese adults. The finding supports the use of the GDQS in different demographic groups of Chinese adults to assess diet quality and nutritional status.

There's an App for That: Development of an Application to Operationalize the Global Diet Quality Score.

BACKGROUND: The global diet quality score (GDQS) is a simple, standardized metric appropriate for population-based measurement of diet quality globally. OBJECTIVES: We aimed to operationalize data collection by modifying the quantity of consumption cutoffs originally developed for the GDQS food groups and to statistically evaluate the performance of the operationalized GDQS relative to the original GDQS against nutrient adequacy and noncommunicable disease (NCD)-related outcomes. METHODS: The GDQS application uses a 24-h open-recall to collect a full list of all foods consumed during the previous day or night, and automatically classifies them into corresponding GDQS food group. Respondents use a set of 10 cubes in a range of predetermined sizes to determine if the quantity consumed per GDQS food group was below, or equal to or above food group-specific cutoffs established in grams. Because there is only a total of 10 cubes but as many as 54 cutoffs for the GDQS food groups, the operationalized cutoffs differ slightly from the original GDQS cutoffs. RESULTS: A secondary analysis using 5 cross-sectional datasets comparing the GDQS with the original and operationalized cutoffs showed that the operationalized GDQS remained strongly correlated with nutrient adequacy and was equally sensitive to anthropometric and other clinical measures of NCD risk. In a secondary analysis of a longitudinal cohort study of Mexican teachers, there were no differences between the 2 modalities with the beta coefficients per 1 SD change in the original and operationalized GDQS scores being nearly identical for weight gain (-0.37 and -0.36, respectively, P < 0.001 for linear trend for both models) and of the same clinical order of magnitude for waist circumference (-0.52 and -0.44, respectively, P < 0.001 for linear trend for both models). CONCLUSION: The operationalized GDQS cutoffs did not change the performance of the GDQS and therefore are recommended for use to collect GDQS data in the future.

Development and Validation of a Novel Food-Based Global Diet Quality Score (GDQS).

BACKGROUND: Poor diet quality is a major driver of both classical malnutrition and noncommunicable disease (NCD) and was responsible for 22% of adult deaths in 2017. Most countries face dual burdens of undernutrition and NCDs, yet no simple global standard metric exists for monitoring diet quality in populations and population subgroups. OBJECTIVES: We aimed to develop an easy-to-use metric for nutrient adequacy and diet related NCD risk in diverse settings. METHODS: Using cross-sectional and cohort data from nonpregnant, nonlactating women of reproductive age in 10 African countries as well as China, India, Mexico, and the United States, we undertook secondary analyses to develop novel metrics of diet quality and to evaluate associations between metrics and nutrient intakes and adequacy, anthropometry, biomarkers, type 2 diabetes, and iteratively modified metric design to improve performance and to compare novel metric performance to that of existing metrics. RESULTS: We developed the Global Diet Quality Score (GDQS), a food-based metric incorporating a more comprehensive list of food groups than most existing diet metrics, and a simple means of scoring consumed amounts. In secondary analyses, the GDQS performed comparably with the Minimum Dietary Diversity - Women indicator in predicting an energy-adjusted aggregate measure of dietary protein, fiber, calcium, iron, zinc, vitamin A, folate, and vitamin B12 adequacy and with anthropometric and biochemical indicators of undernutrition (including underweight, anemia, and serum folate deficiency), and the GDQS also performed comparably or better than the Alternative Healthy Eating Index - 2010 in capturing NCD-related outcomes (including metabolic syndrome, change in weight and waist circumference, and incident type 2 diabetes). CONCLUSIONS: The simplicity of the GDQS and its ability to capture both nutrient adequacy and diet-related NCD risk render it a promising candidate for global monitoring platforms. Research is warranted to validate methods to operationalize GDQS assessment in population surveys, including a novel application-based 24-h recall system developed as part of this project.

[Application of different spatial interpolation methods in sodium intake estimation].

OBJECTIVE: The spatial interpolation method was used to estimate the intake of sodium in the areas without dietary sodium intake data. METHODS: The data of dietary sodium consumption in this study are from the 2010-2012 China National Nutrition and Health Surveillance(CNNHS), the CNNHS was carried out on stratified multistage systematic clustered random sampling method with proportional to the population to form a representative sample of China as a whole, including 150 survey site. Dietary data was collected through face-to-face interview, based on a combination of three consecutive days of 24-h recalls combined with a household food weighting method, a total of 48 826 participants aged 20 years old and more were recruited in this study. The average sodium intake among 150 survey sites were calculated according to data of the CNNHS 2010-2012. The accuracy of spatial analysis techniques, such as Inverse Distance Weight, Ordinary Kriging, Cooperative Kriging method and Regression Kriging Interpolation method, was compared in the estimation of dietary sodium intake. The spatial analysis method with the highest accuracy was used to estimate the daily dietary sodium intake of each district and county in China, and then the dietary sodium intake of each province was calculated according to the population weight. RESULTS: The average sodium intake among Chinese adults was 5. 18 g, among which the average intake of men is 5. 33 g and that of women was 5. 03 g. Comparing the accuracy of four spatial analysis method in estimating dietary sodium intake, it was found that the Regression Kriging Interpolation method was superior to the other three methods, with root mean square error and mean absolute error of 0. 54 and 0. 44. The Regression Kriging Interpolation method was used to estimate the dietary sodium intake in different regions of China, the estimated national dietary sodium intake by population weighted calculation was 5. 17 g/d, the estimated national dietary sodium intake was 5. 33 g/d for men and 5. 01 g/d for women. The difference rate between the measured and estimated dietary sodium intake for all age groups was not more than 10%. Shandong Province, Tianjin City and Hebei Province had the highest sodium intake, which was 5. 98 g/d, 5. 83 g/d and 5. 82 g/d, respectively. Guizhou Province had the lowest sodium intake, with an estimated intake value of 4. 27 g/d. CONCLUSION: The spatial interpolation method can be used to estimate the intake of sodium, and the accuracy of Regression Kriging Interpolation method is higher than other spatial interpolation method.

[China prime diet quality score].

OBJECTIVE: To Develop the China Prime Diet Quality Score(CPDQS) and evaluate the relationship between dietary quality and health-related outcomes in Chinese adults. METHODS: CPDQS was conducted by 22 components, including dark green vegetables, dark red/orange vegetables, other vegetables, dark yellow fruits, citrus fruits, other fruits, whole grains/legumes, sweet potato, other potatoes, soybean, nuts, poultry, fish and shrimp, milk, eggs, red meat, fried food, refined grains, sugar sweetered beverages, salt, cooking oil, and alcohol. CPDQS components were selected based on Chinese Dietary Guidelines, and the values of each CPDQS components were set according to the dietary recommendations of foods and nutrients. According to the recommended amount of all kinds of foods under energy requirements of 2000 kcal in the Balanced Diet Pagoda, the basic score for each kind of food was 0-4, and the total score of the 22 components ranges from 0 to 100. Dietary quality of Chinese residents was evaluated according to CPDQS by analyzing data of adults aged 20-80 from Chinese Nutrition and Health Surveillance in 2010-2012. RESULTS: Mean of CPDQS for Chinese residents aged 20 and above was 40. 28±0. 08. CPDQS was higher in urban areas than in rural areas with median 48 and 39 respectively. CPDQS of female was slightly higher than that of male with median 44 and 43 respectively. CPDQS showed significantly correlation with all kinds of nutrients, in which correlation coefficient with carbohydrate and MPA was-0. 18 and 0. 35. With the increase of CPDQS score, the risk of overweight and obesity, abdominal obesity, hypertension, low high-density lipoprotein cholesterol-emia and metabolic syndrome decreased. After multi-factor adjustment, ORs of the highest quantile-group were 0. 73(95%CI 0. 63-0. 84), 0. 72(95%CI 0. 63-0. 83), 0. 67(95%CI 0. 57-0. 78), 0. 85(95%CI 0. 73-0. 99) and 0. 72(95%CI 0. 61-0. 85), respectively compared with the lowest quantile-group. CONCLUSION: CPDQS is a simplified index for comprehensive evaluation of dietary quality and it can reflect differences in diet quality among people in different regions and different health conditions. CPDQS could be used as an effective tool for evaluation of dietary quality.

[Status of parents' feeding behavior and influencing factors in 3-5 years old children in 5 provinces (autonomous regions and municipalities) of China in 2018].

OBJECTIVE: To understand the status of preschool children's feeding behavior, to analyse the feeding behavior of parents and its main influencing factors of children aged 3-5 years old. METHODS: From August to December 2018, 10 kindergartens in Liaoning Province, Shanghai City, Inner Mongolia Autonomous Region, Guangdong Province and Sichuan Province were selected by means of convenient sampling. A survey of 1057 preschool children's caregivers was conducted using the caregiver feeding style questionnaire. Chi-square test and binary Logistic regression were used to analyze the demographic characteristics of families with different feeding behaviors. RESULTS: It was found that among the four feeding style, the authoritative type accounted for only 10. 3%, and the authoritarian type accounted for 36. 1%, followed by the indulgent type(35. 8%) and the uninvolved type(17. 8%). Parents of 5-year-old were more likely to adopt indulgent type(OR=2. 60, 95%CI 1. 60-4. 22);fathers with a college degree or above were more likely to adopt authoritarian type(OR=2. 77, 95%CI 1. 39-5. 52) and indulgent type(OR=3. 79, 95%CI 1. 86-7. 72); mothers as primary caregivers were more likely to adopt authoritarian feeding method(OR=2. 48, 95%CI 1. 06-5. 83) and grandparents as primary caregivers were more likely to adopt indulgent feeding method(OR=3. 49, 95%CI 1. 54-7. 91). CONCLUSION: The proportion of children aged 3-5 whose parents adopt authoritarian, indulgent feeding method is higher. Among them, mothers are more likely to adopt authoritarian feeding behaviors, grandparents are more likely to adopt permissive feeding behaviors, and fathers with higher education are more likely to adopt authoritarian and permissive feeding behaviors.

Screen time and childhood overweight/obesity: A systematic review and meta-analysis.

BACKGROUND: Controlling childhood overweight/obesity would help early prevention on children from getting chronic noncommunicable diseases, exposing to screen for long periods may increase the risk of overweight/obesity due to lack of physical activity and tend to intake too much energy, and the relationship between screen time and overweight/obesity is inconsistent. Thus, the object of the present study was to estimate the relationship between screen time and overweight/obesity in children (<18 years) by systematically review prevalence studies. METHODS: We collected data from relevant studies published up to May 2019 using predefined inclusion/exclusion criteria. And all the literatures were searched in PubMed, ScienceDirect, Embase, and Web of Science. RESULTS: A total of 16 studies met the criteria and were included in the meta-analysis. When compared with the screen time <2 hr/day, an increased overweight/obesity risk among children was shown in the screen time ≥2 hr/day (OR = 1.67; 95% CI [1.48, 1.88], P < .0001). The subgroup analysis showed a positive association between the different types of screen time and overweight/obesity among children. CONCLUSION: Based on our study, increasing screen time could be a risk factor for being overweight/obesity in children and adolescents.

Prevalence of metabolic syndrome and individual metabolic abnormalities in China, 2002-2012.

BACKGROUND AND OBJECTIVES: The purpose of our study was to estimate the national prevalence of metabolic syndrome, its individual components and its changes in the past decade. METHODS AND STUDY DESIGN: Two national-representative cross-sectional surveys: the China National Nutrition and Health Survey 2002 (CNNHS 2002) and the Chinese National Nutrition and Health Surveillance 2010-2012 (CNNHS 2010-2012). A total of 48,235 and 104,098 participants aged 18 years or older who had completed data on physical examination, blood lipids, and fasting glucose tests from CNNHS 2002 and CNNHS 2010-2012, respectively, were included in current study. RESULTS: The prevalence of metabolic syndrome in Chinese adults increased from 9.5% (95% confident interval [CI]: 9.2%-9.7%) in 2002 to 18.7% (18.3%-19.1%) in 2010-2012, corresponding to an estimated 83.6 million adults in 2002 and 189 million adults in 2010-2012 living with metabolic syndrome in China. The increment was more than doubled among young, rural residents and those from poor households. Abdominal obesity, hyperglycemia, high triglycerides, low HDL-C, and elevated blood pressure were found in 18.9% (18.5%-19.3%), 6.4% (6.2%-6.7%), 13.8% (13.5%-14.2%), 19.3% (18.9%-19.7%), and 34.0% (33.5%-34.5%) of adults in 2002, respectively, which was 25.8% (25.3%-26.2%), 16.2% (15.8%-16.5%), 23.7% (23.3%-24.2%), 32.6% (32.0%-33.1%), and 34.4% (33.9%-34.9%), respectively, in 2010-2012. CONCLUSIONS: Based on two nationally representative surveys, our results indicated that the prevalence of metabolic syndrome is widespread and increasing in China.

[A cohort study of serum leptin level in Zhejiang Province middle and old age residents on blood pressure and hypertension from 2014 to 2017].

OBJECTIVE: To investigate the association between serum leptin concentration with blood pressure and hypertension in different gender. METHODS: A total of 343 non-hypertensive residents aged 30 to 65 were randomly selected from Zhejiang Province in 2014. Parameters including height, weight, waist, blood pressure, serum lipid and serum leptin concentration of participants were measured and determined by physical examination and laboratory detection in 2014 and 2017. The differences in serum leptin levels between the new hypertensive and non-hypertensive people were compared after three years. The relationship between serum leptin levels and hypertension was analyzed by Logistic regression. RESULTS: In 2014 and 2017, concentration of serum leptin in females was significantly higher than that in males, and the blood pressure in males was higher than that in females. At the end of follow-up, 26 new cases of hypertension were found. Serum leptin levels were higher in the female hypertensive group than in the non-hypertensive group(P=0. 0289), whereas there was no statistical difference in males(P>0. 01). Regardless of gender, serum leptin was significantly positively correlated with body mass index(BMI) and waist-to-height ratio(WHtR)(P<0. 0001), and also had correlation with blood pressure. However, after adjusting for BMI or WHtR, the correlation between serum leptin and blood pressure disappeared(P>0. 01). Logistic regression also showed the similar result. CONCLUSION: Serum leptin is not directly related to blood pressure and hypertension, and the positive correlation between them may be explained largely by BMI and WHtR.

Preclinical Study of Anticoagulation Regimens in Sheep After Implantation of CH-VAD Blood Pump.

Effective anticoagulation regimens are needed to reduce risks of thrombosis and bleeding in animal models of ventricular assist device to verify its hemocompatibility, biologic safety and reliability. This study is to develop a validated anticoagulation procedure for a sheep model to test the newly developed CH-VAD. CH-VAD models were established in six healthy sheep by constructing blood bypass of left ventricle → ventricular assist device → descending aorta. Heparin infusion was used during operation and in the prior 4 days to maintain activated clotting time 1.5-2.0 times the baseline. From the third day, proper dosage of warfarin was used orally to maintain international normalized ratio values within the range of 1.2-2.0. After termination, we examined whether there was thrombosis in the blood pump, grafts, and anastomotic stoma. Macroscopic and histopathologic examinations were performed in major organs to check for congestion and infarction. Bleeding complications were not found in any animals throughout the experiments. Activated clotting time values were 326 ± 33 s intraoperatively and 157 ± 28 s in the prior 4 days postoperatively. Activated partial thromboplastin time values increased slowly and reached the lower limit of the target range on the fourth day. Only in one of six cases was thrombus or fibrosis tissue found in the blood flow channel of the pump. Pathologic analysis showed no thrombosis, necrosis and microembolus in end-stage organs. Under the anticoagulation regimens, coagulation system could be well controlled to avoid thrombosis and bleeding complications in sheep models for CH-VAD.

Vitamin D status among the elderly Chinese population: a cross-sectional analysis of the 2010-2013 China national nutrition and health survey (CNNHS).

BACKGROUND: Vitamin D inadequacy is common among the elderly, especially within the Asian population. The vitamin D status among healthy adults in the elderly Chinese population was evaluated. METHODS: A total of 6014 healthy adults aged 60 years or older (2948 men, 3066 women) participated in this descriptive cross-sectional analysis. Possible predictors of vitamin D inadequacy were evaluated via multiple logistic regression analyses. RESULTS: The median serum 25-hydroxyvitamin D (25(OH)D) levels were 61.0 nmol/l (interquartile range (IQR) 44.3-80.6, range 5.1-154.5) for men and 53.7 nmol/l (IQR 38.8-71.0, range 6.0-190.0) for women, with 34.1% (95% confidence interval (CI) 32.4-35.8) of men and 44.0% (95% CI 42.2-45.8) of women presenting vitamin D inadequacy (25(OH)D <50 nmol/l). According to the multivariate logistic regression analyses, vitamin D inadequacy was positively correlated with female gender (P <0.0001), underweight (P = 0.0259), the spring season (P <0.0001), low ambient UVB levels (P <0.0001) and living in large cities (P = 0.0026). For men, vitamin D inadequacy was positively correlated with the spring season (P = 0.0015), low ambient UVB levels (P <0.0001) and living in large cities (P = 0.0022); for women, vitamin D inadequacy was positively correlated with the spring season (P = 0.0005) and low ambient UVB levels (P <.0001). CONCLUSIONS: Vitamin D inadequacy is prevalent among the elderly population in China. Because residing in regions with low ambient UVB levels increases the risk of vitamin D inadequacy both for men and women, vitamin D supplementation and sensible sun exposure should be encouraged, especially during the cooler seasons. Further studies are required to determine the optimal vitamin D intake and sun exposure levels to maintain sufficient vitamin D levels in the elderly Chinese population.

Vitamin D deficiency prevalence and risk factors among pregnant Chinese women.

OBJECTIVE: To evaluate vitamin D deficiency prevalence and risk factors among pregnant Chinese women. DESIGN: A descriptive cross-sectional analysis. SETTING: China National Nutrition and Health Survey (CNNHS) 2010-2013. SUBJECTS: A total of 1985 healthy pregnant women participated. Possible predictors of vitamin D deficiency were evaluated via multiple logistic regression analyses. RESULTS: The median serum 25-hydroxyvitamin D level was 15·5 (interquartile range 11·9-20·0, range 3·0-51·5) ng/ml, with 74·9 (95 % CI 73·0, 76·7) % of participants being vitamin D deficient (25-hydroxyvitamin D <20 ng/ml). According to the multivariate logistic regression analyses, vitamin D deficiency was positively correlated with Hui ethnicity (P=0·016), lack of vitamin D supplement use (P=0·021) and low ambient UVB level (P<0·001). In the autumn months, vitamin D deficiency was related to Hui ethnicity (P=0·012) and low ambient UVB level (P<0·001). In the winter months, vitamin D deficiency was correlated with younger age (P=0·050), later gestational age (P=0·035), higher pre-pregnancy BMI (P=0·019), low ambient UVB level (P<0·001) and lack of vitamin D supplement use (P=0·007). CONCLUSIONS: Vitamin D deficiency is prevalent among pregnant Chinese women. Residing in areas with low ambient UVB levels increases the risk of vitamin D deficiency, especially for women experiencing advanced stages of gestation, for younger pregnant women and for women of Hui ethnicity; therefore, vitamin D supplementation and sensible sun exposure should be encouraged, especially in the winter months. Further studies must determine optimal vitamin D intake and sun exposure levels for maintaining sufficient vitamin D levels in pregnant Chinese women.

[Effect of body mass index, waist-to-height ratio and dietary fat on serum leptin level of middle-age adult in Zhejiang Province].

OBJECTIVE: To investigate the association between body mass index(BMI), waist-to-height ratio(WHtR) and dietary fat with serum leptin concentration. METHODS: A three-day 24-h dietary recall method was conducted on 513 participants aged30-65 years who were randomly selected from Zhejiang Province in 2014 to investigate usual fat intake. In addition, parameters including height, weight, waist and serum leptinconcentration of participants were measured and determined by physical examination and laboratory detection. RESULTS: Concentration of serum leptin in women was significantly higher than that in men( P< 0. 001). Both BMI and WHtR were positively correlated with serum leptin level( men: r=0. 488 and 0. 576, women: r =0. 453 and 0. 333, P<0. 0001), but only correlation of WHtR that men(r=0. 354, P<0. 0001) and BMI in women(r=0. 321, P< 0. 0001) remained when BMI and WHtR were controlled respectively. Standardized partial regression coefficient of WHtR(ß =0. 27) was higher than that of BMI(ß=0. 21) in men while in women the coefficient of BMI(ß=0. 26)was higher than that of WHtR(ß = 0. 20). Serum leptin level was negatively correlated with total energy, total fat and MUFA in men(P<0. 05), but the correlation between total energy and leptin was disappeared when WHtR was controlled for. Serum leptin level was positively correlated with the proportion of PUFA from total energy and(PUFA +MUFA) ∶ SFA in women(P<0. 05), while only the correlation between the proportion of PUFA from total energy and leptin remained when BMI was controlled for. CONCLUSION: Obesity degree was gender-specifically positively correlated with serum leptin level, which indicated different obesity indicators should be used for men and women when analyzing serum leptin. Serum leptin was negatively correlated with total fat and MUFA in men, while positively correlated with the proportion of PUFA from total energy in women.

[Consumption of fruits and vegetables in Chinese adults from 2010 to 2012].

OBJECTIVE: To analyze the consumption of fruits and vegetables of Chinese adults. METHODS: Data were collected from 2010-2012 China National Nutrition and Health Surveillance. Information on fruits and vegetables consumption was collected by using the 24 h recall method for 3 consecutive days. Using the multi-stage stratified cluster randomization sampling method. The participants selected were more than 18 years old of 150 counties from 31 provinces in China. Age and sex standardization was performed based on the China 2009 population published by National Statistics Bureau. The average consumption of vegetables or fruits after weight adjustment for complex sampling was reported to analyze the consumption of fruits and vegetables of Chinese adults (x ± Sx). RESULTS: The average daily consumptions of vegetables and fruits for Chinese residents were (255 ± 6) and (36 ± 3)g/d, respectively. The total consumptions of fruits and vegetables were (291 ± 7)g/d, (295 ± 8)g/d for male, (286 ± 7)g/d for female. Rates on intake of vegetables in Chinese adults during the three survey days were 99.0%-99.8%.Rates on intake of fruits of urban and rural residents were 36.9%-51.5% and 21.3%-30.3%,respectively.The proportion of people whose total amount of vegetables and fruits intake reached 400 g/d were 24%-28% and 13%-23% in urban and rural areas, respectively. In urban and rural areas, the proportion of adults whose consumption reached Chinese dietary guidelines recommended level were 22%-26% and 14%-19% in vegetables, 2%-5% and 1%-2% in fruit, respectively. CONCLUSION: The consumptions of vegetables and fruits were inadequate in Chinese adults.

[Salt intake among Chinese adults in 2010-2012].

OBJECTIVE: To analyze the mean population intake of salt in Chinese adults in 2010-2012. METHODS: Data were from the Chinese Nutrition and Health Surveillance in 2010-2012. The samples were selected through the method of probability proportion to size (PPS). The study objects were 55 531 adults aged 18 and over from 150 sites in 31 provinces, autonomous regions or municipalities in China. The information of oil, salt and other condiments for household was from the 3 d food weighed record. The average of salt intake for individuals was calculated based on the energy percentage in one family. The results presented the level of salt intake (x ± Sx) by analyzing the different demography characteristics. The results were calculated using complex weighting by the population data from National Bureau of Statistics in 2009. RESULTS: The intake of salt was (9.6 ± 0.3) g/d and it was higher in men ((10.4 ± 0.4) g/d) than that in women ((8.8 ± 0.3) g/d). The intake in the age group of 40-49, 50-59 and 60-69 was (9.9 ± 0.5) g/d, (10.3 ± 0.4) g/d and (9.9 ± 0.3) g/d, respectively. The adults in rural ((10.2 ± 0.3) g/d) had a higher salt intake than that of urban ((9.0 ± 0.5) g/d). An average of salt intake was increased gradually in big city ((7.9 ± 0.3) g/d), medium /small city ((9.2 ± 0.6) g/d) , general rural ((9.9 ± 0.4) g/d) and poor rural ((10.8 ± 0.7)g/d). CONCLUSION: The mean salt intake among Chinese adults was still in a very high level. Something should be done to reduce the salt intake for the government and policy-makers.

[Comparison of 24 hour dietary recalls with a food frequency questionnaire in evaluating dietary fat intakes].

OBJECTIVE: To compare the difference and correlation of dietary fat intakes measures from the food-frequency questionnaire (FFQ) with measures from 24 hour dietary recalls (24HDRs), and provide evidence for the future research of dietary fat. METHODS: A total of 511 participants, selected from Zhejiang province, were asked to complete an FFQ and 24HDRs. The consumption of energy, fat, fatty acids, the percentages of energy from fat were calculated with the FFQ and 24HDRs and the results were analyzed. RESULTS: There was no difference between FFQ and 24HDRs in energy, fat, fatty acids and the percentages of energy from fat. Sperman's rank correlation coefficient between the two methods were 0.51 in energy, 0.58 in fat and 0. 57 in the percentages of energy from fat. The proportion of subjects who were assigned to the same or adjacent quintile groups were 80.73% for energy, 84.81% for fat and 83. 38% for the percentages of energy from fat. CONCLUSION: An effective FFQ can evaluate dietary fat consumption and rank participants well. Selecting the simple and easy FFQ method to assess the dietary fat intake would he a good choice when research the relationship between dietary fat and chronic disease in the future.