Association of consumption of sugar-sweetened beverages with elevated blood pressure among college students in Yunnan Province, China.

OBJECTIVE: Although some studies have examined the association between eating behaviour and elevated blood pressure (EBP) in adolescents, current data on the association between sugar-sweetened beverages (SSB) and EBP in adolescents in Yunnan Province, China, are lacking. SETTING: Cluster sampling was used to survey freshmen at a college in Kunming, Yunnan Province, from November to December. Data on SSB consumption were collected using an FFQ measuring height, weight and blood pressure. A logistic regression model was used to analyse the association between SSB consumption and EBP, encompassing prehypertension and hypertension with sex-specific analyses. PARTICIPANTS: The analysis included 4781 college students. RESULTS: Elevated systolic blood pressure (SBP) and diastolic blood pressure (DBP) were detected in 35·10 % (1678/4781) and 39·34 % (1881/4781) of patients, respectively. After adjusting for confounding variables, tea beverage consumption was associated with elevated SBP (OR = 1·24, 95 % CI: 1·03, 1·49, P = 0·024), and carbonated beverage (OR = 1·23, 95 % CI: 1·04, 1·45, P = 0·019) and milk beverage (OR = 0·81, 95 % CI: 0·69, 0·95, P = 0·010) consumption was associated with elevated DBP in college students. Moreover, fruit beverage (OR = 1·32, 95 % CI: 1·00, 1·75, P = 0·048) and milk beverage consumption (OR = 0·69, 95 % CI: 0·52, 0·93, P = 0·014) was associated with elevated DBP in males. CONCLUSION: Our findings indicated that fruit and milk beverage consumption was associated with elevated DBP in males, and no association was observed with EBP in females.

Moderating effects of plastic packaged food on association of urinary phthalate metabolites with emotional symptoms in Chinese adolescents.

Previous research reports that diet is the main source of phthalate exposure to adolescents, and phthalate is associated with adolescent mental and behavioral problems. However, no study has explored the moderating effects of eating behavior in this association. This study aimed to analyze the moderating effects of plastic packaged food consumption in the longitudinal association between phthalate metabolite concentration and emotional symptoms in adolescents. This school-based survey was carried out among adolescents in two Chinese provinces. We conducted a baseline and follow-up surveys for 893 freshmen using the purposive sampling method from December 2018 to November 2019. We used food frequency questionnaire to assess eating behavior. The Chinese version of 21-item Depression Anxiety Stress Scales was used to assess emotional symptoms, and high-performance liquid chromatography-tandem mass spectrometry was used to analyze the concentration of six urine phthalate metabolites. The results of latent moderation model indicated that plastic packaged food consumption moderated the association of low molecular weight phthalate (LMWP) with depressive symptoms (ß = 0.27, P = 0.002), anxiety symptoms (ß = 0.89, P < 0.01), and stress symptoms (ß = 0.23, P = 0.019). The moderating effects were significant at the higher scores (ß = 0.14-0.35, P < 0.05) and/or the lower scores (ß = -0.35 to -0.12, P < 0.05) of plastic packaged food consumption. The results suggest that plastic packaged food consumption to some extent moderates the longitudinal association of phthalate exposure with emotional symptoms in adolescents.

Interaction between physical activity and problematic mobile phone use on suicidality in Chinese college students.

BACKGROUND: Previous research has found a relationship between problematic mobile phone use (PMPU) and suicidality. However, few studies have examined the interaction effects between low physical activity (PA) and PMPU on suicidality among college students. This study aimed to examine the interactions of PA and PMPU and their impact on suicidality in a school-based sample among Chinese college students. METHODS: Analysis is based on date from two university in China, which recruited 4787 participants. Binomial logistic regression models were used to explore the associations of PA, PMPU with suicidal ideation and suicide attempt, as well as the interaction of PA and PMPU with suicidality. RESULTS: The prevalence of suicide attempt and suicidal ideation were 3.5 and 7.2%, respectively. Low PA was significantly associated with suicide attempt (OR = 3.48, 95%CI: 2.52-4.81) and suicidal ideation (OR = 1.90, 95%CI: 1.46-2.46). PMPU was significantly associated with suicide attempt (OR = 3.65, 95%CI: 2.66-5.01) and suicidal ideation (OR = 2.83, 95%CI: 2.25-3.54). Interaction analysis indicated that low PA and PMPU were interactively associated with suicide attempt (OR = 9.51, 95%CI: 6.15-14.73, P < 0.001), RERI = 4.85(1.20-8.50), AP = 0.51(0.29-0.73), SI = 2.32(1.34-4.04). There was no additive interaction effects between PA and PMPU on suicidal ideation. CONCLUSIONS: The findings reveals that the intervention programs of suicide attempt should consider the students PA levels and PMPU.

Basic Reproduction Number of the 2019 Novel Coronavirus Disease in the Major Endemic Areas of China: A Latent Profile Analysis.

Objective: The aim of this study is to analyze the latent class of basic reproduction number (R0) trends of the 2019 novel coronavirus disease (COVID-19) in the major endemic areas of China. Methods: The provinces that reported more than 500 cases of COVID-19 till February 18, 2020 were selected as the major endemic areas. The Verhulst model was used to fit the growth rate of cumulative confirmed cases. The R0 of COVID-19 was calculated using the parameters of severe acute respiratory syndrome (SARS) and COVID-19. The latent class of R0 was analyzed using the latent profile analysis (LPA) model. Results: The median R0 calculated from the SARS and COVID-19 parameters were 1.84-3.18 and 1.74-2.91, respectively. The R0 calculated from the SARS parameters was greater than that calculated from the COVID-19 parameters (Z = -4.782 to -4.623, p < 0.01). Both R0 can be divided into three latent classes. The initial value of R0 in class 1 (Shandong Province, Sichuan Province, and Chongqing Municipality) was relatively low and decreased slowly. The initial value of R0 in class 2 (Anhui Province, Hunan Province, Jiangxi Province, Henan Province, Zhejiang Province, Guangdong Province, and Jiangsu Province) was relatively high and decreased rapidly. Moreover, the initial R0 value of class 3 (Hubei Province) was in the range between that of classes 1 and 2, but the higher R0 level lasted longer and decreased slowly. Conclusion: The results indicated that the overall R0 trend is decreased with the strengthening of comprehensive prevention and control measures of China for COVID-19, however, there are regional differences.

Chronotype, Sleep, and Depressive Symptoms Among Chinese College Students: A Cross-Sectional Study.

Objective: To describe the prevalence of chronotype and depressive symptoms among Chinese college students and to examine the association between chronotype and depressive symptoms. Methods: From April to May 2019, a cross-sectional survey was conducted among 1,179 Chinese college students from 2 universities in Anhui and Jiangxi provinces. A total of 1,135 valid questionnaires were collected, the valid response rate was 98.6%. The questionnaire investigated age, gender, major, height, weight, only child status, living place, self-reported family economy, and self-reported study burden. The chronotype was assessed by the Morning and Evening Questionnaire (MEQ). Depressive symptoms and sleep quality were evaluated by the Patient Health Questionnaire 9 (PHQ-9) and the Pittsburgh Sleep Quality Index (PSQI), respectively. A Chi-square test was used to examine the proportion of depressive symptoms among Chinese college students with different demographic characteristics. The generalized linear model was used to analyze the relationships between chronotype and depressive symptoms. Results: The proportion of morning types (M-types), neutral types (N-types), and evening types (E-types) of college students were 18.4, 71.1, and 10.5%, respectively. The proportion of mild depression, moderate depression, and moderate to severe depression of participants were 32.4, 6.0, and 4.2%, respectively. Compared to the M-types, after controlled for age, gender, major, sleep quality, self-reported study burden, father's education level, and self-reported family economy, depressive symptoms were positively correlated with E-types (OR = 2.36, 95% CI: 1.49-3.73). Conclusions: There was a significant association between chronotype and depressive symptoms among Chinese college students. Further longitudinal studies were needed to clarify the causal relationship between chronotype and depressive symptoms.

Association Between Screen Time, Fast Foods, Sugar-Sweetened Beverages and Depressive Symptoms in Chinese Adolescents.

OBJECTIVE: Although previous studies have shown that screen time (ST), fast foods (FFs) and sugar-sweetened beverages (SSBs) consumption are associated with depressive symptoms in adolescents, research on these associations in Chinese adolescents is scarce. This study aimed to examine the association between ST, FFs, SSBs and depressive symptoms in Chinese adolescents, and explore the mediating effects of FFs and SSBs in the association between ST and depressive symptoms. METHODS: This school-based nationwide survey was carried out among 14,500 students in four provinces of China. The Children's Depression Inventory was used to assess the participants' depressive symptoms. ST, FFs and SSBs consumption was measured by a self-reported questionnaire. The Bayesian multiple mediation model was used to analyze the mediation effect. RESULTS: ST, FFs and SSBs, were more likely to be associated with depressive symptoms, and ORs (95%CI) was 1.075 (1.036-1.116), 1.062 (1.046-1.078) and 1.140 (1.115-1.166), after we adjusted for sociodemographic variables. Additionally, in Bayesian multiple mediation model, direct effect, mediating effect, total effect, the ratio of mediating effect to total effect was 0.125, 0.034, 0.159, and 0.214, respectively. All path coefficients of the three mediation paths are statistically significant (p < 0.05). CONCLUSIONS: Our study demonstrates that ST, FFs and SSBs consumption are associated with depressive symptoms in Chinese adolescents. It is likely that FFs and SSBs partially mediate the association between ST and depressive symptoms by chain-mediating effects.

Interaction effects of co-consumption of fast food and sugar-sweetened beverages on psychological symptoms: Evidence from a nationwide survey among Chinese adolescents.

BACKGROUND: Although fast food and sugar-sweetened beverages (SSBs) consumption have been closely linked to childhood and adolescent obesity, the data regarding their co-consumption and relationship to mental health remains controversial. METHODS: A multi-centered population-based survey was conducted among Chinese adolescents from grades 7 to 12. Data about participants' consumption of fast foods and SSBs were obtained from self-reported questionnaires. Psychological symptoms were assessed using the Multi-dimensional Sub-health Questionnaire of Adolescents (MSQA). The association between co-consumption of fast food and SSBs and psychological symptoms was assessed using quantile regression analysis, adjusting for covariates. RESULTS: Approximately one-fifth of the 14,500 participants reported psychological symptoms. The regression coefficient (ß) value increased as the quantile of fast food, SSBs, and co-consumption increased in the quantile regression model, and the model had an excellent goodness-of-fit (F = 192.51, p < 0.001). In the interaction model, fast food and SSBs in combination were associated with greater odds of psychological symptoms (aOR = 1.90, 95% CI: 1.69, 2.12). The synergy index, relative excess risk of interaction, and attributable proportions were 1.86 (95% CI: 1.17, 2.96), 0.4 (95% CI: 0.20, 0.63), and 0.22 (95% CI: 0.11, 0.33), respectively. LIMITATIONS: Information bias is inevitable in self-reported data among participants. The ability to assess causal relationships is reduced by a cross-sectional study design. CONCLUSIONS: Our findings suggest that co-consumption of fast food and SSBs was cross-sectionally associated with mental health problems among adolescents.

Association of urinary phthalates metabolites concentration with emotional symptoms in Chinese university students.

Previous studies have shown the associations between phthalates exposure and psychological behavior problems in children and adolescents, but such associations have not been fully elucidated in university students, especially among Chinese university students. This study aims to examine the association between urinary phthalates metabolites concentration and emotional symptoms in Chinese university students. A school-based cross-sectional survey was carried out among 990 university students aged 17-24 years from two universities in Anhui and Jiangxi provinces of China. Concentration of six phthalate metabolites in urine was determined by high-performance liquid chromatography-tandem mass spectrometry and the emotional symptoms were assessed by the 21-item Depression, Anxiety, and Stress Scale. The detection rate of six phthalate metabolites in urine ranged from 79.6% to 99.7%. The median concentration of six phthalate metabolites ranged from 2.90 to 119.64 ng/mL. The positive rates of depressive symptoms, anxiety symptoms, and stress were 17.4%, 24.8%, and 9.5%, respectively. After adjusting for the confounding variables, mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) was found to be associated with depressive symptoms (ß = 8.84, P = 0.017), anxiety symptoms (ß = 8.46, P = 0.015), and stress symptoms (ß = 9.95, P = 0.012) in males; whereas, monobutyl phthalate (MBP) was found to be associated with depressive symptoms (ß = 1.86, P = 0.002), anxiety symptoms (ß = 1.81, P = 0.005), and stress symptoms (ß = 1.48, P = 0.047) in females. Our study demonstrates that Chinese university students are widely exposed to phthalates; and high- and low-molecular weight phthalates are associated with emotional symptoms in males and females, respectively.

Mediating Effect of Sleep Quality on the Relationship Between Problematic Mobile Phone Use and Depressive Symptoms in College Students.

Background and Aim: Problematic mobile phone use (PMPU) and depression are great public health concerns among adolescents. The aim of this study was to determine the association between PMPU and symptoms of depression, as well as the mediating role of sleep quality. Methods: A total of 4,624 college students participated in this study. The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU), Pittsburgh Sleep Quality Index (PSQI), and Patient Health Questionnaire-9 (PHQ-9) were administered to assess PMPU, sleep quality, and symptoms of depression. Mediation analysis was conducted using PROCESS macro in the SPSS software. Results: Of the participants, 27.5% were classified as PMPU, 44.9% exhibited symptoms of depression, and 15.6% reported sleep problems. Compared with those without PMPU, those with PMPU exhibited higher rates of sleep problems and depressive symptoms. The mediation analysis further revealed partial mediation effects of sleep quality on the association between PMPU and depression. Conclusions: This study demonstrated that PMPU was associated with mental health in college students, and sleep quality played a mediating role in this relationship. Our findings highlight the critical role of early intervention for depression with a focus on those with PMPU and, more specifically, on those with sleep problems.

Eating pattern and psychological symptoms: A cross-sectional study based on a national large sample of Chinese adolescents.

BACKGROUND: Previous studies showed inconsistent results of the relationship between eating patterns and mental health in adolescents, and little is known in Chinese adolescents. METHODS: A multi-center population-based survey was conducted in 32 schools in 4 provinces across China. A total of 14,500 adolescents at grade 7-12 completed eligible questionnaires. Emotional, conduct and social adaptation problems were assessed using Multi-dimensional Sub-health Questionnaire of Adolescents (MSQA), while eating pattern was collected using the semi-quantitative food frequency questionnaire (SQFFQ). RESULTS: Four principal components were obtained, including healthy, meat, sugar-sweetened beverages (SSBs) and fast foods patterns. The healthy pattern associated with lower risk of psychological symptoms (adjusted odds ratio (AORs) was 0.59, 0.60, 0.62, 0.53, respectively, all p < 0.01). While the fast foods pattern (AOR was 2.16, 2.04, 1.84, 2.24, respectively, all p < 0.01), the SSBs pattern (AOR was 1.38, 1.34, 1.25, 1.56, respectively, all p < 0.01) and the meats pattern (AOR was 1.24, 1.15, 1.12, 1.28, respectively, all p < 0.05) significantly associated with higher risk of psychological symptoms. Dose-response relationships were observed in all eating patterns with psychological symptoms, except for meats pattern (p-trend < 0.01). LIMITATIONS: The cross-sectional design limited the ability to infer causality. Meanwhile, it was difficult for estimating the eating quantity accurately by SQFFQ, and can only be assessed by the dietary pattern score. CONCLUSIONS: Our findings highlight the potential importance of eating pattern for mental health during adolescence.

Factors influencing HIV infection in men who have sex with men in China.

To identify risk factors for HIV infection among men who have sex with men (MSM) and to provide a theoretical basis for prevention interventions. Between December 2011 and August 2012, a case-control study was conducted among MSM who underwent voluntary counselling and testing for HIV. Confirmed HIV-positive MSM were included in the case group, and HIV-negative MSM were included in the control group. Information on possible risk factors was collected by a survey questionnaire and a qualitative interview. The results of a conditional logistic regression showed that the following were influencing factors for HIV infection: average monthly income between 2001 and 3000 Yuan (odds ratio (OR)=6.341, 95% CI: 1.714-12.544), only sometimes using condoms when having anal sex with men in the last 6 months (OR=7.601, 95% CI: 1.359-23.083), having HIV-positive sex partners (OR=5.273, 95% CI: 1.572-17.691), rectal trauma with bleeding in the last 6 months (OR=2.947, 95% CI: 1.308-6.638), not using condoms at last sexual encounter (OR=1.278, 95% CI: 1.012-5.595), engaging in commercial sex (OR=5.925, 95% CI: 1.923-13.890) and having more than 16 sex partners in the last 6 months (OR=1.175, 95% CI: 1.021-1.353). These seven factors were the risk factors of HIV infection (OR>1). However, having anal sex less than 10 times in the previous 1 month (OR=0.002, 95% CI: 0.000-0.287) was a protective factor against HIV infection among MSM (OR<1), and insertive (OR=0.116, 95% CI: 0.000-0.236) (OR<1) anal intercourse influenced HIV infection. Interventions should be targeted at MSM whose average monthly income is between 2001 and 3000 Yuan, and who engage in commercial sex. In addition, the importance of using condoms at every sexual encounter should be emphasised in health education, as should the treatment of rectal trauma with bleeding. Finally, MSM should decrease the number of sex partners and frequency of anal sex to decrease the rate of HIV infection.