Exploring the complex dynamics of BMI, age, and physiological indicators in early adolescents.

BACKGROUND AND OBJECTIVES: To investigate the relationship between body mass index (BMI) and blood biochemical indicators in early adolescence, and to provide ideas for early prevention of diseases and explore possible disease-related predictors. METHODS: 3125 participants aged 10 ∼ 14 years were selected from China from the survey of "China Nutrition and Health Surveillance ( 2016 ∼ 2017 ) ". Employing advanced statistical methods, including generalized linear models, heatmaps, hierarchical clustering, and generalized additive models, the study delved into the associations between BMI and various biochemical indicators. RESULTS: In early adolescence, indicators including systolic pressure, diastolic pressure, weight, height, BMI, hemoglobin, blood uric acid, serum creatinine, albumin, vitamin A presented increasing trends with the increase of age ( P < 0.05 ), whereas LDL-C, vitamin D, and ferritin showed decreasing trends with the increase of age ( P < 0.05 ). The increase in hemoglobin and blood uric acid levels with age was more pronounced in males compared to females ( P < 0.05 ). BMI was positively correlated with blood glucose, hemoglobin, triglyceride, LDL-C, blood uric acid, serum creatinine, ferritin, transferrin receptor, hs-CRP, total protein, vitamin A ( P < 0.05 ). There was a significant BMI × age interaction in the correlation analysis with LDL-C, transferrin receptor, serum creatinine, and hs-CRP ( P < 0.05 ). BMI was a risk factor for hypertension, hypertriglyceridemia, low high density lipoprotein cholesterolemia, and metabolic syndrome in all age groups ( OR > 1, P < 0.05 ). CONCLUSIONS: High BMI was a risk factor for hypertension, hypertriglyceridemia, low high density lipoprotein cholesterolemia, and MetS in early adolescents. With the focus on energy intake beginning in early adolescence, the maintenance of a healthy weight warrants greater attention.

Dietary branched-chain amino acids intake and new-onset hypertension: a nationwide prospective cohort study in China.

OBJECTIVE: This study aimed to investigate the relationship between dietary branched-chain amino acids (BCAAs) and the risk of developing hypertension. METHODS: A cohort study of 14,883 Chinese adults without hypertension at baseline with were followed for an average of 8.9 years. Dietary intakes of BCAAs, including Ile, Leu, and Val, were collected using 3-day 24-h meal recall and household condiment weighing. Cox proportional hazards regression, restricted cubic splines, interaction analysis, and sensitivity analysis were used to assess the relationship between dietary BCAAs and risk of developing self-reported hypertension, adjusting for age, gender, region, body mass index (BMI), smoking and drinking status, physical activity, energy intake, salt intake. RESULTS: Among 14,883 study subjects, 6386(42.9%) subjects aged ≥ 45 years at baseline, 2692 (18.1%) had new-onset hypertension during the study period, with a median age of 56 years. High levels of dietary BCAAs were associated with an increased risk of new-onset hypertension. Compared with the 41st-60th percentile, multivariable adjusted hazard ratio (HR) for new-onset hypertension was 1.16 (95% CI 1.01-1.32) for dietary BCAAs 61st-80th percentiles, 1.30 (1.13-1.50) for 81st-95th, 1.60 (1.32-1.95) for 96th-100th. The cut-off value of new-onset hypertension risk, total BCAAs, Ile, Leu, and Val were 15.7 g/day, 4.1 g/day, 6.9 g/day, 4.6 g/day, respectively, and the proportion of the population above these intake values were 13.9%, 13.1%, 15.4%, and 14.4%, respectively. Age, BMI, and salt intake had an interactive effect on this relationship (P < 0.001). CONCLUSION: There was a significant positive association between total dietary BCAAs, Ile, Leu, Val intake and the risk of developing hypertension, after adjustment for confounders. This relationship was influenced by age, BMI, and salt intake. Further research is needed to clarify the mechanism and potential role of BCAAs in the pathogenesis of hypertension.

Short sleep time may be the main reason for irregular breakfast to cause overweight-a cross-sectional study.

Introduction: In recent years, the relationship between circadian rhythm and overweight and obesity has attracted the attention of many scholars. Methods: To evaluate association between the duration of sleep and the regularity of breakfast and overweight. A total of 1,178 students from Qingdao University were selected by stratified cluster sampling. There were 601 males (24.69 ± 0.80 years old) and 569 females (24.54 ± 0.70 years old). We used body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) to define overweight levels. Chi-square test, Pearson correlation test, and logistic regression were applied to test association among overweight, sleep duration, sleep onset time, and breakfast regularity. Pittsburgh sleep quality index was used to assess the overall sleep quality of the study subjects. Mediation effect and Sobel test were used to analyze the effect of sleep duration on breakfast regularity and overweight. Results: Only 34.1% of the population ate breakfast every day, and eating breakfast 1-3 times per week was associated with a higher risk of overweight (BMI: OR = 2.183, 95%CI: 1.369,3,481; WC: OR = 2.101, 95%CI: 1.232,3,583; WHR: OR = 2.108, 95%CI: 1.331,3,337). The effects of all types of Usual Breakfast Consumption Frequency on overweight were fully mediated by sleep duration (p < 0.05). In particular, the subjects exercised outdoors more than five times per week slept longer (p < 0.05). Conclusion: Short sleep duration may be the main reason for irregular breakfast leading to overweight. Adequate outdoor exercise is essential for weight maintenance.

The dynamic nexus: exploring the interplay of BMI before, during, and after pregnancy with Metabolic Syndrome (MetS) risk in Chinese lactating women.

BACKGROUND AND AIM: The health implications of BMI and MetS in lactating women are significant. This study aims to investigate the relationship between risk of Mets in lactation and BMI in four stages: pre-pregnancy, prenatal period, 42 days postpartum, and current lactation. METHODS AND RESULTS: A total of 1870 Lactating Women within 2 years after delivery were included from "China Child and Lactating Mother Nutrition Health Surveillance (2016-2017)". Logistic regression model and Restricted cubic spline (RCS) were used to estimate the relationship between BMI and risk of MetS. ROC analysis was used to determine the threshold for the risk of MetS. Chain mediating effect analysis was used to verify the mediating effect. BMI of MetS group in all stages were higher than non-MetS group (P < 0.0001). There were significant positive correlations between BMI in each stage and ORs of MetS during lactation (P < 0.05). The best cut-off values for BMI in the four stages were 23.47, 30.49, 26.04 and 25.47 kg/m2. The non-linear spline test at BMI in 42 days postpartum, current and MetS in lactation was statistically significant (P non-linear = 0.0223, 0.0003). The mediation effect of all chains have to work through lactation BMI. The total indirect effect accounted for 80.95% of the total effect. CONCLUSIONS: The risk of MetS in lactating women is due to a high BMI base before pregnancy and postpartum. High BMI in all stages of pregnancy and postpartum were risk factors for MetS in lactation. BMI during lactation plays a key role in the risk of MetS.

[Status of dietary energy and consumption of food among Chinese diabetics aged 45 years and above in 2015].

OBJECTIVE: To investigate the macronutrient and food intake of diabetics aged 45 years and above in China. METHODS: The research data was based on the China Adult Chronic Disease and Nutrition Surveillance in 2015. The dietary nutrition status of diabetics living in community was investigated by questionnaire, condiments weighing and 3 days-24 hours dietary questionnaire. Assessment was compared with the recommended amount of macronutrient energy supply ratio in The guideline for the prevention and treatment of type 2 diabetes mellitus in China(2020 edition). The macronutrient energy supply ratio of patients with different types of diabetes was evaluated and their food intake was statistically analyzed. RESULTS: The median of daily intake of total energy, protein, fat and carbohydrate were 1585 kcal, 50.1 g, 62.4 g and 200.1 g, respectively. The energy ratios of protein, fat and carbohydrate were 12.6%, 36.3% and 52.1%, respectively. In diabetics, the proportion of protein, fat and carbohydrate energy ratios that meet the recommendations in The guideline for the prevention and treatment of type 2 diabetes mellitus in China(2020 edition) were 20.5%, 21.7% and 40.4%, respectively. CONCLUSION: There is an unreasonable macronutrient energy ratio in the diet of diabetic over 45 years old in China, which mainly shows that the proportion of protein energy supply ratio in most diabetics is low, and the proportion of fat energy ratio exceeds the standard is high.

[Dietary consumption of branched-chain amino acids among Chinese middle-aged and elderly population aged 50 and over in 2015].

OBJECTIVE: To investigate the dietary consumption of branched-chain amino acids(BCAAs)intake status of middle-aged and elderly people 50 years and older in China, and to analyze the distribution differences between different ages, genders and regions. METHODS: The research sample was derived from the 2015 Chinese adult chronic disease and nutrition monitoring data. The survey adopts the stratified multi-stage cluster random sampling method, and selects 298 monitoring points from 31 provinces(autonomous regions and municipalities), a total of 44 218 people aged 50 years and over were sampled. Condiment weighing method, 24-hour dietary review method, and weighing method were used to obtain individual dietary data, and the dietary BCAAs intake of middle-aged and elderly people was calculated based on the Chinese Food Composition Table. RESULTS: In 2015, the dietary BCAAs of middle-aged and elderly people in China accounted for 45.1% of leucine, 29.8% of valine and 25.1% of isoleucine. The top six dietary sources were cereals, red meat, vegetables, fish and seafood, beans and eggs. There were differences in the intake of three branched-chain amino acids(F=1926.67, P<0.01), the intake of leucine was greater than that of valine, and the intake of valine was greater than isoleucine. There were statistically significant differences in dietary BCAAs intake between different age groups, genders, urban and rural areas and regions(P<0.01), among which men were greater than women(t=12.89, P<0.01), and the south was greater than the north(t=-6.36, P<0.01), the eastern part was larger than the central part, and the central part was larger than the western part(F=82.42, P<0.01). The intake of BCAAs decreased with the increase of age groups(F=22.69, P<0.01), and there was no significant difference in age groups over 70 years old. The dietary intake of BCAAs was higher in the eastern coastal areas and Inner Mongolia, Xinjiang and Tibet. CONCLUSION: There were gender, age and geographical differences in dietary BCAAs intake among middle-aged and elderly people in China, and the contribution of various foods to dietary BCAAs was also different.

Association between dietary approaches to stop hypertension (DASH) diet and hyperuricemia among Chinese adults: findings from a nationwide representative study.

BACKGROUND: Certain foods and food groups could positively or negatively impact serum uric acid (SUA) levels. However, evidence on the holistic dietary strategy to prevent and control hyperuricemia (HUA) development remains limited. OBJECTIVE: The aim of this research work was to explore the association of dietary approaches to stop hypertension (DASH) diet with SUA levels and odds of HUA among Chinese adults. METHODS: This research premise included 66,427 Chinese adults aged 18 and above who were part of the China Adult Chronic Disease and Nutrition Surveillance in 2015. Dietary consumptions were assessed via the household condiment weighing approach and a three-day, 24-hour dietary recall. Total fat, saturated fat, calcium, protein, potassium, cholesterol, magnesium, fiber, and sodium were all adopted to calculate the DASH score (score range, 0-9). The associations of DASH score with SUA levels and odds of HUA were evaluated using multiple linear and logistic regression models, respectively. RESULTS: We established that a higher DASH score was linked with a lower SUA levels (ß = - 0.11; 95% CI: - 0.12, - 0.1; p < 0.001) and odds of HUA (OR = 0.85; 95% CI: 0.83, 0.87; p < 0.001) after adjustment for age, sex, ethnicity, education status, marital status, health behaviours and health factors. The association of the DASH diet with odds of HUA was stronger among men (p-interaction = 0.009), non-Han Chinese (p-interaction< 0.001) as well as rural residents (p-interaction< 0.001). CONCLUSIONS: Our results illustrate that the DASH diet was remarkably negatively with SUA levels and odds of HUA in the Chinese adult population.

Exposure assessment of aflatoxins and zearalenone in edible vegetable oils in Shandong, China: health risks posed by mycotoxin immunotoxicity and reproductive toxicity in children.

Human exposure to aflatoxins (AFs) and zearalenone (ZEA) has not been sufficiently investigated. Here, we analyzed the exposure level and health risks posed by AFs (B1, B2, G1, G2) and ZEA through cooking oil consumption in Shandong, China. The individual daily consumption of cooking oil was calculated through 2745 questionnaires during 2017-2019. The average contamination levels of mycotoxins were estimated by examining 60 cooking oil samples. For the peanut oil, AFs ranged from <0.2 to 274 µg/kg, with a positive rate of 66.6% (20/30). Average levels of 36.62 µg/kg AFB1 and 44.43 µg/kg total AFs were found. Over-the-limit level (20 µg/kg) of AFB1 was detected in 8/30 samples. Estimated daily intake (EDI) and margin of exposure (MOE) for age-stratified population groups showed that children are facing highest adverse health risk with AFB1 (MOE 5.88-6.39). The liver cancer incidences attributable to AFB1 exposure are non-negligible as 0.896, 0.825, and 0.767 cases per 100,000 for 6-14 age group, 15-17 age group, and adult labor-intensive workers. Over-the-limit level (60 µg/kg) ZEA contamination was detected in 25/30 corn oil samples with a 50th percentile value of 97.95 µg/kg. Our health risk assessment suggested significant health risks of enterohepatic (inflammation and cancer), reproductive, and endocrine systems posed by AFs and ZEA. However, the health risk of immunotoxicity is unclear because currently animal study data are not available for the immunotoxicity induced after long-term exposure. In general, the health risks posed by mycotoxins are non-negligible and long-term mycotoxin surveillance is necessary.

Geographical Distribution of Dietary Patterns and Their Association with T2DM in Chinese Adults Aged 45 y and Above: A Nationwide Cross-Sectional Study.

BACKGROUND: This study aimed to investigate the geographical distribution of dietary patterns and their association with T2DM among Chinese adults aged 45 years and above. METHODS: Data was from the China Adults Chronic Diseases and Nutrition Surveillance (2015). Dietary intake for each participant was determined through a combination of 3-day 24-h dietary recall interviews and food frequency questionnaires. Principal component analysis was used to extract dietary patterns and spatial analysis was employed to investigate the geographic distribution of them. T2DM was diagnosed using criteria of ADA 2018, and binary logistic regression was employed to examine the relationship between dietary patterns and T2DM. RESULTS: A total of 36,648 participants were included in the study; 10.9% of them were diagnosed as T2DM. Three dietary patterns were identified with the name of plant-based pattern, animal-based pattern, and oriental traditional pattern, which were represented located in northern, northwest, and southern regions, respectively. After adjusting for potential confounders, participants in the highest quartile of the plant-based pattern were associated with lower T2DM odds (OR = 0.82, 95% CI: 0.74, 0.90) when comparing with the lowest quartile. However, participants inclined to higher quartiles of animal-based pattern had a higher risk of T2DM (OR = 1.15, 95% CI: 1.04, 1.27) compared with those in the lower quartiles. No significant association was found between the oriental traditional pattern and T2DM (OR = 1.03, 95% CI: 0.93, 1.14). CONCLUSION: Dietary patterns of Chinese population revealed geographical disparities, with plant-based dietary pattern showing protective effects and animal-based pattern carrying high risks for T2DM. Regional dietary variations and food environment are paramount in T2DM prevention and management.

The Effect of BMI on Blood Lipids and Dyslipidemia in Lactating Women.

Background: This study aimed to explore the correlation between body mass index (BMI) and dyslipidemia and the optimal cut-off point for BMI to distinguish the risk of dyslipidemia in lactating women. Methods: A total of 2295 lactating women subjects were included in this study, all within 2 years postpartum. All samples were from "China Children and Lactating Mothers Nutritional Health Surveillance (2016−2017)". BMI, blood lipids, demographic information, lifestyle habits, and other serum indicators were obtained in this survey. Generalized linear model, logistic regression, restricted cubic spline (RCS) and ROC curve analysis were used to evaluate the relationship among BMI, blood lipids, and dyslipidemia. Results: BMI in lactating women was positively correlated with total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), but negatively correlated with high-density lipoproteincholesterol (HDL-C) (p < 0.05). Higher BMI in lactating women was associated with higher ORs of dyslipidemia (hypercholesterolemia, hypertriglyceridemia, high-LDL-cholesterolemia, low HDL-cholesterolemia) (p < 0.05). These associations were stable across age groups, breastfeeding child age (months), parity, physical activity level, fasting plasma glucose (FPG), and hemoglobin. These factors did not interact with this relationship (p > 0.05). The optimal cut-off point for BMI was 24.85 kg/m2 determined by using ROC analysis, which can distinguish the risk of dyslipidemia. Conclusions: BMI was positively correlated with risk of dyslipidemia. Maintaining an ideal weight may prevent dyslipidemia in lactating women, and BMI is recommended to be controlled below 24.85 kg/m2.

Sugar Is the Key Cause of Overweight/Obesity in Sugar-Sweetened Beverages (SSB).

To evaluate association between overweight/obesity and sugar-sweetened beverages (SSB) types, SSB sugar, among children and adolescents. A total of 1,068 children and 751 adolescents were identified from a provincial survey conducted in Shandong, China. χ2 tests, logistic regression, restricted cubic spline (RCS), mediation analysis, pathway analysis, and ordinary least square (OLS) regression were applied to test association among overweight/obesity, SSB sugar, SSB types, and a set of factors. The mean daily SSB intake for children and adolescents was 210.7 and 208 ml, respectively. The threshold of SSB sugar consumption causing overweight/obesity was around 25 g/day and verified by RCS based on logistic regression. Approximately, 44.8% of the study subjects consumed more than 25 g/day of SSB sugar. SSB sugar intake above 25 g/day resulted in higher risk of overweight/obesity (OR = 1.391, 95% CI, 1.115-1.734). The effects of all types of SSBs on overweight/obesity were fully mediated by SSB sugar (p < 0.05), except for milk. Consumption of any types of SSBs had a positive impact on SSB sugar intake in both children and adolescents. Any type of SSB intake was a risk factor in excessive intake of SSB sugar (OR > 1, p < 0.05). In particular, milk powder, tea, and tea-flavored drinks, and carbonated have greater ORs for excessive intake of SSB sugar (OR = 76.08, 8.879, 4.355, p < 0.05, respectively). It was found that the effect of SSB on overweight/obesity was mediated by the intake of SSB sugar, and the effects of various SSBs were different according to multiple linear regression and pathway analysis (p < 0.05, respectively).

The Dietary Branched-Chain Amino Acids Transition and Risk of Type 2 Diabetes Among Chinese Adults From 1997 to 2015: Based on Seven Cross-Sectional Studies and a Prospective Cohort Study.

Background: The situation is grim for the prevention and control of type 2 diabetes (T2D) and prediabetes in China. Serum and dietary branched-chain amino acids (BCAAs) were risk factors for T2D. However, there is a lack of information on trends in consumption of BCAAs and the risk of T2D associated with BCAAs intake, based on nationally representative data in China. Thus, we aimed to comprehensively describe the dietary BCAAs transition and risk of T2D, at a national level among Chinese adults from 1997 to 2015. Methods: The data sources were the China Health and Nutrition Survey (CHNS) and China Nutrition and Health Survey (CNHS). Cross-sectional data on intake were obtained from CHNS (1997, n = 9,404), CHNS (2000, n = 10,291), CHNS (2004, n = 9,682), CHNS (2006, n = 9,553), CHNS (2009, n = 9,811), CHNS (2011, n = 12,686) and CNHS (2015, n = 71,695). Prospective cohort data were obtained CHNS (1997-2015, n = 15,508). Results: From 1997 to 2015, there was a significant decreasing trend in the BCAAs intake of Chinese adults in all subgroups (P < 0.0001) except for Leu in 80 or older, and a decreasing trend in the consumption of BCAAs after 40 years old (P < 0.05). The mean intake of BCAAs in the population of cohort study was 11.83 ± 3.77g/day. The 95% CI was above the HR of 1.0, when the consumptions were higher than 14.01, 3.75, 6.07, 4.21 g/day in BCAAs, Ile, Leu and Val, based on RCS curves. According to the Cox proportional hazards models, Compared with individuals with BCAAs consumption of 10.65-12.37 g/day, the multivariable-adjusted HR for diabetes was 2.26 (95% CI 1.45 to 3.51) for individuals with consumption of BCAAs more than 18.52 g/day. A statistically significant positive association between BCAAs intake and risk of T2D was observed in males or participants aged 45 years and older, but not in females or participants younger than 45 years. Conclusion: Our results reveal a trend toward decreased BCAAs intake in Chinese from 1997 to 2015. After 40 years of age, consumption of BCAAs declined with increasing age. Higher BCAAs intake was associated with higher risk of T2D. This relationship is more stable among men and middle-aged and elderly people.

Dietary Branched-Chain Amino Acids (BCAAs) and Risk of Dyslipidemia in a Chinese Population.

This study aimed to explore the association between dietary BCAAs, blood lipid levels and risk of dyslipidemia. In this case−control study, a total of 9541 subjects with normal blood lipids were included as a control group, and 9792 patients with dyslipidemia were included as a case group. Dietary BCAA intake data were measured using 3-day 24 h meal recalls and household condiment weighing. All samples were from China Nutrition and Health Surveillance (2015). Generalized linear model, logistic regression, and restricted cubic spline (RCS) were used to evaluate the relationship between dietary BCAAs, blood lipids and dyslipidemia. After adjusting for confounding factors, dietary BCAAs were positively correlated with TC and LDL-C (p < 0.05). Higher dietary BCAAs were associated with higher OR for Hypercholesteremia (Q4 vs. Q1, OR = 1.29, 95% CI: 1.05−1.58, p-trend = 0.034). The ORs of Hyper-LDL-cholesterolemia showed inverted U-shaped with increasing dietary BCAAs (Q3 vs. Q1, OR = 1.20, 95% CI: 1.03−1.39; Q2 vs. Q1, OR = 1.05, 95% CI: 1.01−1.31). The relationship between dietary BCAAs and the risk of Hypercholesteremia and Hyper-LDL-cholesterolemia were both nonlinear (p nonlinearity = 0.0059, 0.0198). Our study reveals that dietary BCAAs are associated with specific types of lipids and risk of dyslipidemia, some of which may be non-linear.

Stroke Risk Factors of Stroke Patients in China: A Nationwide Community-Based Cross-Sectional Study.

BACKGROUND: Stroke is the leading cause of death in China, and its burdens are rapidly increasing. The prevalence and control of stroke risk factors among stroke patients in China are unknown. OBJECTIVE: We investigated the stroke risk factors of stroke patients in China. DESIGN: We examined stroke risk factors in 6580 stroke patients aged 18 years or older in the China National Chronic Diseases and Nutrition Surveillance of Adults (2015-2017). With regard to the basic characteristics of the study participants, categorical variables were described as frequency (percent). The chi-square test was used to analyze the difference between men and women. The multivariate logistic regression model was used in the multivariate analysis. RESULTS: Among the 6580 stroke patients, hypertension was the most common stroke risk factor identified in most cases (78.51%), followed by overweight or obesity (61.58%), dyslipidemia (54.38%), smoking (24.04%), diabetes (21.75%), family history of stroke (17.43%), lack of exercise (16.35%), and atrial fibrillation (4.47%). Drinking stroke patients had a lower rate of hypertension, diabetes, and dyslipidemia. Patients with hyperuricemia had a higher rate of hypertension and dyslipidemia than no-hyperuricemia patients. The hypertension awareness, treatment, and control rates among hypertension stroke patients were 73.62%, 70.19%, and 17.79%, respectively. The diabetes awareness, treatment, and control rates among diabetes patients were 69.74%, 65.83%, and 34.59%, respectively. The dyslipidemia awareness, treatment, and control rates among dyslipidemia patients were 42.37%, 29.4%, and 20.07%, respectively. Among treated hypertension patients, the rates of taking medicine as medically advised, controlled diet, increased exercise, and blood pressure monitoring were 91.31%, 58.88%, 45.78%, and 73.99%, respectively. Among treated diabetes patients, the rates of oral antidiabetic medications, insulin injection, diet control, and blood glucose monitoring were 78.24%, 34.71%, 85.77%, and 78.24%, respectively. Among treated dyslipidemic patients, the rate of taking medicine as medical advice, controlled diet, increased exercise, and regular blood lipid monitoring was 80.61%, 77.57%, 56.46%, and 40.3%, respectively. CONCLUSIONS: The most common risk factors for community stroke patients in China are hypertension, dyslipidemia, and overweight or obesity. The stroke community patients' suboptimal awareness and treatment of hypertension, and suboptimal awareness, treatment, and control of diabetes, and dyslipidemia are significant problems in China.

Association between Dietary Fiber Intake and Hyperuricemia among Chinese Adults: Analysis of the China Adult Chronic Disease and Nutrition Surveillance (2015).

This study aimed to assess the association of dietary fiber intake with serum uric acid (SUA) levels and risk of hyperuricemia (HUA) among Chinese adults using the latest nationally representative data. A total of 66,427 Chinese adults aged 18 years and over from the China Adult Chronic Disease and Nutrition Surveillance in 2015 were included in this study. Dietary intakes were measured with a 3-day 24 h dietary recall and the household condiment weighing method. Mixed-effect linear and logistic regression models were used to evaluate the associations of dietary fiber intake with SUA levels and risk of HUA, respectively. Compared to the lowest intake group, the coefficient and 95% confidence in the highest intake group of total fiber were −0.06 (−0.08, −0.04) (p-trend < 0.001), −0.18 (−0.2, −0.16) (p-trend < 0.001) for cereal fiber, 0.03 (0.01, 0.04) (p-trend = 0.051) for legume fiber, 0 (−0.01, 0.02) (p-trend = 0.869) for vegetable fiber and 0.01 (−0.001, 0.04) (p-trend = 0.296) for fruit fiber. The odds ratio (OR) and 95% confidence interval (CI) of HUA for the highest vs. lowest intake group of total fiber were 0.88 (0.84, 0.91) (p-trend = 0.001), 0.67 (0.63, 0.71) (p-trend < 0.001) for cereal fiber, 1.05 (1, 1.09) (p-trend = 0.248) for legume fiber, 1.01 (0.97, 1.05) (p-trend = 0.982) for vegetable fiber and 1.06 (1, 1.12) (p-trend = 0.264) for fruit fiber. Our findings suggest that consumption of total fiber and cereal fiber were significantly inversely associated with SUA levels and HUA risk among the Chinese adult population. Developing and implementing effective public education programs are urgently needed to increase the intake of dietary fiber, especially cereal fiber among Chinese adults.

Association between Serum Vitamin A, Blood Lipid Level and Dyslipidemia among Chinese Children and Adolescents.

Background: To study the relationship between serum vitamin A (VA) level and blood lipid profiles in children and adolescents aged 6−18 years, as well as the effect of VA on dyslipidemia. Methods: The project adopted a multistage stratified cluster sampling method. The Food Frequency Questionnaire (FFQ) was used to obtain dietary factors data. Blood samples of subjects were taken via venipuncture. Generalized linear models were used to explore the correlation be-tween VA and biochemical indicators, as well as stratified and inter-actions analysis to explore the influence of confounders on these relationships. Generalized linear models were constructed to explore the association between VA and blood lipids. Restricted cubic splines were used to characterize dose−response associations between serum VA and dyslipidemia based on logistic regression. Results: Serum VA was positively correlated with TC, TG and HDL-C (p < 0.05), but these associations were influenced by age (p < 0.05). The adjusted odds ratio (OR) values of VA for hypercho lesterolemia, hypertriglyceridemia, mixed hyperlipidemia and low high-density lipoprotein cholesterolemia were 3.283, 3.239, 5.219 and 0.346, respectively (p < 0.01). Meanwhile, significant age interactions affected the relationship between VA and TC, as well as TG and LDL-C (p < 0.01). Conclusion: Serum VA was positively correlated with blood lipids, but these associations were influenced by age. VA was a risk factor for dyslipidemias, such as hypercholesterolemia, hypertriglyceridemia and mixed hyperlipidemia, but was a protective factor for low high-density lipoprotein cholesterolemia.

Dietary Pattern Associated with the Risk of Poor Glycemic Control in Chinese Diabetic Adults: Results from the China Nutrition and Health Surveillance 2015-2017 Survey.

The present study was conducted to investigate the nutrition status of dietary patterns and the association between dietary patterns and the risk of poor glycemic control in Chinese diabetics. The relevant data was collected from the China Nutrition and Health Surveillance 2015-2017 survey, which is a national cross-sectional surveillance program. A total of 2031 participants were included in the present statistical analysis. Food consumption was assessed through a validated and standard food frequency questionnaire. Dietary patterns were derived with reduced rank regression using hemoglobin A1c. Diabetes was diagnosed by medical institutions, glycemic control was defined as hemoglobin A1c less than 7%, poor glycemic control was defined as hemoglobin A1c greater than 7%. A multiple-variable-adjusted logistic regression, including age, living area, income level, educational attainment, body mass index, occupational physical activity, energy intake, current smoking status, current drinking status, diabetic medication use, insulin use, following diabetic diets, increased exercise, and glucose monitoring, was adjusted to explore the association between dietary patterns and the risk of poor glycemic control in diabetes. Two gender-specific dietary patterns have an increased risk of poor glycemic control and are characterized by a low intake of freshwater fish, poultry, and fruits. For male participants, the dietary pattern was characterized by a high intake of wheat and its products, a low intake of vegetables, corn and its products, shrimp and crab, and beans (Q4 vs. Q1, OR = 2.69, 95% CI: 1.76 to 4.10). For female participants, the dietary pattern was characterized by a low intake of snacks and nuts, and algae and mushroom (Q4 vs. Q1, OR = 2.18, 95% CI: 1.48 to 3.20).

[Impact of overweight and obesity on the relationship between serum vitamin D and fasting blood glucose in children aged 6-17 years in Shandong Province].

OBJECTIVE: To study the relationship between serum vitamin D and fasting blood glucose in children and adolescents, and its influence on overweight and obesity. METHODS: Using a multi-stage stratified cluster sampling method, 13 districts and counties in Shandong Province were selected as survey points, and a total of 26 elementary schools, 26 junior high schools and 13 high schools were selected. Questionnaire surveys and physical examination were conducted on children and adolescents aged 6-17.Serum vitamin D and fasting blood glucose were uniformly measured. The "BMI Classification Standard for Overweight and Obesity Screening for Chinese School-age Children and Adolescents" was used to determine overweight and obesity. Statistical method adopt t-test and generalized linear regression model for analysis. RESULTS: A total of 3562 children aged 6-17 years were investigated, 2666 were healthy, 446 were overweight, 450 were obese, including 131 peripheral obesity and 319 abdominal obesity. The fasting blood glucose level of the 13-17-year-old group was significantly higher than that of the 6-12-year-old group(t=-3.13, P=0.002), and the male was significantly higher than that of the female(t=7.87, P& lt; 0.001). In the healthy and obesity group, there was a negative correlation between serum vitamin D and fasting blood glucose(P& lt; 0.05). In overweight group, serum vitamin D was not significantly related to fasting blood glucose(P& gt; 0.05). Serum vitamin D and fasting blood glucose were negatively correlated with healthy bodies in female group and 13-17 years old group, and the abdominal obesity bodies in the 6-12 year old group(P& lt; 0.05). CONCLUSION: The fasting blood glucose of adolescents aged 13-17 is significantly higher than that of children aged 6-12, and the fasting blood glucose of men is significantly higher than that of women. Different gender, age, and overweight and obesity status have an impact on the relationship between serum vitamin D and fasting blood glucose.

Association between dietary essential amino acids intake and metabolic biomarkers: influence of obesity among Chinese children and adolescents.

Essential amino acids (EAAs) are involved in growth and development in children and adolescents. This study was aimed at exploring the relationship between dietary EAA intakes and metabolic biomarker, and the influence of obesity in children and adolescents. A total of 3566 subjects were analysed. Participators were classified according to weight status. Metabolic biomarkers were determined using standardized methods and conditions. Normal, overweight, and obesity statuses were defined according to the Working Group on Obesity in China (WGOC) BMI cutoff points based on age- and sex-specific screening criteria. In normal-weight group, blood uric acid was negatively correlated with dietary Ile, Leu, Lys, Phe, Thr, Val, and His, and zinc was negatively correlated with Ile, Leu, Lys, Phe, Thr, Val, His, Met, and Trp. In overweight group, TC was negatively correlated with Ile, Leu, Phe, Val, and His, and LDL-C was negatively correlated with Ile, Leu, Lys, Phe, Thr, Val, His, and Met, while TG was positively correlated with Leu, Lys, Phe, Thr, Val, and Met. In obesity group, hemoglobin was positively related to Ile, Leu, Lys, Phe, Thr, Val, His, and Trp, while vitamin D was positively correlated with His and Trp. The serum creatinine was negatively correlated with Ile, Leu, Phe, Val, His, and Met in normal-weight group, and positively correlated with Ile, Leu, Lys, Phe, Thr, Val, His, Met, Trp, His, and Trp in obesity group. Dietary amino acid score (AAS) and Leu intake were protective factors for obesity. The association between fasting blood glucose and EAAs intake was weak and labile. Metabolic biomarkers and EAA intakes were only related under certain weight status. The dietary AAS is positively correlated with HDL-C, LDL-C, serum creatinine, albumin, serum vitamin D, and zinc. The subtle relationship of EAAs and kidney function should be explored further. There is a complex relationship between EAAs and metabolic biomarkers, and overweight and obesity have a certain influence on this relationship.