Compliance with the EAT-Lancet diet and risk of colorectal cancer: a prospective cohort study in 98,415 American adults.

Background: The EAT-Lancet diet (ELD) is a recommended dietary pattern for achieving simultaneous improvements in both individual health and environmental sustainability. While research on the association between ELD and colorectal cancer (CRC) remains scarce, the potential impact of nutrition on CRC prevention and progression is a topic of growing interest. This study aims to investigate the relationship between adherence to the ELD and the risk of CRC, shedding light on the role of nutrition in CRC prevention. Methods: A total of 98,415 participants were included. A Diet History Questionnaire (DHQ) was used to collect dietary information, and an ELD score was used to assess adherence to ELD. Higher scores indicated greater adherence. Cox hazard regression analyses were conducted to examine whether there were associations between the ELD score and CRC risk. The restricted cubic spline (RCS) model was used to further explore the dose-response association between the ELD score and CRC incidence. Subgroup analyses were conducted to identify potential modifiers that interacted with ELD on CRC incidence, and sensitivity analyses were performed to evaluate the robustness of the established association. Results: During a mean follow-up of 8.82 years, a total of 1,054 CRC cases were documented. We found a statistically significant correlation between the ELD score and CRC risk (Q4 vs. Q1: HR 0.81, 95% CI 0.67-0.98; P for trend = 0.034) after adjusting for potential confounders. No statistically significant associations were discovered between ELD adherence and CRC by anatomical site. Subgroup analyses found no interactional factor, sensitivity analyses, and the RCS model showed a robustness and linearity association (P-linearity >0.05). Conclusion: We concluded that adherence to ELD contributes to the prevention of CRC.

Value of frontal QRS axis for risk stratification of individuals with prolonged PR interval.

BACKGROUND: There is ongoing controversy regarding the prognostic value of PR prolongation among individuals free of cardiovascular diseases. It is necessary to risk-stratify this population according to other electrocardiographic parameters. METHODS: This study is based on the Third National Health and Nutrition Examination Survey. Cox proportional hazard models were constructed and Kaplan-Meier method was used. RESULTS: A total of 6188 participants (58.1 ± 13.1 years; 55% women) were included. The median frontal QRS axis of the entire study population was 37° (IQR: 11-60°). PR prolongation was present in 7.6% of the participants, of whom 61.2% had QRS axis ≤37°. In a multivariable-adjusted model, mortality risk was highest in the group with concomitant prolonged PR interval and QRS axis ≤37° (hazard ratio [HR]: 1.20; 95% confidence interval [CI]: 1.04-1.39). In models with similar adjustment where population were reclassified depending on PR prolongation and QRS axis, prolonged PR interval and QRS axis ≤37° was still associated with increased risk of mortality (HR: 1.18; 95% CI: 1.03-1.36) compared with normal PR interval. CONCLUSIONS: QRS axis is an important factor for risk stratification in population with PR prolongation. The extent to which this population with PR prolongation and QRS axis ≤37° is at higher risk of death compared with the population without PR prolongation.

Association of low diastolic blood pressure with all-cause death among US adults with normal systolic blood pressure.

Although the effect of intensive systolic blood pressure lowering is widely recognized, treatment-related low diastolic blood pressure still worrisome. This was a prospective cohort study based on the National Health and Nutrition Examination Survey. Adults (≥20 years old) with guideline-recommended blood pressure were included and pregnant women were excluded. Survey-weighted logistic regression and cox models were used for analysis. A total of 25 858 participants were included in this study. After weighted, the overall mean age of the participants was 43.17 (16.03) years, including 53.7% women and 68.1% non-Hispanic white. Numerous factors were associated with low DBP (<60 mmHg), including advanced age, heart failure, myocardial infarction, and diabetes. The use of antihypertensive drugs was also associated with lower DBP (OR, 1.52; 95% CI, 1.26-1.83). DBP of less than 60 mmHg were associated with a higher risk of all-cause death (HR, 1.30; 95% CI, 1.12-1.51) and cardiovascular death (HR, 1.34; 95% CI, 1.00-1.79) compared to those with DBP between 70 and 80 mmHg. After regrouping, DBP <60 mmHg (no antihypertensive drugs) was associated with a higher risk of all-cause death (HR, 1.46; 95% CI, 1.21-1.75). DBP <60 mmHg after taking antihypertensive drugs was not associated with a higher risk of all-cause death (HR, 0.99; 95% CI, 0.73-1.36). Antihypertensive drug is an important factor contributing to DBP below 60 mmHg. But the pre-existing risk does not increase further with an additional reduction of DBP after antihypertensive drugs treatment.

Association between energy intake patterns and outcome in US heart failure patients.

Background: The association between dietary energy patterns, calories, and the outcomes of heart failure (HF) is still unclear. Objectives: To evaluate the proper energy intake patterns and daily calorie intake in patients with heart failure among US adults. Methods: The data were derived from the 2001-2014 National Health and Nutrition Examination Survey (NHANES). A calorie intake pattern variable was created using latent class analysis (LCA) based on the calorie ratio of three major nutrients. Cox proportional hazard regression models were used to evaluate the hazard ratios (HR) and 95% confidence intervals (CI) of the association between calorie intake and energy patterns. The primary endpoint was all-cause mortality. Results: Among 991 participants (mean age 67.3 ± 12.9 years; 55.7% men) who suffered from heart failure; the median calorie intake was 1,617 kcal/day [interquartile range (IQR): 1,222-2,154 kcal/day]. In the multivariable-adjusted model, moderate malnutrition was more frequent to death (HR: 2.15; 95% CI: 1.29-3.56). Low-carbohydrate pattern (LCP) and median-carbohydrate pattern (MCP) had lower risks of death compared to high-carbohydrate pattern (HCP) (LCP: HR: 0.76; 95% CI: 0.59-0.97; MCP: HR: 0.77; 95% CI: 0.60-0.98). No association between different amounts of calorie intake and all-cause mortality was found. There was an adjusted significant interaction between calorie intake and energy intake patterns (p = 0.019). There was a linear relationship between energy intake through HCP and all-cause mortality (p for non-linear = 0.557). A non-linear relationship between energy intake through MCP and all-cause mortality (p for non-linear = 0.008) was observed. Conclusion: Both LCP and MCP, compared to HCP, were associated with better outcomes in the HF population. The relationship between energy intake and all-cause death may be influenced by energy intake patterns in HF patients.

Long-term Effects of a Social Media-Based Intervention (Run4Love) on Depressive Symptoms of People Living With HIV: 3-Year Follow-up of a Randomized Controlled Trial.

BACKGROUND: Emerging studies have shown the effectiveness of mobile health (mHealth) interventions in reducing depressive symptoms among people living with HIV. Most of these studies included only short-term follow-up, with limited data on long-term effects. OBJECTIVE: The purpose of this study is to assess the long-term effects of a randomized controlled trial called Run4Love on depressive symptoms among people living with HIV at 1-year and 3-year follow-ups. METHODS: A total of 300 people living with HIV with depressive symptoms were recruited and randomized to an intervention or a control group in Guangzhou, China, from September 2017 to January 2018. The intervention group received a 3-month Run4Love program, including adapted evidence-based cognitive behavioral stress management courses and exercise promotion via WeChat (Tencent), a popular social media app. The control group received usual care and a brochure on nutrition. The primary outcome was reduction in depressive symptoms, measured using the Center for Epidemiological Studies-Depression (CES-D) scale. Data used in this study were collected at baseline and at the 1-year and 3-year follow-ups. Generalized estimating equations were used to examine the group differences at 1-year and 3-year follow-ups. RESULTS: Approximately half of the participants completed the assessment at 1-year (149/300, 49.7%) and 3-year (177/300, 59%) follow-ups. At 1-year follow-up, participants in the intervention group reported significant reduction in depressive symptoms compared with the control group (CES-D: from 23.9 to 18.1 in the intervention group vs from 24.3 to 23.3 in the control group; mean -4.79, SD 13.56; 95% CI -7.78 to -1.81; P=.002). At 3-year follow-up, between-group difference in CES-D remained statistically significant (from 23.9 to 20.5 in the intervention group vs from 24.3 to 24.4 in the control group; mean -3.63, SD 13.35; 95% CI -6.71 to -0.54; P=.02). No adverse events were reported during the 3-year follow-up period. CONCLUSIONS: The mHealth intervention, Run4Love, significantly reduced depressive symptoms among people living with HIV, and the intervention effects were sustained at 1-year and 3-year follow-ups. Further research is needed to explore the mechanisms of the long-term effects of mHealth interventions such as Run4Love and to implement these effective interventions among people living with HIV. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR-IPR-17012606. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/10274.

Risk factors for children s blood lead levels in one city of Jiangsu / 中国学校卫生

Objective@#To understand the level and risk factor of lead exposure among children in one city of Jiangsu.@*Methods@#In northern Jiangsu Province, 373 children from 2 primary schools were enrolled and were tested for blood lead and heavy metal exposure. Lead exposure was tested in household dust of 46 children. A multivariate Logistic regression was used for lead exposure risk analysis. Spatial distribution of lead contamination in household dust was conducted and compared with the location of industrial enterprises.@*Results@#The geometric mean of blood lead in 373 children was 25.80 mg/L,the blood lead of 3 children (0.8%) was more than 100 mg/L. Pencil biting ( OR=4.26, 95%CI=1.61-10.68, P <0.05) and lead contamination in surrounding environment ( OR=2.93, 95%CI=1.24-7.34, P =0.02) was positively related to high blood lead level in children. The geometric mean household dust lead concentrations in 46 children was 302.27 μg/mg, and household with high dust lead levels were mainly located around manufacturing enterprises.@*Conclusion@#Environmental factors correlate with blood lead level in children. Efficient strategies and public health policies are urgently needed to control and prevent environmental lead pollution. Families and schools should actively carry out health education to engourage children good hygiene habits, and effectively reduce lead exposure.

The association between short-term exposure to extremely high level of ambient fine particulate matter and blood pressure: a panel study in Beijing, China.

High blood pressure (BP) is known as the main determinant of high cerebrovascular disease levels in China. Many studies discovered the associations between short-term exposure to PM2.5 and BP, while most of those focused on low or medium PM2.5 concentration. The aim of this study was to reveal the association between extremely high level ambient PM2.5 exposure and BP. We conducted a repeated-measures panel study in Beijing, China, during December 1, 2016 to December 28, 2016. BP was monitored daily for all 133 participants. Daily concentration of PM2.5 was obtained from local monitoring sites. A linear mixed-effect model combined with the distributed lag non-linear model was used to evaluate the associations between PM2.5 and daily variations in BP. This study showed short-term exposure to PM2.5 that was significantly associated with increased DBP (on lags of 0-8 days, Beta = 0.12, 95% confidence interval 0.04, 0.20). The single day effect of PM2.5 on DBP had a 2-day lag, and the cumulative effect lags 5 days. The effects of PM2.5 on SBP and DBP on hypertensive adults were significant. The cumulative effect of PM2.5 on SBP and DBP had 2 rapidly increasing periods in hypertensive adults: lags of 0-2 days and lags of 0-7 days to lags of 0-11 days. Our study revealed that short-term exposure in the extreme high level of ambient PM2.5 may increase BP among adults. Hypertensive adults may more sensitive than normotensive adults. The periodic high concentration of ambient PM2.5 might magnify the effect of PM2.5 on BP increase.

[Natural occurrence of masked deoxynivalenol and multi-mycotoxins in cereals from China harvested in 2007 and 2008].

OBJECTIVE: To elucidate the natural occurrence of masked deoxynivalenol (DON-3-G) and other multi-mycotoxins in cereals from parts of China. METHODS: A total of 446 corn and wheat samples harvested in 2007 and 2008 collected from Henan, Hebei, Guangxi, Anhui, Sichuan, Chongqing and Jiangsu provinces were analyzed for DON-3-G and other multi-mycotoxins (including deoxynivalenol (DON), zearalenone (ZEN), nivalenol (NIV), et al) by UPLC-MS/MS. RESULTS: Corn and wheat samples were mainly contaminated by DON and its derivatives as well as ZEN.88% (169/192) of wheat samples were positive for DON (range: 1.5 - 590.7 µg/kg; median: 30.8 µg/kg); 22.9% (44/192) of wheat samples were contaminated with ZEN (range: 1.7 - 3425.0 µg/kg; median: 8.0 µg/kg) and six samples contained ZEN concentration higher than the ZEN tolerance limit of 60 µg/kg. DON was detected in 50.5% (103/204) corn samples (range: 1.6 - 4374.4 µg/kg; median: 94.9 µg/kg); Seven samples contained DON exceeding the tolerance limit of 1000 µg/kg for DON. Additionally, ZEN was found in 41.7% (85/204) corn samples with the concentration between 1.6 µg/kg and 4808.7 µg/kg (median: 48.5 µg/kg) and there were 37 corn samples with ZEN level in the excess of tolerance limit for ZEN (60 µg/kg). DON-3-G was detected in corn and wheat samples for the first time in China with the median level of 21.4 µg/kg and 34.6 µg/kg for wheat and corn, respectively. Wheat was more heavily contaminated with DON-3-G than both 3-acetyl-DON (3-A-DON, median: 4.1 µg/kg) and 15-acetyl-DON (15-A-DON, median: 3.1 µg/kg) (t values were 5.111 and 5.966, respectively, both P values < 0.01). While, the level of 15-A-DON (median: 48.6 µg/kg) in corn was higher than 3-A-DON (median: 6.8 µg/kg) (t = -3.579, P < 0.01). The concentration of DON, DON-3-G, 3-A-DON, 15-A-DON and ZEN in corn were higher than that in wheat (Z values were -3.492, -1.960, -2.467, -8.711 and -6.272, respectively, all P values < 0.05). Wheat (median: 29.0 µg/kg) contained higher NIV in comparison with corn (median: 18.2 µg/kg, Z = -2.086, P < 0.05). CONCLUSION: Wheat and corn samples from parts of China were contaminated with multi-mycotoxins and DON was the predominant;in comparison of wheat, corn was more heavily contaminated with DON, DON-3-G, 3-A-DON, 15-A-DON and ZEN.

[Study advance on formation, transformation and detection of masked deoxynivalenol].

Conjugated deoxynivalenol, in which the toxins were usually bound to a more polar substance like glucose in crops, is referred to as masked deoxynivalenol. It could not detected with routine detection methods, but could release its toxic precursor after hydrolysis in gastrointestinal tract. In this paper, summarizes the formation, transformation and detection of masked deoxynivalenol as well as its relationship with human health were reviewed.