Association between Whole Grain Intake and Chronic Kidney Disease.

BACKGROUND: The relationship between whole grain intake and chronic kidney disease (CKD) remains uncertain. OBJECTIVE: This study aimed to evaluate the association between whole grain intake and risk of CKD in Chinese adults. METHODS: The present cross-sectional study used data from the China Health and Nutrition Survey conducted in 2009. Whole grain intake was measured using 3 consecutive 24-h dietary recalls and a household food inventory. A multivariable logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for risk of CKD. In addition, a restricted cubic spline was used to investigate the dose‒response relationship between whole grain and risk of CKD. RESULTS: A total of 6747 participants were included, 728 of whom had CKD. Compared with those in the lowest whole grain intake group, those in the higher grain intake group had an inverse association with risk of CKD (Q2: adjusted OR 0.70, 95% CI: 0.54, 0.89; Q3: adjusted OR 0.54, 95% CI: 0.42, 0.69; and Q4: adjusted OR 0.29, 95% CI: 0.21, 0.41). The association between whole grain intake and CKD seems to be stronger for individuals who were male (P for interaction = 0.008) or smokers (P for interaction = 0.013). In addition, the restricted cubic spline suggested an obvious L-shaped correlation. CONCLUSIONS: Increased whole grain intake was associated with a decreased risk of CKD in Chinese adults.

Gender differences in adolescent food preferences and their association with parent food preferences: data from the China Health and Nutrition Survey (CHNS).

PURPOSE: Food preference is an important factor that affects one's eating behavior and dietary intake. Parent food preferences and food choices may influence children food preferences. This study is aimed to describe gender differences and time trends of Chinese adolescent food preferences and to explore the association between adolescent and their parent food preferences. METHODS: The data were drawn from four waves of the China Health and Nutrition Survey (CHNS) conducted between 2006 and 2015. Participants were asked to indicate their degree of preferences for five food categories (fast food, salty snack food, fruits, vegetables, and soft/sugary drinks) using a 5-point Likert scale (from "dislike very much" to "like very much"). Logistic regression was performed to determine the association of food preferences between adolescents and their parents. RESULTS: Adolescent preferences for unhealthy foods were significantly higher than those of adults. Adolescent food preferences for fruits and vegetables decreased slightly over nine years, and there were gender differences in healthy food preferences (girls > boys, P < 0.05). Regardless of boys or girls, adolescent food preferences for healthy foods (fruits and vegetables) were significantly associated with both their fathers (OR: 3.64-4.58 for boys and 2.71-4.39 for girls) and mothers (OR: 2.13-4.11 for boys and 3.07-5.66 for girls) food preferences. For fast food and salty snack food preferences, boys appeared to be influenced greater by their fathers than girls, while girls appeared to be influenced greater by their mothers than boys. CONCLUSIONS: The present study reveals a high degree of unhealthy food preferences among Chinese adolescents and a gender-specific association of fast food and salty snack preference between Chinese adolescents and their parents. Our results may be useful for interventions to reduce adolescent unhealthy food preferences and intakes.

Association between triglyceride-glucose index and hypertension: a cohort study based on the China Health and Nutrition Survey (2009-2015).

AIM: Insulin resistance (IR) may participate in the pathogenesis of hypertension by mediating low-grade systemic inflammation. The triglycerides-glucose (TyG) index has recently been suggested as a reliable alternative biochemical marker of IR compared with traditional methods. Herein, we speculated TyG index may also be associated with hypertension. METHODS: Data of adults were extracted from the China Health and Nutrition Survey (CHNS) in 2009-2015 in this retrospective cohort study. The TyG index was calculated using the formula: TyG = Ln [fasting triglycerides (mg/dL) ×fasting glucose (mg/dL)/2]. Associations between TyG index and hypertension were evaluated by univariate and multivariate logistic regression analyses with odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses of age and gender were also performed. In addition, we assessed the interaction effect between TyG index and body mass index (BMI) on hypertension in participants with different age and gender. RESULTS: Among 3,413 eligible participants, 1,627 (47.67%) developed hypertension. The average TyG index in hypertension group and non-hypertension group was 8.58 and 8.39 respectively. After adjusting for covariates, we found that compared with participants with TyG index ≤ 8.41 (median value), those who had higher TyG index seemed to have higher odds of hypertension [OR = 1.17, 95%CI: (1.01-1.37)]. Similarly, this association was also discovered in participants who aged ≤ 65 years old [OR = 1.19, 95%CI: (1.01-1.39)] or were female [OR = 1.35, 95%CI: (1.10-1.65)]. Additionally, there was a potential additive interaction effect between obesity and TyG index on hypertension. CONCLUSION: High TyG index was associated with high odds of hypertension in general population in China, but the causal relationship between them needed further exploration.

Bone fracture is associated with incident myocardial infarction in long-term follow-up.

BACKGROUND: The association between bone fracture and cardiovascular diseases is examined in this study. While basic research has established a connection between fractures and heart attacks through the linkage between bones and arteries, population studies have not provided clear evidence. The aim of the present study is to investigate the association between bone fracture and the occurrence of myocardial infarction in a natural population during long-term follow-up. METHODS: A total of 13,196 adult participants with bone fracture history at baseline from the China Health and Nutrition Survey (CHNS) prospective cohort were included in this study. Baseline investigation was performed in 1997-2009 and the outcome was followed up till 2015. Hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. RESULTS: From 1997 to 2015, a total of 329 incident myocardial infarction cases were identified. In univariate and multivariate Cox regression analysis, a history of bone fracture was associated with an increased risk of myocardial infarction incidence in the total population (for the crude model: HR = 2.56, 95% CI 1.83-3.53, P < 0.001; for the multivariate model: HR = 1.43, 95% CI 1.02-1.99, P = 0.036). In the stratified analysis, bone fracture was not associated with an increased risk of incident myocardial infarction in subjects with age < 50 years (HR = 0.71, 95% CI 0.34-1.47, P = 0.356), but significantly associated with an increased risk of incident myocardial infarction in subjects with age ≥ 50 years (HR = 1.80, 95% CI 1.23-2.63, P = 0.003). CONCLUSIONS: It is suggested by the present study that bone fracture may be associated with an increased risk of incident myocardial infarction in the elderly population during long-term follow-up.

Inclusion of Pseudomonas fluorescens into soil-like fraction from municipal solid waste management park to enhance plastic biodegradation.

Single-use facial masks which are predominantly made out of polypropylene is being used and littered in large quantities during post COVID-19 situation. Extensive researches on bioremediation of plastic pollution on soil led to the identification of numerous plastic degrading microorganisms. These organisms assimilate plastic polymers as their carbon source for synthesizing energy. Pseudomonas fluorescens (PF) is one among such microorganism which is being identified to biodegrade plastic polymers in controlled environment. The natural biodegradation of facial mask in soil-like fraction collected from municipal waste management site, bioaugmentation of the degradation process with Pseudomonas fluorescens, biostimulation of the soil with carbonless nutritional supplements and combined bioaugmentation with biostimulation process were studied in the present work. The study has been conducted both in controlled and in natural condition for a period of 12 months. The efficiency of the degradation was verified through FTIR analyses using carbonyl index, bond energy change, Loss in ignition (LOI) measurement along with CHNS analyses of residual substances. The analysis of results reported that carbonyl index (in terms of transmittance) was reduced to 46% of the control batch through the inclusion of PF in natural condition. The bioaugmented batch maintained in natural condition showed 33% reduction of LOI with respect to the control batch. The unburnt carbon content of the residual matter obtained from the furnace were analysed using CHNS analyser and indicated the lowest carbon content in the same bioaugmented batch. In this study, an attempt is made to verify the feasibility of enhancing biodegradation of single-use facial mask by bioaugmentation of soil-like fraction available in solid waste management park with Pseudomonas fluorescens under natural condition. CHNS and FTIR analysis assures the biodegradation of plastic waste in the soil-like fraction using Pseudomonas fluorescens under both controlled and natural environmental condition.

Relationship between dietary knowledge, food preference, and long-short term health status among Chinese adults.

BACKGROUND AND OBJECTIVES: In recent years, with the improvement of people's living standards and changes in dietary patterns, dietary knowledge and food preference have been playing an increasingly crucial role in health. The aim of our study was to examine the relationship between dietary knowledge, food preference, and long-short term health status among Chinese adults aged 18-70. METHODS AND STUDY DESIGN: This study employed cross-sectional data from the 2015 China Health and Nutrition Survey obtained from 4822 adults. We utilized self-assessed health status as an indicator of long-term health status and utilized sickness in the last four weeks as a measure of short-term health status. Taking advantage of ordered probit regression, long-term health status was regressed on all predictors, while the binary logistic regression was used to analyze the factors influencing short-term health status. The propensity score matching is employed to account for potential selection bias in analysis, thereby increasing the robustness and credibility of results. RESULTS: The analysis revealed that dietary knowledge and food preference can improve an individual's long-term health status significantly. However, there is no evidence to show that short-term health status is affected by food preference. Furthermore, dietary knowledge is negatively associated with short-term health status. CONCLUSIONS: These findings highlight the importance of dietary education and healthy eating habits in improving the long-term health status of Chinese adults. The study suggests implications for public health strategies aimed at enhancing the health and well-being of Chinese adults.

Positive association of triglyceride-glucose index with new-onset hypertension among adults: a national cohort study in China.

BACKGROUND: Previous studies showed that the triglyceride-glucose (TyG) index was a better predictor of adverse cardiovascular events than triglycerides or fasting blood glucose alone. However, few studies have focused on new-onset hypertension. We aimed to explore the association of TyG index with new-onset hypertension in Chinese adults. METHODS: A total of 4,600 participants who underwent at least 2 rounds of visits from 2009 to 2015 in the China Health and Nutrition Survey were enrolled in this study. Our outcome of interest was new-onset hypertension. Multivariate Cox hazard regression models and restricted cubic spline were performed to explore the relationship between TyG index and new-onset hypertension. RESULTS: The mean (standard deviation, SD) age of the study population was 48.1 (13.6) years, and 2058 (44.7%) of the participants were men. The mean (SD) TyG index level was 8.6 (0.7). A total of 1,211 (26.3%) participants developed new-onset hypertension during a median (interquartile range) follow-up duration of 6.0 (2.0-6.1) years. The incidences of new-onset hypertension were 18.1%, 25.3%, 28.5%, and 33.4% by quartiles of TyG index [from quartile 1 (Q1) to Q4], respectively. The Cox model showed that high levels of TyG index were significantly associated with increased risk of new-onset hypertension (adjusted hazard ratio [aHR]: 1.29, 95% confidence interval [CI] 1.07-1.55, Q2; aHR, 1.24, 95% CI 1.03-1.49, Q3; aHR, 1.50, 95% CI 1.22-1.84, Q4) compared with Q1. Consistently, as a continuous variable, for every 1.0 increase in TyG index, there was a 17% increase in the risk of new-onset hypertension (aHR, 1.17; 95% CI 1.04-1.31). The associations were consistent in various subgroups and sensitivity analysis. The dose-response curve indicated a positive, linear association between TyG index and the risk of new-onset hypertension. CONCLUSIONS: High TyG index was significantly associated with an increased risk of new-onset hypertension among Chinese adults. Our findings suggest that maintaining a relatively low level of TyG index might be effective in the primary prevention of hypertension.

Potential impact of time trend of whole grain intake on burden of major cancers in China.

Numerous studies have revealed associations between high intake of whole grains and reduced risk of various cancers. Yet, in recent decades, the traditional Chinese diets have been challenged by reduction in whole grains and increase in refined grains. To assess the impact of this dietary transition on cancer prevention, we analyzed the time trend of whole grain intake using nationally representative sampling data of over 15 thousand individuals from the China Health and Nutrition Survey. We applied the comparative risk assessment method to estimate the population attributable fraction of cancers due to insufficient whole grain intake from 1997 to 2011 and projected the trend of whole grain intake and the associated burden of cancers to 2035. We found a significant decrease of approximately 59% of whole grain intake in the Chinese population from 1997 to 2011. Compared with 1997, insufficient intake of whole grains was responsible for 9940 more cases of breast cancer, 12,903 more cases of colorectal cancer and 434 more cases of pancreatic cancer in 2011. Our projections suggest that if every Chinese would consume 125 g whole grain per day as recommended by the latest Chinese Dietary Guidelines, 0.63% bladder cancer, 8.98% breast cancer, 15.85% colorectal cancer, 3.86% esophageal cancer, 2.52% liver cancer and 2.22% pancreatic cancer (totaling 186,659 incident cases) could theoretically be averted by 2035. Even if everyone maintained the 2011 whole grain intake level, an estimated 8.38% of cancer events could still be prevented by 2035.

Association of dietary patterns with general and central obesity among Chinese adults: a longitudinal population-based study.

BACKGROUND: Limited evidence exists for the association between dietary patterns and later obesity phenotypes among Chinese adults. This longitudinal study aimed to evaluate associations of dietary patterns with general and central obesity in Chinese adults. METHODS: Based on the China Health and Nutrition Survey (CHNS) waves 2004 and 2015, the study was conducted on 4207 adult men and women (age range: 18-65 years). Dietary intakes were assessed by three consecutive 24-h dietary recalls, and dietary patterns were identified using exploratory factor analysis. Longitudinal associations of dietary patterns with general and central obesity were evaluated using logistic regression analyses. RESULTS: The prevalence rates of general and central obesity were 14.2% and 42.1%, respectively. Factor analysis extracted three major dietary patterns: "traditional southern," "modern," and "traditional northern." After adjustment for potential confounders, adults in the highest quartile of the traditional southern dietary group were less likely to develop over 10 years general (odds ratio [OR] = 0.50, 95% confidence interval [95%CI]: 0.39, 0.65) and central (OR = 0.52, 95%CI: 0.43, 0.63) obesity compared to those in the lowest quartile group. The modern dietary pattern was not significantly associated with general and central obesity. Adherence to the traditional northern dietary pattern increased the chance of both general and central obesity (OR = 1.61, 95%CI: 1.23, 2.10; OR = 1.64, 95%CI: 1.36, 1.98) after 10 years. CONCLUSIONS: Our study provides longitudinal evidence for associations between dietary patterns and later obesity phenotypes among Chinese adults. Our findings may guide the development of evidence-based preventive nutrition interventions to control the obesity epidemic.

Factors influencing blood pressure variability in postmenopausal women: evidence from the China Health and Nutrition Survey.

BACKGROUND: The aim is to identify the factors influencing blood pressure variability in postmenopausal women based on the China Health and Nutrition Survey (CHNS). MATERIAL AND METHODS: The data on postmenopausal women between 1993 and 2015 were extracted from the CHNS. Group-based trajectory modeling was used to analyze the development track of blood pressure changes, based on which the subjects were separately divided into two groups for systolic blood pressure (SBP) and diastolic blood pressure (DBP). Univariate and multivariate analyzes were performed to analyze the factors influencing SBP and DBP. RESULTS: A total of 346 women were eligible for the study. Group-based trajectory modeling showed two different trajectories of blood pressure, including the low-level, slowly developed type and the high-level, rapidly developed, stable type of SBP, as well as the low-level, slowly developed type and the high-level, slowly developed type of DBP. In multivariate analysis, age (odds ratio [OR]: 1.118, 95% confidence interval [CI]: 1.082-1.156), body mass index (BMI) (OR: 2.239, 95%CI: 1.010-4.964), antihypertensive agents (OR: 7.293, 95%CI: 2.191-24.275), hip circumference (OR: 1.069, 95%CI: 1.014-1.128) and marital status (OR: 3.103, 95%CI: 1.028-9.361) were found to be the significant factors influencing SBP; age (OR: 1.067, 95%CI: 1.039-1.096), alcohol consumption (OR: 2.741, 95%CI: 1.169-6.429), antihypertensive agents (OR: 4.577, 95%CI: 1.553-13.492), hip circumference (OR: 1.093, 95%CI: 1.049-1.138), and marital status (OR: 3.615, 95%CI: 1.228-10.644) were the predominant factors influencing DBP. CONCLUSIONS: In postmenopausal women, age, BMI, antihypertensive agents, hip circumference, and marital status are associated with SBP changes, while age, alcohol consumption, antihypertensive agents, hip circumference, and marital status with DBP variability. MESH KEYWORDS: postmenopausal women, blood pressure, development track, influencing factors, CHNS.

Association of the ApoB/ApoA-I ratio with stroke risk: Findings from the China Health and Nutrition Survey (CHNS).

BACKGROUND AND AIMS: Studies on associations of apolipoprotein B (ApoB), apolipoprotein A-I (ApoA-I) and the ApoB/ApoA-I ratio with stroke risk are scarce. We aimed to prospectively examine the associations of the ApoB/ApoA-I ratio and other lipid profiles with the risk of stroke using data from the China Health and Nutrition Survey (CHNS). METHODS AND RESULTS: A total of 7318 participants without stroke at baseline in 2009 were included in the final analysis and followed for a median of 6.1 years. The serum lipid profiles including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), ApoA-I, and ApoB were measured at baseline. Multivariable Cox proportional hazards models were used to evaluate the associations between these parameters and stroke risk. The ApoB/ApoA-I ratio was positively associated with incident stroke, yielding adjusted hazard ratio (HR) of 1.32 (95% CI: 1.09-1.59, P = 0.004). In comparison, ratio of ApoB and ApoA-I containing lipoproteins, the non-HDL-C/HDL-C ratio, possessed relatively weaker association with incident stroke (HR: 1.24, 95% CI: 1.01-1.52, P = 0.036). Furthermore, the risk associations for the ApoB/ApoA-I and non-HDL-C/HDL-C ratios were prominent among those participants aged >51, body mass index ≤23, or female. There were no significant associations of other lipids and their ratios with the stroke risk. CONCLUSIONS: Higher ApoB/ApoA-I ratio was associated with an increased risk of stroke. Our findings suggest that the ApoB/ApoA-I ratio may serve as a better risk indicator of stroke than other lipid profiles and their ratios.

Screen-detected disordered eating and related traits in a large population sample of females in mainland China: China Health and Nutrition Survey.

OBJECTIVE: We describe the prevalence and sociodemographic factors associated with screen-detected disordered eating and related traits in a population-based sample of women in China. We also explored prevalence trends over time. METHOD: A total of 4,218 females aged 12-50 were sampled from 15 provinces as part of the China Health and Nutrition Survey (CHNS) in 2015. The SCOFF questionnaire screened for disordered eating and the selected questions from the Eating Disorders Examination-Questionnaire measured dietary restraint, shape concerns, and weight concerns. Body mass index (BMI) was measured and sociodemographic factors captured urban/rural residence, age, ethnicity, income, education, marital status, and occupational status. We calculated the prevalence of screen-detected disordered eating and related traits broadly and across several dimensions and compared prevalence estimates to 2009 and 2011 reports. RESULTS: We detected 296 individuals who screened positive for disordered eating on the SCOFF (prevalence = 7.04%). Positive screens were associated with urban residence (p = .002) and higher education levels (p < .001). Scores on restraint, shape concerns, and weight concerns were all higher for individuals in urban versus village locations (all p's < .001), and with higher BMI (p < .001) for shape and weight concerns. The prevalence of screen-detected disordered eating increased numerically across 2009, 2011, and 2015. DISCUSSION: The prevalence of screen-detected disordered eating in mainland China was comparable to other populations worldwide obtained from a recent meta-analysis. The distribution of disordered eating and related traits varied by several sociodemographic factors, which include age, BMI, urban/rural residence, education, and income, suggesting important directions for case detection and intervention in China.

Association of leisure sedentary time with common chronic disease risk factors: A longitudinal study of China Health and Nutrition Surveys.

BACKGROUND: Although the common risk factors were identified and controlled for many years, the overall prevalence of chronic diseases continued to increase in China. OBJECTIVE: We presumed the leisure sedentariness as a latent but pivotal factor of chronic diseases, and examined its distribution and changing trend, analysed its interaction effects on common risk factors, which could provide a new perspective for the prevention and management. METHODS: A total of 5013 participants were screened out from China Health and Nutrition Survey. Random-effects ordered logistic models were used for ordinal dependent variables, and fixed-effects or random-effects logit models were used for binary dependent variables. RESULTS: From 2004 to 2011, the prevalence of high leisure sedentary time (LSED) increased by 58.58%. Members of the high LSED group were likely to choose fast food, salty snacks, soft drinks and more likely to smoke or drink alcohol compared with those of the low LSED group. However, they preferred walking, sports and body building more than those of the low LSED group. CONCLUSIONS: For the unhealthy dietary, tobacco and alcohol consumption, more targeted introduction and guidance related to sedentary time should be promoted. Meanwhile, the appeal for physical exercise as well as adequate facilities should be initiated.

Plain Water Intake and Association With the Risk of Overweight in the Chinese Adult Population: China Health and Nutrition Survey 2006-2011.

BACKGROUND: The prevalence of overweight is increasing dramatically worldwide. The aim of our study was to investigate the association of plain water intake (PWI) with the risk of new-onset overweight risk among Chinese adults. METHODS: A total of 3,200 adults aged 18-65 who were free of overweight at baseline were enrolled from China Health and Nutrition Survey (CHNS) cohort study in 2006-2011. The risk of new-onset overweight with different amounts of PWI per day was analyzed in this 5-year cohort. A multiple logistic regression model was used to assess the association of PWI and the risk of new-onset overweight and adjust for potential confounders. Moreover, dose-response models were developed to estimate the linear relationship. RESULTS: During 5 years of follow-up, 1,018 incident cases were identified. Our analysis indicated an inverse association of more than 4 cups of PWI per day and the risk of new-onset overweight among normal weight individuals. Compared with participants who drank 2 to 3 cups PWI, the adjusted odds ratios (OR) of overweight were 0.741 (95% confidence interval [CI], 0.599-0.916) in participants who drank 4 to 5 cups PWI, and 0.547 (95% CI, 0.435-0.687) in participants who drank more than 6 cups PWI. The dose-response analysis showed that every cup of PWI was associated with a 6.5% and 8.4% decrease in the risk of new-onset overweight among men and women, respectively. The interactions of PWI and covariates on the risk of overweight were not found. CONCLUSION: Drinking more than 4 cups (≈1 liter) per day of plain water is associated with decrease in the risk of new-onset overweight among normal-weight individuals.

Association between serum magnesium and blood count: influence of type 2 diabetes and central obesity.

The relationship between serum Mg and blood cell counts in Chinese adult diabetes or central obesity was assessed by investigating 8163 subjects with China Health and Nutrition Survey (mean age 59⋅6 years, 54⋅9 % men). Participants were classified according to blood Mg (below 0⋅65 mmol/l, or 0⋅66-0⋅94 mmol/l or above 0⋅95 mmol/l), type 2 diabetes (yes/no) and central obesity (yes/no). Leucocytes, erythrocytes, platelets (PLT), Hb and glycated Hb (HbA1c) were determined using standardised methods and conditions. HbAc1, leucocytes and PLT were significantly higher among subjects with central obesity than without central obesity (P < 0⋅05). A significant increase for Hb, erythrocytes, PLT, but not leucocytes, across progressive Mg groups was observed in subjects without diabetes (P < 0⋅05). Hb, erythrocytes and HbAc1 were significantly higher among subjects with higher Mg than in subjects with lower Mg with diabetes (P < 0⋅05). Central obesity disturbed the positive association between PLT count and serum Mg. Type 2 diabetes caused metabolism disorder in serum Mg, blood sugar and blood cell count. Hb, erythrocytes and PLT, but not leucocytes, are positively correlated with serum Mg, but this association is somehow disturbed by type 2 diabetes or central obesity.

[The relationship between smoking and hyperuricemia in Chinese residents].

Objective: To explore the relationship between smoking and hyperuricemia in Chinese residents. Methods: Based on data from the China Health and Nutrition Survey (CHNS), residents with blood samples provided in the 2009 round (including information of socio-demographic factors, lifestyle behaviors, medical history, and laboratory examinations etc.) were selected as the participants in the current analysis. Unconditional logistic regression models were utilized to compute the ORs and corresponding 95%CIs for assessing the relationship between smoking and hyperuricemia. Results: Among the 8 785 subjects, 1 435 had hyperuricemia with a prevalence rate of 16.3%, consisting of 886 men and 549 women with prevalence rates of 21.6% (886/4 110) and 11.7% (549/4 675) , respectively. Compared with never smokers, the adjusted OR (95%CI) for hyperuricemia was 0.83 (0.70-0.98) among current smokers, 0.77 (0.63-0.94) among current smokers with 20-39 years of smoking, and 0.79 (0.65-0.97) among current smokers with 11-20 cigarettes per day. When stratified by gender and compared with non-smoker, the adjusted OR (95%CI) for hyperuricemia among current smokers compared with never smokers was 0.83 (0.70-0.98) among men, while no significant association was found in female current smokers (OR=0.73, 95%CI: 0.42-1.26, P=0.260). Conclusion: In Chinese residents, there is an inverse association between smoking and hyperuricemia prevalence, and this association may be related to duration and intensity of smoking among current smokers. The findings need to be validated in large prospective cohort studies.

Association between spicy food consumption and lipid profiles in adults: a nationwide population-based study.

CVD remains the leading cause of mortality worldwide, with abnormal lipid metabolism as a major risk factor. The aim of this study was to investigate associations between spicy food consumption and serum lipids in Chinese adults. Data were extracted from the 2009 phase of the China Health and Nutrition Survey, consisting of 6774 apparently healthy Chinese adults aged 18-65 years. The frequency of consumption and degree of pungency of spicy food were self-reported, and regular spicy food consumption was assessed using three consecutive 24-h recalls. Total cholesterol, TAG, LDL-cholesterol and HDL-cholesterol in fasting serum were measured. Multilevel mixed-effects models were constructed to estimate associations between spicy food consumption and serum lipid profiles. The results showed that the frequency and the average amount of spicy food intake were both inversely associated with LDL-cholesterol and LDL-cholesterol:HDL-cholesterol ratio (all P for trend<0·05) after adjustment for potential confounders and cluster effects. HDL-cholesterol in participants who usually consumed spicy food (≥5 times/week) and who consumed spicy food perceived as moderate in pungency were significantly higher than those who did not (both P<0·01). The frequency and the average amount of spicy food intake and the degree of pungency in spicy food were positively associated with TAG (all P for trend<0·05). Spicy food consumption was inversely associated with serum cholesterol and positively associated with serum TAG, and additional studies are needed to confirm the findings as well as to elucidate the potential roles of spicy food consumption in lipid metabolism.

Association between predominantly plant-based diets and iron status in Chinese adults: a cross-sectional analysis.

Current evidence of the relationship between diets and Fe status is mostly derived from studies in developed countries with Western diets, which may not be translatable to Chinese with a predominantly plant-based diet. We extracted data that were nationally sampled from the 2009 wave of China Health and Nutrition Survey; dietary information was collected using 24-h recalls combined with a food inventory for 3 consecutive days. Blood samples were collected to quantify Fe status, and log-ferritin, transferrin receptor and Hb were used as Fe status indicators. In total, 2905 (1360 males and 1545 females) adults aged 18-50 years were included for multiple linear regression and stratified analyses. The rates of Fe deficiency and Fe-deficiency anaemia were 1·6 and 0·7 % for males and 28·4 and 10·7 % for females, respectively. As red meat and haem Fe consumption differed about fifteen to twenty times throughout the five groups, divided by quintiles of animal protein intake per 4·2 MJ/d, only Fe status as indicated by log-ferritin (P=0·019) and transferrin receptor (P=0·024) concentrations in males was shown to be higher as intakes of animal foods increased. Log-ferritin was positively associated with intakes of red meat (B=0·3 %, P=0·01) and haem Fe (B=12·3 %, P=0·010) in males and with intake of non-haem Fe in females (B=2·2 %, P=0·024). We conclude that diet has a very limited association with Fe status in Chinese adults consuming a traditional Chinese diet, and a predominantly plant-based diet may not be necessarily responsible for poor Fe status.

High blood pressure is associated with increased risk of future fracture, but not vice versa.

The association between high blood pressure and fracture showed obvious discrepancies and were mostly between hypertension with future fracture, but rarely between fracture and incident hypertension. The present study aims to investigate the associations of hypertension with future fracture, and fracture with incident hypertension. We included adult participants from the China Health and Nutrition Survey (CHNS) prospective cohort in 1997-2015 (N = 10,227), 2000-2015 (N = 10,547), 2004-2015 (N = 10,909), and 2006-2015 (N = 11,121) (baseline in 1997, 2000, 2004, 2006 respectively and outcome in 2015). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs. In the analysis of the association between hypertension and future fracture, the adjusted HRs (95% CIs) were 1.34 (0.95-1.90) in 1997-2015, 1.40 (1.04-1.88) in 2000-2015, 1.32 (0.98-1.78) in 2004-2015, and 1.38 (1.01-1.88) in 2006-2015. In the analysis of the association between fracture and incident hypertension, the adjusted HRs (95% CIs) were 1.28 (0.96-1.72) in 1997-2015, 1.18 (0.94-1.49) in 2000-2015, 1.12 (0.89-1.40) in 2004-2015, and 1.09 (0.85-1.38) in 2006-2015. The present study showed that hypertension history was associated with increased risk of future fracture, but not vice versa.

Association between Dietary Acid Load and Chronic Kidney Disease in the Chinese Population: A Comprehensive Analysis of the China Health and Nutrition Survey (2009).

BACKGROUND: Dietary acid load (DAL) is closely related to several chronic diseases. However, the link between DAL and chronic kidney disease (CKD) remains scarce and without data from the Chinese populations whose diet is quite different from people in Western countries. METHODS: This study evaluated DAL by potential renal acid load (PRAL) and net endogenous acid production (NEAP). We clarified the relationship between DAL and CKD by logistic regression analysis based on data from the China Health and Nutrition Survey (CHNS). RESULTS: The final analysis included 7699 individuals, of whom 811 (11.44%) were CKD patients. Although there was no notable link between PRAL and CKD, higher NEAP levels were independently correlated with CKD. As NEAP values rise, so does CKD prevalence. This trend remains highly significant even after adjustments. In subgroup analyses, the relationship between NEAP and CKD was more consistent in the elderly and subjects with a waistline of less than 82 cm and those without diabetes and heart disease. RCS analysis further confirmed the clear linear relationship between the OR of CKD and NEAP score. CONCLUSIONS: This study highlighted that higher NEAP was positively correlated with the risk of CKD.