A randomized controlled trial to evaluate the effects of an early postnatal lifestyle modification program on diet, adiposity and metabolic outcome in mothers with gestational diabetes mellitus.

OBJECTIVE: The aim of the present study was to evaluate the effectiveness of a 12-month early postnatal lifestyle intervention program in women with gestational diabetes in a recent pregnancy. METHODS: This study was a prospective randomized intervention study conducted at a diabetes center in Hong Kong. Chinese women aged 18-45 years, who developed gestational diabetes mellitus (GDM) in their most recent pregnancy, were invited. Eligible women were randomized in 1:1 ratio at baseline (6-12 weeks postpartum), to standard care or lifestyle intervention (diet and physical activity) groups for 12 months. A standardized biochemistry assessment including oral glucose tolerance test, blood lipids, complete blood count, renal and liver functions, were measured at baseline and at 12-month. Anthropometry assessment and lifestyle questionnaire were performed at various timepoints. RESULTS: A total of 103 women were randomized at baseline and a total of 79 women (standard care, n = 39, intervention, n = 40) completed the assessment. After the 12-month study period, women in the intervention group had significantly lower energy intake (intervention, -497.6 ± 488.3 kcal; standard, -222.0 ± 390.0 kcal, P < 0.01) compared to the standard care group, and a trend towards greater weight reduction (intervention, -0.93 ± 4.68 kg; standard, -0.01 ± 3.12 kg, P = 0.36). CONCLUSION: The lifestyle intervention implemented within 3 months postpartum appeared to promote postpartum weight loss. The early postnatal lifestyle intervention program may provide an opportunity to reduce the long-term risk of diabetes in this high-risk population.

Dietary patterns of Chinese pregnant women in Hong Kong.

BACKGROUND AND OBJECTIVES: Maternal nutrition is important for healthy pregnancy, but it has not been well studied among pregnant women in Hong Kong. This study aims to examine the dietary pattern and nutritional intake of women in early pregnancy, and the associations between dietary patterns, dietary quality, and other health parameters. METHODS AND STUDY DESIGN: This is a prospective cohort study of healthy Chinese pregnant women, recruited at their first antenatal appointment. Dietary intakes were assessed by a locally validated food frequency questionnaire (FFQ) and dietary patterns were derived by principal component analysis. RESULTS: Of 160 women recruited, the mean age was 32.7±3.9 years and body mass index (BMI) before pregnancy was 22.6±3.8 kg/m2. The dietary analyses were restricted to 156 women who had completed the FFQ. 99% of women had excessive sodium intake and only 2.6% of women met the recommended fibre intake. Three dietary patterns identified were 'sweet and fast-food pattern', 'prudent pattern' and 'meat pattern', which altogether accounted for 23.5% of the total variation. The 'prudent pattern' was positively associated with dietary quality indices [Dietary Approaches to Stop Hypertension score, ρ=0.323, p<0.01; Dietary Quality Index-International, ρ=0.400, p<0.01; Mediterranean Diet Score, ρ=0.243, p=0.02]; and was inversely associated systolic (B=-3.71, 95% CI -7.06, -0.36) and diastolic blood pressure (B=-2.69, 95% CI -5.12, -0.26), suggesting this pattern represented a relatively healthier dietary option. CONCLUSIONS: Suboptimal dietary intake is a common issue among pregnant women in Hong Kong. Early dietary assessment and attention are warranted in this population.

Aquaglyceroporin AQP7's affinity for its substrate glycerol: Have we reached convergence in the computed values of glycerol-aquaglyceroporin affinity?

AQP7 is one of the four human aquaglyceroporins that facilitate glycerol transport across the cell membrane, a biophysical process that is essential in human physiology. Therefore, it is interesting to compute AQP7's affinity for its substrate (glycerol) with reasonable certainty to compare with the experimental data suggesting high affinity in contrast with most computational studies predicting low affinity. In this study aimed at computing the AQP7-glycerol affinity with high confidence, we implemented a direct computation of the affinity from unbiased equilibrium molecular dynamics (MD) simulations of three all-atom systems constituted with 0.16M, 4.32M, and 10.23M atoms, respectively. These three sets of simulations manifested a fundamental physics law that the intrinsic fluctuations of pressure in a system are inversely proportional to the system size (the number of atoms in it). These simulations showed that the computed values of glycerol-AQP7 affinity are dependent upon the system size (the inverse affinity estimations were, respectively, 47.3 mM, 1.6 mM, and 0.92 mM for the three model systems). In this, we obtained a lower bound for the AQP7-glycerol affinity (an upper bound for the dissociation constant). Namely, the AQP7-glycerol affinity is stronger than 1087/M (the dissociation constant is less than 0.92 mM). Additionally, we conducted hyper steered MD (hSMD) simulations to map out the Gibbs free-energy profile. From the free-energy profile, we produced an independent computation of the AQP7-glycerol dissociation constant being approximately 0.18 mM.

Dual Time-Scale Proton Transfer and High-Energy, Long-Lived Excitons Unveiled by Broadband Ultrafast Time-Resolved Fluorescence in Adenine-Uracil RNA Duplexes.

In contrast to the immense amount of research on electronically excited DNA, surprisingly little has been done about the excited states of RNA. Herein, we demonstrate an ultrafast broadband time-resolved fluorescence and fluorescence anisotropy study to probe directly the intrinsic fluorescence and overall dynamics of the fluorescence from a homopolymeric adenine·uracil RNA duplex adopting the A-form structure. The results unveiled complex deactivation through distinctive multichannels mediated by states of varied energy, a character of charge transfer, and a lifetime from sub-picosecond to nanoseconds. In particular, we observed an unprecedented kinetic isotopic effect and participation of unusual proton transfer from states in two discrete energies and time domains. We also identified a high-energy nanosecond emission that we attributed to its fluorescence anisotropy to long-lived weakly emissive excitons not reported in DNA. These distinguishing features originate from the stacking, pairing, and local hydration environment specific to the A-form conformation of the adenine·uracil double helix.

Underdevelopment of the gut microbiota and bacteria species as non-invasive markers of prediction in children with autism spectrum disorder.

OBJECTIVE: The gut microbiota has been suggested to play a role in autism spectrum disorder (ASD). We postulate that children with ASD harbour an altered developmental profile of the gut microbiota distinct from that of typically developing (TD) children. Here, we aimed to characterise compositional and functional alterations in gut microbiome in association with age in children with ASD and to identify novel faecal bacterial markers for predicting ASD. DESIGN: We performed deep metagenomic sequencing in faecal samples of 146 Chinese children (72 ASD and 74 TD children). We compared gut microbial composition and functions between children with ASD and TD children. Candidate bacteria markers were identified and validated by metagenomic analysis. Gut microbiota development in relation to chronological age was assessed using random forest model. RESULTS: ASD and chronological age had the most significant and largest impacts on children's faecal microbiome while diet showed no correlation. Children with ASD had significant alterations in faecal microbiome composition compared with TD children characterised by increased bacterial richness (p=0.021) and altered microbiome composition (p<0.05). Five bacterial species were identified to distinguish gut microbes in ASD and TD children, with areas under the receiver operating curve (AUC) of 82.6% and 76.2% in the discovery cohort and validation cohort, respectively. Multiple neurotransmitter biosynthesis related pathways in the gut microbiome were depleted in children with ASD compared with TD children (p<0.05). Developing dynamics of growth-associated gut bacteria (age-discriminatory species) seen in TD children were lost in children with ASD across the early-life age spectrum. CONCLUSIONS: Gut microbiome in Chinese children with ASD was altered in composition, ecological network and functionality compared with TD children. We identified novel bacterial markers for prediction of ASD and demonstrated persistent underdevelopment of the gut microbiota in children with ASD which lagged behind their respective age-matched peers.

Certain dietary patterns are associated with GLIM criteria among Chinese community-dwelling older adults: a cross-sectional analysis.

Disease-related malnutrition is prevalent among older adults; therefore, identifying the modifiable risk factors in the diet is essential for the prevention and management of disease-related malnutrition. The present study examined the cross-sectional association between dietary patterns and malnutrition in Chinese community-dwelling older adults aged ≥65 years in Hong Kong. Dietary patterns, including Diet Quality Index International (DQI-I), Dietary Approaches to Stop Hypertension (DASH), the Mediterranean Diet Score, 'vegetable-fruit' pattern, 'snack-drink-milk product' pattern and 'meat-fish' pattern, were estimated and generated from a validated food frequency questionnaire. Malnutrition was classified according to the modified Global Leadership Initiative on Malnutrition (GLIM) criteria based on two phenotypic components (low body mass index and reduced muscle mass) and one aetiologic component (inflammation/disease burden). The association between the tertile or level of adherence of each dietary pattern and modified GLIM criteria was analysed using adjusted binary logistic regression models. Data of 3694 participants were available (49 % men). Malnutrition was present in 397 participants (10⋅7 %). In men, a higher DQI-I score, a higher 'vegetable-fruit' pattern score and a lower 'meat-fish' pattern score were associated with a lower risk of malnutrition. In women, higher adherence to the DASH diet was associated with a lower risk of malnutrition. After the Bonferroni correction, the association remained statistically significant only in men for the DQI-I score. To conclude, a higher DQI-I score was associated with a lower risk of malnutrition in Chinese older men. Nutritional strategies for the prevention and management of malnutrition could potentially be targeted on dietary quality.

Peripheral Blood T Cell Gene Expression Responses to Exercise and HMB in Sarcopenia.

BACKGROUND: Sarcopenia is a major health problem in older adults. Exercise and nutrient supplementation have been shown to be effective interventions but there are limited studies to investigate their effects on the management of sarcopenia and its possible underlying mechanisms. Here, we studied T cell gene expression responses to interventions in sarcopenia. METHODS: The results of this study were part of a completed trial examining the effectiveness of a 12-week intervention with exercise and nutrition supplementation in community-dwelling Chinese older adults with sarcopenia, based on the available blood samples at baseline and 12 weeks from 46 randomized participants from three study groups, namely: exercise program alone (n = 11), combined-exercise program and nutrition supplement (n = 23), and waitlist control group (n = 12). T cell gene expression was evaluated, with emphasis on inflammation-related genes. Real-time PCR (RT-PCR) was performed on CD3 T cells in 38 selected genes. Correlation analysis was performed to relate the results of gene expression analysis with lower limb muscle strength performance, measured using leg extension tests. RESULTS: Our results showed a significant improvement in leg extension for both the exercise program alone and the combined groups (p < 0.001). Nine genes showed significant pre- and post-difference in gene expression over 12 weeks of intervention in the combined group. Seven genes (RASGRP1, BIN1, LEF1, ANXA6, IL-7R, LRRN3, and PRKCQ) showed an interaction effect between intervention and gene expression levels on leg extension in the confirmatory analysis, with confounder variables controlled and FDR correction. CONCLUSIONS: Our findings showed that T cell-specific inflammatory gene expression was changed significantly after 12 weeks of intervention with combined exercise and HMB supplementation in sarcopenia, and that this was associated with lower limb muscle strength performance.

Fracture Incidence and the Relevance of Dietary and Lifestyle Factors Differ in the United Kingdom and Hong Kong: An International Comparison of Longitudinal Cohort Study Data.

Geographic variation in fracture risk may be due to divergent profiles of dietary, lifestyle, and other risk factors between populations. We investigated differences in fracture rates between two older-population cohorts: the European Prospective Investigation into Cancer and Nutrition (EPIC) Norfolk cohort (n = 7732) in the United Kingdom (UK), and the Mr and Ms Os cohort (n = 3956) in Hong Kong (HK). Data were collected by questionnaires, laboratory assessments, and hospital records. Incidence of hip, spine, and wrist fractures in the two cohorts was calculated and multivariable regression was used to explore variables important to fracture risk. Total hip, spine, and wrist fracture incidence was higher in the UK vs HK for women (13.70 vs 8.76 per 1000 person-years; p < 0.001), but not men (5.95 vs 5.37 per 1000 person-years; p = 0.337), and the proportions of different fractures also varied between cohorts (p < 0.001). Hip fracture was the most common UK fracture (accounting for 56.8% fractures in men and 52.6% in women), while wrist fracture was most common in HK (42.9% in men and 57.9% in women). The major contributor to total fracture risk in multivariable regression models of both cohorts and sexes, was age; with BMI also an important contributor to fracture risk HK men and UK women. The distribution of factors relevant to fracture risk, and the rates of different fractures, varied significantly between UK and HK cohorts. However, the importance of each factor in contributing to fracture risk was similar between the cohorts. The differences in fracture rates suggest targeted approaches may be required when developing interventions and public health recommendations to reduce the burden of osteoporosis in these two countries.

Eating Behaviors and Diet Quality in Chinese Preschoolers with and without Autism Spectrum Disorder: A Case-Control Study.

OBJECTIVES: To compare mealtime behaviors and diet quality in Chinese preschoolers with autism spectrum disorder (ASD) and typically developing preschoolers in Hong Kong. STUDY DESIGN: This case-control study included a community sample of 65 families with preschoolers with ASD aged 3-6 years and 65 families with typically developing preschoolers matched for age and sex. Preschoolers' eating behaviors were assessed using the Brief Autism Mealtime Behaviour Inventory and the Preschoolers' Eating Behaviour Questionnaire (CPEBQ). Preschoolers' usual diet and nutrient intake were assessed using a validated food frequency questionnaire. Diet quality and diversity were generated using the Chinese Children Dietary Index total score and diet variety score. Between-group differences in various scales and dietary variables were examined using multivariate linear or logistics regression models adjusting for baseline demographic differences. RESULTS: Compared with the typically developing group, the ASD group had greater scores in the Brief Autism Mealtime Behaviour Inventory food refusal domain (P < .001), the CPEBQ food fussiness (P = .001) and eating habit (P = .001) domains, and lower CPEBQ exogenous eating score (P = .003) and initiative eating score (P < .001). The Chinese Children Dietary Index total score (P = .001) and diet variety score (P = .005) and intake of soy and soy products (P = .001) were lower in the ASD group compared with the typically developing group. CONCLUSIONS: Preschoolers with ASD showed more eating and mealtime problems, and lower diet quality and diversity than their typically developing counterparts. Our findings highlight the need for regular monitor and early identification of mealtime behavioral and nutrition problems among preschoolers with ASD.

Long living excited state of protonated adenosine unveiled by ultrafast fluorescence spectroscopy and density functional theoretical study.

Adenosine (Ado) possesses ultrafast nonradiative dynamics accounting for its remarkably high photostability. The deactivation dynamics of Ado after protonation in an aqueous solution remains an elusive issue. Herein we report an investigation of the excited state dynamics of protonated Ado (AdoH+) performed using ultrafast time-resolved fluorescence spectroscopy combined with density functional theoretical calculation. The result obtained from comparison of conformers with protonation at different sites revealed that the syn-conformer with protonation occurring at the N3 position (syn-N3) is the predominant form of AdoH+ in the ground state, similar to that of Ado. In contrast, the fluorescence of AdoH+ with maximum intensity at 385 nm, significantly red-shifted from that of Ado, displaying decay dynamics composed of an ultrafast component with the lifetime of ∼0.5 ps and a slower one of ∼2.9 ns. The former is because of the decay of the syn-N3 conformer, similar to that reported for AdoH+ under the gas phase condition. The latter is due to the syn-N1 conformer formed via ultrafast proton transfer of the syn-N3. The excited state of syn-N1 has a peculiar nonplanar conformation over the purine molecule, which is responsible for the substantial Stokes shift showed in the fluorescence spectrum and correlates with a large energy barrier for nonradiative decay likely involving a reversed proton transfer. This study demonstrates the importance of protonation and solvent environment in altering dramatically the excited states of Ado, providing insight for better understanding nonradiative dynamics of both the monomeric bases and the oligomeric or polymeric DNAs.

Urinary sodium excretion and dietary sources of sodium intake in community-dwelling Chinese adults aged 50 years and over.

OBJECTIVE: This study examined Na intake and identified the major food sources of Na in healthy Chinese adults aged ≥50 years in Hong Kong. DESIGN: Participants who completed a baseline assessment of a randomised controlled trial assessing the effectiveness of exercise and nutrition supplementation on improving physical and cognitive functions were included. A single 24-h urine sample and a 3-d diet record were used to measure urinary Na excretion and dietary intake, respectively. The compliances to the WHO (<5 g/d) and China Nutrition Society (<6 g/d) recommendations for salt intake were assessed based on the urinary Na excretion. The relative contribution of sixteen food groups to the dietary Na intake was expressed as percentages. Associations between food groups and urinary Na excretion were analysed using multiple linear regression. SETTING: Community facilities. PARTICIPANTS: Totally, 114 healthy Chinese adults (mean age 60·6 years, 55 % women). RESULTS: The mean urinary Na excretion over 24-h was 2876·6 ± 1249·4 mg/d (7·3 ± 3·2 g salt/d). Overall, 22·8 % of participants met the WHO recommendation and 34·2 % met the Chinese Nutrition Society recommendation for salt intake. The major food sources of dietary Na intake were condiments (42·4 %), cereals and their products (16·8 %) and soups (13·5 %). Higher intakes of seafood and nuts were associated with lower urinary Na excretion. CONCLUSIONS: Public health strategies should target healthy Chinese adults in Hong Kong to modify the current patterns of Na intake. Targeting condiments, cereals and their products and soups will be an important strategy to reduce their Na intake.

Protein and physical activity in older persons.

PURPOSE OF REVIEW: The aim of this study was to highlight recent evidence on protein requirement and physical activity recommendations in older adults and their interrelationship. RECENT FINDINGS: Higher protein intake in older adults is beneficial for better physical function, reduced fracture risk, healthy ageing and lower mortality. However, the association between protein quality and health remains inconsistent. Higher physical activity is associated with a lower risk of physical dependence, frailty, cognitive impairment and mortality. Prospectively increasing or even sustaining physical activity can be protective against adverse health outcomes compared with decreasing physical activity. There is a synergistic protective effect of protein intake and physical activity on health. Data on the bidirectional link between protein intake and physical activity are scarce. Whether increasing physical activity can help to increase energy intake (and thus protein intake) and vice versa require further research. SUMMARY: The key role of protein intake and physical activity in optimizing health in older adults is well established. The synergistic effects of these two modifiable lifestyle factors strengthen the need to consider dietary and physical activity recommendations together. Future research may examine the bidirectional link between diet and physical activity, which could potentially be one of the strategies to increase the uptake of recommendations for protein intake and physical activity in older adults.

Malnutrition According to GLIM Criteria and Adverse Outcomes in Community-Dwelling Chinese Older Adults: A Prospective Analysis.

OBJECTIVES: The Global Leadership Initiative on Malnutrition (GLIM) has proposed a consensus scheme for classifying malnutrition. This study examined the prevalence of malnutrition according to GLIM criteria and evaluated if these criteria were associated with adverse outcomes in community-dwelling older adults. DESIGN: This was a prospective cohort study. SETTING AND PARTICIPANTS: Community-dwelling Chinese men and women aged ≥65 years in Hong Kong. METHODS: A health check including questionnaire interviews and physical measurements was conducted at baseline and 14-year follow-up. Participants were classified as malnourished at baseline according to the GLIM criteria based on 2 phenotypic components (low body mass index and reduced muscle mass) and 1 etiologic component (inflammation). Adverse outcomes including sarcopenia, frailty, falls, mobility limitation, hospitalization, and mortality were assessed at 14-year follow-up. Adjusted multiple logistic regression and Cox proportional hazards model were performed to examine the associations between malnutrition and adverse outcomes and presented as odds ratio (OR) or hazard ratio (HR) and 95% confidence interval (CI). RESULTS: Data of 3702 participants [median age: 72 years (IQR 68-76)] were available at baseline. Malnutrition was present in 397 participants (10.7%). Malnutrition was significantly associated with higher risk of sarcopenia (n = 898, OR 2.25; 95% CI 1.04-4.86), frailty (Fried (n = 971, OR 2.83; 95% CI 1.47-5.43), FRAIL scale (n = 985, OR 2.30; 95% CI 1.06-4.98)) and all-cause mortality (n = 3702, HR: 1.62; 95% CI 1.39-1.89). There was no significant association between malnutrition and falls (n = 987, OR 1.09; 95% CI 0.52-2.31), mobility limitation (n = 989, OR 0.98; 95% CI 0.36-2.67), and hospitalization (n = 989, OR 1.37; 95% CI 0.67-2.77). CONCLUSIONS AND IMPLICATIONS: Among community-dwelling Chinese older adults, malnutrition according to selected GLIM criteria was a predictor of sarcopenia, frailty, and mortality at 14-year follow-up; whereas no association was found for falls, mobility limitation, and hospitalization. Clinicians may consider applying the GLIM criteria to identify malnourished community-dwelling older adults.

Quantitative study of unsaturated transport of glycerol through aquaglyceroporin that has high affinity for glycerol.

The structures of several aquaglyceroporins have been resolved to atomic resolution showing two or more glycerols bound inside a channel and confirming a glycerol-facilitator's affinity for its substrate glycerol. However, the kinetics data of glycerol transport experiments all point to unsaturated transport that is characteristic of low substrate affinity in terms of the Michaelis-Menten kinetics. In this article, we present an in silico-in vitro research focused on AQP3, one of the human aquaglyceroporins that is natively expressed in the abundantly available erythrocytes. We conducted 2.1 µs in silico simulations of AQP3 embedded in a model erythrocyte membrane with intracellular-extracellular asymmetries in leaflet lipid compositions and compartment salt ions. From the equilibrium molecular dynamics (MD) simulations, we elucidated the mechanism of glycerol transport at high substrate concentrations. From the steered MD simulations, we computed the Gibbs free-energy profile throughout the AQP3 channel. From the free-energy profile, we quantified the kinetics of glycerol transport that is unsaturated due to glycerol-glycerol interactions mediated by AQP3 resulting in the concerted movement of two glycerol molecules for the transport of one glycerol molecule across the cell membrane. We conducted in vitro experiments on glycerol uptake into human erythrocytes for a wide range of substrate concentrations and various temperatures. The experimental data quantitatively validated our theoretical-computational conclusions on the unsaturated glycerol transport through AQP3 that has high affinity for glycerol.

Evaluation of dietary pattern in early pregnancy using the FIGO Nutrition Checklist compared to a food frequency questionnaire.

OBJECTIVE: To evaluate the reliability and utility of the FIGO Nutrition Checklist to identify dietary and nutritional inadequacy in early pregnancy by comparing it against nutritional indicators and dietary quality indices (Dietary Approaches to Stop Hypertension [DASH] score, Mediterranean Diet Score [MDS], and Dietary Quality Index-International [DQI-I]), derived by a locally validated food frequency questionnaire (FFQ). METHODS: A prospective cohort study of healthy Chinese pregnant women randomly recruited between September 2017 and April 2018 at their first antenatal appointment. Women completed the FIGO Nutrition Checklist (translated into Chinese) and the FFQ. Spearman correlation was performed to examine association between the Checklist and dietary quality indices or food and nutrient intakes, calculated based on dietary data from the FFQ. RESULTS: Of 160 participants, 156 (97.5%) completed both the FIGO Nutrition Checklist and FFQ and were included. There were 148 (95%) women who reported at least one suboptimal dietary behavior using the Checklist. Checklist score was significantly associated with dietary quality indices (DASH ρ=0.344, P<0.001; DQI-I ρ=0.304, P<0.001; MDS ρ=0.164, P=0.041). The Checklist question on fruit/vegetables was significantly associated with fiber, vitamin C, and fruit and vegetable intake as calculated from the FFQ (0.325 ≤ ρ ≤0.441, P<0.001). The question on dairy intake was significantly associated with intake of calcium, milk and dairy products captured via FFQ (0.576 ≤ ρ ≤0.655, P<0.001). CONCLUSION: This study supports the use of the FIGO Nutrition Checklist to identify women with suboptimal dietary quality in early pregnancy.

In silico simulations of erythrocyte aquaporins with quantitative in vitro validation.

Modelling water and membrane lipids is an essential element in the computational research of biophysical/biochemical processes such as water transport across the cell membrane. In this study, we examined the accuracies of two popular water models, TIP3P and TIP4P, in the molecular dynamics simulations of erythrocyte aquaporins (AQP1 and AQP3). We modelled the erythrocyte membrane as an asymmetric lipid bilayer with appropriate lipid compositions of its inner and outer leaflet, in comparison with a symmetric lipid bilayer of a single lipid type. We computed the AQP1/3 permeabilities with the transition state theory with full correction for recrossing events. We also conducted cell swelling assays for water transport across the erythrocyte membrane. The experimental results agree with the TIP3P water-erythrocyte membrane model, in confirmation of the expected accuracy of the erythrocyte membrane model, the TIP3P water model, and the CHARMM parameters for water-protein interactions.

A Combined Nutrition and Exercise Intervention Influences Serum Vitamin B-12 and 25-Hydroxyvitamin D and Bone Turnover of Healthy Chinese Middle-Aged and Older Adults.

BACKGROUND: Hong Kong faces several public health problems including malnutrition and osteoporosis. Considering the typical Chinese diet and overall low physical activity levels of Chinese adults, timely interventions to improve nutritional status and bone health are needed. OBJECTIVES: We examined the effects of a nutrition plus exercise intervention on serum vitamin B-12 and 25-hydroxyvitamin D [25(OH)D], bone turnover markers, and parathyroid hormone (PTH) concentrations in apparently healthy Chinese middle-aged and older adults. METHODS: In this 24-wk randomized controlled trial, 180 Chinese adults (85 women, mean ± SD age: 61 ± 6 y) were randomly assigned to receive a fortified milk supplement (2 × 30 g/d) and an exercise program (2 × 1 h/wk including resistance, balance, and aerobic training) or no intervention. The primary outcome was physical performance. In this article we analyzed the secondary outcomes serum vitamin B-12 and 25(OH)D concentrations, assessed at baseline, 12 wk, and 24 wk. Also, bone turnover markers and PTH concentrations were studied. Linear mixed models evaluated group differences over time. RESULTS: A significant time × group interaction (P < 0.001) was found for serum vitamin B-12 and 25(OH)D concentrations and the bone turnover markers, but not for serum PTH concentrations (P = 0.09). The intervention increased mean ± SD vitamin B-12 concentrations from baseline (345 ± 119 pmol/L) to 24 wk (484 ± 136 pmol/L), whereas concentrations remained stable within the control. For 25(OH)D concentrations, the intervention group had a greater increase from baseline (54.7 ± 14.2 nmol/L) to 24 wk (80.1 ± 19.2 nmol/L) than the control (60.6 ± 15.2 compared with 65.6 ± 14.6 nmol/L). The ratio of the net effect of bone formation and resorption was greater in the intervention group, suggesting less bone remodeling, irrespective of sex. CONCLUSIONS: A fortified milk supplement and exercise intervention successfully improved vitamin B-12 and 25(OH)D concentrations as well as the balance of bone turnover markers of Chinese middle-aged and older adults.This trial was registered at trialregister.nl as NTR6214.

Psychological Factors of Long-Term Dietary and Physical Activity Adherence among Chinese Adults with Overweight and Obesity in a Community-Based Lifestyle Modification Program: A Mixed-Method Study.

There is a paucity of research on factors influencing long-term adherence to lifestyle modification. We conducted a mixed-method study to explore the psychological factors of dietary and physical activity (PA) adherence among Chinese adults with overweight and obesity at 10 months after enrollment of a community-based lifestyle modification program in Hong Kong. We recruited Chinese adults newly enrolled in a culturally adapted lifestyle modification program and followed them for 10 months. For the quantitative study, primary outcomes were dietary and PA adherence scores while secondary outcomes included knowledge, self-efficacy, motivation and stage of change. For the qualitative study, data were collected using semi-structured interviews and observation. A total of 140 participants completed the 10-month follow-up. They reported moderate level of dietary adherence but low level of PA adherence at 10 months. Multivariable regression analyses revealed that greater improvement in nutrition knowledge and diet stage of change predicted higher dietary adherence while greater improvement in PA self-efficacy and PA stage of change predicted higher PA adherence. Qualitative data on 26 participants suggest that participants' knowledge and self-efficacy but not motivation were enhanced during the program. The findings of this study enhanced our understanding on factors influencing long-term adherence to lifestyle changes.

A long lasting sunscreen controversy of 4-aminobenzoic acid and 4-dimethylaminobenzaldehyde derivatives resolved by ultrafast spectroscopy combined with density functional theoretical study.

4-Aminobenzoic acid (PABA) is one of the earliest patented and most commonly used sunscreen components. There is however a long-lasting controversy on its photo-protective efficacy owing to the lack of information on its protolytic equilibrium and photo-dynamics after absorption of ultraviolet radiation in physiologically relevant aqueous solution. The excitation dynamics in water also remains largely unknown for analogs of PABA such as 4-dimethylaminoacetophenone (DMAAP) and 4-dimethylaminobenzaldehyde (DMABA) which are recognized as prototypes for photo-induced twisted intramolecular charge transfer (TICT). Herein we report a combined application of femtosecond broadband time-resolved fluorescence and transient absorption coupled with density functional theoretical study for PABA, DMAAP, and DMABA under several solvent conditions with representative properties in terms of the pH, polarity and hydrogen bonding capacity. The results we gained demonstrate that, in a neutral aqueous solution, PABA taking the deprotonated anion form in the ground state undergoes rapid protonation after excitation, producing excited state species in the neutral form that may shift effectively by intersystem crossing (ISC) to the long-lasting triplet state capable of damaging nucleic acids. This provides evidence at the molecular level for the detrimental effect of PABA if used as a sunscreen ingredient. In contrast, our investigation on DMAAP and DMABA unveils an unusual solvent controlled deactivation dynamics rendered by the participation of the carbonyl oxygen associated nOπ* state featuring energy and structure strongly responsive to solvent properties. In particular, these molecules in water exhibit solute-solvent hydrogen bonding at the sites of the carbonyl oxygen and the amino nitrogen which is, respectively, weakened and strengthened after the excitation, leading to state reversal and formation of a nOπ* state with a peculiar non-planar structure. This quenches strongly the excitation, eliminates the TICT, suppresses the ISC and opens up the otherwise inaccessible internal conversion (IC) to account for ∼80% of the entire deactivation. The IC, observed to proceed at a rate of ∼2.5 ps, allows the effective recovery of the ground state, providing substantial protection against ultraviolet irradiation. Moreover, the revelation of highly solvent sensitive fluorescence emission from DMABA and DMAAP implies the potential application of these molecules as the functional element in the design of sensory materials for probing the polarity and hydrogen bonding character of the surrounding environment.

Dietary patterns and telomere length in community-dwelling Chinese older men and women: a cross-sectional analysis.

PURPOSE: Environmental and lifestyle factors that affect oxidative stress and inflammation may influence telomere length (TL). There are limited data to relate dietary patterns with TL. This study examined the association of various dietary patterns with TL in Chinese older adults. METHODS: We conducted a cross-sectional analysis and performed multivariate linear regression analyses using available data from 1981 (965 men, 1016 women) community-dwelling Chinese adults aged 65 years and over in Hong Kong. The interviewer administered questionnaires that covered dietary intake estimation and dietary pattern generation from the food frequency questionnaire, demographic and lifestyle factors, and self-reported medical history. TL was measured by quantitative real-time polymerase chain reaction. RESULTS: None of the dietary pattern scores including the Diet Quality Index-International (DQI-I) score, the Dietary Approaches to Stop Hypertension (DASH) score, the Mediterranean-DASH Intervention for Neurodegenerative Delay Diet (MIND) score, the Mediterranean Diet Score (MDS), the Okinawan diet score, as well as the "vegetables-fruits" pattern score, the "snacks-drinks-milk" pattern score, and the "meat-fish" pattern score were associated with TL in the age- and sex-adjusted model and the multivariate adjusted model. CONCLUSION: Our findings suggest a minimal role of dietary patterns in telomere length in community-dwelling Chinese older adults.