Association of maternal body mass index and gestational weight gain rate with cardiometabolic traits in childhood: A prospective cohort study.

BACKGROUND AND AIMS: Evidence on the association of maternal obesity with offspring cardiometabolic health is limited, particularly for the Asian population. We aimed to examine the associations of maternal body mass index (BMI) in early pregnancy and gestational weight gain (GWG) rate in mid- and late-pregnancy with childhood cardiometabolic traits. METHODS AND RESULTS: We used data of 1452 mother-child pairs from a population-based prospective cohort study in China. Maternal BMI in early pregnancy and GWG rate in mid- and late-pregnancy were calculated. Childhood cardiometabolic traits were assessed at aged 4-7 years, including BMI, BMI-z, systolic blood pressure (SBP), diastolic blood pressure, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, total cholesterol, triglycerides, fasting glucose, and C-reactive protein. Each 1 kg/m2 increase in maternal BMI in early pregnancy was associated with 0.46% (95% confidence interval, 0.19%-0.72%) higher children BMI, 0.05 (0.02-0.08) higher BMI-z, 0.41% (0.22%-0.59%) higher waist circumference, and 0.24% (0.03%-0.46%) higher SBP. Each 1 kg/week higher GWG rate in mid- and late-pregnancy was associated with higher children SBP (4.58% [1.46%-7.71%]), triglycerides (18.28% [3.13%-33.44%]), and fasting glucose (5.83% [2.64%-9.02%]) and lower BMI-z (-0.45 [-0.82 to -0.08]). Additional adjustment for offspring BMI attenuated the associations for maternal BMI but not for GWG rate. CONCLUSIONS: The increase in maternal BMI and GWG are associated with adverse cardiometabolic profiles in childhood. The association between maternal BMI and childhood cardiometabolic traits is likely mediated using the offspring BMI.

The association of maternal gestational weight gain with cardiometabolic risk factors in offspring: a systematic review and meta-analysis.

CONTEXT: Gestational weight gain (GWG) is known to be a risk factor for offspring obesity, a precursor of cardiometabolic diseases. Accumulating studies have investigated the association of GWG with offspring cardiometabolic risk factors (CRFs), leading to inconsistent results. OBJECTIVE: This study synthesized available data from cohort studies to examine the effects of GWG on offspring CRFs. DATA SOURCE: Four electronic databases, including PubMed, Web of Science, Scopus, and Embase, were searched through May 2023. DATA EXTRACTION: Cohort studies evaluating the association between GWG and CRFs (fat mass [FM], body fat percentage [BF%], waist circumference [WC], systolic blood pressure [SBP] and diastolic blood pressure, high-density-lipoprotein cholesterol [HDL-C] and low-density-lipoprotein cholesterol, triglyceride [TG], total cholesterol, fasting blood glucose, and fasting insulin levels) were included. Regression coefficients, means or mean differences with 95% confidence intervals [CIs], or standard deviations were extracted. DATA ANALYSIS: Thirty-three cohort studies were included in the meta-analysis. Higher GWG (per increase of 1 kg) was associated with greater offspring FM (0.041 kg; 95% CI, 0.016 to 0.067), BF% (0.145%; 95% CI, 0.116 to 0.174), WC (0.154 cm; 95% CI, 0.036 to 0.272), SBP (0.040 mmHg; 95% CI, 0.010 to 0.070), and TG (0.004 mmol/L; 95% CI, 0.001 to 0.007), and with lower HDL-C (-0.002 mmol/L; 95% CI, -0.004 to 0.000). Consistently, excessive GWG was associated with higher offspring FM, BF%, WC, and insulin, and inadequate GWG was associated with lower BF%, low-density lipoprotein cholesterol, total cholesterol, and TG, compared with adequate GWG. Most associations went non-significant or attenuated with adjustment for offspring body mass index or FM. CONCLUSIONS: Higher maternal GWG is associated with increased offspring adiposity, SBP, TG, and insulin and decreased HDL-C in offspring, warranting a need to control GWG and to screen for cardiometabolic abnormalities of offspring born to mothers with excessive GWG. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42023412098.

Anti-Hyperuricemic Effect of Anserine Based on the Gut-Kidney Axis: Integrated Analysis of Metagenomics and Metabolomics.

Nowadays, developing effective intervention substances for hyperuricemia has become a public health issue. Herein, the therapeutic ability of anserine, a bioactive peptide, was validated through a comprehensive multiomics analysis of a rat model of hyperuricemia. Anserine was observed to improve liver and kidney function and modulate urate-related transporter expressions in the kidneys. Urine metabolomics showed that 15 and 9 metabolites were significantly increased and decreased, respectively, in hyperuricemic rats after the anserine intervention. Key metabolites such as fructose, xylose, methionine, erythronic acid, glucaric acid, pipecolic acid and trans-ferulic acid were associated with ameliorating kidney injury. Additionally, anserine regularly changed the gut microbiota, thereby ameliorating purine metabolism abnormalities and alleviating inflammatory responses. The integrated multiomics analysis indicated that Saccharomyces, Parasutterella excrementihominis and Emergencia timonensis were strongly associated with key differential metabolites. Therefore, we propose that anserine improved hyperuricemia via the gut-kidney axis, highlighting its potential in preventing and treating hyperuricemia.

Multi-omics analysis reveals therapeutic effects of Bacillus subtilis-fermented Astragalus membranaceus in hyperuricemia via modulation of gut microbiota.

At present, uncovering how to preventandcontrol hyperuricemia has become an important public health issue. Fermented traditionalChinesemedicine has exhibited promising applications in the clinical management of hyperuricemia. In this study, we generated a hyperuricemic mouse model to explore the potent therapeutic ability of Bacillus subtilis-fermented Astragalus membranaceus (BFA) on this condition by multi-omics analysis. We found that the serum uric acid level was decreased in hyperuricemic mice after BFA treatment. BFA effectively attenuated renal inflammation and regulated the expression of urate transporters. Additionally, we found that BFA could increase the abundances of butyrate-producing bacteria, including Butyricimonas synergistica, Odoribacter splanchnicus, and Collinsella tanakaei, and probiotics, including Lactobacillus intestinalis and Bacillus mycoides, in hyperuricemic mice. Therefore, we believe that BFA has the potential to become a novel safe and valid functional food for addressing hyperuricemia.

Oat ß Glucan Ameliorates Renal Function and Gut Microbiota in Diabetic Rats.

Diabetic nephropathy is a severe complication of diabetes and the leading cause of end-stage renal disease and death. Therefore, we must find effective prevention and treatment approaches to the problem. Oat has a long history of use for its nutritional and medicinal properties, such as maintaining physiological blood glucose levels. Oat ß glucan is one of the major bioactive substances produced by oat. However, the protective effects of oat ß glucan on diabetic nephropathy are still unclear. This study generated a rat model of diabetic nephropathy to explore the potent therapeutic ability and mechanism of oat ß glucan in renal function by 16S rRNA genes sequencing. Diabetic nephropathy model was established in forty rats by left nephrectomy and single intraperitoneal injection of streptozotocin. These rats were randomly divided into the model group and three oat ß glucan intervention groups. Twenty rats underwent sham operation and were randomly divided into normal control group and oat ß glucan control group. Animals were treated by oral gavage for 8 consecutive weeks. The results showed that oat ß glucan reduced blood glucose level and improved renal function (P < 0.05). Oat ß glucan significantly improved serum inflammatory levels (P < 0.05). The diversity of intestinal microflora in diabetic nephropathy rats decreased with time prolongation, while oat ß-glucan reversed the result. Compared with the model group at week 8, the abundances of Eubacterium, Butyricicoccus, and Ruminococcus were elevated significantly after oat ß glucan intervention (P < 0.05). Correlation analysis indicated that abundances of Eubacterium, Butyricicoccus, and Ruminococcus were significantly negatively correlated with the levels of renal impairment markers. In summary, the findings of this study showed that oat ß glucan can increase the diversity of intestinal flora, regulate the composition of intestinal flora, modulate intestinal flora metabolism, alleviate the inflammatory response, and further delay the development of diabetic nephropathy. Therefore, oat ß glucan has the potential to be developed into the novel and safe drug for diabetic nephropathy.

Long-Term High Dietary Diversity Maintains Good Physical Function in Chinese Elderly: A Cohort Study Based on CLHLS from 2011 to 2018.

(1) Objective: This study aimed to explore the correlation between dietary factors and physical function in Chinese elderly. (2) Methods: A cohort study was conducted on the association of long-term dietary intake status with physical function in older people based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2011 to 2018. The physical function of the subjects was judged according to the scores of basic activities of daily living (BADL) and instrumental activities of daily living (IADL). The dietary diversity score was established according to the intake frequency of the food groups, and the dietary pattern score was obtained by factor analysis. The associations between dietary factors and functional impairment was investigated by logistic regressions. (3) Results: A total of 2282 subjects were included in our cohort study, 458 and 1439 of whom had BADL limitation and IADL limitation, respectively. The risk of functional impairment decreased in the consistent high dietary diversity groups compared with the consistent low dietary diversity group (p < 0.05). The fruit-egg-milk pattern, vegetable-meat-fish pattern, and condiment and tea pattern reduced the risk of functional impairment (p < 0.05). (4) Conclusions: Long-term maintenance of high dietary diversity and increasing total dietary intake can help maintain good physical function of Chinese elderly.

Development and Validation of a Food and Nutrition Literacy Questionnaire for Chinese Adults.

The purpose of this study aimed to develop and validate the Food and Nutrition Literacy Questionnaire for Chinese adults (FNLQ). The dimensions and core components of Food and Nutrition Literacy were constructed though literature review and qualitative consensus study. A cross-sectional survey of 8510 participants was conducted. The reliability of the questionnaire was determined by internal consistency, the construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and the content validity was assessed by the Pearson correlation coefficient. From the literature review and qualitative methods, 20 core components and 50 questions of the FNLQ were developed, including 1 dimension of knowledge and 3 practice dimensions (ability of selection, preparing food and eating). The overall FNLQ questionnaire had good reliability and validity (Cronbach's α = 0.893, χ2/DF = 4.750, RMSEA = 0.048, GFI = 0.891 and AGFI = 0.876). The average FNLQ score of all participants was (64.08 ± 12.77), and the score for the knowledge and understanding dimension was higher than that for the practice dimensions. In addition, 80 was set as the nutritional literacy threshold, and only 12.2% met this threshold in this survey. Sociodemographic and health status characteristics were predictors of FNLQ (R2 = 0.287, F = 244.132, p < 0.01). In conclusion, the FNLQ built in this study had good validity and reliability. It could be considered as a reliable tool to assess Food and Nutrition Literacy of Chinese adults.

Sarcopenia and catastrophic health expenditure by socio-economic groups in China: an analysis of household-based panel data.

BACKGROUND: Sarcopenia was thought to be associated with adverse outcomes and will cause lots of health expenditure. But the relationship between sarcopenia and catastrophic health expenditure (CHE) had been little explored. Here, we examined the distribution of sarcopenia in relation to medical and payment burdens. METHODS: We used data from three waves of China Health and Retirement Longitudinal Study including 14 130 participants from 9077 households aged over 50 years old. Sarcopenia was operationalized according to the Asian Working Group for Sarcopenia 2019. Medical expenditure was obtained by self-reported data, and CHE was identified by WHO definitions. We used the negative binomial regression model and logistic mixed-effects models to examine the associations between sarcopenia and medical and CHE. RESULTS: A total of 14 130 participants [52.2% female, aged 60.8 (SD 9.3)] from 9077 households were included in this study. The prevalence of sarcopenia was 19.8%, 11.9% for moderate sarcopenia, and 7.9% for severe sarcopenia, respectively. We identified 1416 household CHE events in all three waves. Severe sarcopenia was associated with an increase in the number of inpatient visits [incidence rate ratio 1.31, 95% confidence interval (CI): 1.03-1.66, P = 0.03] and the risk of CHE (odds ratio: 1.04, 95% CI: 1.01-1.07, P < 0.01). We saw similar effects in health service use of sarcopenia in different socio-economic groups. Moderate sarcopenia increased the risk of CHE in the lowest socio-economic group (odds ratio 1.03, 95% CI: 1.01-1.06, P = 0.03) and had no statistical significance in other groups. The association between severe sarcopenia and CHE did not attenuate after the adjustment of disease factors. CONCLUSIONS: Severe sarcopenia may increase the risk of CHE. Timely and effective intervention on moderate sarcopenia from severe sarcopenia will contribute to reduce the health burden.

Development and Validation of Nutrition Literacy Questionnaire for the Chinese Elderly.

(1) Background: Improving nutrition literacy is crucial for maintaining a healthier state of the elderly to achieve healthy ageing. Therefore, it is necessary to develop a Nutrition Literacy Questionnaire for the Chinese Elderly (NLQ-E). (2) Methods: an NLQ-E was developed according to the core components of nutrition literacy for the elderly. Internal consistency, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to validate the reliability and validity of the NLQ-E. A cross-sectional study of 1490 elderly people was used to analyze the application of the NLQ-E. (3) Results: The NLQ-E was constructed with 3 domains (knowledge and understanding, healthy lifestyle and dietary behavior and skill), with a total of 25 questions. The overall NLQ-E had acceptable reliability and validity (Cronbach's α = 0.678, χ2/DF = 4.750, RMSEA = 0.045, PCFI = 0.776 and PNFI = 0.759). The average nutrition literacy score of the subjects in this cross-sectional study was 65.95 (65.95 ± 10.93). The OR between the nutrition literacy score and multimorbidity was 0.965 (95% CI: 0.954, 0.976); (4) Conclusions: We developed and validated the NLQ-E and found that the nutrition literacy level of the Chinese elderly was generally low. This study is of great value to improve the nutrition literacy of the elderly and effectively prevent nutrition-related chronic diseases and multimorbidity.

Dietary Inflammatory Index and the Risk of Hyperuricemia: A Cross-Sectional Study in Chinese Adult Residents.

BACKGROUND: Dietary Inflammatory Index (DII) scores have been consistently associated with several chronic diseases. This study explored the correlation between the DII and hyperuricemia in Chinese adult residents. METHODS: The study included 7880 participants from the China Health and Nutrition Survey (CHNS), which was taken in in 2009. A 3-day 24 h meal review method was used to collect diet data and to calculate the DII score. Serum uric acid was obtained to determine hyperuricemia levels. Subjects were divided into a hyperuricemia group and a non-hyperuricemia group, according to their serum uric acid level. Multilevel logistic regression models were used to examine the association between DII scores and hyperuricemia. RESULTS: After adjusting for covariates, a higher DII score was determined to be associated with a higher risk of hyperuricemia. Compared to those in the highest DII score group, the lower DII score group had an inverse association with hyperuricemia risk (Q2: 0.83, 95% CI: 0.70-0.99; Q3: 0.72, 95% CI: 0.60-0.86; Q4: 0.73, 95% CI: 0.61-0.88). The intake of energy-adjusted protein, total fat, MUFAs, PUFAs and saturated fatty acid was higher in the hyperuricemia group. CONCLUSIONS: A higher DII score is significantly associated with a higher risk of hyperuricemia. Controlling the intake of pro-inflammatory food may be beneficial to reduce the risk of hyperuricemia.

Associations between Early-Life Food Deprivation and Risk of Frailty of Middle-Age and Elderly People: Evidence from the China Health and Retirement Longitudinal Study.

BACKGROUND: The association between childhood food deprivation (FD) and health in later life has been extensively studied; however, studies on the association between childhood food deprivation and frailty are scarce. This study assessed the associations between childhood FD and the risk of frailty at middle-age and old age. METHODS: Three waves of the China Health and Retirement Longitudinal Study (CHARLS), including 11,615 individuals aged over 45 years, were used for this research. Frailty was operationalized according to the FRAIL scale as a sum of fatigue, resistance, ambulation, illness, and the loss of weight. Childhood FD experiences and levels were measured by self-reported FD and historical content. Logistic mixed-effects models and proportional odds ordered logistic regression models were used to analyse the association between childhood FD and frailty. FINDINGS: Childhood FD increased the odds of frailty at old age (1.30, 95% CI: 1.26-1.36). Compared with subjects with mild FD, those with extreme FD experiences had increased risks of frailty (1.34, 95% CI: 1.26-1.43). Subjects exposed to hunger at different ages all had an increased risk of frailty, and subjects who had FD during ages 6-12 (1.15, 95% CI: 1.09-1.22) were more likely to have an increased risk of frailty than those who had experienced FD in younger ages. The interaction of experience of FD at ages 0-6 and the experience of FD at ages 6-12 is not statistically significant after adjusting all covariates. CONCLUSIONS: Our findings suggest that childhood FD exerts long-lasting effects on frailty among older adults in China. The prevention of childhood FD may delay or even avert the emergence of frailty in people of middle-age and old age.

The Association between Purine-Rich Food Intake and Hyperuricemia: A Cross-Sectional Study in Chinese Adult Residents.

OBJECTIVE: To explore the correlation between purine-rich food intake and hyperuricemia in Chinese adult residents. METHOD: A cross-sectional study was conducted on the purine-rich food intake of Chinese adult residents based on the China Health and Nutrition Survey (CHNS) in 2009. The subjects were divided into hyperuricemia group and nonhyperuricemia group according to serum uric acid level, and the differences of the sociodemographic information (age, gender, and region), health status (weight status, blood pressure, blood sugar status), living habits (alcohol consumption, smoking status) and food intake (purine-rich food, other food) were compared between the two groups. Logistic regressions investigated the associations between the daily intake of purine-rich food (animal-derived food and legumes) and hyperuricemia. RESULTS: Eventually, 6813 subjects were included in our study, 1111 of them had hyperuricemia. The intake of seafood, legumes, red meat, and poultry all increased the risk of hyperuricemia (p < 0.05), while the intake of purine-rich fungi and purine-rich vegetables did not affect the occurrence of hyperuricemia. Animal-derived food was the main source of purine-rich food consumed by Chinese adult residents (140.67g/day), which had a great impact on hyperuricemia. Finally, after adjusting for gender, age, region, body mass index (BMI), alcohol consumption, hypertension, and refined grains intake, the risk of hyperuricemia increased by 2.40% and 1.10% for each increase of 10 g in animal-derived food intake (OR = 1.024, 95% CI: 1.018-1.030) and legumes intake (OR = 1.011, 95% CI: 1.003-1.019), respectively. CONCLUSION: The intake of animal-derived food and legumes were positively correlated with the occurrence of hyperuricemia. Controlling the intake of animal-derived food and legumes would be more beneficial to controlling the risk of hyperuricemia.

[Establishment of nutrition literacy core items for Chinese people].

Objective: To establish core items of nutrition literacy for general population in China. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts' consultation. Content validity test was used to determine the nutrition literacy item. Thirteen experts in the field of human nutrition, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of experts towards the items, active coefficient, and content validity were analyzed to generate the final list of nutrition literacy items. Results: 92.3% of questionnaires in two rounds were collected.The active coefficient of experts was satisfied and the authority coefficient was 0.96.In the content validity evaluation, the correlation I-CVI value of each item was above 0.83 and the κ value was above 0.74. The evaluation result was excellent.After the second round of expert consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of three scales (knowledge and concepts, lifestyles and dietary behaviors, and basic skills), ten subscales (basic nutrition philosophy, food classification and nutrition knowledge, healthy weight, eating behavior and culture, balanced diet, exercise health, food assessment, nutrition information acquisition and decision, nutrition safety, and weight management)with 25 items in total. Conclusions: The framework system and core items of nutrition literacy are established for Chinese people based on the content validity evaluation. The experts involved in the consultation process present a performance with good representativeness, enthusiasm and authority, and the content validity evaluation result is satisfied.

[Establishment of nutrition literacy core items for Chinese old people].

Objective: To establish the nutrition literacy core items for older people in China. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts consultation. Content validity test was used to determine the nutrition literacy items. Seven experts in the field of human nutrition, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of expertstowards the items, active coefficient, and content validitywere evaluated and analyzed to generate the final list of nutritionliteracy items. Results: A total of 85.7% (6/7) of questionnaires in two rounds were collected.The active coefficient of experts was satisfied and the authority coefficient was 0.96. In the content validity evaluation, the correlation I-CVI value of each item was above 0.90 and theκvalue was above 0.74. The evaluation result was excellent. After the second round of consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of three scales (knowledge and concepts, lifestyles and dietary behaviors, and basic skills), twelve subscales (reasonable nutrition, healthy weight, environment of dining, food classification, nutrition and disease, eat regularly, balanced diet, exercise health, information getting, household food measurement, reading nutrition label and calculating, and food safety)with 20 items in total. Conclusions: The framework system and core items of nutrition literacy are established for Chinese older people based on the content validity evaluation. The experts involved in the consultation process present a performance with good representativeness, enthusiasm and authority, and the content validity evaluation result is satisfied.