Comparison of data-driven identified hypertension-protective dietary patterns among Chinese adults: based on a nationwide study.

PURPOSE: Diet pattern (DP) is a key modifiable and cost-effective factor in hypertension (HTN) management. The current study aimed to identify and compare the hypertension-protective DPs among Chinese adults. METHODS: 52,648 participants aged over 18 years were included from China Nutrition and Health Surveillance (CNHS) 2015-2017. Reduced rank regression (RRR) and partial least square regression (PLS) was applied to identify the DPs. Multivariable-adjusted logistic regression was used to assess the association between the DPs and HTN. RESULTS: DPs derived by RRR and PLS were both featured by higher consumption of fresh vegetables and fruits, mushrooms and edible fungi, seaweeds, soybeans and related products, mixed legumes, dairy products, fresh eggs, and lower of refined grain consumption. Compared to the lowest quintile, participants in the highest quintile had lower odds of HTN (RRR-DP: OR = 0.77, 95% CI = 0.72-0.83; PLS-DP: OR = 0.76, 95% CI = 0.71-0.82; all p < 0.0001). Simplified DP scores were observed the same protective tendencies (Simplified RRR-DP: OR = 0.81, 95% CI = 0.75-0.87; Simplified PLS-DP: OR = 0.79, 95% CI = 0.74-0.85; all p < 0.0001) and showed effective extrapolation in subgroups defined by gender, age, location, lifestyle, and different metabolic conditions. CONCLUSIONS: The identified DPs had high conformity with East Asian dietary habits, and significantly negative associations with HTN among Chinese adults. The simplified DP technique also indicated the potential for improving the extrapolation of the results of DP analysis related to HTN.

[Screen time among Chinese primary and middle school students from 2016 to 2017].

OBJECTIVE: To get a better knowledge of the current situation of screen time among primary and secondary school students in all provinces of China from 2016 to 2017. METHODS: Data was from the China National Nutrition and Health Surveillance of Children and Lactating Women(2016-2017).275 monitoring points were selected from 31 provinces of China by multi-stage stratified cluster random sampling. A total of 280 primary and secondary school students from 2 primary schools, 2 junior middle schools and 1 senior high school were randomly selected from each monitoring point to complete the survey.73629 primary and secondary school students(except grade 9 and grade 12) were included in this study. RESULTS: From 2016 to 2017, the average daily screen time of Chinese primary and secondary school students was(1.65±1.54) hours, M(P25, P75) was 1.29(0.58, 2.21) h. In terms of provinces, the average daily electronic screen time of primary and secondary school students in Beijing, Tianjin, Jilin, Fujian, Guangdong and Hainan is more than 2 hours. In terms of rural and urban areas, the screen time of students in Beijing's rural and urban areas, Tianjin's rural areas, Hebei's urban areas, Liaoning's rural areas, Jilin's rural areas, Fujian's urban areas, Guangdong's urban areas, Guangxi's urban areas, Hainan's rural and urban areas, and Xinjiang's urban areas all exceeds 2 hours/day. Besides, screen times of rural primary and secondary school students in Beijing(Z=2.62, P<0.01), Tianjin(Z=5.94, P<0.01), Liaoning(Z=11.56, P<0.01), Jilin(Z=-7.59, P<0.01), Shanghai(Z=3.19, P<0.01), Jiangsu(Z=12.00, P<0.01), Zhejiang(Z=-4.80, P<0.01), Anhui(Z=-4.67, P<0.01), Jiangxi(Z=-3.29, P=0.01), and Sichuan(Z=-4.53, P<0.01) are longer than that of urban students. CONCLUSION: There are urban-rural differences in the average daily electronic screen time and different types of electronic screen time of primary and secondary school students in China's provinces from 2016 to 2017.

[Energy and macronutrients intake of the elderly aged 75 years and above in China in 2015].

OBJECTIVE: To analyze the intake of energy and macronutrients in the elderly aged 75 years and above in China. METHODS: The data was sourced from the China National Chronic Non-communicable Disease and Nutrition Surveillance, which adopted a multi-stage stratified clustered random sampling method and selected 298 monitoring points from 31 provinces across the country to carry out chronic non-communicable disease and nutrition surveillance of Chinese adults. The condiments weighting method and 3-day 24-hour dietary review method were used to collect dietary data for residents. Based on the dietary survey result of 3368 elderly people aged 75 years and above in the surveillance, the intake of energy and macro nutrients of elderly people was analyzed. RESULTS: Among the elderly aged 75 years and above included in the analysis, there were 1727 males and 1641 females, 1511 people in urban areas and 1857 people in rural areas, 1956 people aged 75-79, 1412 people aged ≥ 80. The average energy intake of the elderly aged 75 years and above in China was(1601.0±473.4)kcal, and the average intakes of carbohydrate, protein and fat were(219.6±76.6)g, (48.2±18.6)g and(60.2±31.5)g, respectively. The energy supply ratios of carbohydrate, protein and fat were 54.9%, 12.0% and 33.1% respectively. The carbohydrate intake and its energy supply ratio of the urban elderly((200.0±74.0)g and 51.8%) were significantly lower than those of the rural elderly((235.5±75.0) and 57.4%), while the protein intake and its energy supply ratio((50.2±18.9)g and 13.0%), fat intake and its energy supply ratio((61.2±30.2)g and 35.2%)of the urban elderly were significantly higher than those of the rural elderly((46.5±18.2)g and 11.2% for protein, and(59.4±32.5)g and 31.4% for fat). According to Chinese dietary reference intake standard, only 28.1% of the elderly aged 75 and above reached the recommended value of energy, 71.9% of the elderly did not take enough energy, the proportion of insufficient protein intake was 72.2%, 68.5% in urban areas and 75.2% in rural areas, the proportion of people with fat to energy ratio more than 30% was 58.5%, 65.3% in urban areas and 52.9% in rural areas. CONCLUSION: The energy intake of the elderly aged 75 years and above in China was insufficient, the protein intake was low, the fat to energy ratio was too high, and the dietary structure was unreasonable.

[Eating out behavior of residents aged 6 and above in China from 2015 to 2017].

OBJECTIVE: To analyze the eating out behavior of Chinese residents aged 6 and above from 2015 to 2017. METHODS: Using the data of eating out behavior in the past week from China Nutrition and Health Surveillance(2015-2017), after data cleaning, a total of 150 682 subjects were included in this study, including 80 703 in 2015 and 69 979 in 2016-2017. The percentage of cases were used to describe the eating behaviors of different characteristics of the population, Chi-square test was used to comparative analysis. RESULTS: From 2015 to 2017, proportions of eating out for all the three meals was 46.3% of Chinese residents aged 6 and above in the past week, that of were 69.7%, 84.6%, 33.2%, 19.8% and 9.1% of Chinese residents aged 6 to 11, 12 to 17, 18 to 44, 45 to 59 and 60 and above, respectively. The proportion of urban and rural residents eating out in the past week were 52.8% and 41.2%, respectively, the difference was statistically significant(P<0.05). The proportion of male and female residents eating out in the past week were 49.6% and 43.1%, respectively, the difference was statistically significant(P<0.05). Proportions of eating out for breakfast, lunch and dinner were 31.4%, 37.2% and 21.4% respectively of Chinese residents, that of were 17.3%, 29.1% and 15.1% of Chinese residents eating breakfast, lunch and dinner in work/school canteens. CONCLUSION: Children aged 6 to 17 years old are the key groups for eating out. Among adults aged 18 and above, residents aged 18 to 44 have the highest proportion of eating out. Proportions of eating out for lunch is the highest and the main eating-out place is the canteen for Chinese residents.

[Current situation of screen time among Chinese primary and middle school students from 2016 to 2017].

OBJECTIVE: To analyze and describe the status and characteristics of using electronic screens of primary and middle school students in China from 2016 to 2017. METHODS: From 2016 to 2017, 275 monitoring points were selected from 31 provinces in China, and 280 primary and middle school students were selected from each monitoring point to complete the survey. Using the suggestion from "Healthy China Initiative(2019-2030)"of which the screen time of primary and middle school students should be less than one hour per day as the standard. RESULTS: A total of 74 314 primary and secondary school students(except grade 9 and grade 12) were included in this study. Among them, there were 37 147 boys(50.0%) and 37 167 girls(50.0%); 44 612 pupils(60.0%), 14 858 junior school students(20.0%), and 14 844 senior high school students(20.0%); 38 995(52.5%) rural students and 35 319(47.5%) urban students; 53 287 boarding students(71.7%) and 20 537 day students(27.6%). From 2016 to 2017, the average daily screen time of Chinese primary school students was 1.45 hours, M(P25, P75) was 1.14(0.57, 1.93) h. That of junior high school students was 1.92 hours, M(P25, P75) was 1.43(0.71, 2.48) h. That of senior high school students was 2.37 hours, M(P25, P75) was 1.71(0.90, 3.02) h. The average daily screen time qualified rates of primary school, junior high and senior high school students were 46.1%, 37.1% and 27.7%, respectively. From 2016 to 2017, the most used electronic screen products of primary school students in China were TV/videos(62%), followed by mobile phones(21%). Junior high school students spent 38% and 37% of the total time watching TV/videos and playing mobile phones, respectively. High school students spend the longest time using mobile phones(49%) of the total time, followed by watching TV/videos(26%). CONCLUSION: With the increasing of grade, screen time became longer, and screen time qualified rate dropped. Moreover, the most used electronic screens were mobile phones and TV/videos.

[Status of dietary micronutrient intakes among the children of 12-17 years old in China from 2016 to 2017].

OBJECTIVE: To analyze the status of dietary micronutrient in takes among the children of 12-17 years old in China from 2016 to 2017. METHODS: Multistage stratified random sampling method was used to collect data in 275 monitoring sites of the China National Nutrition and Health Survey of Chinese children and lactating mothers in 31 provinces of China from 2016 to 2017. Three consecutive 24-hour recalls method wasused to collect the information of food intake, and household or school canteen edible oil and condiments weighing were adopted. The dietary micronutrient were analyzed based on theChina Food Composition table. RESULTS: The average daily intakes of vitamin A(retinol activity equivalents), vitamin B_1(thiamine), vitamin B_2(riboflavin), vitamin C(ascorbic acid), calcium, iron, zinc and sodium were 356.8 µ g, 0.8 mg, 0.8 mg, 60.5 mg, 342.8 mg, 19.2 mg, 9.8 mg and 5 230.4 mg, respectively. The proportion ofdaily average intakes of vitamin A, vitamin B_1, vitamin B_2, vitamin C and calcium lower than 60% of the recommended value were 74.3%, 59.4%, 57.7%, 62.6% and 93.0%, respectively. The proportion of daily intake of iron and zinc reaching 80% of the recommended value were 73.8% and 64.8%, respectively. The proportion of daily average intake of sodium exceeded the appropriate intake by 94.4%. The average daily intakes of micronutrients increased with age among the children of 12-17 years old. There were differences of daily intake of vitamin A in gender, urban and rural areas(P<0.05), there was difference of vitamin C in urban and rural areas(P<0.01), there were differences of daily intake of vitamin B_1, vitamin B_2, calcium, iron and zinc in age, gender, urban and rural areas(P<0.01), there were differences in the average daily intake of sodium in age, gender(P<0.01). CONCLUSION: The average daily dietary of iron and zinc intakes in the diet were basically enough in most children of 12-17 years old in China, that of sodium was too much, and that of some micronutrients was insufficient.

Investigation of optimal gestational weight gain based on the occurrence of adverse pregnancy outcomes for Chinese women: a prospective cohort study.

OBJECTIVE: To investigate recommendations for appropriate gestational weight gain (GWG) of Chinese females. METHODS: In total of 3,172 eligible women in the first trimester were recruited into the Chinese Pregnant Women Cohort Study (CPWCS) project. Pregnancy complications and outcomes were collated using the hospital medical records system. The method of occurrence of participants with adverse pregnancy outcomes (Occurrence Method) was conducted to calculate the recommended total GWG for each participant's pre-pregnancy BMI. Occurrence Method data were judged against the Institute of Medicine (IOM) and Japanese recommended criteria in terms of the total occurrence of adverse pregnancy outcomes of pregnant women with appropriate weight gain. RESULTS: The most frequent GWG was ≥ 14 kg and < 16 kg (19.4%), followed by ≥ 10 kg and < 12 kg (15.5%) and ≥ 12 kg and < 14 kg (15.2%). The most frequently occurring adverse pregnancy outcomes were cesarean sections for underweight (30.0%), normal weight (40.4%), overweight (53.6%) and obese (53.7%) women. A large for gestational age (LGA) accounted for 18.0% of the overweight and 20.9% of the obesity group. Gestational diabetes mellitus (GDM) occurred in 16.9% of overweight and 23.1% of obese women. The recommended total GWG in a Chinese women population is ≥ 8 and < 12 kg if underweight, ≥ 12 and < 14 kg for normal weight, ≥ 8.0 and < 10.0 kg if overweight, and < 8 kg for women with obesity. CONCLUSIONS: Current Chinese recommendations provide the optimal ranges of GWG to minimize the occurrence of undesirable pregnancy outcomes for each group of pre-pregnancy BMIs in a Chinese population. TRIAL REGISTRATION: Registered with ClinicalTrials ( NCT03403543 ).

Dietary patterns and their associations with overweight/obesity among preschool children in Dongcheng District of Beijing: a cross-sectional study.

BACKGROUND: Few studies investigated the associations between dietary patterns and overweight/obesity among Chinese preschool children. Thus, the study aims to explore dietary patterns and their associations with overweight/obesity among preschool children in the Dongcheng District of Beijing. METHODS: With a stratified proportionate cluster sampling, the study included 3373 pairs of preschool children and their guardians. Children's weight and height were measured by school nurses, and their food and beverage consumption frequencies were reported by guardians via a food frequency questionnaire. Children's age, gender, physical activity time, and sedentary time, as well as their parents' highest level of educational attainment, occupation, weight, and height were also collected. Dietary patterns were identified through exploratory factor analysis. Among these identified dietary patterns, the one with the largest factor score was defined as the predominant dietary pattern for each child. The associations between predominant dietary patterns and overweight/obesity were tested by two-level random-intercept logistic models with cluster-robust standard errors. RESULTS: Four dietary patterns, i.e., a "Sugar-sweetened beverage (SSB) and snack" pattern, a "Chinese traditional" pattern, a "Health conscious" pattern, and a "Snack" pattern, were identified. Among the children, 21.02% (95% CI: 19.68 to 22.43%) were predominated by the "SSB and snack" pattern, 27.78% (95% CI: 26.29 to 29.32%) by the "Chinese traditional" pattern, 24.90% (95% CI: 23.47 to 26.39%) by the "Health conscious" pattern, and 26.30% (95% CI: 24.84 to 27.81%) by the "Snack" pattern. After controlling for potential confounders, the "SSB and snack" pattern characterized by fresh fruit/vegetable juice, flavored milk drinks, carbonated drinks, flavored fruit/vegetable drinks, tea drinks, plant-protein drinks, puffed foods, fried foods, and Western fast foods was associated with a higher risk of overweight/obesity (OR: 1.61, 95% CI:1.09 to 2.38), compared with the "Chinese traditional" pattern. CONCLUSIONS: The preference for dietary patterns with high energy density but low nutritional value was prevalent among preschool children in the Dongcheng District of Beijing. Comprehensive measures to simultaneously reduce consumption of SSBs and unhealthy snacks among preschool children should be taken urgently to address the childhood obesity problem in China, particularly in metropolises.

[Intakes of energy and macronutrients in 6-11 years old age group in 2016-2017 in China].

OBJECTIVE: To survey the intakes of energy and macronutrients in 6-11 years old age group in 2016-2017 in China. METHODS: Multi-stage cluster randomization sampling method was used to collect the data from China Nutrition and Health Surveillance of Children and Lactating Mothers in 2016-2017 in 257 surveillance sites of 31 provinces. 24-h dietary recalls for three consecutive days were used to obtain the dietary information. The intakes of energy, protein, fat and carbohydrate were calculated by the China Food Composition, and the intakes of protein were assessing by Chinese Dietary Reference Intakes(DRIs). RESULTS: A total of 8777 children in 6-11(9. 2±1. 6) years old group were recruited in this surveillance, the number of boys and girls were 4364 and 4413, respectively. The general intakes of energy were 1591. 7 kcal and that of boys and girls were 1624. 1 kcal and 1559. 7 kcal, respectively. The energy intakes in urban children were higher than rural children. The energy intakes in the east region were the highest and the middle region were the lowest. The general protein intakes were 50. 0 g, and that of boys and girls were 50. 9 g and 49. 1 g, respectively. The intakes of protein in urban children were higher than in rural. The intakes of protein in east region were higher than that in the middle and west regions. The ratios that above RNI of protein intakes were 52. 4%, and the ratios of urban and rural were 63. 0% and 42. 9%, respectively. The general fat intakes were 69. 6 g and that of boys and girls were 71.4 g and 67.8 g, respectively. The fat intakes in urban children were higher than in rural, but in the rural of the west the fat intakes were higher than in the urban of the east. The general intakes of carbohydrate were 196. 3 g, and that of boys and girls were 199. 5 g and 193. 2 g, respectively. The carbohydrate intakes in urban children were higher than in rural, and in the west region the intakes of carbohydrate were higher than in the east region. But in the rural populations, the carbohydrate intakes in the west region were higher than that in the east region. CONCLUSION: Comparing with 2010-2013, obvious changes of energy and macronutrients intakes in China 6-11 y children were observed in 2016-2017 surveillance. Inadequate intakes of protein were still the problem in rural children populations. The increase of fat intake was larger and more significant in the western region.

[Eating out behavior and its impact on obesity among Chinese residents aged 18-59 in 2015].

OBJECTIVE: To study the eating out behavior and its impact on obesity among Chinese residents aged 18-59. METHODS: Multistage stratified random sampling method was used to collect data in 302 monitoring sites of the China National Chronic Non-communicable Disease and Nutrition Surveillance of adults in 31 provinces of China from 2015. A total of 53 887 subjects were included in this study by data cleaning. The population data published by the National Bureau of Statistics in 2010 were used as a standard population of the data result for 2015. Complex sampling weighting method was adopted in data analyses. The number and percentage of cases were used to describe the eating behaviors of different characteristics of the population, Statistical analysis was conducted by using SURVEYFREQ process, and Chi-square test was used to comparative analysis. Multi-factor analysis was conducted to the relationship between eating out frequency and different characteristics and obesity by using SURVEYLOGISTIC model regression. RESULTS: In 2015, proportions of eating out for all the three meals was 36. 1% of Chinese residents aged 18-59 in the past week, that of were 41. 3% and 24. 3% of Chinese residents aged 18-44 and 45-59, respectively. Proportions of Chinese residents was 12. 2% for eating out 1-6 times a week, 15. 8% for eating out 7-13 times a week, and 8. 1% for eating out 14-21 times a week. Results from the multivariate Logistic regression analysis showed that 18-44 years old, male, urban, highly educated, family per capita annual income ≥ 20 000 yuan, unmarried, on the job and school students chose to eat out more commonly. No statistical association was noticed between the frequency of eating out and obesity in women, men who ate out 14-21 times a week showed higher risk of obesity than those who not ate out, with OR=1. 8(95%CI 1. 3-2. 5). CONCLUSION: Proportions of eating out increased for Chinese residents aged 18-59, men who ate out 14-21 times a week showed higher risk of obesity.

Association among pre-pregnancy body mass index, gestational weight gain and neonatal birth weight: a prospective cohort study in China.

BACKGROUND: This study aims to explore the relationships between pre-pregnancy body mass index (BMI), gestational weight gain (GWG), rate of GWG during the second and third trimesters (GWGrate) and birth weight among Chinese women. METHODS: Women were enrolled by 24 hospitals in 15 different provinces in mainland China from July 25th, 2017 to 26 November 2018. Pre-pregnancy BMI, GWG and GWGrate were calculated and divided in to different groups. The multinomial logistic regression model and restrictive cubic spline model were used to explore the relationships. RESULTS: Of the 3585 participants, women who were underweight, had insufficient GWG or GWGrate had 1.853-, 1850- or 1.524-fold higher risks for delivering small-for-gestational-age (SGA) infant compared with women who had normal BMI, sufficient GWG or GWGrate. Women who were overweight/obese, had excessive GWG or GWGrate had 1.996-, 1676- or 1.673-fold higher risks for delivering large-for-gestational-age (LGA) infant. The effects of GWG and GWGrate on birth weight varied by pre-pregnancy BMI statuses. Dose-response analysis demonstrated L-shaped and S-shaped relationships between pre-pregnancy BMI, GWG, GWGrate and neonatal birth weight. CONCLUSIONS: Pre-pregnancy BMI, GWG or GWGrate were associated with neonatal birth weight among Chinese women. Both body weight before and during pregnancy should be maintained within the recommendations to prevent abnormal birth weight.

Effects of pre-pregnancy body mass index and gestational weight gain on maternal and infant complications.

BACKGROUND: The potential effects of pre-pregnancy body mass (BMI) and gestational weight gain (GWG) on pregnancy outcomes remain unclear. Thus, we investigated socio-demographic characteristics that affect pre-pregnancy BMIs and GWG and the effects of pre-pregnancy BMI and GWG on Chinese maternal and infant complications. METHODS: 3172 women were enrolled in the Chinese Pregnant Women Cohort Study-Peking Union Medical College from July 25, 2017 to July 24, 2018, whose babies were delivered before December 31, 2018. Regression analysis was employed to evaluate the socio-demographic characteristics affecting pre-pregnancy BMI and GWG values and their effects on adverse maternal and infant complications. RESULTS: Multivariate logistic regression analysis revealed that age groups < 20 years (OR: 1.97), 25-30 years (OR: 1.66), 30-35 years (OR: 2.24), 35-40 years (OR: 3.90) and ≥ 40 years (OR: 3.33) as well as elementary school or education below (OR: 3.53), middle school (OR: 1.53), high school (OR: 1.40), and living in the north (OR: 1.37) were risk factors in maintaining a normal pre-pregnancy BMI. An age range of 30-35 years (OR: 0.76), living in the north (OR: 1.32) and race of ethnic minorities (OR: 1.51) were factors affecting GWG. Overweight (OR: 2.01) and inadequate GWG (OR: 1.60) were risk factors for gestational diabetes mellitus (GDM). Overweight (OR: 2.80) and obesity (OR: 5.42) were risk factors for gestational hypertension (GHp). Overweight (OR: 1.92), obesity (OR: 2.48) and excessive GWG (OR: 1.95) were risk factors for macrosomia. Overweight and excessive GWG were risk factors for a large gestational age (LGA) and inadequate GWG was a risk factor for low birth weights. CONCLUSIONS: Overweight and obesity before pregnancy and an excessive GWG are associated with a greater risk of developing GDM, GHp, macrosomia and LGA. The control of body weight before and during the course of pregnancy is recommended to decrease adverse pregnancy outcomes, especially in pregnant women aged < 20 or > 25 years old educated below university and college levels, for ethnic minorities and those women who live in the north of China. TRIAL REGISTRATION: Registered at Clinical Trials ( NCT03403543 ), September 29, 2017.

Dietary patterns in relation to gestational depression and sleep disturbance in Chinese pregnant women.

AIM: To investigate the association of dietary patterns with gestational depression and sleep disturbance. METHODS: Women in early pregnancy were recruited from the Chinese Pregnant Women Cohort Study (CPWCS) through July 25th, 2017 to November 26th, 2018, and eventually 7615 participants were included in this study. The qualitative food frequency questionnaire (Q-FFQ), Edinburgh Postnatal Depression Scale (EPDS), and the Pittsburgh Sleep Quality Index (PSQI) were used to assess dietary, depression and sleep quality during pregnancy, respectively. Dietary patterns were derived by factor analysis. Logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of each outcome according to quartiles of each dietary pattern. RESULTS: Five dietary patterns were identified. Participants with the highest quartile in plant-based pattern had a significantly lower likelihood of mental problems (OR: 95% CI for depression: 0.66, 0.55-0.79; sleep disturbance: 0.80, 0.68-0.93); Similar results were observed in vitamin-rich pattern (OR: 95% CI for depression: 0.46, 0.38-0.55; sleep disturbance: 0.76, 0.65-0.89); However, contrary results were found in high-fat pattern (OR: 95% CI for depression: 2.15, 1.25-1.85; sleep disturbance: 1.43, 1.22-1.67); In animal protein-rich pattern, participants with the highest quartile had a decreased likelihood of depression (OR: 0.80, 95% CI: 0.67-0.96). As for bean products pattern, participants with the highest quartile had an increased risk of depression (OR: 1.28, 95% CI:1.06-1.53). Interactions of dietary patterns and lifestyles on mental disorders were observed. CONCLUSION: Dietary patterns were associated with gestational depression and sleep disturbance. Relevant departments and maternal and child health personnel should conduct health education for pregnant women and guide them to eat properly.

Photo-Fenton degradation of ethyl xanthate catalyzed by bentonite-supported Fe(II)/phosphotungstic acid under visible light irradiation.

In this study, using bentonite-supported Fe(II)/phosphotungstic acid composite (HPW-Fe-Organicbent) prepared by mechanochemical synthesis as heterogeneous catalyst, the photo-Fenton degradation of ethyl xanthate under visible light irradiation was studied in detail. The results showed that the degradation of ethyl xanthate was mainly impacted by H2O2 dosage, catalyst dosage and reaction time. HPW-Fe-Organicbent catalyst had a wide applicable range of pH and kept a high catalytic activity even at high pH in the photo-Fenton degradation of ethyl xanthate. It was found that the degradation of ethyl xanthate in the photo-Fenton process catalyzed by HPW-Fe-Organicbent mainly resulted from the hydroxyl radicals. HPW-Fe-Organicbent had an excellent stability in use, and retained almost all of its catalytic activity for four recycling times. Moreover, the kinetics study showed the degradation of ethyl xanthate, with the initial concentration below 50 mg/L, was well fitted by the pseudo-first-order rate model.

The impact of green credits on high-quality energy development: evidence from China.

The implementation of green credits has become an important engine for China's high-quality energy development (HQED). On the basis of constructing an index of HQED and the panel data of thirty provinces in China from 2008 to 2019, this study empirically investigated the effects of green credits on HQED and the action mechanisms behind it in a multi-dimensional manner using a panel fixed-effects model, mediating-effects model, and spatial Durbin model. The results indicated that green credits had significantly contributed to China's HQED, and that conclusion still held true after a series of robustness tests were conducted. It was found that industrial structures and human capital were important channels through which green credits influenced China's HQED. Moreover, the spatial spillover effects of green credits on HQED were also confirmed. Finally, in terms of temporal heterogeneity, the positive effects of green credits on HQED were found to have increased significantly after 2012. Also, in terms of regional heterogeneity, this study observed that the positive influence of green credits on HQED was more significantly in central and western China than in eastern China, and in southern China than in northern China. The results obtained in this research investigation will potentially provide some important insights for energy planners and policymakers to further the understanding of the drivers of HQED, and the corresponding transmission mechanisms and regional differences.

Weight-Control Behaviors and Dietary Intake in Chinese Adults: An Analysis of Three National Surveys (2002-2015).

Weight control through dietary management is becoming increasingly common worldwide. This study aimed to evaluate and compare the dietary intake and diet quality between Chinese adults with and without weight-control behaviors. Data were collected from the China National Nutrition Survey 2002, 2012, and 2015. Dietary intake was assessed using a combination of 24 h dietary recall of three consecutive days and a weighing method. Diet quality was calculated based on China healthy diet index (CHDI). A total of 167,355 subjects were included, of which 11,906 (8.0%) adults reported attempting to control weight within the past 12 months. Participants with weight control had lower daily total energy intake, as well as lower percentages of energy from carbohydrates, low-quality carbohydrates, and plant protein, but higher percentages of energy from protein, fat, high-quality carbohydrates, animal protein, saturated fatty acids, and monounsaturated fatty acids than those without weight control. Additionally, the CHDI score in the weight-control group was higher than those without (53.40 vs. 48.79, p < 0.001). Fewer than 40% of participants in both groups met the requirement for all specific food groups. Chinese adults who reported weight-control behaviors had an energy-restricted diet characterized by reduced carbohydrate intake and overall higher diet quality compared with those without dietary-control behaviors. However, both groups had significant room for improvement in meeting dietary recommendations.

The Prevalence of Hyperuricemia and Its Correlates among Adults in China: Results from CNHS 2015-2017.

This study aimed to investigate the prevalence of hyperuricemia (HUA) and associated risk factors in Chinese adults aged 18 to 59 years. All the data were collected from the China Nutrition and Health Surveillance during the period 2015-2017, which adopted a stratified, multistage, random sampling method on a national scale. A total of 52,627 participants aged 18 years or older were included in this study. The definition of hyperuricemia was 420 µmol/L for male and 360 µmol/L for female. The Rao-Scott chi-square test was used to compare the differences in prevalence between or among the subgroups. A weighted two-level multivariate survey-logistic regression was used to detect the correlations between HUA and demographic, physical, lifestyle and metabolic factors. The total prevalence of HUA was 15.1%, and that was higher in male, current smokers, higher BMI and less physical activities subgroups, and also in noninfectious chronic diseases (NCDs) subgroups. The subgroups of non-vegetarian diet, insufficient vegetable intakes and excessive red meat and alcohol intakes had significantly higher HUA prevalence. After introducing all the variables in the survey-logistic regression, gender, age, BMI, physically active, hypertension, diabetes mellitus, bean and nut intake, vegetable intake, red meat intake, alcohol consumption and vegetarian were associated with HUA. Among the significant variables, age and physical active served as a protective factor, and BMI showed to be a risk factor for HUA. Hypertension and dyslipidemia could increase the risk for HUA, while diabetes mellitus was shown a negative association with it. For dietary factors, vegetarian diet, sufficient beans and nuts and vegetables intake could lower the risk of HUA, but more alcohol could increase the risk of HUA. Dietary factor played a key role in HUA. It suggested that the intervention of dietary factor should receive more attention to ameliorate the high prevalence of HUA in China.

Self-Reported Dietary Management Behaviors and Dietary Intake among Chinese Adults with Diabetes: A Population-Based Study.

Few studies have analyzed the implementation of dietary management in Chinese adults with diabetes. Thus, we assessed and compared dietary intake and diet quality between diabetic patients with and without dietary management behaviors (DPDM vs. NDPDM), and evaluated the adherence to dietary guidelines in both groups of patients. The data were obtained from the 2002, 2010-2013, and 2015 China National Nutrition Survey. A total of 69,583, 67,177, and 96,631 subjects participated in the 2002, 2010-2013, and 2015 survey rounds, respectively. The dietary intake data were measured using 3-day 24 h dietary recalls and weighed records of household condiments. The China Healthy Diet Index (CHDI) was used to evaluate diet quality. The study included 6229 patients with diabetes, of which 78% had dietary management behaviors. The diabetic patients with dietary management behaviors showed higher percentages of energy from high-quality carbohydrates, animal protein, saturated fatty acids, and unsaturated fatty acids and lower percentages from low-quality carbohydrates and plant protein than NDPDM. The diabetic patients with dietary management behaviors also had lower intakes of cereals and tubers and higher intakes of vegetables than NDPDM. The total CHDI score of DPDM was higher than NDPDM (56.3 ± 12.7 vs. 54.1 ± 12.3). The proportion of DPDM meeting the recommended intake for different food items ranged from 3.3% to 42.8% and from 3.0% to 39.2% in NDPDM. The diabetic patients with dietary management behaviors showed better adherence to dietary guidelines and higher diet quality scores than NDPDM, while the overall adherence was poor in both groups of patients. Our findings suggested that measures are needed to promote and refine dietary management behaviors, which can help to improve disease management in diabetic patients.

Dietary Micronutrient Status and Relation between Micronutrient Intakes and Overweight and Obesity among Non-Pregnant and Non-Lactating Women Aged 18 to 49 in China.

Women between the ages of 18 and 49 are women of reproductive age, for whom physical health and nutritional status are closely related to successful pregnancy, good pregnancy outcomes and the nurturing of the next generation. Overweight and obesity have become important nutrition and health problems of women aged 18−49 years in China. In social life, non-pregnant and non-lactating Chinese women aged 18−49 are the most vulnerable and neglected group. At present, there are no research data on their dietary micronutrient intake, and the relationship between dietary micronutrient intake and overweight and obesity in China. However, non-pregnant and non-lactating women aged 18−49 are the best window of opportunity to implement strategies, correct nutrition and improve physical health. It remains to be explored whether their overweight and obesity are related to inadequate dietary micronutrient intake. The aim of this study was to evaluate dietary micronutrient intake in non-pregnant and non-lactating Chinese women aged 18−49 years, and to analyze the relationship between dietary micronutrient intake and overweight and obesity. Data were obtained from 2015 China Adult Chronic Disease and Nutrition Surveillance (CACDNS 2015). In CACDNS 2015, 12,872 women aged 18 to 49 years (excluding pregnant women and lactating mothers) were surveyed for a three-day 24 h dietary recall and a three-day household weighing of edible oil and condiments. The average daily dietary intake of micronutrients was calculated according to the Chinese food composition table. In 2015, the median intake of vitamin A, vitamin B1, vitamin B2, vitamin C and folate in non-pregnant and non-lactating women aged 18−49 years in China was 267.0 µg RE/day, 0.7 mg/day, 0.6 mg/day, 63.5 mg/day and 121.0 µg/day, respectively. The median mean intake of vitamin A, niacin, calcium and zinc in overweight/obese group was lower than that in non-overweight/obese group, and the difference was statistically significant (p < 0.05). Multivariate Logistic regression analysis showed that vitamin A intake (Q3 vs. Q1: OR = 0.785, 95% CI: 0.702~0.878; Q4 vs. Q1: OR = 0.766, 95% CI: 0.679~0.865), niacin intake (Q2 vs. Q1: OR = 0.801, 95% CI: 0.715−0.898; Q3 vs. Q1: OR = 0.632, 95% CI: 0.554~0.721; Q4 vs. Q1: OR = 0.662, 95% CI: 0.568~0.772), Zinc intake (Q4 vs. Q1: OR = 0.786, 95% CI: 0.662~0.932) were a protective factor for overweight/obesity in women, while vitamin B2 intake (Q2 vs. Q1: OR = 1.256, 95% CI: 1.120~1.408; Q3 vs. Q1: OR = 1.416, 95% CI: 1.240~1.617; Q4 vs. Q1: OR = 1.515, 95% CI: 1.293−1.776), vitamin E intake (Q2 vs. Q1: OR = 1.114, 95% CI: 1.006−0.235; Q3 vs. Q1: OR = 1.162, 95% CI: 1.048~0.288; Q4 vs. Q1: OR = 1.234, 95% CI: 1.112−1.371) was a risk factor for overweight/obesity in females. The intakes of most dietary micronutrients in non-pregnant and non-lactating women aged 18−49 in China were low. The intakes of dietary vitamin A, niacin and zinc were negatively correlated with the risk of overweight/obesity, while the intakes of vitamin B2 and vitamin E were positively correlated with the risk of overweight/obesity.

Consumption of Milk and Dairy Products Among Junior High and Senior High School Students - China, 2016-2017.

What is already known about this topic?: Chinese dietary guidelines recommend an intake of milk and dairy products to be closely related to human health. Although the production capacity of dairy in China is strong, the per capita consumption of dairy products is not high. What is added by this report?: This report showed that the consumption rate of milk and dairy products of junior high and senior high school students in China was 82.5% from 2016 to 2017. Only 44.1% of them consumed milk and dairy products every day. Only 20.4% of these students reached intake levels recommended by the Dietary guidelines for Chinese residents (2016). What are the implications for public health practice?: Milk and dairy products are a key food group in a healthy dietary pattern. To cultivate a healthy eating habit of including dairy for children and adolescents, the government, suppliers, schools, and parents need to cooperate together.