[Cost-benefit analysis on the intervention of application iron-fortified soy sauce for anemia in Deqing 15-54 years women, Zhejiang].

OBJECTIVE: To make a cost-benefit analysis on anemia intervention with iron-fortified soy sauce in 15-54 years old women. METHODS: The study was conducted in Deqing county, Zhejiang province in 2012-2013. A total 585 women as sampling size were estimated with statistical model and randomly selected by probability proportionate to size sampling. Hemoglobin were measured before intervention and after 15 months. The cost of the intervention project were collected with manpower, communication and other invest. The benefit was estimated with profiling model. RESULTS: After the intervention, the anemia prevalence of sampled women decreased from 31.1% to 21.9%(P<0.01). The major cost of the project was 156 400 RMB, and total benefits result ing from projects were 1 448 485 RMB. The cost-benefit ratio of the project is 1∶9.49. If investing one yuan can produce economic benefits of nearly 9.49 yuan, therefore, the intervention projectis worth to be scaling up. Sensitivity analysis showed the result of this study was stable. CONCLUSION: The intervention can significantly reduce the prevalence of anemia in women, and reduce the economic burden of the diseases. .

Dietary Fat Intake among Chinese Adults and Their Relationships with Blood Lipids: Findings from China Nutrition and Health Surveillance and Comparison with the PURE Study.

Dietary fat intake in the Chinese population has increased. The PURE (prospective urban rural epidemiology) study concluded the potential advantage of total fat and saturated fats (SFA) over carbohydrates on blood lipids with the inaccurate assessment of dietary fats. We investigated the dietary fat profile among 48,315 participants (aged 30−70 years, national representative) from the China Nutrition and Health Surveillance (2015−2017), determined the relationship of various fats with blood lipid biomarkers in the selected 39,115 participants, and compared the results with the PURE study. Dietary fat intake was calculated by using 3 days of 24 h recalls and food inventory. Serum lipid biomarkers were assessed at morning fasting state by health professionals. Plant fats (21.5% of total energy (TE)) dominated in total fat intake (69.5 g/day, 35.6% TE), with monounsaturated fats (MUFA) in the largest (13.8% TE) portion and plant oils as the major source (43.7%). Two thirds of the population consumed more than 30% TE from dietary fats and nearly half more than 35%, while 26.4% of them exceeded 10% TE from SFA. Total fat was positively associated with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), but also high-density lipoprotein cholesterol (HDL-c), and negatively with triglyceride (TG)-to-HDL-c ratio (TGHDL) (all p-trend < 0.05). Replacing total fat with carbohydrate yielded adverse changes in most biomarkers (higher LDL-c, TG, and TGHDL, lower HDL-c, all p < 0.05) when total fat was low (<34.9% TE). Regardless of fat intake level, replacing plant fat or polyunsaturated fats (PUFA) with carbohydrate yielded the most adverse changes (higher TC, LDL-c, TG, TC-to-HDL-c ratio (TCHDL), and TGHDL, but lower HDL-c, all p < 0.01), while replacing animal fat/SFA with plant fat/PUFA yielded the most favorable changes (lower all biomarkers, all p < 0.01). The results suggested a less harmful effect of carbohydrate on blood lipids when total fat was high, and more beneficial effect of unsaturated fats, than the PURE. In conclusion, dietary fat intake in Chinese adults had reached quite a high level, but with a different profile from Western populations. Replacement of SFA (animal fat) with PUFA (plant fat) could most effectively improve blood lipids, while replacement with carbohydrate could slightly benefit only when total fat was high. The present results may be more applicable to the Chinese population than the PURE study.

The future of prevention and treatment of diabetes with nutrition in China.

The significant transformation of dietary patterns in China has contributed to an increasing prevalence of type 2 diabetes over the past few decades. In this article, we comprehensively summarize the epidemiological characteristics of diabetes in China and further discuss major nutritional risk factors for diabetes. Although China has committed to combat diabetes through health system reform and national initiatives, the burden of diabetes remains a major challenge, with an increased premature mortality for the population. We therefore provide several recommendations for the nation's future diabetes agenda, with the aim of establishing an environment of healthy nutrition through multi-sectoral government and community engagement, and novel, robust scientific research.

Relationship between consumption of raw garlic and handgrip strength in a large-scale adult population.

BACKGROUND: Garlic-derived organosulfur compounds have numerous potential benefits (e.g. antioxidant and anti-inflammatory effects) on human health. Although these functions might be related to the onset and progression of muscle strength decline, no studies have explored the relationship between garlic consumption and muscle strength in the general population. The aim of this study was to investigate whether raw garlic consumption is related to handgrip strength in a large-scale adult population. METHODS: A cross-sectional study (n = 28,958) was performed in Tianjin, China. Frequency of raw garlic consumption was assessed using a valid self-administered food frequency questionnaire. Handgrip strength was measured using a handheld digital dynamometer. Analysis of covariance and multiple logistic regression were used to evaluate the relationship between raw garlic consumption and handgrip strength. RESULTS: In males, after adjusted potential confounding factors, the least square means (95% confidence intervals) of handgrip strength across raw garlic consumption categories were 42.5 (40.2-44.9) for almost never; 43.0 (40.7-45.5) for <1 time/week; 43.4 (41.0-45.8) for 1 time/week; and 43.8 (41.5-46.3) for ≥2-3 times/week (P for trend <0.0001). The adjusted odds ratios (95% confidence intervals) of low handgrip strength (<20th percentile of handgrip strength) across the categories of raw garlic consumption in males were 1.00, 0.86 (0.76, 0.98), 0.76 (0.67, 0.87), and 0.66 (0.58, 0.74) (P for trend <0.0001). Similar results were also observed in females. CONCLUSIONS: The study firstly revealed a positive correlation between raw garlic consumption and handgrip strength in both males and females. Further studies are needed to explore the casual relationship.

Current level of fish and omega-3 fatty acid intakes and risk of Type 2 diabetes in China.

Whether fish and marine omega-3 polyunsaturated fatty acid (PUFA) intakes are linked to type 2 diabetes (T2D) risk remains unclear in China. We aimed to assess the long-term associations in a nationwide cohort. Overall 15,100 Chinese adults, aged ≥20 years, were included from China Health and Nutrition Survey. The cumulative averages of fish and marine omega-3 PUFA intakes were evaluated based on 3-day 24-h records. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) of T2D risk. Overall 1017 T2D cases were documented over a median of 14 years of follow-up. Compared with non-fish consumers, low and moderate fish consumption were associated with higher T2D risk whereas high fish consumption was not associated. Multivariable-adjusted HRs (95% CIs) for low and moderate fish consumption were 1.43 (1.09, 1.86) and 1.42 (1.07, 1.85) respectively in men, and were 1.58 (1.22, 2.02) and 1.39 (1.08, 1.83) respectively in women. In meat substitution analyses, low and moderate fish consumption was related to 55% and 69% higher T2D risk for men, and was associated with 68% and 54% higher T2D risk for women, respectively. Fried but not non-fried fish intake was associated with higher T2D risk. Intake of marine omega-3 PUFAs was dose-dependently associated with higher T2D risk for both men and women (P-trend<0.001). Overall low and moderate intakes of fish, especially fried fish, and marine omega-3 PUFAs were associated with higher T2D risk. Current level of fish and marine omega-3 PUFA consumption is not protective against T2D incidence among Chinese people.

Nutrient Supplement Use among the Chinese Population: A Cross-Sectional Study of the 2010⁻2012 China Nutrition and Health Surveillance.

Nutrient supplements play a key role in managing malnutrition/chronic diseases and are commonly used in the world, but few studies described the prevalence of nutrient supplement use at the national level in China. To our knowledge, this study provides the first detailed investigation of nutrient supplement use in a nationally representative sample of the Chinese population. This study aimed to describe the prevalence of the nutrient supplement use among the Chinese population aged 6 years or older in 2010⁻2012. A stratified multistage cluster sampling method was conducted to recruit participants from 150 surveillance sites. The demographic characteristics and information about nutrient supplement use were collected through an interview-administrative questionnaire. A total of 74,501 children and adults (excluding the pregnant women) were included in the study (mean age, 35.7 years; male, 47.0%, female, 53.5%). Only 0.71% of the participants reported using nutrient supplements in the previous month. Participants aged 6⁻11 years and 60 years and above, female, living in large urban, with higher education level and higher family incomes were more likely to use nutrient supplements than their counterparts (p < 0.05). The prevalence of nutrient supplement use increased with age in Chinese adults. The highest usage among the nutrient supplements was multi-vitamins and minerals with 0.37%. More females used single vitamin, multi-mineral, multi-vitamins and minerals than males (p < 0.05). The nutrient supplement use proportion was highest amongst the participants with a health problem, and the participants who had no idea about their health conditions were the least likely to use the nutrient supplements (p < 0.05). The prevalence of nutrient supplement use was low among the Chinese population in 2010⁻2012. Further research is required to understand the social cognition, usage reasons, dosage and consumption motivation of NS, and the relationships with health effects, to ensure that the nutrient supplements can be appropriately promoted in China.

Altered GNAS imprinting due to folic acid deficiency contributes to poor embryo development and may lead to neural tube defects.

Disturbed epigenetic modifications have been linked to the pathogenesis of Neural Tube Defects (NTDs) in those with folate deficiency during pregnancy. However, evidence is lacking to delineate the critical region in epigenome regulated by parental folic acid and mechanisms by which folate deficiency affects normal embryogenesis. Our data from clinical samples revealed the presence of aberrant DNA methylation in GNAS imprinting cluster in NTD samples with low folate concentrations. Results from mouse models indicated that the establishment of GNAS imprinting was influenced by both maternal and paternal folate-deficient diets. Such aberrant GNAS imprinting was present prior to the gametogenesis period. Imprinting in Exon1A/GNAS gDMR was abolished in both spermatozoa and oocytes upon treating with a parental folate-deficient diet (3.6% in spermatozoa, 9.8% in oocytes). Interestingly, loss of imprinting in the GNAS gene cluster altered chromatin structure to an overwhelmingly open structure (58.48% in the folate-free medium group vs. 39.51% in the folate-normal medium group; P < 0.05), and led to a disturbed expression of genes in this region. Furthermore, an elevated cyclic AMP levels was observed in folate acid deficiency group. Our results imply that GNAS imprinting plays major roles in folic acid metabolism regulation during embryogenesis. Aberrant GNAS imprinting is an attribute to NTDs, providing a new perspective for explaining the molecular mechanisms by which folate supplementation in human pregnancy provides protection from NTDs.

[Dietary vitamins intakes status of elderly people of 6 minitoring areas in Zhejiang Province in 2010-2012].

OBJECTIVE: To assess the situations of dietary vitamins intakes among aged 60 years old adults in different areas of Zhejiang Province, and analyze the food sources of vitamins. METHODS: Data were obtained from the 2010-2012 Chinese National Nutrition and Health Survey in Zhejiang Province. Dietary intakes among elderly people of vitamin A, vitamin B_1, vitamin B_2, vitamin C, vitamin E and their sources were acquired by 24-hour dietary recalls for 3 days in different areas. RESULTS: The elderly people' intakes of VA(296. 85(174. 32, 500. 28) µg RAE/d), VB_1(0. 68(0. 47, 0. 96) mg/d), VB2(0. 65(0. 47, 0. 90) mg /d) and VC(54. 54(33. 65, 83. 82) mg/d) were generally low. Intakes of vitamin B_1, vitamin C and vitamin E were significantly different in different areas( χ~2=41. 201, 39. 262 and 19. 474, P<0. 001). The food sources of vitamins were slightly variant. CONCLUSION: The insufficient status of vitamins intakes among elderly people in Zhejiang was serious, and there were differences among elderly people from different areas in intakes and food sources of vitamins.

[Adefovir dipivoxil effects on and related factors of blood phosphorus metabolism in patients with chronic hepatitis B].

OBJECTIVE: To investigate the effects of adefovir dipivoxil (ADV) on blood phosphorus metabolism in patients with chronic hepatitis B (CHB). METHODS: Patients with hepatitis B surface antigen (HBsAg)-positive CHB were treated with ADV alone, ADV combined with interferon (IFN), or ADV combined with lamivudine (LAM). Changes in levels of calcium, phosphate, urea, and creatinine were assessed at treatment weeks 4, 12, 24, 48, 72 and 96. Statistical analysis was carried out with SPSS 16 software; influential factors were analyzed by ANOVA and non-conditional logistic regression analysis. RESULTS: During the course of treatments, 32 (42.6%) of the patients presented with low phosphorus. The highest incidence of low phosphorus was found to have occurred at treatment week 24 (25.0%, 27.5% and 36.4% respectively, with no statistical difference between three groups, x2=0.225, P>0.225). Patients with hypophosphatemia did not show a significant difference in serum phosphorus levels from the other patients (F=1.853, P=0.169). Logistic regression showed a correlation between low phosphorus and sex (x2=7.876, P<0.05), age (t=2.479, P<0.05), and serum creatinine (t =-2.256, P<0.05), but not with blood urea nitrogen or blood calcium (P>0.05). CONCLUSION: ADV antiviral treatment can decrease the blood phosphorous levels of CHB patients, particularly over extended time of treatment, and the occurrence of low phosphorus is more common than of mild phosphorus decrease.Male and elderly patients may be at greater risk of this complication. The incidence and severity of low phosphorus is not significantly different for the different ADV-based treatment regimens.

Iodine nutritional status after the implementation of the new iodized salt concentration standard in Zhejiang Province, China.

BACKGROUND: Iodine deficiencies were prevalent in China until the introduction of universal salt iodization (USI) in 1995. In 2012, the standard salt iodine concentration was adjusted to 20-30 mg/kg. The success of USI for the control of iodine deficiency disorders requires monitoring its effect at a population level. METHODS: Two cross sectional surveys of a representative sample of children aged 8-10 years in Zhejiang Province were carried out in 2011 and 2013. Data on participants' socio-demographic characteristics were collected from the children using a structured questionnaire. Spot urine samples were collected and delivered to local Center for Disease Control and Prevention laboratory for measuring urinary iodine concentration. In 2011, out of 420 selected children aged 8-10 years, 391 were recorded and provided urine samples. In 2013, out of 1560 selected children aged 8-10 years, 1556 were recorded and provided urine samples. RESULTS: The median urinary iodine concentration of subjects in the 2013 survey was 174.3 µg/L, significantly lower than that of 2011(p = 0.000). The median urinary iodine concentration of subjects living in urban and rural areas in the 2013 survey was 169.0 µg/L, and 186.1 µg/L respectively, significantly lower than that of 2011 only for subjects living in urban areas (p = 0.000). There were no significant differences for subjects living in rural areas in the survey in 2011 and in 2013 (p = 0.086). CONCLUSIONS: At the time the new local iodization policy put forward, iodine nutrition was generally adequate in both urban and rural areas, suggesting that the new policy for adjusting the standard salt iodine concentration is effective. Our data also indicate that the reason people living in urban areas had a lower urinary iodine concentration than people in rural areas may be due to their preference for using non-iodized salt in the last 2 or 3 years. Maintaining USI at an appropriate level is an important part of preventing iodine deficiency disorders and should always be based on regular monitoring and comparison of urinary iodine concentration by province.

Immunoregulatory effects of ethyl-acetate fraction of extracts from Tetrastigma hemsleyanum Diels et. Gilg on immune functions of ICR mice.

OBJECTIVE: To evaluate the effects of ethyl-acetate fraction (EAF) of extracts from Tetrastigma hemsleyanum Diels et. Gilg (TDG) on immune functions of ICR mice. METHODS: ICR mice were exposed to different doses of EAF for 15 or 30 days and then their immune functions were analyzed, including ConA-induced splenic lymphocyte transformation, SRBC-induced delayed type hypersensitivity response, serum hemolysin analysis, antibody-producing cells, peritoneal macrophage phagocytized chicken red blood cells, natural killer cell activity, and serum level of cytokines. RESULTS: EAF of extracts from TDG at different doses had various effects on immune functions of ICR mice. As compared with the controls, it increased the mouse spleen lymphocyte transformation induced by ConA, the left-hind voix pedis thickness and the number of plague forming cells (PFCs) at the dose of 1.82 mg/mL, 5.48 mg/mL, and 9.12 mg/mL, respectively; increased the ink clearance ability at the dose of 0.91 mg/mL, 1.82 mg/mL, 5.48 mg/mL, and 9.12 mg/mL, respectively; increased the phagocytosis index of mononuclear-macrophages and production of serum interferon-gamma (IFN-gamma) at the dose of 5.48 mg/mL; and could promote the production of serum tumor necrosis factor-alpha (TNF-alpha) at the dose of 9.12 mg/mL. CONCLUSION: EAF of extracts from TDG can regulate mouse immune functions in vivo.

Renal protective activity of Hsian-tsao extracts in diabetic rats.

OBJECTIVE: To investigate the renal protective activity of Hsian-tsao Mesona procumbens Hemsl. water extracts in diabetic rats. METHODS: Thirty Sprague-dawley female rats were randomly divided into three groups (n = 10 each), "control group" with intraperitoneal saline injection, "diabetic group" with 60 mg of intraperitoneal streptozotocin injection per kg of body weight and "Hsian-tsao group" with intragastric administration of Hsian-tsao extraction everyday for 4 weeks after intraperitoneal streptozotocin injection. The body weight and blood sugar were measured before and after model induction in the three groups. Thrombospondin-1 (TSP-1) expressions in the kidney were monitored by immunohistochemistry. Kidney ultrastructural changes were also analyzed by using transmission electron microscopy. RESULTS: Before diabetic model induction, there were no significant differences among the three groups in body weight and blood sugar. Four weeks after the induction of diabetes, the differences became statistically significant. Electron microscopy also revealed disruption of the foot processes of the podocytes and other damages in diabetic group. These damages were significantly less severe in Hsian-tsao group when compared with the diabetic group. TSP-1 expressions in the kidney were significantly increased in both the diabetic group and Hsian-tsao group, but it was relatively lower in Hsian-tsao group than in diabetic group. CONCLUSION: Our results showed that Hsian-tsao treatment in the diabetic rats effectively prevented the pathological alterations in the kidney and decreased the TSP-1 expression. It was suggested that Hsian-tsao had protective effect on the kidneys of the diabetic rats.