[Expert consistency evaluation on nutrition and health knowledge questionnaire items for Chinese adults].

OBJECTIVE: To establish nutrition knowledge questionnaire items for Chinese adults by Delphi consensus study. METHODS: The framework system and preliminary items of nutrition knowledge questionnaire were established through literature review and experts consultation, considering the nutrition status and problems of Chinese people. Delphi method was used to conduct consensus analysis with 11 experts in related field involved to determine the nutrition knowledge questionnaire items. RESULTS: The active coefficients of consultation in two rounds were both 100%(11/11), and the authority coefficients of experts were 0.900. The average scores of all items were(4.67±0.28) and(4.80±0.21), the variation coefficients were 0.06 and 0.04, and the Kendall harmony coefficients were 0.261(χ~2=39.645, P=0.004) and 0.324(χ~2=43.122, P=0.001), respectively. After the second round of consultation, all selected items met the inclusion criteria. Finally, 20-item nutrition knowledge questionnaire were determined, including five dimensions of dietary recommendations, food characteristics, nutrition and health, food choices and food safety. CONCLUSION: The Delphi consensus of nutrition knowledge questionnaire items for Chinese adults were basically achieved.

[Dietary recommendation-related knowledge level of Chinese adults in 2021].

OBJECTIVE: To analyze the knowledge level and related factors related to dietary recommendations for Chinese residents aged 18-64 years in 2021. METHODS: A multi-stage cluster random sampling was used to select 302 survey sites across the country, there were 102 398 people surveyed, with 98 567 valid questionnaires, 49.4% male and 41.9% urban, and an average age of(38.5±12.2) years. A standardized questionnaire certified by experts and evaluated for reliability and validity was used to conduct the face-to-face survey. The questionnaire was scored out of 100 points; dietary recommendation-related knowledge was scored out of 30 points, and a score of 22.5 points or above was judged as acquiring relevant knowledge. Descriptive statistics were used to report the values of relevant knowledge level of respondents with different characteristics, and univariate and multi-variate Logistic regression models were used to analyze the factors influencing relevant knowledge level. RESULTS: The average score of dietary recommendation-related knowledge was(17.9±4.2), and the knowledge awareness rate was 14.7%. The five knowledge points with the lowest correct rates were the recommended intakes of soybeans and products(21.1%), added sugars(22.6%), milk(25.5%), food groups(27.6%), and cooking oils(31.4%) and the recommended intakes of fruits and salt were also less correct(56.9% and 58.5%). Multi-variate analysis revealed that the knowledge of dietary recommendations was lower among residents in rural(OR=0.945, 95%CI 0.944-0.945), central(OR=0.863, 95%CI 0.863-0.864) and western(OR=0.983, 95%CI 0.982-0.983) areas, those with chronic diseases(OR=0.784, 95%CI 0.783-0.784) and those who did not know about chronic diseases(OR=0.694, 95%CI 0.694-0.694) compared to the counterparts; female(OR=1.090, 95%CI 1.090-1.091) had a higher knowledge rate compared to male. The awareness rate of residents increased with the level of education, and the trend was statistically significant(P<0.001). CONCLUSION: The level of knowledge related to dietary recommendations for the adult population in China in 2021 is low, especially for the recommended intake of dairy, soybeans and products, and cooking oils, and the knowledge level of men, rural, central and western, and less educated populations is even lower.

[Geographical distribution differences of nutrition and health knowledge among Chinese adults in 2021].

OBJECTIVE: To explore the geographical distribution of nutrition and health knowledge among 18-64 years old adults in China. METHODS: A total of 102 398 residents aged 18-64 from 302 survey sites were selected by multi-stage cluster random sampling method, a total of 98 567 respondents were included in the study. Both mean and rate were calculated by complex sampling weighting. RESULTS: The nutrition and health knowledge score in eastern region(65.5±12.0) was higher than that in central(62.4±11.9) and western(61.4±12.9), and the score in northern region(63.9±11.8) was higher than that in southern(63.1±12.8). In the seven geographical regions, the highest score was in north(65.8±11.4), and the lowest score was in northwest(61.6±12.2). The awareness rate of nutrition and health in eastern region(22.4%) was higher than that in central(14.7%) and western(14.9%), the highest awareness rate among the seven geographic regions was in east(23.2%), followed by north(22.5%) and the lowest was in northwest(13.2%). There were also differences in nutritional health knowledge levels of residents in different regions in the five dimensions(P<0.001). Northwest China had the lowest awareness of food characteristics and nutrition and disease dimensions, South China had the lowest awareness of dietary recommendations and food choices dimensions, and Southwest China had the lowest awareness of food safety dimensions. CONCLUSION: The level of nutrition and health knowledge of Chinese adults have large geographical differences.

The association between frequency of eating out with overweight and obesity among children aged 6-17 in China: a National Cross-sectional Study.

BACKGROUND: In parallel with the increased prevalence of childhood overweight and obesity, the proportion of eating out in China has increased dramatically in recent years. The purpose of the study was to explore the association between frequency of eating out with overweight and obesity among Chinese children. METHODS: The representative sample was recruited from Chinese National Nutrition and Health Survey (CNNHS) in 2010-2012, which included Chinese children aged 6-17 years (7685 boys and 7576 girls). Frequency of eating out was collected by interview-administered questionnaire and categorized as: 0, 1-2 and ≥ 3 times per week. Height and weight were measured, consequently body mass index was calculated. RESULTS: The prevalence of eating out among Chinese children aged 6-17 years old was 23.2%. Children who ate out 0, 1-2, ≥3 times per week were accounted for 76.8, 10.9 and 12.3% respectively. Findings revealed that eating out three times per week or more was statistically significant associated with higher prevalence of overweight and obesity among boys (OR = 1.20,95CI:1.04-1.38) compared with those ate out less than three times per week. However, no significantly association was observed among girls (OR = 0.91, 95CI:0.78-1.01). In additional, Younger children, rural children, children from low income family, those with leisure exercises (certain physical activities regularly carried out such as swimming, walking, running, equipment fitness), leisure time sedentary behaviors (LTSB)(> 2 h/d) were relatively more likely to eat out. CONCLUSIONS: The results illustrated that eating out three times or more had a significantly positive effect on overweight and obesity among boys in China.

[Usage status of salt control spoon and influencing factors among students' caregivers of four cities in China in 2014].

OBJECTIVE: To analysis the usage status of salt control spoon and explore its influencing factors among student caregivers of four cities. METHODS: The data of 2014 salt knowledge, attitude, practice(KAP) survey among urban residents in China was used, which a total of 12 848 student caregivers(male 4862, female 7986) were recruited from Guangzhou, Wuhan, Chengdu and Shenyang by stratified random cluster sampling method. A self-filling questionnaire survey was used to collect information about knowledge of salt and usage of salt control spoon. Logistic regression model was used to explore influencing factors of salt control spoon usage effected by gender, education level, family income, salt related knowledge, etc. . RESULTS: The proportion of student caregivers who didn't know salt control spoon was 33. 3%, and 41. 9% of them knew salt control spoon but hadn't it. Only 24. 8% of them have heard of salt control spoon and had it at home. The proportion of having not heard salt control spoon among Wuhan, male, junior high school and below, other occupation and low family income group was higher than other groups. The proportion of having salt control spoon of groups in Guangzhou, female, high school and above, professional technical and clerical personnel, high family income was higher than other groups, and the difference was statistically significant(P<0. 01). Among the student caregivers having salt control spoon, the proportion of did not used salt control spoon, used it occasionally or used it without controlling the quantity and used it often and controlled the quantity was 10. 0%, 60. 6% and 29. 5%, respectively. The student caregivers of Shenyang, male, high family income groups used salt control spoon and controlled the quantity more often than the other groups, and the difference was statistically significant(P<0. 05). As shown in multivariate logistic regression analysis, the OR(95%CI) of high school and above, high income level, knowing the recommended intake of salt, knowing that high salt diet can cause high blood pressure on the influence of having salt control spoon was 1. 328(1. 221-1. 445), 1. 268(1. 029-1. 563), 1. 243(1. 145-1. 348)and 0. 838(0. 763-0. 921), respectively. Among the student caregivers who having salt control spoon, the OR(95%CI) of knowing the recommended intake of salt, knowing that high salt diet can cause high blood pressure, and source of salt control spoon(community/unit, friends/relatives) on the influence of using salt control spoon was 1. 473(1. 259-1. 722), 1. 249(1. 040-1. 501)and 0. 505(0. 415-0. 615)/0. 603(0. 441-0. 823), respectively. CONCLUSION: There still existed lower proportion of awareness and usage of salt control spoon.

[Salt intake knowledge and behavior among school teachers in four Chinese cities in 2014].

OBJECTIVE: To learn the knowledge level on "salt and health", and analyze the influence on related behavior among school teachers in four Chinese cities. METHODS: The data of 2014 salt KAP among urban residents in China was used, with stratified random cluster sampling, a total of 2518(male 708, female 1810) school teachers were selected from four cities of China, including Shenyang, Wuhan, Chengdu and Guangzhou city. Self-filled questionnaire was used to collect the information on the salt intake knowledge and behavior. The statistical software package SAS version 9. 4 was used for data analysis. RESULTS: Among the teachers in four Chinese cities, about 50. 9% of them knew the recommendation of salt intake, about 66. 6% of them knew sodium in the salt may influence health. Approximately 85. 3% of them knew eating long-term salty food may cause hypertension. The proportions of knowing salt intake among female, 40 years and older, below the undergraduate, higher family income teachers were higher than their counterparts(P<0. 05). The proportions of knowing the health influence of sodium among female, higher family income teachers were higher than their counterparts(P<0. 05). The proportions of knowing that eating long-term salty food may cause hypertension among female, undergraduate and above, higher family income teachers were higher than their counterparts(P<0. 05). About 80. 1% of them knew the nutrition labeling on the package food, about 19. 7% of them knew the nutrition labeling contents. Teachers utilized nutrition labeling differently owing to their knowledge on the labeling contents(P<0. 05). In the past three months, about 21. 4% of the teachers always use low-sodium salt when cooking, only 4. 2% of them always control their family's salt intake by using salt control spoon, about 25. 4% of them always choose low-sodium food when purchasing, only 15. 1% of the teachers requested the meals cooked lightly when eating out. The proportions of teachers who used low-sodium salt among female, higher family income, knowing salt intake recommended, knowing the health influence of sodium, knowing that long-term salty food may cause hypertension, active learning related knowledge, family members suffering from hypertension were higher than their counterparts(P<0. 05). The proportions of using salt control spoon among teachers under Bachelor's degree, active learning related knowledge were higher than their counterparts(P<0. 05). The proportions of teachers purchasing low-sodium food among 40 years and older, under Bachelor's degree, higher family income, knowing salt intake recommended, knowing the health influence of sodium, knowing that long-term salty food may cause hypertension, family members not suffering from hypertension, active learning related knowledge were higher than their counterparts(P<0. 05). The proportions of teachers requesting the meals cooked slightly when eating-out among 40 years and older, under Bachelor's degree, not knowing salt intake recommended, not knowing that long-term salty food may cause hypertension, not knowing if their family members suffered from hypertension, active learning related knowledge were higher than their counterparts(P<0. 05). The teachers consumed soy sauce, bean paste, fried bread stick differently owing to their knowledge about this(P<0. 05). CONCLUSION: The teachers in the four cities have grasped some knowledge on salt and health, but their related behaviors should be improved to reduce the salt intake.

Physical activity and sedentary behavior among Chinese children aged 6-17 years: a cross-sectional analysis of 2010-2012 China National Nutrition and health survey.

BACKGROUND: Patterns of physical activity (PA) and sedentary behavior have important implications for child health. The purpose of the study was to describe the PA and sedentary behavior among Chinese children. METHODS: The study analyzed the PA and sedentary behavior status of 38,744 Chinese children aged 6-17 years, based on the data from China National Nutrition and Health Survey (CNNHS) in 2010-2012. RESULTS: Chinese children spent 61.6 min/d on school-time PA and the proportion with 60 min and over on school-time PA was 52.5%. The average transportation time was 38.5 min/d and the main mode for children was walking (50.9%), followed by taking private vehicles (19.4%), taking public transportation (16.4%) and cycling (13.3%). Approximately 70% Chinese children did domestic PA and they spent 17.2 min/d on it. Children spent 2.9 h per day on leisure-time sedentary behaviors and 85.8% of them engaged in sedentary behaviors longer than 2 h/d. The proportion of children participating in leisure-time PA was 35.4%and they performed moderate-to-vigorous PA on 3.4 days per week with average 44.9 min per day. Boys were more active in school-time PA, leisure-time PA and transportation, while girls spent more time on domestic PA and homework. More older children took active transportation and spent more time on domestic PA, leisure-time PA and sedentary behaviors compared with younger children. Children in urban area were more likely to take inactive transportation and participate in leisure-time PA, spent less time on domestic PA while more time on sedentary behaviors compared with their counterpart. CONCLUSIONS: Chinese children performed little physical activity and spent long time engaging in sedentary behaviors. Their physical activity and sedentary behaviors varied by gender, age and area.

[Beverage consumption among Chinese adults in 2010-2012].

OBJECTIVE: Analyzing and described the beverage consumption among Chinese adults. METHODS: Using the data from nutrition and health monitoring of Chinese residents in 2010-2012. Multi-stage stratified proportion to the population cluster random sampling method was conducted to determine residents in 150 sites in 31 provinces. The food frequency questionnaire was used to collect the consumption frequency and amount of the carbonated beverage, fresh fruit and vegetable juice, fruit and vegetable juice beverage, lactobacillus beverage, dairy drink mix, coffee and tea beverage. The indicators of beverage consumption were calculated through weighted complex sampling processing by population data released by the National Bureau of Statistics in 2009. RESULTS: In 2010-2012 the proportion of drinking beverages ≥ 1 times/day, 1-6 times/week, 1-3 times/month, < 1 times/month and none was 5. 7%( 95% CI 4. 4%-7. 0%), 24. 1%( 95% CI 21. 3%-26. 9%), 19. 5%( 95% CI 17. 0%-22. 1%), 9. 3%( 95% CI 7. 6%-10. 9%), 41. 4%( 95% CI 36. 4%-46. 5%), respectively. The proportion of drinking beverages ≥1 times/week among urban residents, men and18-44 age group was significantly higher than their counter part. The top consumption rate among the surveyed beverages was carbonated beverage with 41. 5%( 95% CI36. 8%-46. 2%). The average annual beverage consumption was 30. 6 L, with the highest consumption on tea beverage( 26. 2 L). CONCLUSION: The beverage consumption rate was high among Chinese adults.

[Distribution of the diabetes related gene variants among Chinese population born in early 1960s].

OBJECTIVE: To describe the distributions of the diabetes related gene variants among Chinese population born in early 1960s. METHODS: A total of 1983 subjects( 770 male, 1213 female) were selected from the cross-sectional 2010-2012 China National Nutrition and Health Surveillance. The 45 diabetes related single nucleotide polymorphism( SNPs) were detected by the Mass Array. The distributions of these risk allele in the current study were compared with the result of Utah residents with Northern and Western European ancestry, Japanese in Tokyo, African ancestry inSouthwest USA and Han Chinese in Beijing from the 1000 Genomes project. RESULTS: Among Chinese population born in 1960-1961 and 1963, significant differences in the frequency of the risk allele of rs17584499, rs10906115, rs10886471 and rs11257655 were found between male and female. Compared to the female population, the male have the higher frequency in rs17584499( χ~2= 4. 270, P = 0. 039) and rs10906115( χ~2= 4. 254, P = 0. 039), while lower frequency of risk allele in rs10886471( χ~2= 6. 199, P = 0. 013)and rs11257655( χ~2= 5. 644, P = 0. 018). There was ethnic difference in the frequency of most of the risk alleles, and the difference between the Chinese population and the European ancestry or African ancestry were higher than between the Chinese population and Japanese population. CONCLUSION: The distributions of the diabetes risk alleles among the Chinese population born in early 1960 s have slight gender difference only in few SNPs. There is significant ethnic difference in the frequency of risk allele in most of the diabetes related SNPs.

Ferulic acid alleviates symptoms of preeclampsia in rats by upregulating vascular endothelial growth factor.

Preeclampsia is a complication affecting pregnant women worldwide, which leads to maternal and fetal morbidity and mortality. In this study, we evaluated the efficacy of ferulic acid (FA) on an Nω -nitro-L-arginine methyl ester hydrochloride (L-NAME) induced rat model of preeclampsia. L-NAME was administered to pregnant rats to induce preeclampsia. 48 rats were divided into three experimental groups (n=16 each): control group, preeclampsia group and preeclampsia with FA treatment (preeclampsia+FA). Physiological characteristics such as urine volume, total urine protein and blood pressure were assessed. Expressions levels of urinary nephrin and podocin mRNAs were analyzed by RT-PCR. Levels of renal vascular endothelial growth factor (VEGF), renal soluble fms-like tyrosine kinase-1 (sFlt-1) and serum placenta growth factor (PlGF) were also examined. Urine volume, total urine protein and blood pressure were markedly increased in preeclampsia group rats compared to control (P<.05), which were then significantly reduced in preeclampsia+FA group (P<.05). Expressions of urinary nephrin and podocin mRNAs, levels of VEGF, sFlt-1 and PlGF were also reversed in preeclampsia+FA group compared to preeclampsia rats (P<.05). We hereby report for the first time, FA alleviates preeclampsia symptoms in a rat preeclampsia model, supporting its potential value in treating preeclampsia.

[Status of sedentary activities in the leisure time in Chinese pupils in 2010-2012].

OBJECTIVE: To describe the status of sedentary activities of the Chinese pupils in the leisure time, and to provide basic information for developing intervention strategies. METHODS: Utilizing the data of 2010-2012 China National Nutrition and Health Surveillance, using the multi-stage stratified cluster randomization sampling method, a total of 39 242 pupils on sedentary activities including watching TV, using computer, playing computer games, reading and doing homework, was analyzed. Age and sex standardization was performed based on the China 2009 population published by National Statistics Bureau. The sedentary time after weight adjustment for complex sampling was reported to analyze the time distribution of Chinese pupils. RESULTS: The average time of Chinese pupils' sedentary activities was 2. 92 h/d. There was significant difference between the urban and rural area( 3. 04 h vs 2. 81 h), the boys spent more time slightly on the sedentary activities in their spare time. The senior high school students spent more time on the sedentary activities than the junior school students( 3. 45 h vs 3. 06h), who spent more time than the elementary school students( 3. 06 h vs 2. 60 h). The prevalence of engaging sedentary activities longer than 2 hours was 86. 2%, there was significant difference between the urban and rural area( 87. 5% vs 85. 1%) and the ratio of boys and girls was 86. 4% and 86. 0%, respectively. More senior high school students engaged in sedentary activities longer than 2 hours daily than the junior school students, and the proportion of the junior school students engaged in sedentary activities longer than2 hours was higher than the elementary school students. The average daily homework time was 1. 48 h, and boys spent less time on homework than girls slightly( 1. 44 h vs 1. 52 h). Pupils in the senior school engaged more time in their homework than the junior school students( 1. 90 h vs 1. 62 h). and pupils in the junior school engaged more time in their homework than the elementary school students( 1. 62 h vs 1. 20 h). CONCLUSION: Chinese pupils engaged too much time in sedentary activities in the leisure time, so it is recommended that schools and families create a supportive environment, encouraging the children to reduce their sedentary activities and to improve their physical activity levels.

[Effects of parents on primary and secondary school students' breakfast behaviors in four cities in China].

OBJECTIVE: To study the effects of parents on primary and secondary school students' breakfast behaviors in four cities in China. METHODS: A stratified random cluster sampling method was used to recruit subjects. A total of 10 545 primary and secondary students and their parents were selected from Shenyang, Guangzhou, Wuhan and Chengdu. A questionnaire survey was used to collect information about frequency and nutrition quality of their breakfast. RESULTS: Primary and secondary school students' breakfast behaviors were positively correlated with their parents'. Compared with not eating breakfast, the OR( 95% CI) values of parents eating 1 to 3 times, 4 to 6 times and 7 times breakfast a week were 2. 917( 1. 856-4. 585), 4. 323( 3. 010-6. 208) and 5. 829( 4. 317-7. 870), respectively. Compared with poor nutrition quality, the OR( 95% CI)values of adequate and good nutrition quality of parents' breakfast were 1. 875( 1. 542-2. 280) and 6. 372( 5. 270-7. 704). The higher the educational level of parents, the more likely students did not eat breakfast, but the more adequate nutrition quality of breakfast. CONCLUSION: Parents' breakfast behaviors greatly influence on the students'. Interventions should be taken against the different educational levels of parents.

[Inhibition of antisense VEGF gene on the growth of glioma cells BT325].

OBJECTIVE: To investigate the inhibitory effect of antisense VEGF gene on growth of human glioma BT325 and induced apoptosis in cells. METHODS: The pcDNA3.1/anti-VEGF eukaryotic expression vector was constructed and transfected into human glioma BT325. The ELISA assay was used to assess the expression of VEGF gene. Soft agar colony formation, MTT assay and electron microscope were used to evaluate the proliferation, apoptosis and the morphological changes of BT325. RESULTS: Compared with a control group, the level of VEGF expression was significantly decreased and was almost completely suppressed. The amount in soft agar colony at vector group and antisense VEGF gene group were 21 and 2, respectively. The growth of BT325 was significantly inhibited to 38.23% and resulted in the apoptotic morphology by antisense VEGF gene under electron microscope, compared to vector group. CONCLUSION: Antisense VEGF gene inhibited the growth and proliferation, induced cell apoptosis, played an efficient role of anti-cancer in BT325 cells.

The Nutrition Knowledge Level and Influencing Factors among Chinese Women Aged 18-49 Years in 2021: Data from a Nationally Representative Survey.

Women aged 18-49 years are women of childbearing age. Their nutrition knowledge (NK) is not only related to their physical health but also affects the diet quality of the entire family and the health status of the next generation. Studies that assess the NK level of women of childbearing age using representative data in China are lacking. This study aimed to evaluate the NK level of Chinese women aged 18-49 years and explore influencing factors at both the individual and provincial levels. Data were from the Chinese Nutrition and Health Knowledge Survey 2021. A total of 38,065 females aged 18-49 years were included in the analysis. A face-to-face validated standard questionnaire was used to collect NK from respondents. The full score of the questionnaire was 100. Respondents who scored higher than 75 were considered to have NK. The Rao-Scott chi-square test was used to compare the differences in the NK awareness rate between or among the subgroups. A multilevel logistic regression model was used to explore influencing factors at the individual and provincial levels. All analyses accounted for complex sample design including clustering, stratification, and sample weights. The mean score of NK among Chinese women aged 18-49 years was 65.1 ± 11.8, and the awareness rate was 20.9% (95% CI: 19.6-22.3%). Among the five dimensions, the awareness rate of food safety was the highest (74.0%, 95% CI: 72.8-75.3%), and the dietary recommendation was the lowest (16.4%, 95% CI: 15.3-17.5%). The two-level logistic regression model analysis revealed that at the individual level, age, education level, occupation, chronic disease status and residence were the main influencing factors of the NK level. At the provincial level, the region and the female illiteracy rate were associated with the NK level. Dependent children ratio, per capita income, and health expenditure were not significantly associated with the NK level. The model accounted for 58.8% of the variance in the NK level. The NK level of Chinese women aged 18-49 years was low. Knowledge of dietary recommendations was weakest. Both individual and provincial-level factors were associated with the NK level. There is an urgent need to strengthen nutrition education actions for enhancing the NK of reproductive-age women effectively to improve their dietary behaviors.

Gene-Environment Interaction on Type 2 Diabetes Risk among Chinese Adults Born in Early 1960s.

BACKGROUND: Gene-environment interactions on type 2 diabetes (T2D) risk are studied little among Chinese adults. AIM: This study aimed to explore the interactions among Chinese adults born in early 1960s. METHODS: The interaction of single nucleotide polymorphisms (SNPs) and environmental factors on T2D risk were analyzed by multiple linear or logistic regression models, and in total 2216 subjects were included with the age of 49.7 ± 1.5 years. RESULTS: High dietary intake increased the effects of rs340874 on impaired fasting glucose (IFG), rs5015480, rs7612463 on T2D (OR = 2.27, 2.37, 11.37, respectively), and reduced the effects of rs7172432 on IFG, rs459193 on impaired glucose tolerance (IGT) (OR = 0.08, 0.28, respectively). The associations between rs4607517 and T2D, rs10906115 and IGT, rs4607103, rs5015480 and IFG could be modified by drinking/smoking (OR = 2.28, 0.20, 3.27, 2.58, respectively). Physical activity (PA) interacted with rs12970134, rs2191349, rs4607517 on T2D (OR = 0.39, 3.50, 2.35, respectively), rs2796441 and rs4607517 on IGT (OR = 0.42, 0.33, respectively), and rs4430796, rs5215, and rs972283 on IFG (OR = 0.39, 3.05, 7.96, respectively). Significant interactions were identified between socioeconomic status and rs10830963, rs13266634 on T2D (OR = 0.41, 0.44, respectively), rs1470579 and rs2796441 on IGT (OR = 2.13, 2.37, respectively), and rs7202877 and rs7612463 on IFG (OR = 5.64, 9.18, respectively). CONCLUSION: There indeed existed interactions between environmental factors and genetic variants on T2D risk among Chinese adults.

Association between Physical Activity, Sedentary Behaviors, Sleep, Diet, and Adiposity among Children and Adolescents in China.

INTRODUCTION: Physical activity (PA), sedentary behaviors (SB), sleep, and diet are related to adiposity among children and adolescents. However, there may be interactions between PA, SB, sleep, and diet, and these lifestyle behaviors may work together to affect body weight. The purpose of this study was to explore the impact of multiple lifestyle behaviors of PA, SB, sleep, and diet on childhood adiposity (body mass index z-score and overweight/obesity), and to investigate the effect of meeting multiple guidelines on adiposity among children and adolescents in China. METHODS: Cross-sectional results were based on 28,048 children aged 6-17 years from the China National Nutrition and Health Surveillance in 2010-2012. Information about PA, SB, and sleep was measured through interview-administered questionnaire. Dietary intake was assessed with food frequency questionnaire. The associations between multiple lifestyle behaviors and BMI z-score and overweight/obese were examined. RESULTS: The prevalence of overweight/obesity in the participants was 19.2%. The average time of moderate-to-vigorous PA (MVPA), leisure SB, and sleep was 76.7 ± 45.5 min, 2.9 ± 1.4 h, and 8.5 ± 1.1 h per day, respectively. The China Dietary Guidelines Index for Youth (CDGI-Y) score was 62.6 ± 11.0. Sleep duration and diet score were negative associated with BMI z-score (both p < 0.001). MVPA and SB time were positive associated with BMI z-score (p = 0.041, 0.004). Meeting the SB, sleep, and diet guidelines had a lower BMI z-score (all p < 0.01) and lower odds of overweight/obesity (all p < 0.05). There were significant interactions between PA and diet. Compared with meeting no guidelines, those who met multiple guidelines had a lower risk of overweight/obesity (all p < 0.01). The more guidelines the participants met, the lower odds of overweight/obesity (p for trend <0.001). CONCLUSIONS: PA, SB, sleep, and diet are important behaviors associated with adiposity among children and adolescents. Attaining adequate amounts of appropriate multiple behaviors provided an additional benefit. It is important for children to meet recommended behavioral guidelines or recommendations. Interventions that aim to improve awareness of and compliance with these guidelines are needed in future.

The Association of Sleep Duration with Breakfast Patterns and Snack Behaviors among Chinese Children Aged 6 to 17 Years: Chinese National Nutrition and Health Surveillance 2010-2012.

A significant increase in the prevalence of short sleep among children has been observed. Short sleep may be associated with unhealthy breakfast and snacking behaviors. The purpose of the current study was to explore the associations of short sleep with breakfast and snacking behaviors among children. Data were obtained from the 2010-2012 China National Nutrition and Health Surveillance (CNNHS). A total of 5254 children aged 6 to 17 years were included. Sleep duration was classified into three categories: moderate sleep, slightly short sleep, and severely short sleep. Breakfast behaviors included skipping breakfast, food diversity, intake of energy and macronutrients, and their proportion of daily total intake. Snack behaviors included snack consumption rate/frequency, types, intake of energy and macronutrients, and proportion of daily total intake. Multiple linear regression and multivariate logistic regression were used for analysis, with models adjusted for the potential effects of gender, age, region, and family income level. The bootstrapping method was used to calculate the 95% confidence intervals of the model statistics. Results showed that slightly short sleep (OR = 1.15, 95%CI: 1.00, 1.33)) and severely short sleep (OR = 1.36, 95%CI: 1.04, 1.77) was related to higher rates of skipping breakfast compared to moderate sleep. Severely short sleep was associated with higher energy (ß = 28.44, 95%CI: 31.97, 44.70), carbohydrate (ß = 6.62, 95%CI: 8.29, 8.84) and protein (ß = 1.17, 95%CI: 1.44, 1.70) intake at breakfast and breakfast accounted for a higher proportion of total daily energy (ß = 1.39, 95%CI: 1.48, 2.52), protein (ß = 2.26, 95%CI: 3.16, 5.84) and carbohydrate (ß = 0.83, 95%CI: 0.07, 3.41). Severely short sleep was associated with higher energy (ß = 27.4, 95%CI: 18.64, 69.41), protein (ß = 0.8, 95%CI: 0.48, 2.40), and fat (ß = 1.40, 95%CI: 1.21, 3.16) intake at snacks and snacks accounted for a higher proportion of total daily protein intake (ß = 1.23, 95%CI: 0.71, 3.58) and fat intake (ß = 2.74, 95%CI: 3.13, 6.09). Slightly short sleep was associated with higher energy (ß = 7.28, 95%CI: 0.15, 28.13) and carbohydrate (ß = 1.67, 95%CI: 0.86, 5.73) intake at snacks and snacks accounted for a higher proportion of total daily carbohydrate intake. Children with severely short sleep were more likely to choose sugar-sweetened beverages (SSBs) as snacks (16.5%) and intake them more frequently, at a daily consumption of 204.7 g and 26.7 g per night. Overall, short sleep was associated with unhealthy breakfast patterns and snack behaviors among children. Children with short sleep had higher intake of energy and macronutrients at breakfast and snacks compared with those with moderate sleep. Promoting adequate sleep among children may have a positive effect on developing healthy eating behaviors.

Effects of Gene-Environment Interaction on Obesity among Chinese Adults Born in the Early 1960s.

The prevalence of obesity has been increasing sharply and has become a serious public health problem worldwide. Gene-environment interaction in obesity is a relatively new field, and little is known about it in Chinese adults. This study aimed to provide the effects of gene-environment interaction on obesity among Chinese adults. A stratified multistage cluster sampling method was conducted to recruit participants from 150 surveillance sites. Subjects born in 1960, 1961 and 1963 were selected. An exploratory factor analysis was used to classify the environmental factors. The interaction of single nucleotide polymorphisms (SNPs) and environmental factors on body mass index (BMI) and waist circumference were analyzed using a general linear model. A multiple logistic regression model combined with an additive model was performed to analyze the interaction between SNPs and environmental factors in obesity and central obesity. A total of 2216 subjects were included in the study (mean age, 49.7 years; male, 39.7%, female, 60.3%). Engaging in physical activity (PA) could reduce the effect of MC4R rs12970134 on BMI (ß = -0.16kg/m2, p = 0.030), and also reduce the effect of TRHR rs7832552 and BCL2 rs12454712 on waist circumference (WC). Sedentary behaviors increased the effects of SNPs on BMI and WC, and simultaneously increased the effects of FTO rs9939609 and FTO rs8050136 on obesity and central obesity. A higher socioeconomic status aggravated the influence of SNPs (including FTO rs9939609, BNDF rs11030104, etc.) on BMI and WC, and aggravated the influence of SEC16B rs574367 on central obesity. The MC4R rs12970134 association with BMI and the FTO rs8050136 association with central obesity appeared to be more pronounced with higher energy intake (ß = 0.140 kg/m2, p = 0.049; OR = 1.77, p = 0.004, respectively). Engaging in PA could reduce the effects of SNPs on BMI and WC; nevertheless, a higher socioeconomic status, higher dietary energy intake and sedentary behaviors accentuated the influences of SNPs on BMI, WC, obesity and central obesity. Preventative measures for obesity should consider addressing the gene-environment interaction.

Association of Physical Activity and Sitting Time with Overweight/Obesity in Chinese Occupational Populations.

The aim of this study was to explore association of physical activity and sitting time with overweight/obesity in Chinese occupational populations for the development of intervention and prevention strategies for obesity. METHODS: A total of 23,112 participants were selected from the 2010-2012 China National Nutrition and Health Survey (CNNHS). A logistics regression model was used to examine the associations of physical activity and sitting time with overweight/obesity by gender after adjusting for age, educational level, marital status, and family economic level. RESULTS: The prevalence of overweight/obesity based on the WHO definition and the WGOC definition was 30.8% and 41.3%, respectively. Male employees with moderate and heavy occupation activity intensity had a lower risk for overweight/obesity than those with light occupation activity intensity (moderate: OR 0.90, 95% CI 0.82-0.98; heavy: OR 0.75, 95% CI 0.65-0.86), and the risk of overweight/obesity of male employees with long work-time spent sitting was higher than those with short work-time spent sitting (2-4.9 h/day: OR 1.26, 95% CI 1.14-1.40; ≥5 h/day: OR 1.29, 95% CI 1.15-1.44). The risk of overweight/obesity of male employees with active transportation mode was lower than those with inactive transportation mode (OR 0.91, 95% CI 0.84-0.99), while the risk of overweight/obesity of female employees with active transportation mode was higher (OR 1.14, 95% CI 1.04-1.25). Female employees with leisure-time physical activity (LTPA) for ≥150 min/week had lower risk of overweight/obesity than those with LTPA for <150 min/week (OR 0.69, 95% CI 0.56-0.84). There was no significant association of leisure-time sitting and housework time with overweight/obesity in Chinese occupational populations. CONCLUSION: Occupation activity intensity, LTPA, transportation mode, and work sitting time were associated with overweight/obesity. Reducing work sitting time, moderate and heavy occupation activity intensity, and an active transportation mode could help male employees decrease the risk of overweight/obesity. Increasing leisure-time physical activity could reduce the risk of overweight/obesity in women. Our findings provided insight into the association of physical activity and sitting time with overweight/obesity. It will be necessary to carry out workplace-based interventions, have an active transportation mode, and increase leisure-time physical activity to decrease the risks of overweight/obesity.

The Relationship between Leisure-Time Sedentary Behaviors and Metabolic Risks in Middle-Aged Chinese Women.

The prevalence of metabolic diseases has increased over the past few decades, and epidemiological studies suggest that metabolic diseases may be associated with lifestyle. The purpose of the present study was to investigate the relationship between leisure-time sedentary behaviors (LTSBs) and metabolic risks in middle-aged women in China. Data came from the China National Nutrition and Health Surveillance (CNNHS) in 2010-2012. A total of 2643 women aged 46 to 53 years were involved. Multiple linear regression was used to examine the association of leisure-time sedentary duration (LTSD) with total cholesterol (TC), triglyceride (TG), waist circumference (WC), and body mass index (BMI). Restrictive cubic splines (RCS) were used to plot the curves between LTSD and the risk of metabolic diseases. Region, education, income, alcohol consumption, exercise, daily energy intake, and fat energy ratio were adjusted for all models. After adjusting for potential influencing factors, the results of multiple linear regression showed that for each additional hour increase in LTSD, TC and TG increased by 0.03 mmol/L and 0.04 mmol/L, respectively. The results of RCS curves showed that the risks of MetS (p for trend = 0.0276), obesity (p for trend = 0.0369), hypertension (p for trend = 0.0062), and hypercholesteremia (p for trend = 0.0033) increased with the increase in LTSD. LTSB was associated with the risks of MetS, obesity, hypertension, and hypercholesteremia in middle-aged women. Reducing LTSD may be an effective way of preventing metabolic diseases in middle-aged women.