Comparison of different BMI cut-offs to screen for child and adolescent obesity in urban China.

OBJECTIVES: To determine which set of BMI cut-offs is the most appropriate to define child and adolescent obesity in urban China. DESIGN: A cross-sectional study was carried out between 1 November and 31 December in 2017. SETTING: Community Healthcare Center in Minhang District, Shanghai, China. PARTICIPANTS: A total of 12 426 children and adolescents aged 7-17 years were selected by cluster random sampling. Bioelectrical impedance analysis was the gold standard to measure body composition. RESULTS: Comparisons of three sets of BMI cut-offs by sensitivity and κ value revealed that the Working Group on Obesity in China (WGOC) (sensitivity 39·9-84·0 %; κ 0·51-0·79) and WHO (sensitivity 25·5-74·5 %; κ 0·35-0·78) cut-offs were not superior to the International Obesity Task Force (IOTF) (sensitivity 47·9-92·4 %; κ 0·58-0·85) cut-offs across all subgroups. The WGOC and WHO cut-offs yielded higher misclassification rates, in the worst case, categorising 11·2 % of girls with high adiposity as normal and 44·4 % of them as overweight, while the IOTF cut-offs categorised 2·3 % as normal and 30·7 % as overweight. Individuals who were classified by the IOTF cut-offs as overweight had the lowest ratios of high adiposity (4·2-41·6 %) than by the BMI cut-offs for each subgroup. Among pubertal girls, none of the BMI-based cut-offs indicated excellent agreement with body fat percentage, and κ value of the WHO cut-offs (0·35 (95 % CI 0·29, 0·41)) was lower than the other two sets of BMI cut-offs (all P < 0·001). CONCLUSIONS: The IOTF cut-offs for Asian should be recommended for child obesity screening in urban China. Pubertal individuals need a more accurate indicator of obesity screening.

Pregnancy outcomes of Chinese women with gestational diabetes mellitus defined by the IADPSG's but not by the 1999 WHO's criteria.

OBJECTIVE: To compare pregnancy outcomes of women with gestational diabetes mellitus (GDM) newly defined by the International Association of Diabetes and Pregnancy Study Group (IADPSG)'s criteria vs GDM cases missed by a shift from the 1999 World Health Organization (WHO)'s criteria to the IADPSG's. METHODS: From 2010 to 2012, we recruited 17 808 women who registered within 12 weeks of gestation in Tianjin, China. All women underwent a 50-g 1-h glucose challenge test (GCT) at 24-28 weeks of gestation and further underwent a 75-g 2-h oral glucose tolerance test (OGTT) if the GCT result was ≥7·8 mmol/l. Women were divided into four groups, i.e., GDM defined by both criteria, GDM defined by the IADPSG's only, GDM defined by the 1999 WHO's only and non-GDM by either of them. Large for gestational age (LGA), macrosomia, pregnancy-induced hypertension (PIH) and preterm birth were compared among the four groups. Logistic regression was used to control for confounders. RESULTS: The use of IADPSG's and the 1999 WHO's criteria detected that 7·7% (n = 1378) and 6·8% (n = 1206) of women had GDM, respectively, with 429 GDM newly identified and 257 women missed by a shift from the 1999 WHO's to the IADPSG's. The IADPSG's newly defined GDM had significantly increased risks of LGA (adjusted OR: 2·23, 95%CI: 1·36-3·64) and macrosomia (2·65, 95%CI: 1·50-4·66) than the 1999 WHO's only defined GDM cases. CONCLUSIONS: A shift of the 1999 WHO's criteria to the IADPSG's diagnosed more GDM cases who had worse pregnancy outcomes than those cases missed.

Birth weight and overweight or obesity risk in children under 3 years in China.

OBJECTIVE: To investigate the association between different levels of birth weight and the risk of overweight and obesity in children aged 3 years and under. METHODS: Between 2009 and 2011, health care records of 55,925 children had been collected, and body weight and length had been measured from birth to 3 years old. RESULTS: Prevalence of overweight/obesity (BMI ≥85th percentiles and BMI ≥95th percentiles, referring to WHO BMI standards) at 0.5, 1, 2, and 3 years of age are 34.7%/16.8%, 36.4%/17.7%, 26.6%/11.0%, 22.3%/9.3%, respectively. There was a positive association between birth weight and childhood overweight or obesity from 6 months to 3 years of age. After adjustment for gestational age, maternal age, weight gain during pregnancy, maternal history of diabetes, mother's and father's education, occupation, and health status, family income, feeding modalities, and sex, the odds ratios (ORs) of overweight or obesity were significantly higher among children whose birth weights were 3,000-3,499 g (1.35-1.53 folds), 3,500-3,999 g (2.09-2.37 folds), 4,000-4,499 g (2.80-3.32 folds), and more than 4,500 g (3.54-4.90 folds), compared with the reference group (2,500-2,999 g). CONCLUSIONS: Higher levels of birth weight were associated with an increased risk of overweight or obesity among Chinese children from 6 months to 3 years of age.

The correlation between fruit intake and all-cause mortality in hypertensive patients: a 10-year follow-up study.

Objective: Extensive research has consistently shown the beneficial impact of fruit consumption on overall health. While some studies have proposed a potential association between fruit consumption and hypertension management, the influence of fruit consumption on mortality rates among hypertensive individuals remains uncertain. Consequently, aim of this study is to evaluate whether fruit consumption is associated with all-cause mortality among hypertensive patients. Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES), conducted between 2003 and 2006. Ten-year follow-up data from the National Death Index (NDI) were used to assess all-cause mortality. Cox proportional hazard model was utilized to explore the impact of fruit intake on all-cause mortality among hypertensive individuals. Results: The study included a cohort of 2,480 patients diagnosed with hypertension, and during the follow-up period, a total of 658 deaths from various causes were recorded. The COX regression analysis demonstrated that hypertensive patients who consumed apples three to six times per week exhibited a significantly reduced risk of all-cause mortality (HR = 0.60, 95%CI: 0.45-0.78, p < 0.001) in comparison to those who consumed apples less than once per month. Likewise, consuming bananas three to six times per week also led to a comparable outcome (HR = 0.76, 95%CI: 0.59-0.97, p = 0.027). Moreover, Combined consumption of bananas and apples three to six times per week exhibited a noteworthy decrease in all-cause mortality (HR = 0.57, 95%CI: 0.39-0.84, p = 0.005) when compared to individuals who consumed these fruits less frequently. Conversely, no significant association was found between the consumption of other fruits, including pears, pineapples, and grapes, and all-cause mortality. Conclusion: The study discovered that moderate consumption of apples and bananas was associated with a reduced risk of all-cause mortality in patients with hypertension.

Transition patterns of weight status: A cohort study of Chinese school-age children.

Background: Childhood overweight and obesity are increasing public concerns. However, little is known about the transition patterns of childhood weight status, especially in developing countries. In this study, we aimed to evaluate patterns of change in weight status and the risk factors among Chinese school-age children. Methods: This retrospective cohort study included 2,334 children aged 6 years with complete 5-year (2012-2017) physical examination data in Minhang District, Shanghai. A time-homogeneous three-state Markov model was fit to the longitudinal data with dynamic outcomes (normal weight, overweight, and obesity). Results: According to the Markov model, 42.3% of school-age children who were initially overweight transitioned to another weight status within 1 year, with 24.8% (95% confidence interval [CI]: 23.1, 27.0) transitioning to normal weight and 17.5% (95% CI: 15.9, 19.3) becoming obese. In contrast, children who were initially normal weight (92.9% [95% CI: 92.3, 93.5]) or obese (83.1% [95% CI: 81.1, 84.8]) tended to maintain their initial weight status. Male sex, semi-urban area, absence of late adiposity rebound, lower annual height increments, higher annual weight increments, and higher initial body mass index were significantly associated with a higher risk of developing or maintaining overweight and obesity (p < 0.05). Conclusions: The weight status of Chinese school-age children is more likely to change among those who are initially overweight than in those who are initially obese. Interventions to promote healthy weight status may be more effective if key groups are targeted, such as overweight and pre-school-age children.

Trends in the Prevalence of Overweight and Obesity among Chinese School-Age Children and Adolescents from 2010 to 2015.

BACKGROUND: In China, recent rapid economic growth has been associated with increasing prevalence of childhood obesity. This study aimed to provide the most updated prevalence and trends in overweight and obesity among school-age children and adolescents in Shanghai, China, in 2010-2015. METHODS: Annual physical examination data were collected from 66,410, 43,812, 104,887, 113,667, 119,401, and 109,068 school children and adolescents aged 6-17 in Minhang District, Shanghai, in 2010-2015. The outcome of interest was the prevalence of overweight and obesity based on the body mass index (BMI) criteria from the International Obesity Task Force. RESULTS: In 2010-2015, the age-adjusted prevalence of overweight and obesity among boys increased from 21.2% to 31.7% and from 10.6% to 16.9% among girls. In 2015, the prevalence of obesity among boys was 9.3% higher than among girls (3.5%). The prevalence for boys was consistently higher than that for girls at each age and across years. The prevalence of overweight and obesity was highest at 11 years: 37.3% for boys and 19.8% for girls. CONCLUSIONS: The prevalence of overweight and obesity among Chinese urban children and adolescents is comparable to that in developed countries and was still increasing in 2010-2015. The prevalence among boys was alarmingly high. The findings highlight the need to develop public intervention strategies targeting urban children to stop the increasing trend in childhood obesity in China.

Dietary α-ketoglutarate supplementation improves hepatic and intestinal energy status and anti-oxidative capacity of Cherry Valley ducks.

α-Ketoglutarate (AKG) is an extensively used dietary supplement in human and animal nutrition. The aim of the present study was to investigate effects of dietary AKG supplementation on the energy status and anti-oxidative capacity in liver and intestinal mucosa of Cherry Valley ducks. A total of 80 1-day-old ducks were randomly assigned into four groups, in which ducks were fed basal diets supplemented with 0% (control), 0.5%, 1.0% and 1.5% AKG, respectively. Graded doses of AKG supplementation linearly decreased the ratio of adenosine monophosphate (AMP) to adenosine triphosphate (ATP) in the liver, but increased ATP content and adenylate energy charge (AEC) in a quadratic and linear manner, respectively (P < 0.05). Increasing dietary AKG supplemental levels produced linear positive responses in ATP content and AEC, and negative responses in AMP concentration, the ratio of AMP to ATP and total adenine nucleotide in the ileal mucosa (P < 0.05). All levels of dietary AKG reduced the production of jejunal hydrogen peroxide and hepatic malondialdehyde (P < 0.05). Hepatic and ileal messenger RNA expression of AMP kinase α-1 and hypoxia-inducible factor-1α were linearly up-regulated as dietary AKG supplemental levels increased (P < 0.05). In conclusion, dietary AKG supplementation linearly or quadratically enhanced hepatic and intestinal energy storage and anti-oxidative capacity of Cherry Valley ducks.