Association of the Healthy Dietary Index 2020 and its components with chronic respiratory disease among U.S. adults.

Background: Chronic respiratory disease is an important public health problem in the United States and globally. Diet, an important part of a healthy lifestyle, is also relevant to chronic respiratory health. We aimed to explore the relationship between overall dietary quality and the risk of chronic respiratory disease (CRD), include chronic bronchitis (CB), emphysema and asthma. Method: A total of 4,499 United States adults were extracted from the National Health and Nutrition Examination Survey (NHANES) in 2017-2018. Diet quality was assessed using 2 day, 24 h dietary recall data and quantified as the Healthy Diet Index (HEI)-2020 score. Binary logistic regression models, restricted cubic splines (RCS) and generalized additive modeling (GAM), the weighted quartile sum (WQS) and qgcom models were used to assess the relationship between HEI-2020 scores and risk of CB, emphysema and asthma. Results: High HEI-2020 scores are associated with low risk of chronic respiratory disease (CB: 0.98, 0.97-0.99; emphysema: 0.98, 0.97-0.99; asthma: 0.98, 0.97-0.99) and consistent results across different dietary variable categorization (Tertile: CB: 0.58, 0.42-0.81; asthma: 0.51, 0.35-0.74; Quartile: CB: 0.57, 0.34-0.97; asthma: 0.56, 0.36-0.86) and different weighting models. Negative dose-response relationship between dietary quality and risk of chronic respiratory disease also shown in RCS and GAM models. The WQS and qgcom models also showed a healthy mixing effect of dietary components on respiratory disease, with high-quality proteins, vegetables, and fruits making the heaviest contributions. Conclusion: Higher HEI-2020 scores were associated with lower risk of CB, emphysema, and asthma. Following Dietary Guidelines for Americans 2020-2025 could support enhanced respiratory health.

Association between dietary quality and perceived stress based on the CHNS database / 公共卫生与预防医学

Objective To explore the association between dietary quality and perceived stress among adult Chinese. Methods The China Health and Nutrition Survey (CHNS) was used to investigate the association between dietary quality and perceived stress in Chinese adults. The Chinese Perceived Stress Scale (CPSS) was used to assess the perceived stress in Chinese adults. Binary logistic regression models were utilized to explore the relationship between diet quality and perceived stress. Restricted cubic splines (RCS) were utilized to clarify the dose response relationship between diet quality and perceived stress. Results Binary logistic regression models revealed that adults with CHEI score ranged from P25 to P50 and higher than P75 had 15.1% (OR=0.849，95%CI：0.738-0.977) and 23.0% (OR=0.770，95%CI：0.666-0.891) reduced risk of high perceived stress after multivariable adjustment when compared with adults with CHEI score less than P25. RCS results showed that the OR value of high perceived stress risk decreased gradually with increasing CHEI score in the overall population, but this association was not statistically significant in adults with lower CHEI score. Conclusion High dietary quality is associated with a reduced risk of high perceived stress. This study provides a theoretical reference for the health effects of high dietary quality on high perceived stress risk reduction.

Association between obesity indicators and hyperuricemia in Chinese adults / 公共卫生与预防医学

Objective The study aims to find a suitable obesity index for predicting hyperuricemia (HUA)in Chinese adults. Methods The obesity indexes of 8133 subjects in China Health and Nutrition Survey in 2009 were calculated, and the basic situation of them was analyzed descriptively. χ2 test and t test were used to test the differences of categorical variables and continuous variables between the HUA group and the non-HUA group. The area under the curve (AUC) and receiver operating characteristic (ROC) curves were used to analyze the predictive value of these indices for HUA. Binary logistic regression was used to analyze the relationship between obesity and HUA. Results Demographic covariates, prevalence and Body Mass Index (BMI) all have impacts on the prevalence of HUA. Obesity indexes have a good predictive effect on HUA, and the Lipid Accumulation Product (LAP) is the best (AUC=0.77 (95% CI [0.75, 0.78]). Obesity indexes all have a significant correlation with HUA. When covariates were not adjusted, LAP had the highest OR value (OR=5.87, 95% CI [5.08, 6.77]). Conclusion LAP index is significantly related to HUA, and it can be used as an emerging index to assess the prevalence of HUA in Chinese adults.