Effect of Lacticaseibacillus paracasei N1115 on Immunomodulatory and Gut Microbial Composition in Young Children: A Randomized, Placebo-Controlled Study.

Lactobacillus paracasei N1115 (Lp N1115) was isolated from fermented milk products. The administration of Lp N1115 is safe and well tolerated in Chinese children, but its effectiveness among young Chinese children is still unclear. To investigate the efficacy of Lp N1115 as a probiotic to enhance gut development in Chinese infants and toddlers born by cesarean section, 109 healthy and cesarean-delivered infants aged 6-24 months were recruited for a 12-week randomized, placebo-controlled trial, with 101 finally completing the study. Saliva and stool samples were collected and detected at weeks 0, 4, 8, and 12 of the intervention. Statistical analyses were performed by using a per-protocol (PP) approach. After 12 weeks of intervention, the fecal pH in the control group increased (p = 0.003), while the fecal pH in the experimental group did not change. Salivary cortisol decreased from baseline in the experimental group (p = 0.023), while the control group showed little change. In addition, Lp N1115 increased the fecal sIgA content of infants aged 6-12 months (p = 0.044) but had no obvious effect on fecal calprotectin and saliva sIgA. At week 4, the increase in Lactobacillus relative to baseline was higher in the experimental group than in the control group (p = 0.019). Further analysis showed a trend toward a higher detection rate of Lactobacillus in the experimental group than in the control group (p = 0.039). In conclusion, Lp N1115 was able to enhance the content of Lactobacillus and maintain fecal pH levels. Its beneficial effects on gut development were more obvious in 6-12-month-old infants.

Sleep quality, antepartum depression and self-harm thoughts in pregnant Chinese women.

BACKGROUND: Previous literature has shown a significant association between sleep and depression, whereas limited studies have examined the association of sleep quality with self-harm ideation in pregnant Chinese women. METHODS: A total of 898 pregnant women (first to third trimester) from the Young Investigation Study were enrolled in this study. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Antepartum depression and self-harm ideation were evaluated using the Edinburgh Postnatal Depression Scale (EPDS). Multivariable logistic regression models were used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs). RESULTS: In this sample, the prevalence of poor sleep quality and antepartum depression was 44.3 % and 24.4 %, respectively. Furthermore, 12.8 % of women were considered as having self-harm ideation. Individuals in different trimesters reported similar prevalence of self-harm thoughts. Women were more likely to report self-harm thoughts if they were categorized as poor sleep quality or antepartum depression. And women with moderate or severe depression had higher risk of self-harm ideation and poor sleep, compared with those with mild depression. Although sleep quality indirectly influenced self-harm thoughts through the mediation effect of depressive symptoms, poor sleep quality was still associated with a 2.62-fold increased odds of self-harm ideation among women in the second trimester (OR = 2.62; 95 % CI: 1.11-6.21), after adjustment for depression. LIMITATIONS: Causality cannot be inferred. Results should be generalized carefully. Depression was evaluated by a screening tool rather than clinical interviews. CONCLUSIONS: The prevalence of poor sleep quality, depressive symptoms and self-harm ideation in pregnant Chinese women were noteworthy and high. Besides, a direct effect was also found between sleep quality and self-harm thoughts among women in the second trimester. Our findings suggest the need to identify and intervene when sleep disturbances are observed in women during pregnancy.

Perinatal depression and serum vitamin D status: A cross-sectional study in urban China.

BACKGROUND: Although vitamin D has been found to be associated with perinatal depression, the results are inconsistent. The aim of this cross-sectional study was to examine the association between vitamin D and PND in Chinese pregnant women and lactating women. METHODS: A total of 1773 participants were included, including 907 lactating women and 866 pregnant women. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for PND, and those with scores ≥13 were considered to have PND. Serum 25-hydroxyvitamin D concentrations were assessed with high-performance liquid chromatography. RESULTS: The prevalence of postpartum depression (PPD) and antenatal depression (AD) were 15.9 % and 9.8 %, respectively. Compared with individuals with sufficient vitamin D, those with vitamin D deficiency were associated with a higher prevalence of PPD in lactating women (OR = 1.71, 95%CI: 1.01-2.88, p = 0.044). The serum 25(OH)D of lactating women was inversely associated with the scores of the factor "depressive mood" of the EPDS (ORper 5 ng/mL = -0.10, 95%CI: -0.19 to -0.01, p = 0.032). No significant association between serum 25-hydroxyvitamin D and AD was observed. LIMITATIONS: First, this study is a cross-sectional design, which can only determine associations but not causality. Secondly, this study only included participants from urban areas. Thirdly, there are still some possible confounding factors that have not been considered. CONCLUSION: In conclusion, this study suggested a significant association between vitamin D status and PPD; however, the association between vitamin D status and AD was not significant.

Vitamin A Nutritional Status of Urban Lactating Chinese Women and Its Associated Factors.

We aimed to investigate dietary vitamin A (DVA) intake, serum vitamin A (SVA) concentrations, and breast milk vitamin A (BMVA) concentrations of urban lactating Chinese women and explore the associated factors. We recruited 326 lactating women from ten cities in China and collected their dietary information, blood samples, and breast milk samples. SVA and BMVA were assessed with high-performance liquid chromatography. Mann-Whitney U tests, Kruskal-Wallis H tests, Chi-square tests, Spearman correlation tests, and multiple regression analyses were conducted. The median (25th, 75th) of DVA, SVA and BMVA were 372.36 (209.12, 619.78) µg RAE/day, 1.99 (1.71, 2.35) µmol/L, and 1.67 (1.13, 2.15) µmol/L, respectively. Only 3.1% of lactating women met the recommended nutrient intake of Vitamin A (VA), and 20.6% had a BMVA level below 1.05 µmol/L. Compared to underweight or normal weight women, overweight or obese lactating women had lower DVA and BMVA but higher SVA (p = 0.022; p = 0.030; p = 0.003). Multiparous women had a higher risk of inadequate BMVA (p = 0.023) than primiparous women. SVA and BMVA were positively associated with DVA, especially for lactating women not using VA supplements (ß = 0.174, 95%CI = 0.025, 0.324, p = 0.022; ß = 0.501, 95%CI = 0.208, 0.795, p = 0.001). There was no association between SVA and BMVA (ß = 0.165, 95%CI = -0.037, 0.366, p = 0.109). In conclusion, VA nutritional status among Chinese urban lactating women needs more attention, especially for those who are obese, overweight, or higher parity. Increased DVA may contribute to increased BMVA.

Consumption of Added Sugar among Chinese Toddlers and Its Association with Picky Eating and Daily Screen Time.

Objectives: This study aimed to examine the relationship between daily screen time, picky eating, and consumption frequency of sugared foods and sugar-sweetened beverages (SSBs). Methods: The research data came from the Young Investigation (YI) study conducted in 10 cities in China. This study used sociodemographic information, feeding behavior, picky eating reported by parents, and the consumption frequency of sugared foods and SSBs of 879 toddlers aged 1−3 years. The relationship between daily screen time and picky eating behavior was assessed using logistic regression. The zero-inflated negative binomial (ZINB) model was used to fit the consumption frequencies of sugared foods and SSBs. Results: In all, 13.1% (n = 115) of toddlers did not have sugared foods 1 month before the survey, while 73.3% (n = 644) of toddlers did not have SSBs 1 month before the survey. The consumption rate of sugared foods was relatively higher than SSBs (χ2 = 661.25, p < 0.001). After adjusting for social demographic information, no relationship was found between daily screen time and picky eating (OR = 1.437; 95% CI: 0.990,2.092). The ZINB model showed that, among children who ate sugared foods, children who were picky eaters ate them more often (IRR = 1.133; 95% CI: 1.095,1.172), but no association was found between picky eating and the chance of avoiding sugared foods (OR = 0.949; 95% CI: 0.613,1.471). Children who were picky eaters were less likely not to drink SSBs (OR = 0.664; 95% CI: 0.478,0.921). However, among children who consumed SSBs, picky eaters drank them less frequently (IRR = 0.599; 95% CI: 0.552,0.650). Children with a screen time of no less than 1 h/d ate sugared foods more frequently (IRR = 1.383; 95% CI: 1.164,1.644), and they were less likely to avoid sugared foods (OR = 0.223; 95% CI: 0.085,0.587). The longer the screen time per day was, the less likely children did not have SSBs (<1 h/d: OR = 0.272; 95% CI: 0.130, 0.569; ≥1 h/d: OR = 0.136; 95% CI: 0.057, 0.328). Conclusions: The consumption rate of sugared foods was higher than that of SSBs. Picky eating and daily screen time were related to the consumption frequency of added sugar among Chinese toddlers aged 1−3 years. Picky eaters consumed sugared foods more frequently and were more likely to drink SSBs. Children whose daily screen time reached 1 h/d were more likely to eat sugared foods and drink SSBs.

Research update on psychological stress and eating behaviors in children and adolescents / 中国学校卫生

Abstract@#Psychological stress and coping strategies are important factors affecting physical and mental health. Unhealthy eating behavior caused by stress is common in children and adolescents, which has not been fully clarified. In this paper, studies on the association of psychological stress with general eating behavior, abnormal eating behavior or eating disorders among children and adolescents were reviewed. The epidemiology and influencing factors were elaborated, and the possible physiological mechanism was summarized, in order to provide reference for the future research.

Feeding Difficulty Among Chinese Toddlers Aged 1-3 Years and Its Association With Health and Development.

Feeding problems are biopsychosocial in nature and have a great influence on children's growth. The aim of this study was to profile the status and possible influencing factors of feeding difficulty among normal Chinese toddlers, and to investigate its association with health and development. This study is a part of the Young Investigation (YI study) conducted in 10 cities in China. Data from 924 children aged 1-3 years were analyzed. Data on socio-demographic factors, feeding behaviors, self-reported diseases, and anthropometry parameters were collected. Blood samples were drawn to determine hemoglobin levels. Feeding difficulty was evaluated by the Montreal Children's Hospital Feeding Scale (MCH-FS). Ages and Stages Questionnaires, Third Edition (ASQ-3) were used to assess developmental progress. Multivariable analyses were performed to explore the potential associations. The mean total score of the MCH-FS was 35.21 ± 12.90 and the highest scored item was "acting up/making a big fuss during mealtimes." Feeding difficulty occurred more often among children with picky eating behavior or whose caregivers once used the strategy of pre-mastication. Children with feeding difficulty had lower intakes of cereals, vegetables, and fruits, and were more likely to suffer from diarrhea (OR, 2.04; 95%CI: 1.32, 3.11) or constipation (OR, 2.04; 95%CI: 1.27, 3.24), but not anemia. Feeding difficulty was also negatively associated with weight, height, head circumference and mid-upper-arm circumference-related Z-scores (P all < 0.05). In addition, it was related to poorer fine motor skills, personal and social skills, and total scores of ASQ-3 (ß, -9.00; 95%CI: -15.11, -2.89). Feeding difficulty assessed by MCH-FS showed a negative association with children's health and development, supporting the need for early identification.

Fruit and vegetable consumption and serum vitamin A in lactating women: A cross-sectional survey in urban China.

During the lactation period, healthy eating behavior is essential to maternal and child health. However, Chinese lactating women may have some traditional food restrictions. Our aims were to evaluate the fruit and vegetable consumption of Chinese lactating women and to examine the associations between fruit and vegetable consumption and serum vitamin A concentrations. A total of 885 participants were included. Dietary intakes were assessed during the same time frame as blood collection via a one-time 24-h dietary recall (24HDR) and a semiquantitative food frequency questionnaire (SFFQ), respectively. Serum vitamin A concentrations were assessed with high-performance liquid chromatography. Based on 24HDR, 64.7% and 85.5% of lactating women did not consume the appropriate amount of fruits and vegetables, respectively. New mothers who adopt zuo yuezi behavior during the first month were negatively associated with fruit consumption. The median (25th to 75th) dietary vitamin A intake was 349.5 (202.5-591.4) µg RAE/day. Vegetable contributed 24.9% and fruit 4.8% of the dietary vitamin A intake. The median (25th to 75th) serum vitamin A concentration was 1.92 (1.61-2.30) µmol/L. 24HDR assessments of total fruit and vegetable consumption, and fruit consumption were positively associated with higher serum vitamin A concentrations, respectively (ß = 0.200, 95%CI = 0.077, 0.323, p = .001; ß = 0.241, 95%CI = 0.008, 0.474, p = .044). These positive associations were replicated in the SFFQ assessments (ß = 0.102, 95%CI = 0.016, 0.188, p = .020; ß = 0.215, 95%CI = 0.088, 0.341, p = .001). Chinese lactating women had inappropriate fruit and vegetable consumption. Fruit and vegetable consumption was associated with serum vitamin A concentrations.

Association Between Dietary Quality and Postpartum Depression in Lactating Women: A Cross-Sectional Survey in Urban China.

Background: Evidence on the effects of dietary quality on the risk of postpartum depression in the Chinese population is limited. This study aimed to examine the association between dietary quality and postpartum depression in Chinses lactating women. Methods: A total of 939 participants from 10 cities were included in this analysis. A one-time 24-h dietary recall was used to obtain the data on food consumption and dietary quality was assessed based on Diet Balance Index. The Edinburgh postnatal depression scale was considered at a cutoff point of 10 to detect postpartum depression. Poisson regression models were used to explore the association of dietary quality with postpartum depression. Results: Depressed women tended to have a more inadequate intake of vegetables and have more insufficient food variety. The median (25th, 75th) of the overall high bound score (HBS), low bound score (LBS), and diet quality distance (DQD) was 9 (5, 14), 30 (25, 37), and 40 (34, 47), respectively. Compared with subjects with the lowest quartile of LBS, those with the highest quartile of LBS had a higher risk of postpartum depression [adjusted prevalence ratio (aPR), 1.08; 95% confidence interval (95% CI), 1.01, 1.15; P for trend, 0.043]. We also observed a significant association between DQD and postpartum depression (Q4 vs. Q1: aPR, 1.07; 95% CI: 1.00, 1.14; P for trend, 0.036). Conclusion: Poor dietary quality was associated with postpartum depression in Chinese lactating women.

Association of serum 25-hydroxy vitamin D with obesity-related indices in Chinese adults: A cross-sectional study.

Obesity has been a well-known risk factor of low-level serum vitamin D. Compared with the traditional obesity-related indicator (body mass index, BMI), associations for two novel anthropometric indices, a body shape index (ABSI) and body roundness index (BRI) with vitamin D deficiency or insufficiency, still remain unclear. This study aimed to assess the associations of serum 25-hydroxy vitamin D (25(OH)D) status with these three obesity-related indices among Chinese adults. A total of 1666 individuals were included. Anthropometric measurements were performed to calculate the indices, and fasting blood was collected to determine serum 25(OH)D deficiency (<12 ng/ml) and insufficiency (12-20 ng/ml). Deficiency or insufficiency of 25(OH)D was found in 37.5% and 43.1% of the participants, respectively. After adjustment for potential confounders, a significantly increased prevalence of 25(OH)D deficiency was observed for higher ABSI (OR Q4 vs Q1 2.334, 95% CI 1.458-3.734; p trend = 0.002) and BRI (OR Q4 vs Q1 2. 215, 95%CI 1.365-3.594; p trend = 0.010), and for higher BMI in men. Regarding 25(OH)D insufficiency, a significant association was also found for ABSI (OR Q4 vs Q1 2.372, 95%CI 1.558-3.612; p trend = 0.001). The area under the ROC of ABSI (0.731, 95%CI 0.687-0.774) for predicting a low level of 25(OH)D was significantly larger than that of BMI (0.695, 95%CI 0.649-0.741) in men, but not in women. A positive association between obesity and lower 25(OH)D serum concentration was found among Chinese adults. Besides BMI, novel obesity-related indicator, ABSI and BRI were associated with lower serum 25(OH)D to some extent, and further studies are needed to clarify their potential to be used as screening tools in clinical practice.

Effect of Sea Buckthorn on Plasma Glucose in Individuals with Impaired Glucose Regulation: A Two-Stage Randomized Crossover Intervention Study.

Sea buckthorn (SB) has been indicated to have hypoglycemic potential, but its effects on glucose in people with impaired glucose regulation (IGR) are still unclear. This work presents a randomized, double-blinded, two-way crossover study. A total of 38 subjects with IGR completed the intervention of consuming sea buckthorn fruit puree (SBFP, 90 mL/day, five weeks), washing out (four weeks), and then consuming placebo (90 mL/day, five weeks) or in reverse order. In our methodology, a unified questionnaire was used to gather information on physical activity and dietary intakes, and physical examinations were performed to measure blood pressure, height, and weight. Fasting blood samples were collected to detect the fasting plasma glucose (FPG) and glycated serum protein (GSP). To calculate the area under the curve of 2 h postprandial plasma glucose (2 h PG-AUC), blood samples at t = 30, 60, and 120 min were also collected and analyzed. Effects of the intervention were evaluated by paired-sample Wilcoxon test and mixed model analyses. Our results show that the FPG in subjects with IGR decreased by a median reduction of 0.14 mmol/L after five weeks' consumption of SBFP, but increased by a median of 0.07 mmol/L after placebo intervention, and the comparison of these two interventions was statistically significant (p = 0.045). During the wash-out period, a similar difference was observed as the FPG decreased in the group that received SBFP intervention first, but increased in another group (p = 0.043). Both SBFP and placebo significantly raised GSP during the intervention period, but lowered it in the wash-out period (p < 0.05), while no significant difference was found between the two interventions. The 2 h PG-AUC remained relatively stable throughout the study. Our results indicated that consumption of SBFP for five weeks showed a slight downward trend on FPG in subjects with IGR.

Dietary Diversity Is Associated With Memory Status in Chinese Adults: A Prospective Study.

BACKGROUND AND AIM: Subjective memory complaints are common in elderly people. Nutrition plays an important role in keeping brain health, however, the evidence on dietary diversity and subjective memory status is limited. This study aimed to investigate the effect of dietary diversity score (DDS) on memory status in Chinese adults in a prospective cohort study. METHODS: Data of the China Health and Nutrition Survey was used in this study. A total of 4356 participants aged 50 years or older were enrolled in the analysis. DDS was calculated based on the dietary recall data collected in the wave of 2011. Information on self-report memory status (OK, good, or bad) and memory change in the past 12 months (stayed the same, improved, or deteriorated) were obtained from the wave of 2015. A memory score was calculated based on a subset of items of the Telephone Interview for Cognitive Status-modified. Multinomial logistic regression models were used to estimate the associations of DDS with memory status and memory change, and linear regression models were carried out to estimate the association between DDS and memory score. RESULTS: In the study population, the percentages of participants who thought their memory was OK, bad, and good were 43.3, 24.3, and 32.4%, respectively. There were 1.4% of participants reported memory improvement in the past 12 months and 47.2% reported memory decline. Average memory score among participants was 12.8 ± 6.1. Compared with participants who thought their memory was OK, a higher DDS was associated with self-reported good memory (Odds Ratio [OR] 1.15, 95%CI 1.07-1.24) and inversely associated with bad memory (OR 0.82, 95%CI 0.75-0.89). In subgroup analysis, however, in participants aged 65 years and above, the association between DDS and self-reported good memory was insignificant (OR 1.09, 95%CI 0.94-1.25). Compared with participants whose memory stayed the same, higher DDS was inversely associated with memory decline (OR 0.85, 95%CI 0.80-0.91). Besides, higher DDS was associated with higher memory score (ß 0.74, 95%CI 0.56-0.91). CONCLUSION: This study revealed that higher DDS was associated with better memory status and was inversely associated with self-reported memory decline in Chinese adults.

Beneficial Effect of Dietary Diversity on the Risk of Disability in Activities of Daily Living in Adults: A Prospective Cohort Study.

Disability in activities of daily living (ADL) is common in elderly people. Dietary diversity is associated with several age-related diseases. The evidence on dietary diversity score (DDS) and ADL disability is limited. This study was based on the China Health and Nutrition Survey. Prospective data of 5004 participants were analyzed. ADL disability was defined as the inability to perform at least one of the five self-care tasks. Cox proportional regression models were conducted to estimate the association of cumulative average DDS with the risk of ADL disability. Logistic regression models were performed to estimate the odds ratios for the average DDS, the baseline DDS, and the recent DDS prior to the end of the survey in relation to ADL disability, respectively. The results indicate that higher average DDS was associated with a decreased risk of ADL disability (T3 vs. T1: hazard ratio 0.50; 95% confidence interval 0.39-0.66). The association was stronger among participants who did not had comorbidity at baseline than those who did (P-interaction 0.035). The average DDS is the most pronounced in estimating the association of DDS with ADL disability of the three approaches. In summary, higher DDS has beneficial effects on ADL disability, and long-term dietary exposure is more preferable in the investigation of DDS and ADL.

Dietary Behaviors in the Post-Lockdown Period and Its Effects on Dietary Diversity: The Second Stage of a Nutrition Survey in a Longitudinal Chinese Study in the COVID-19 Era.

Coronavirus disease 2019 (COVID-19) has imposed enormous challenges on people's lifestyles. People in China have gradually returned to normal life; however, in the protracted pandemic, people may still follow certain dietary behaviors to cope with COVID-19. This study was the second stage of a longitudinal nutritional survey conducted in post-lockdown China that was aimed at exploring post-lockdown dietary behaviors and their effects on dietary diversity. In line with the first stage of the survey, the current dietary behaviors used to cope with COVID-19 and ways of purchasing food were determined. In addition, changes in dietary behavior compared to the same period in 2019 and those behaviors recommended to ensure food safety were also investigated. The Household Dietary Diversity Score (HDDS) was used to assess dietary diversity; this was also used in the first stage of the survey. Linear regression was used to model the associations between the HDDS, participants' characteristics, and dietary behaviors. The data of 1994 participants were included in the analysis. The overall mean HDDS was 9.2 ± 2.0. Compared to the same period in 2019, a substantial proportion of participants self-reported that they had recently decreased eating in restaurants (61.6%) and reduced intakes of seafood (53.1%), imported frozen food (57.1%), and raw food (60.5%), while 64.8% of participants reported increased cooking at home. People with an increased consumption of seafood (adjusted OR (95%CI) = 0.56 (0.07, 1.04)) and raw food (adjusted OR (95%CI) = 0.74 (0.27, 1.21)) had a significantly higher HDDS. Participants who changed their consumption of imported frozen food (both increased and decreased) had a higher HDDS (adjusted OR (95%CI) = 0.56 (0.07, 1.04) and 0.27 (0.09, 0.44), respectively). People who depended more on purchasing food online had a significantly higher HDDS (adjusted OR (95%CI) = 0.29 (0.02, 0.55)). Compared to the data from stage 1, the proportion of people choosing healthy products to cope with COVID-19 did not greatly change and those people had a higher HDDS (adjusted OR (95%CI) = 0.31 (0.19, 0.42)). Although this study found that the proportion of people who chose to use alcohol or vinegar to prevent COVID-19 had decreased substantially compared to during lockdown, there were still 5.3% and 9.8% who followed these irrational behaviors. Regarding the dietary behavior regarding food safety, except for cooking food fully, fewer than half of participants followed the recommended dietary behaviors, including individual food servings (44.2%), using serving chopsticks and spoons (44.8%), and preparing raw and cooked food separately (43.3%). People who followed these behaviors had a better dietary diversity. In conclusion, during the post-lockdown period, people still followed certain dietary behaviors to cope with COVID-19. While some dietary behaviors were adopted to help prevent infection, irrational dietary behaviors were still followed. These behaviors were associated with the dietary diversity in Chinese adults.

Dietary Diversity among Chinese Residents during the COVID-19 Outbreak and Its Associated Factors.

COVID-19, a Public Health Emergency of International Concern, has imposed enormous challenges on the health system, economy, and food supply and has substantially modified people's lifestyles. This study aimed to (1) explore the dietary diversity during the lockdown time in China and (2) examine factors associated with dietary diversity including socio-economic characteristics, sources for food and food purchases, and specific dietary behaviors responding to COVID-19 and isolation. A cross-sectional questionnaire-based survey was conducted online in March 2020. Multi-stage sampling was used to recruit participants living in Hubei Province and other parts of China. Dietary diversity was assessed using the Household Dietary Diversity Score (HDDS) and clustering analysis was used to categorize people with different propensities of methods for purchasing or obtaining foods. Logistic regression was used to model the associations among HDDS, participants' characteristics, approaches to purchase or obtain food, and behaviors adopted to cope with COVID-19. Results: A total of 1938 participants were included in the analysis. The overall mean HDDS was 9.7 ± 2.1, and the median (25th, 75th) was 10 (8, 12). There were relatively low consumptions of fish, legumes, and miscellaneous foods (e.g., processed food like snacks and beverages). After adjusting for age, family income, and geographic regions, people living in places where laboratory confirmed COVID-19 cases were above 500 (ORadjusted = 0.79, 95%CI 0.65, 0.96), or living in Hubei Province (ORadjusted = 0.60, 95%CI 0.39, 0.93) had a lower HDDS. During isolation time, the most common sources for food and food purchases were in-house storage and in person grocery shopping. More than half of the participants (55.9%) purchased food at least once via online ordering and delivery services. There was no significant difference in HDDS among people with distinct dependences on different ways to obtain or purchase food (i.e., dependence on in-person grocery shopping, dependence on both in-house storage and in-person grocery shopping, or dependence on online food purchasing). We also identified a total of 37.7% participants who consumed certain foods or nutritional supplements to cope with COVID-19, which included vitamin C, probiotics, other dietary supplements, alcohol, and vinegar. People who reported these specific dietary behaviors had a significantly higher HDDS (ORadjusted = 1.23, 95%CI 1.02, 1.45) than those who did not do so. This study revealed an overall good dietary diversity among the studied Chinese residents during the COVID-19 pandemic. However, we observed a lower dietary diversity among people living in areas with a high number of confirmed COVID-19 cases. Online ordering and delivery services were popular and could serve as a feasible method to obtain and purchase food, contributing to ensure diversified diets during the time of lockdown. Certain dietary behaviors associated with COVID-19 were also identified and had significant impacts on HDDS.

Neutral Human Milk Oligosaccharides Are Associated with Multiple Fixed and Modifiable Maternal and Infant Characteristics.

We aimed to identify if maternal and infant factors were associated with neutral human milk oligosaccharides (HMOs) variability and examined the associations between HMOs concentration and infant growth and disease status in healthy Chinese mothers over a 6-month lactation period. We recruited mothers and their full-term infants as our subjects. At 1-5 days, 8-14 days, 4 weeks, and 6 months postpartum, all participants were interviewed to collect breast milk samples, obtain follow-up data and measure infant length and weight at their local hospital. A total of 23 neutral HMOs were analyzed by high performance liquid chromatography (HPLC)- mass spectrometer (MS). Secretor and Lewis phenotype were determined by the concentration of 2'-fucosyllactose (2'-FL) and Lacto-N-fucopentaose (LNFP)-II. The associations between maternal and infant factors with HMOs concentrations were investigated. A total of 464 human breast milk samples were collected from 116 mothers at four different time points. In total, 76.7% mothers were found to be Secretor and Lewis positive phenotype (Se+Le+), 17.2% were Se-Le+, 4.3% were Se+Le-, and 1.7% were Se-Le-. Several individual HMOs, including 2'-FL, Lactodifucotetraose (LDFT), LNFP-I were determined by Secretor phenotype. Most individual HMOs decreased at the later stage of lactation, except 3'-FL. We suggest that Secretor phenotype and lactation stage could influence most of the neutral HMOs. Concentrations of specific HMOs may be associated with maternal age, allergic history, pre-pregnancy body mass index (BMI), parity, delivery mode, infant gestational age and gender.

Association of serum ferritin with metabolic syndrome in eight cities in China.

OBJECTIVE: This study aims to evaluate the cross-sectional association of serum ferritin (SF) and the risk of metabolic syndrome (MetS) and its components among adults in eight cities in China. METHODS: Subjects were recruited using a combination of systematic cluster random sampling and purposive sampling in eight cities in China. The sociodemographic characteristics, data of lifestyle factors, self-reported disease history, and 24-hr dietary intake were obtained using a validated questionnaire. Anthropometry was performed, and fasting blood was collected to test the SF, fasting blood glucose (FBG), insulin, high-sensitivity C-reactive protein (hs-CRP), triglycerides (TG), and cholesterols. Logistic and linear regression analyses were conducted to investigate the associations, adjusting for age, city level, smoking, drinking, weekly moderate-to-vigorous activity, dietary factors, hs-CRP, and BMI. RESULTS: Serum ferritin level is positively correlated with total cholesterol, TG, FBG, HOMA-IR, and hs-CRP after adjusting for age and BMI. The odds ratio (OR) for MetS in the highest quartile of SF was 2.23 (1.32, 3.77) after adjusting for men, compared with the lowest quartile. An elevated ferritin concentration was significantly related to hypertriglyceridemia (p < .001) and elevated glucose (p = .013) among men, but not among women. Furthermore, compared with Q1, the OR for insulin resistance in the ferritin Q4 group was 3.08 (1.50, 6.32) among men and 1.96 (1.19, 3.24) among women. CONCLUSION: A positive association between elevated SF and MetS and its components including hypertriglyceridemia and elevated glucose was found in multivariate analyses among men, and SF levels are independently associated with IR.

Association between Dietary Inflammatory Index, C-Reactive Protein and Metabolic Syndrome: A Cross-Sectional Study.

Increased prevalence of metabolic syndrome (MetS) has become a global major public health problem. Chronic low-grade inflammation associated with diet was found to play an import role in the development of MetS, although further studies are needed. The main purpose of this study was to explore the association between the dietary inflammatory index (DII), C-reactive protein (CRP) as a sign of inflammation status, and MetS. A total of 1712 participants from eight cities in China were included. Sociodemographic and health-related information was collected by a self-administrated questionnaire. Anthropometric information and fasting blood samples were collected for identification of MetS. DII scores were computed based on one time 24-h dietary recall. No significant association between MetS and DII was observed except for the blood pressure component of MetS (OR T3 versus T1 = 1.40; 95% CI: 1.03 to 1.89). A significant increased prevalence for MetS was observed for higher CRP (OR = 1.66; 95% CI: 1.26 to 2.18), as well as four out of five of MetS components. In stratified analyses by sex, the associations between DII/CRP and MetS among women, but not men, are comparable to the whole sample. In addition, Both the 2nd and 3rd tertile of the DII had a higher CRP level (β-Coefficients T2 versus T1 = 0.086, 95% CI: 0.004 to 0.167; β-Coefficients T3 versus T1 = 0.145, 95% CI: 0.045 to 0.245) among subjects with MetS. Participants with higher DII scores reported a higher degree of “Shanghuo” (p = 0.007), which is a traditional concept characterized by “redness, swelling, fever and pain” in Chinese Medicine. This study suggested a close association between CRP and MetS, while the association between the DII and MetS was limited. DII was only specifically associated with CRP at a higher level among participants with MetS.