Does an antihypertensive diet cost more? Analysis from the Chinese Heart-Healthy diet trial.

OBJECTIVE: To determine whether the Chinese heart-healthy diet (Sichuan cuisine version) (CHH diet-SC) was more expensive than the conventional Sichuan diet and explore the food groups and nutrients that mainly affected the cost of CHH diet-SC. DESIGN: Cost analysis of 4-week intervention diets in the Sichuan center representing southwestern China in the CHH diet study. SETTING: A multicentre, parallel-group, single-blind, randomised feeding trial evaluating the efficacy of lowering blood pressure with the cuisine-based CHH diet. PARTICIPANTS: Totally, fifty-three participants with hypertension aged 25-75 years in the Sichuan center were randomised into the control group (n 26) or the CHH diet-SC group (n 27). RESULTS: The CHH diet-SC was more expensive than the control diet (¥27·87 ± 2·41 v. ¥25·18 ± 2·79 equals $3·90 ± 0·34 v. $3·52 ± 0·39, P < 0·001), and the incremental cost-effectiveness ratio for a 1-mm Hg systolic blood pressure reduction was ¥9·12 ($1·28). Intakes and the cost of seafood, dairy products, fruits, soybeans and nuts, whole grains and mixed beans were higher for the CHH diet-SC than for the control diet (P < 0·001). Intakes of vitamin B1, vitamin B6, vitamin C, Mg and phosphorus were positively correlated with the cost (P < 0·05). CONCLUSIONS: The CHH diet-SC costs more than the conventional Sichuan diet, partly due to the high cost of specific food groups. Positive correlations between the intakes of vitamin B1, vitamin B6, vitamin C, Mg, phosphorus and the dietary cost could be a direction to adjust the composition within the food groups to reduce the cost of the CHH diet-SC.

Effects of the Chinese heart-healthy diet (Sichuan cuisine) on lowering blood pressure in adults with hypertension: a randomized controlled feeding trial.

BACKGROUND AND OBJECTIVES: Sichuan cuisine is characterized by high salt and oil content. We aimed to evaluate the effects of the Sichuan cuisine version of Chinese heart-healthy diet (CHH diet-SC) on blood pressure reduction among hypertensive adults. METHODS AND STUDY DESIGN: The Chinese heart-healthy diet (CHH) trial was a multicenter randomized controlled feeding trial among Chinese hypertensive people. We conducted a secondary analysis of the CHH trial using data from the Sichuan center in Southwest China. Fifty-three people aged 25 to 75 years with a mean systolic blood pressure (SBP) between 130 and 159 mmHg were enrolled. Eligible participants underwent a 1-week run-in period with the typical local diet and were randomized 1:1 to consume the CHH diet-SC (n=27) or typical local diet (n=26) for the next 4-week. The primary outcome was the net change in SBP, the secondary outcomes included diastolic blood pressure (DBP), mean arterial pressure (MAP), and the rate of BP control. RESULTS: Compared with the control group, the CHH diet-SC decreased cooking salt, oil, and red meat content and increased inclusion of whole grains, fruits, seafood, low-fat dairy, soybean, and nuts; the SBP experienced reductions of 7.54, 8.60, 9.14, and 10.1 mmHg at the end of weeks 1 through 4; the DBP was reduced 4.01 mmHg at week 4; the MAP was significantly reduced 6.02 mmHg finally; and rate of BP control significantly increased (p<0.05). CONCLUSIONS: Adoption of the CHH diet-SC for 4 weeks can significantly reduce BP and increase the rate of BP control in hypertensive adults.

Effects of the Chinese Heart-Healthy Diet (Sichuan Cuisine Version) on the 10-year CVD risk and vascular age: a randomised controlled feeding trial.

Sichuan cuisine was previously fitted into the Chinese Heart-Healthy Diet (CHH) trial to verify the antihypertensive effect. Whether the modified Sichuan diet lessens cardiovascular disease (CVD) is not fully explored. We aimed to estimate the effects of the Sichuan version of CHH diet (CHH diet-SC) on the 10-year risk of CVD and vascular age. A single-blinded randomised controlled feeding trial was conducted. General CVD prediction model was used in manners of intention-to-treat and per-protocol set. After a 7-d run-in period, fifty-three participants with pre- and grade I hypertension from local communities were randomised and provided with either CHH diet-SC (n 27) or a control diet (n 26) for 4 weeks. Mean absolute and relative estimated CVD risks were reduced by 4·5 % and 27·9 % in the CHH diet-SC group, and the between-group relative risk reduction was 19·5 % (P < 0·001) using linear mixed-effects models. The sensitivity analysis with datasets and models showed consistent results, and pre-specified factors were not associated with the intervention effects. The vascular age of CHH-SC group was theoretically 4·4 years younger than that of the control group after intervention. Compared with a typical diet, adopting the CHH diet-SC over 1 month significantly reduced 10-year CVD risks and vascular ages among local adults with mild hypertension.

[Evaluation of calcium intake levels and sources among pregnant women in a Chengdu hospital in 2017].

OBJECTIVE: Investigate and evaluate the levels and sources of calcium intake of pregnant women in Chengdu during three trimesters. METHODS: Use the data of a cohort study in Chengdu in 2017. The healthy singleton pregnant women with 8-14 weeks of pregnancy in an obstetrical clinic of a maternal-and-child health care institution in Chengdu were selected as the object of the study. Data on maternal demographic characteristics and the use information of calcium supplements in the past month of each trimester were collected by questionnaire investigation. The dietary intakes data of pregnant women in each trimester was collected by the 3-day 24-hour dietary recall method. The dietary calcium intake and the contribution of calcium from different foods were calculated based on the Chinese Food Composition Table(2018). The total calcium intake was obtained by adding the dietary calcium and supplement calcium intake. The calcium intake was evaluated with reference to the Chinese Dietary Nutrient Reference Intakes(2013). RESULTS: Valid samples of 1653 cases in early pregnancy, 1024 cases in middle pregnancy and 1017 cases in late pregnancy were finally included. The median intake of total calcium was 523.3, 1280.5 and 1491.3 mg/d in three trimesters, respectively. The adequate rate of total calcium intake was 16.3%, 63.2% and 67.1%, the insufficient rate was 69.0%, 15.7% and 11.2%, the excess rate was 0.2%, 9.1% and 14.4%, respectively. The median intake of dietary calcium was 453.0, 613.0 and 723.0 mg/d in three trimesters respectively. The dietary calcium adequate rates were 7.1%, 9.7% and 16.2%, the dietary calcium deficiency rates were 82.0%, 75.0%, 62.6%, respectively. The main food sources of dietary calcium in each pregnancy were dairy foods, vegetables, tubers and grains. The contribution of dairy foods to the dietary calcium was 33.8%, 37.7% and 40.2%, respectively. The median intake of milk was 125.0, 235.3 and 250.0 g/d, respectively. Among all pregnant women, the calcium supplement use in three trimesters was 36.2%, 93.4% and 91.7%, respectively; the median intake of supplement calcium was 0.0, 625.0 and 750.0 mg/d, respectively. Among pregnant women who met the dietary calcium standard, the use of calcium supplements in the three trimesters was 38.1%, 95.0% and 94.5%, respectively; the median intake of supplemental calcium was 0.0, 725.0 and 750.0 mg/d, respectively. CONCLUSION: The insufficient and excessive total calcium intake coexisted among pregnant women in Chengdu, with the insufficient dietary calcium intake prominent in all trimesters. The use of calcium supplements was common in middle and late pregnancy.

Healthier diet associated with reduced risk of excessive gestational weight gain: A Chinese prospective cohort study.

Limited studies have examined the associations between diet quality and gestational weight gain (GWG) among Chinese pregnant women, adopting Chinese GWG guidelines. We prospectively investigate the associations of diet quality, using the Chinese Healthy Diet Index for Pregnancy (CHDI-P), which assessed diet quality from 'Diversity', 'Adequacy' and 'Limitation' dimensions with overall 100 points, with GWG among participants enroled in Southwest China. Food consumption was collected by 24 h dietary recalls for three consecutive days and CHDI-P scores were divided into tertiles. GWG was calculated according to the weight measured before delivery and classified into adequate weight gain (AWG), insufficient weight gain (IWG) and excessive weight gain(EWG) following Chinese GWG guidelines. Multinomial regression analyses and stratified analyses by pre-pregnancy body mass index were performed to estimate the association between CHDI-P and GWG. A total of 1416 participants were recruited in early pregnancy, and 971 and 997 participants were respectively followed up in middle and late pregnancy. The mean CHDI-P score was 56.44 ± 6.74, 57.07 ± 7.44 and 57.38 ± 7.94 points in early, middle and late pregnancy, respectively. Women in the lowest CHDI-P scores group had an increased risk of EWG in middle (OR = 1.53, 95% confidence interval [CI] = 1.08-2.17) and late pregnancy (OR = 1.71, 95% CI = 1.21-2.41) than women in the highest group, while overweight/obese women had a greater risk of EWG in late pregnancy (OR = 4.25, 95% CI = 1.30-13.90). No association was found between the CHDI-P scores and IWG. Poor diet quality in middle and late pregnancy was associated with a higher risk of EWG.

Dietary fat quantity and quality in early pregnancy and risk of gestational diabetes mellitus in Chinese women: a prospective cohort study.

We aimed to examine the association between the quantity and quality of dietary fat in early pregnancy and gestational diabetes mellitus (GDM) risk. In total, 1477 singleton pregnant women were included from Sichuan Provincial Hospital for Women and Children, Southwest China. Dietary information was collected by a 3-d 24-h dietary recall. GDM was diagnosed based on the results of a 75-g, 2-h oral glucose tolerance test at 24-28 gestational weeks. Log-binomial models were used to estimate relative risks (RR) and 95% CI. The results showed that total fat intake was positively associated with GDM risk (Q4 v. Q1: RR = 1·40; 95 % CI 1·11, 1·76; Ptrend = 0·001). This association was also observed for the intakes of animal fat and vegetable fat. After stratified by total fat intake (< 30 %E v. ≥ 30 %E), the higher animal fat intake was associated with higher GDM risk in the high-fat group, but the moderate animal fat intake was associated with reduced risk of GDM (T2 v. T1: RR = 0·65; 95 % CI 0·45, 0·96) in the normal-fat group. Vegetable fat intake was positively associated with GDM risk in the high-fat group but not in the normal-fat group. No association between fatty acids intakes and GDM risk was found. In conclusion, total fat, animal and vegetable fat intakes were positively associated with GDM risk, respectively. Whereas when total fat intake was not excessive, higher intakes of animal and vegetable fat were likely irrelevant with increased GDM risk, even the moderate animal fat intake could be linked to lower GDM risk.

[Intakes and sources of fat and fatty acids among pregnant women in Chengdu in 2017: a longitudinal study].

OBJECTIVE: To analyze the intake of fat and fatty acids and their food sources of pregnant women in Chengdu. METHODS: Participants were from a cohort study in 2017, which was conducted among 1652 healthy singleton pregnant women within 6-14 weeks of gestation in a maternity out-patient clinic of maternal-and-child health care institution in Chengdu, Sichuan Province. Data on maternal demographic characteristics was collected by questionnaire. In three trimesters, 3-day 24-hour dietary recall method was applied to collect dietary intakes data, with the information of docosahexaenoic acid(DHA) supplement intake being collected by questionnaire. The intakes and sources of daily fat and fatty acids in three trimesters were calculated using the National Nutrient Database of USDA and China Food Composition Tables(6th edition). The intake levels of fat and fatty acids were evaluated according to 2013 Chinese Dietary Reference Intakes. RESULTS: The study showed that the intakes of total fat and fatty acids increased during pregnancy. The mean intake of total daily fat was 64.8 g/d, 81.2 g/d, 88.5 g/d in three trimesters, respectively. The proportion of energy from total fat >30%E during three trimesters were 67.7%, 77.6%, 82.9%, respectively. The proportions of energy from saturated fatty acids(SFA) were 7.9%E, 8.9%E, 9.7%E, and those higher than 10%E were 20.9%, 31.9%, 44.7% in three trimesters, respectively. The proportions of energy from monounsaturated fatty acids(MUFA) were 12.9%E, 13.5%E, 14.2%E, and the proportions of energy from polyunsaturated fatty acids(PUFA) were 8.5%E, 8.4%E, 8.8%E in three trimesters, respectively. The proportion of DHA intake meeting recommendation(200 mg/d) in three trimesters were 3.6%, 21.7%, 21.1%, respectively. The radio of SFA, MUFA and PUFA(S∶M∶P) was 1∶1.6∶1.1 in the early trimester, and S∶M∶P was 1∶1.5∶1 in the second trimester and third trimester. Total fat and MUFA mainly came from edible oil and meat, and PUFA mainly came from edible oil and nuts. SFA mainly came from meat and milk, and the contribution of milk to SFA increased during pregnancy. CONCLUSION: The excessive intakes of total fat and SFA and the inadequate intake of DHA among pregnant women in Chengdu deserve attention.

Detection and Genetic Characterization of Atypical Porcine Pestivirus in Piglets With Congenital Tremors in Southern China.

Atypical porcine pestivirus (APPV) is an RNA virus newly discovered from swine in Asia, Europe, and the Americas. This novel virus has been confirmed as the cause of congenital tremor (CT) in piglets, which causes extensive economic losses to the swine industry. To investigate the genetic diversity and evolutionary relationship of APPV in China, 83 piglet samples with severe CT clinical signs were obtained from 12 commercial swine farms in 3 provinces of Southern China. RT-PCR revealed that the positive rates of APPV were as high as 100% (12/12) for the swine farms and 90.4% (75/83) for the samples. Subsequently, 21 positive samples and 3 positive samples were selected for partial E2 gene and complete polyprotein gene sequencing, respectively. Phylogenetic analysis showed that 62.5% of the sequences belonged to a novel APPV clade provisionally named genotype 3, which showed 81.0-82.1% sequence identity to genotypes 1 and 2. Amino acid sequence alignment showed that E2 protein of genotype 3 has three specific mutation sites, namely I19V, Y82F, and N107G. The results of the present study demonstrate that a novel APPV subgenotype, which is widely distributed in severe CT clinical samples in Southern China, was genetically diverse. We advocate for the inclusion of genotype 3 during revision of the APPV typing method.

Complete Genome Sequence of Senecavirus A Strain SVV HN16 Identified in China.

A virus that caused blisters and ulcers in pigs in China was detected to be a strain of Senecavirus A (SVA). Complete genome sequencing and analysis results showed that the isolate shares 93.8% to 99.1% identity with other isolates that have been reported, proving that a new isolate of SVA was found in China.

Complete Genome Sequence of a Very Virulent Porcine Epidemic Diarrhea Virus Strain, CH/GDGZ/2012, Isolated in Southern China.

The classical symptoms of porcine epidemic diarrhea (PED) are acute diarrhea and dehydration. The isolated porcine epidemic diarrhea virus (PEDV) CH/GDGZ/2012 strain was obtained from the feces of diseased pigs in 2012 in southern China. We report the complete genome sequence of strain CH/GDGZ/2012, which might be useful for better understanding the molecular characteristics of this virus.

swIFN-ß promotes genetic mutation of porcine reproductive and respiratory syndrome virus in Marc-145.

This result, for the first time, demonstrates that under swine interferon-ß (swIFN-ß) immune pressure molecular variation of porcine reproductive and respiratory syndrome virus (PRRSV) accelerates. PRRSV-A1 strain was continuously propagated in Marc-145 cells primed with swIFN-ß for 20 passages to develop RRRSV-A1ßf20 strains while PRRSV-A1f20 was control without swIFN-ß respectively. NSP2, ORF3, ORF5 and ORF6 genes of these strains were amplified, cloned and sequenced. Sequencing analysis indicated that PRRSV-A1ßf20 had 43 nucleotide mutations while PRRSV-A1f20 had only 14 in NSP2, ORF3, ORF5 and ORF6. The ratio of mutative nucleotides between them was 307%. Amino acid variations were 24 in RRRSV-A1ßf20 and 5 in PRRSV-A1, so that mutation in RRRSV-A1ßf20 appeared to be 4.8 times faster than that in PRRSV-A1. The ratio of non-synonymous (NS) mutations to synonymous (S) mutations, named NS/S, was 3 in RRRSV-A1ßf20 and 0.625 in PRRSV-A1f20. The nucleotide mutation rate of NSP2 ORF3 ORF5 and ORF6 of PRRSV-A1ßf20 were 3.8%, 2.3%, 4.5%, 0.57% and their NS/S were 5, 2, 6 and 1 respectively, which is much higher than those in PRRSV-A1f20. Thus the mutative frequency of PRRSV passaged under swIFN-ß immune pressure was significantly faster than that without swIFN-ß. The immuno-pressure of swIFN-ß accelerated genetic variation on PRRSV ORF5, NSP2 and ORF3, but not on the ORF6 gene. PRRSV NSP2 and ORF5 genes may play a key role in escaping from inhibition of swIFN-ß.

Genomic comparison of foot-and-mouth disease virus R strain and its chick-passaged attenuated strain.

The present study examined the genomic differences between foot-and-mouth disease virus (FMDV) R strain and its attenuated, chick-passaged (R(304)) strain. Eleven pairs of primers were used to amplify the complete genome of FMDV R and R(304) by RT-PCR. Each fragment was cloned into pMD18-T vector and sequenced. Nucleotide analyses showed that the genome encoding regions of R and R(304) strains open reading frame (ORF) were both 6966 nucleotides (nt) in length, encoding 2322 amino acids. One hundred and ten nucleotides or 32 amino acids were found to be mutated most frequently were in the 3A gene. The next highest rates of mutation were observed in the LP and 1D genes. No mutations were found in either the 2A or 2C genes. The length of 5'IRES region and 3'UTR were 450 nt and 94 nt, respectively. The 5'IRES region and 3'UTR had only 4 nt and 3 nt mutation, respectively after attenuation. The R(304) poly(A) tail length of 18 nt, while that of the R strain was 30 nt. This result demonstrated the primary genomic changes of a FMDV and its attenuated strain, which has important implications in understanding the molecular epidemiology and functional genomics of FMDV.