Long-term air pollution and adverse meteorological factors might elevate the osteoporosis risk among adult Chinese.

Objective: This study aims to investigate the relationship between exposure to air pollution and adverse meteorological factors, and the risk of osteoporosis. Methods: We diagnosed osteoporosis by assessing bone mineral density through Dual-Energy X-ray absorptiometry in 2,361 participants from Jiangsu, China. Additionally, we conducted physical examinations, blood tests, and questionnaires. We evaluated pollution exposure levels using grid data, considering various lag periods (ranging from one to five years) based on participants' addresses. We utilized logistic regression analysis, adjusted for temperature, humidity, and individual factors, to examine the connections between osteoporosis and seven air pollutants: PM1, PM2.5, PM10, SO2, NO2, CO, and O3. We assessed the robustness of our study through two-pollutant models and distributed lag non-linear models (DLNM) and explored susceptibility using stratified analyses. Results: In Jiangsu, China, the prevalence of osteoporosis among individuals aged 40 and above was found to be 15.1%. A consistent association was observed between osteoporosis and the five-year average exposure to most pollutants, including PM2.5, PM10, CO, and O3. The effects of PM10 and CO remained stable even after adjusting for the presence of a second pollutant. However, the levels of PM1 and PM2.5 were significantly influenced by O3 levels. Individuals aged 60 and above, those with a BMI of 25 or higher, and males were found to be more susceptible to the effects of air pollution. Interestingly, males showed a significantly higher susceptibility to PM1 and PM2.5 compared to females. This study provides valuable insights into the long-term effects of air pollution on osteoporosis risk among the adult population in China. Conclusion: This study indicates a potential association between air pollutants and osteoporosis, particularly with long-term exposure. The risk of osteoporosis induced by air pollution is found to be higher in individuals aged 60 and above, those with a BMI greater than 25, and males. These findings underscore the need for further research and public health interventions to mitigate the impact of air pollution on bone health.

Differences in the prevalence and risk factors of osteoporosis in chinese urban and rural regions: a cross-sectional study.

BACKGROUND: Bone mineral density (BMD) and prevalence of osteoporosis may differ between urban and rural populations. This study aimed to investigate the differences in BMD characteristics between urban and rural populations in Jiangsu, China. METHODS: A total of 2,711 participants aged 20 years and older were included in the cross-sectional study. Multistage and stratified cluster random sampling was used as the sampling strategy. BMD was measured by the method of dual-energy x-ray absorptiometry (DXA). Data were collected through questionnaires/interview. BMD values at the lumbar spine (L1-L4), femoral neck, total hip, and greater trochanter were collected. Descriptive statistics were used to demonstrate the characteristics of urban and rural participants. Multivariate logistic regression analysis was utilized to analyze the factors that may be associated with osteoporosis in urban and rural populations. RESULTS: Of these participants, 1,540 (50.49%) were females and 1,363 (42.14%) were from urban. The prevalence of osteoporosis in urban and rural populations was 5.52% and 10.33%, respectively. In terms of gender, the prevalence of osteoporosis was 2.68% in males and 13.82% in females. For menopausal status, the prevalence of osteoporosis was 30.34% in postmenopausal females and 4.78% in premenopausal females. In urban populations, older age [adjusted odds ratio (AOR) = 2.36, 95%CI, 2.35-2.36), hypertension (AOR = 1.37, 95%CI, 1.36-1.37), unmarried (AOR = 4.04, 95%CI, 3.99-4.09), smoking everyday (AOR = 2.26, 95%CI, 2.23-2.28), family history of osteoporosis (AOR = 1.66, 95%CI, 1.65-1.67), dyslipidemia (AOR = 1.05, 95%CI, 1.04-1.05), and higher ß-crosslaps (ß-CTX) level (AOR = 1.02, 95%CI, 1.02-1.02) were associated with an increased risk of osteoporosis, while males (AOR = 0.04, 95%CI, 0.04-0.04), higher education level (AOR = 0.95, 95%CI, 0.95-0.95), and aquatic product intake (AOR = 0.99, 95%CI, 0.99-0.99) were related to decreased risk of osteoporosis. Similar results were also observed in rural populations, and (all P < 0.05). CONCLUSION: The prevalence of osteoporosis in rural populations was higher than that in urban populations, and the factors associated with the risk of osteoporosis were similar in urban and rural populations.

A Group-Based Community Reinforcement Approach of Cognitive Behavioral Therapy Program to Improve Self-Care Behavior of Patients With Type 2 Diabetes.

INTRODUCTION: This study evaluated a cognitive behavioral-based self-care intervention program on diabetes management in individuals with type 2 diabetes in Jiangsu Province, China. People with type 2 diabetes were recruited to a 6-month, prospective, intervention study. METHODS: The intervention group (n = 296) received an intensive cognitive behavioral-based self-care intervention, including group activities, frequent blood glucose monitoring, nutritional counseling, diabetes-specific meal and a weekly progress report. The control group (n = 110) received diabetes education, including diet and physical activity instruction only. Assessment data was obtained at baseline, and after 12 and/or 24 weeks of intervention. The intention to treat method was used to assess the effectiveness of the intervention program. RESULTS: The intervention group showed improved fasting blood glucose, HbA1c, systolic and diastolic blood pressures compared to the control group. The intervention group also had significantly improved knowledge and self-care behavior, and general health. CONCLUSION: This study demonstrates that significant improvement in glycemic control and markers of cardiovascular health can occur in Chinese people with type 2 diabetes following a CBT-based intervention program that includes diabetes education, frequent blood glucose monitoring and daily use of a diabetes-specific meal plan, suggesting CBT is beneficial to improve health outcome in patients with type 2 diabetes.

Depression among the general adult population in Jiangsu Province of China: prevalence, associated factors and impacts.

PURPOSE: This study aimed to assess the prevalence of depression and to investigate its associated factors and impacts on daily life functioning among the general adult population in Jiangsu Province of China. METHODS: As part of the Jiangsu Provincial Survey on Chronic Disease and Behavioural Risk Factors (2010), a sample of 8400 community residents aged ≥ 18 years were recruited. Study data were collected through a questionnaire-administered face-to-face interview. Depression was measured by the Patient Health Questionnaire. RESULTS: The estimated prevalence of depression was 0.56% (0.54% in men and 0.58% in women). Increased risk of depression was found to be associated with rural residents (OR 2.24, 95% CI 1.33-3.78) and the comorbidity of chronic diseases (OR 3.83, 95% CI 1.33-11.02). Respondents with depression reported an average of 11.75 unhealthy days caused by physical illnesses and 8.31 unhealthy days by mood problems within the previous 30 days. Depression was also found to be related to worse self-ranked health status, worse relationships with families and lower life satisfaction. CONCLUSIONS: A low prevalence of depression was found in this population of China, though it is not clear the extent to which it reflects issues related to the measurement and/or other factors of the survey. Depression was found to be related to poorer health and poorer life functioning. Further research into the link between depression and access to mental health services in rural areas is necessary. Meanwhile, depression among chronic disease patients should be addressed in clinical settings, health plans and resources allocation.

Age at menarche and age at natural menopause as predictors of glycemic control in type 2 diabetic patients.

OBJECTIVE: To investigate the influence of age at menarche (AM) and age at natural menopause (ANM) on glycemic control in patients with type 2 diabetes mellitus (T2DM). METHODS: A cross-sectional study was undertaken in Jiangsu, China. Logistic regression was used to evaluate the association between AM/ANM and glycemic control. RESULTS: 1195 (14.3%) premenopausal and 7149 (85.7%) postmenopausal women were included in this study. With the increase of AM per 1 year, patients had a low risk of uncontrolled FPG (≥7 mmol/L) and uncontrolled HbA1c (≥7%), as well as poor glycemic control (FPG ≥7 mmol/L and HbA1c ≥7%) after adjusting for age and BMI (model I, P < 0.05) with odds ratio (OR) 0.965, 0.978 and 0.962 respectively. Whereas after adjusting for age, BMI, education, duration of diabetes, smoking, drinking and antidiabetic treatment (model II) as well as further plus diabetic familial history and physical activity (model III), the association between AM and glycemic control was not significant (P > 0.05). Compared with premenopausal women, postmenopausal women had a low risk of uncontrolled FPG and uncontrolled HbA1c after adjusting for confounders in model II (P < 0.05). Furthermore, both patients with early ANM (<45 years) and late ANM (>55 years) had a high risk of uncontrolled HbA1c as well as poor glycemic control even adjusted for full confounders in model III (P < 0.05 for all). CONCLUSION: Early AM, early and late ANM were significantly associated with worse glycemic control. Ascertaining the AM and ANM in women with T2DM may help to identify the risk predisposed to worse glycemic control.

Familial History of Diabetes is Associated with Poor Glycaemic Control in Type 2 Diabetics: A Cross-sectional Study.

To investigate the association of familial history (FH) of diabetes with the glycaemic control status of patients with type 2 diabetes (T2D), a cross-sectional study using stratified cluster sampling was conducted with 20,340 diabetic patients in Jiangsu, China. In total, 21.3% of the subjects reported a FH of diabetes. Patients with a FH of diabetes showed a higher risk of poor glycaemic control (59.7%) than those without a diabetic FH (49.8%), with an odds ratio (OR) of 1.366 (P < 0.001). Glycaemic control status did not significantly differ between the T2D patients with parental FH and those with sibling FH. Compared with patients with paternal FH, patients with maternal FH had a higher risk of poor glycaemic control (OR = 1.611, P = 0.013). Stratified analyses showed that a FH of diabetes was significantly associated with poor glycaemic control among T2D patients with a low education level (P < 0.05). In the <60 years old, overweight, and low level of physical activity groups, patients with a maternal history of diabetes showed a higher risk of poor glycaemic control than those without a FH (P < 0.05). In conclusion, FH of diabetes, especially a maternal history, had an independently adverse effect on the glycaemic control of T2D patients.

Dinner fat intake and sleep duration and self-reported sleep parameters over five years: Findings from the Jiangsu Nutrition Study of Chinese adults.

OBJECTIVES: Cross-sectional studies have indicated an association between fat intake and short sleep. However, whether the association differs by meal occasions, and remains in the long term, is unknown. This study aimed to determine the association between meal specific macronutrients intake (by eating occasions) and persistent short sleep over 5 y. METHODS: Data from 1474 Chinese subjects from the Jiangsu Nutrition Study were analyzed. Two time points were examined (i.e., baseline in 2002 and follow-up in 2007). Meal specific food and macronutrients intake was assessed using three-day weighed food records. Sleep duration and sleep related symptoms (daytime sleepiness and falling asleep) were self-reported using a sleep questionnaire. Persistent short sleep was defined as <7 h/d in 2002 and ≤7 h/d in 2007. RESULTS: Overall, 7.4% of the participants reported persistent short sleep. Fluctuation of sleep duration over 5 y was observed with an increase in short-duration sleepers (<7 h) and a decrease in long-duration sleepers (9 h). The highest quartile of fat intake from dinner at baseline was associated with persistent short sleep over 5 y (odds ratio 3.30, 95% confidence interval 1.40-7.79, P for trend 0.003). The highest quartile of fat intake from breakfast at baseline was associated with less falling asleep during the day at follow up (odds ratio 0.36, 95% confidence interval 0.14-0.94, P for trend 0.006). Dinner fat intake at baseline was not associated with short sleep (<7 h) at follow up. CONCLUSION: The association between fat intake and sleep varies according to how late or how early in the day a meal is eaten by meal occasions. While a high-fat breakfast may prevent daytime falling asleep, a high-fat dinner is-in the case of the Chinese adults of our study-associated with persistent short sleep in Chinese adults.

[Relationship between central obesity and clustering of cardiovascular risk factors in adults of Jiangsu province].

OBJECTIVE: To explore the relationship between central obesity and cardiovascular risk factors and their clustering in adults of Jiangsu province. METHODS: Multi-stratified clustering sampling method was used to sample 8 400 residents aged 18 years and over from 14 diseases surveillance units in Jiangsu province from October to December 2010. Information was obtained with face-to-face interview, physical examination and laboratory testing. A total of 8 380 residents finished the study protocol and their data were analyzed. Central obesity was defined as waist circumference ≥ 85 cm in males or ≥ 80 cm in females. Following complex weighting of the samples, level and proportion of cardiovascular risk factors in group with different waist circumference were analyzed. RESULTS: The prevalence of central obesity among adults in Jiangsu province was 46.2%, the proportion of males and females was 46.4% and 46.1%, respectively (P > 0.05). The prevalence of center obesity varied significantly in residents with different age, area, education and occupation (all P < 0.01). The level of systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol and low density lipoprotein cholesterol was also significantly different in residents with different degree of waist circumference (all P < 0.01). The prevalence of hypertension, diabetes, dyslipidemia and clustering of cardiovascular risk factors increased in proportion to increasing waist circumference (all P < 0.05). Multivariate logistic regression analysis showed that the risk of hypertension, diabetes, dyslipidemia and clustering of cardiovascular risk factors was 2.2 (OR = 2.2, 95% CI: 2.0-2.4) and 4.7 (OR = 4.7, 95% CI: 3.9-5.7); 2.1 (OR = 2.1, 95% CI: 1.7-2.5) and 3.8 (OR = 3.8, 95% CI: 3.2-4.5); 2.3 (OR = 2.3, 95% CI: 1.8-2.9) and 4.1 (OR = 4.1, 95% CI: 3.2-5.3); 3.4 (OR = 3.4, 95% CI: 2.9-3.9) and 8.0 (OR = 8.0, 95% CI: 6.2-10.2) fold higher in residents with mild and severe central obesity than residents without central obesity. CONCLUSIONS: The extent of central obesity positively correlates with the prevalence of cardiovascular risk factors and their clustering in adults of Jiangsu province. Comprehensive interventions on obesity serve as an important tool to reduce the cardiovascular risk in adult Jiangshu residents.

[Evaluation on the status quo of self monitoring of blood glucose and self-efficacy of diabetes patients in community].

OBJECTIVE: To investigate the status quo and influence factors of self monitoring of blood glucose (SMBG) and self-efficacy of diabetes patients' that participated in community diabetes self management group. METHODS: Beijing, Shanghai, Chongqing, Jiangsu, Guangdong, and Zhejiang were selected as the study sites considering patients management experiences they had. 1 401 adult diabetes patients were recruited from communities via health records system screening, telephone notification, poster advertisement, letters invitation ways. Face to face questionnaire survey was applied to obtain patients' general information, diabetes history, diabetes knowledge awareness, SMBG, and self-efficacy information. Multiple linear regression was used to analyze the relationship between factors and self efficacy. RESULTS: There were 519 male patients (37.0%) and 882 female patients (63.0%) with an average age of (64.9 ± 8.9) years old. Patients lived in city accounted for 48.0% (672/1 401) and rural patients accounted for 52.0% (729/1 401). Patients who conducted SMBG accounted for 79.9% (1 120/1 401) and 33.3% (446/1 401) patients conducted blood glucose monitoring 1-3 times per month. Rural patients, primary school educated, and new rural cooperative medical system (NCMS) covered patients had a higher proportion of never conducting SMBG which were 21.9% (160/729), 24.2% (160/662), and 26.3% (125/475) , respectively. Scores of self-efficacy was (69.24 ± 16.30) (hundred-mark system) with a relative lower score in monitoring of blood glucose (64.09 ± 20.08) and foot care (63.63 ± 21.40), as well as a highest score in taking medicine and insulin injections (76.10 ± 22.00). Multiple regression analysis on self-efficacy and its related factors show a negative correlation between patients' place of residence and self-efficacy (ß' = -0.076) and a positive correlation between education and self-efficacy (ß' = 0.114) as well as between diabetes knowledge awareness and self-efficacy (ß' = 0.193)(t = -2.46, 3.71, 7.18, P < 0.05). CONCLUSION: Community diabetes patients had a low self-efficacy and it was even lower among low economic and education degree patients. The worst parts were SMBG and foot care. Place of residence, education, and diabetes knowledge awareness are factors that influence patients' self efficacy.

Association of dietary pattern and body weight with blood pressure in Jiangsu Province, China.

BACKGROUND: To identify risk factors, associations between dietary patterns, body mass index (BMI), and hypertension in a Chinese population. METHODS: Dietary intake was assessed in 2518 adults by a 3-day 24 h recall and a food frequency questionnaire. Salt and oil intake was assessed by weighing records. Four dietary patterns were identified using principal component analysis. Overweight and obesity was determined according to the Chinese cut-offs for BMI. High blood pressure was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Prevalence ratios (PR) were calculated using Poisson regression. RESULTS: Of the subjects, 26.7% had high blood pressure. Subjects with overweight and obesity were more likely to have high blood pressure than those with normal weight (PR, 95% CI: 1.60, 1.40-1.87; 2.45, 2.11-2.85, respectively). Subjects with a 'traditional' dietary pattern were more likely to have high blood pressure (P for trend = 0.001), whereas those with a 'macho' or 'sweet tooth' dietary pattern were less likely to have high blood pressure (P for trend = 0.004 and <0.001, respectively). More than half of the population had salt intakes > 9 g/d, and blood pressure increased with salt intake (P for trend <0.001). Subjects with a 'traditional' dietary pattern had the highest salt intake (12.3 g/d). CONCLUSION: A traditional dietary pattern is associated with high blood pressure among the population of Jiangsu Province, which may be mainly due to high salt intake. Moreover, high BMI is an important determinant of high blood pressure. Both issues need to be addressed by lifestyle interventions.

Anemia in relation to body mass index and waist circumference among Chinese women.

BACKGROUND: This study aimed to investigate the relationship of anemia and body mass index among adult women in Jiangsu Province, China. Data were collected in a sub-national cross-sectional survey, and 1,537 women aged 20 years and above were included in the analyses. Subjects were classified by body mass index (BMI) categories as underweight, normal weight, overweight and obese according to the Chinese standard. Central obesity was defined as a waist circumference ≥ 80 cm. Anemia was defined as hemoglobin concentration < 12 g/dl. Prevalence ratios (PRs) of the relationship between anemia and BMI or waist circumference were calculated using Poisson regression. FINDINGS: Overall, 31.1% of the Chinese women were anemic. The prevalence of overweight, obesity and central obesity was 34.2%, 5.8% and 36.2%, respectively. The obese group had the highest concentrations of hemoglobin compared with other BMI groups. After adjustment for confounders, overweight and obese women had a lower PR for anemia (PR: 0.72, 95% CI: 0.62-0.89; PR: 0.59, 95% CI: 0.43-0.79). Central obesity was inversely associated with anemia. CONCLUSION: In this Chinese population, women with overweight/obesity or central obesity were less likely to be anemic as compared to normal weight women. No measures are required currently to target anemia specifically for overweight and obese people in China.

Dietary patterns are associated with insulin resistance in Chinese adults without known diabetes.

The aim of the present study was to examine the association between dietary patterns and insulin resistance in Chinese adults without known diabetes. Study subjects were 1070 Chinese adults aged 18 years and above in Jiangsu Province who participated in the 2006 wave of the China Health and Nutrition Survey. Usual dietary intake was assessed by using a validated FFQ. Dietary patterns were identified by factor analysis using a principal component analysis method. Insulin resistance was defined as the highest quartile of the homeostasis model assessment of insulin resistance (HOMA-IR) scores. We derived four dietary patterns in our population by factor analysis: the Western, High-wheat, Traditional and Hedonic pattern. After adjusted for potential confounders, the Western pattern was significantly associated with greater odds for insulin resistance (P for trend = 0·009), while a significant negative association was found between the Hedonic pattern and insulin resistance (P for trend = 0·035). Compared with the lowest quartile of the Western pattern, the highest quartile had higher odds of insulin resistance (adjusted OR 1·89, 95 % CI 1·12, 3·19). There was a 42 % decrease in the odds after adjustment for all covariates in the highest quartile of the Hedonic pattern, compared with the lowest quartile (adjusted OR 0·58, 95 % CI 0·34, 0·99). HOMA-IR levels as a continuous variable also increased across the quartiles of the Western pattern and decreased across the quartiles of the Hedonic pattern. In conclusion, dietary patterns were significantly associated with insulin resistance in Chinese adults without known diabetes.

Monosodium glutamate intake, dietary patterns and asthma in Chinese adults.

OBJECTIVES: Emerging evidence shows that diet is related to asthma. The aim of this analysis was to investigate the association between monosodium glutamate (MSG) intake, overall dietary patterns and asthma. METHODS: Data from 1486 Chinese men and women who participated in the Jiangsu Nutrition Study (JIN) were analyzed. In this study, MSG intake and dietary patterns were quantitatively assessed in 2002. Information on asthma history was collected during followed-up in 2007. RESULTS: Of the sample, 1.4% reported ever having asthma. MSG intake was not positively associated with asthma. There was a significant positive association between 'traditional' (high loadings on rice, wheat flour, and vegetable) food pattern and asthma. No association between 'macho' (rich in meat and alcohol), 'sweet tooth' (high loadings on cake, milk, and yoghurt) 'vegetable rich' (high loadings on whole grain, fruit, and vegetable) food patterns and asthma was found. Smoking and overweight were not associated with asthma in the sample. CONCLUSION: While a 'Traditional' food pattern was positively associated with asthma among Chinese adults, there was no significant association between MSG intake and asthma.

Zinc biofortification of rice in China: a simulation of zinc intake with different dietary patterns.

A cross-sectional survey of 2819 adults aged 20 years and above was undertaken in 2002 in Jiangsu Province. Zinc intake was assessed using a consecutive 3-day 24-h dietary recall method. Insufficient and excess intake was determined according to the Chinese Dietary Recommended Intakes. Four distinct dietary patterns were identified namely "traditional", "macho", "sweet tooth", and "healthy". Intake of zinc from biofortified rice was simulated at an intermediate zinc concentration (2.7 mg/100 g) and a high zinc concentration (3.8 mg/100 g) in rice. Average total zinc intake was 12.0 ± 3.7 mg/day, and insufficiency of zinc intake was present in 15.4%. Simulated zinc intake from biofortified rice with intermediate and high zinc concentration decreased the prevalence of low zinc intake to 6.5% and 4.4%, respectively. The effect was most pronounced in the "traditional" pattern, with only 0.7% of insufficiency of zinc intake remaining in the highest quartile of the pattern. Zinc intake was inversely associated with the "sweet tooth" pattern. Zinc biofortifed rice improves dietary zinc intake and lowers risk for insufficient zinc intake, especially for subjects with a more "traditional" food pattern, but less for subjects with a "sweet tooth" food pattern.

Soft drink and sweet food consumption and suicidal behaviours among Chinese adolescents.

AIM: Greater soft drink consumption was associated with increased risk of mental health problems in Western countries. The objective of the study was to examine the association between soft drink and sweet food consumption and suicidal behaviours among adolescents in China. METHODS: In 2005, a population-based cross-sectional study was conducted in 100 schools in Jiangsu Province, China. Participants were aged 12-19 years old (n = 23,976). RESULTS: Among the participants, 20.5% reported daily soft drink consumption; 18.6% reported having suicidal ideation. Soft drink consumption was significantly and positively associated with risk of suicidal plan or suicide attempt. Prevalence of suicidal plan was 12.8% among those who consumed soft drink at least three times per day and 6.2% among those who did not consume any soft drinks. In multivariate analyses, compared with soft drink consumption less than once per day, consumption at least three times per day was associated with 80% increased risk for suicidal plan and more than 3.5-fold increased risk for suicide attempt. Of note, nonconsumption of soft drinks was also associated with about 32% elevated risk for suicidal plan and suicidal attempt. High frequency intake of sweet food was associated with increased risk of suicidal behaviours. CONCLUSIONS: There is a positive association between consumption of soft drinks and sweet food and risks for suicidal behaviours among adolescents in China. Prospective studies are warranted to confirm these findings.

Monosodium glutamate is related to a higher increase in blood pressure over 5 years: findings from the Jiangsu Nutrition Study of Chinese adults.

OBJECTIVE: One large cross-sectional study across four countries suggests that glutamate intake may be inversely associated with blood pressure (BP). The aim of this analysis was to investigate a possible association between monosodium glutamate (MSG) intake and change in blood pressure over 5 years. METHODS: Data from 1227 Chinese men and women who participated in the Jiangsu Nutrition Study (JIN) were analyzed. In this study, MSG intake and blood pressure were quantitatively assessed in 2002, and followed-up in 2007. RESULTS: MSG intake was associated with a significant increase in SBP and DBP. A strong sex interaction was observed in relation to SBP change. Women with high MSG intake were more likely to have increased SBP and DBP. Total glutamate intake was also positively associated with an increase in SBP. In those chronically taking antihypertensive medications, there was a strong association between MSG intake and an increase in DBP. CONCLUSION: MSG intake may have independent BP-increasing effects, especially among women and those taking hypertension medications at baseline and follow-up.

Reactions of Chinese adults to warning labels on cigarette packages: a survey in Jiangsu Province.

BACKGROUND: To compare reactions to warning labels presented on cigarette packages with a specific focus on whether the new Chinese warning labels are better than the old labels and international labels. METHODS: Participants aged 18 and over were recruited in two cities of Jiangsu Province in 2008, and 876 face-to-face interviews were completed. Participants were shown six types of warning labels found on cigarette packages. They comprised one old Chinese label, one new label used within the Chinese market, and one Chinese overseas label and three foreign brand labels. Participants were asked about the impact of the warning labels on: their knowledge of harm from smoking, giving cigarettes as a gift, and quitting smoking. RESULTS: Compared with the old Chinese label, a higher proportion of participants said the new label provided clear information on harm caused by smoking (31.2% vs 18.3%). Participants were less likely to give cigarettes with the new label on the package compared with the old label (25.2% vs 20.8%). These proportions were higher when compared to the international labels. Overall, 26.8% of participants would quit smoking based on information from the old label and 31.5% from the new label. When comparing the Chinese overseas label and other foreign labels to the new Chinese label with regard to providing knowledge of harm warning, impact of quitting smoking and giving cigarettes as a gift, the overseas labels were more effective. CONCLUSION: Both the old and the new Chinese warning label are not effective in this target population.

Monosodium glutamate is not associated with obesity or a greater prevalence of weight gain over 5 years: findings from the Jiangsu Nutrition Study of Chinese adults.

Animal studies and one large cross-sectional study of 752 healthy Chinese men and women suggest that monosodium glutamate (MSG) may be associated with overweight/obesity, and these findings raise public concern over the use of MSG as a flavour enhancer in many commercial foods. The aim of this analysis was to investigate a possible association between MSG intake and obesity, and determine whether a greater MSG intake is associated with a clinically significant weight gain over 5 years. Data from 1282 Chinese men and women who participated in the Jiangsu Nutrition Study were analysed. In the present study, MSG intake and body weight were quantitatively assessed in 2002 and followed up in 2007. MSG intake was not associated with significant weight gain after adjusting for age, sex, multiple lifestyle factors and energy intake. When total glutamate intake was added to the model, an inverse association between MSG intake and 5 % weight gain was found (P = 0.028), but when the model was adjusted for either rice intake or food patterns, this association was abolished. These findings indicate that when other food items or dietary patterns are accounted for, no association exists between MSG intake and weight gain.

[Study on the situation of seat belt wearing among drivers and front-seat passengers of vehicles in Nanjing in 2005-2007].

OBJECTIVE: To find out the situation of seat belt wearing among drivers and passengers in Nanjing after the National Road Traffic Safety Law and its Ordinance had been issued for 3 years, in Jiangsu province. METHODS: Situation on seat belt wearing among drivers and front passengers on four types of vehicles including taxi, cars (below 8 seats), vans and pickups was studied during different time blocks at 4 sites in the city. RESULTS: A total number of 35 256 vehicles, their drivers and another 15 772 passengers sitting in the front, were observed. The prevalence rates of seat belt wearing, not wearing and pretend wearing among drivers were 49.9%, 44.1%, and 4.6% respectively while among front-seat passengers were 9.1% and 90.9% respectively. There were significantly declining trends in seat belt wearing among both drivers and front-seat passengers during the 3-years of observation, after adjustment by sex, types of vehicles and other factors (P < 0.01). Risk of not wearing among front seat passengers was higher for those 'not-wearing' drivers (OR = 8.10, P < 0.01). CONCLUSION: Neither the current law nor ordinance in Jiangsu province gives detailed regulations on seat belt wearing, which hampers the effective enforcement.

Dietary intake of zinc in the population of Jiangsu Province, China.

OBJECTIVES: To evaluate dietary zinc and other divalent minerals intake among the population of Jiangsu Province. METHODS: 3,867 subjects aged 4-89 years were representatively sampled in two urban and six rural areas of Jiangsu Province. Dietary intake was assessed using 24-hour recalls on three consecutive days. Insufficient zinc intake was calculated based on the Chinese Dietary Reference Intakes. RESULTS: Overall, the percentage of subjects with insufficient intake of zinc was 22.9%, with a declining trend with age. Except for the group>or=50 years, mean zinc intake of all other groups were below the age- and sex- specific Recommended Nutrition Intakes (RNI). Approximately 2/3rds of the subjectsor=50 years (OR: 0.76, 95% CI: 0.66-0.8; OR:0.55, 95%CI: 0.47-0.64). Mean intake of iron, copper, magnesium and selenium met the Chinese DRIs respectively, except for selenium in females. The prevalence of insufficient intake of copper, magnesium and selenium was 37.2%, 22.8% and 29.3%, respectively, while the overall prevalence of insufficient iron intake was only 3.4%. CONCLUSION: Dietary zinc intake of the Jiangsu Province population does not generally meet the Chinese RNI. Children and adolescents in particular have a higher risk of insufficient zinc intake.