The Contribution of the Underlying Factors to Socioeconomic Inequalities in Obesity: A Life Course Perspective.

Objectives: Socioeconomic disparities in obesity have been observed in both childhood and adulthood. However, it remains unclear how the role of risk factors influencing these inequalities has evolved over time. Methods: Longitudinal data on 2,866 children and adolescents (6-17 years old) from the China Health and Nutrition Survey were used to track their BMI during childhood, adolescence, and adulthood. Concentration Index was utilized to measure socioeconomic inequalities in obesity, while Oaxaca decomposition was employed to determine the share of different determinants of inequality. Results: The concentration index for obesity during childhood and adulthood were 0.107 (95% CI: 0.023, 0.211) and 0.279 (95% CI: 0.203, 0.355), respectively. Changes in baseline BMI (24.6%), parental BMI (10.4%) and socioeconomic factors (6.7%) were found to be largely responsible for the increasing inequality in obesity between childhood and adulthood. Additionally, mother's education (-7.4%) was found to contribute the most to reducing these inequalities. Conclusion: Inequalities in obesity during childhood and adulthood are significant and growing. Interventions targeting individuals with higher BMI, especially those who are wealthy, can significantly reduce the gap.

Improvement of Urolithin A Yield by In Vitro Cofermentation of Streptococcus thermophilus FUA329 with Human Gut Microbiota from Different Urolithin Metabotypes.

Streptococcus thermophilus FUA329 converts ellagic acid (EA) to urolithin A (Uro-A), which is not autonomously converted by the gut microbiota to produce highly bioavailable and multibiologically active Uro-A in urolithin metabotype 0 (UM-0) populations. We consider that Streptococcus thermophilus FUA329 has the potential to be developed as a probiotic. Therefore, we utilized S. thermophilus FUA329 for in vitro cofermentation with gut microbiota. The results revealed that strain FUA329 increased the production of EA-converted Uro-A during in vitro cofermentation with the human gut microbiota of different urolithin metabotypes (UMs), with a significant increase in the production of Uro-A in the experimental group of UM-0. In addition, changes in the in vitro cofermentation microbial community were determined using high-throughput sequencing. Strain FUA329 modulated the structure and composition of the gut microbiota in different UMs, thereby significantly increasing the abundance of beneficial microbiota in the gut microbiota while decreasing the abundance of harmful microbiota. Of greatest interest was the significant increase in the abundance of Actinobacteria phylum after the cofermentation of strain FUA329 with UM-0 gut microbiota, which might be related to the significant increase in the production of Uro-A.

In vitro conversion of ellagic acid to urolithin A by different gut microbiota of urolithin metabotype A.

The metabolite urolithin A, a metabolite of the dietary polyphenol ellagic acid (EA), has significant health benefits for humans. However, studies on the gut microbiota involved in ellagic acid metabolism are limited. In this study, we conducted in vitro fermentation of EA using human intestinal microbiome combined with antibiotics (vancomycin, polymyxin B sulfate, and amphotericin B). Liquid chromatography-mass spectrometry (LC-MS/MS) analysis demonstrated that the production capacity of urolithin A by gut microbiota co-treated with polymyxin B sulfate and amphotericin B (22.39 µM) was similar to that of untreated gut microbiota (24.26 µM). Macrogenomics (high-throughput sequencing) was used to analyze the composition and structure of the gut microbiota. The results showed that the abundance of Bifidobacterium longum, Bifidobacterium adolescentis, and Bifidobacterium bifidum in the gut microbiota without antibiotic treatment or co-treated with polymyxin B sulfate and amphotericin B during EA fermentation was higher than that in other antibiotic treatment gut microbiota. Therefore, B. longum, B. adolescentis, and B. bifidum may be new genera involved in the conversion of EA to urolithin A. In conclusion, the study revealed unique interactions between polyphenols and gut microbiota, deepening our understanding of the relationship between phenolic compounds like EA and the gut microbiota. These findings may contribute to the development of gut bacteria as potential probiotics for further development. KEY POINTS: • Intestinal microbiome involved in ellagic acid metabolism. • Gram-positive bacteria in the intestinal microbiome are crucial for ellagic acid metabolism. • Bifidobacterium longum, Bifidobacterium adolescentis, and Bifidobacterium bifidum participate in ellagic acid metabolism.

Dynamic gene expression of southern rice black-streaked dwarf virus during its infection in rice plants and vector insects.

In this century, a disease caused by southern rice black-streaked dwarf virus (SRBSDV) has resulted in significant loss in rice production in Asia. Aside from infecting rice plants, SRBSDV is transmitted by white-backed planthopper (WBPH) in a persistent propagative manner. Recent studies showed that SRBSDV can dynamically modulate the host cells throughout the infection progress. However, the expression dynamics of the SRBSDV genes during infection remain unclear. Here we established an absolute real-time quantitative PCR method to assess the dynamic of the SRBSDV genes expression in rice plants and planthoppers. Apart from displaying the expression levels of viral genes, we discovered that the expression level of viral genes in insects significantly surpasses that in plant cells. In addition, we identified two nonstructural proteins with unknown functions that exhibit the highest expression levels in plant and insect cells, respectively, which provide possible targets for restraining the disease outbreaks.

Life-course social disparities in body mass index trajectories across adulthood: cohort study evidence from China health and nutrition survey.

BACKGROUND: The social disparities in obesity may originate in early life or in adulthood, and the associations of socioeconomic position (SEP) with obesity could alter over time. It is unclear how lifetime-specific and life-course SEP influence adult obesity development in China. METHODS: Based on the China Health and Nutrition Survey (CHNS), three SEP-related indicators, including the father's occupational position and the participant's education and occupational position, were obtained. The life-course socioeconomic changes and a cumulative SEP score were established to represent the life-course SEP of the participants in the study. The growth mixture modeling was used to identify BMI trajectories in adulthood. Multinomial logistic regression was adopted to assess the associations between SEP and adult BMI trajectories. RESULTS: A total of 3,138 participants were included in the study. A positive correlation was found between the paternal occupational position, the participants' occupational position, education, and obesity in males, whereas an inverse correlation was observed among females. Males who experienced social upward mobility or remained stable high SEP during the follow-up had 2.31 and 2.52-fold risks of progressive obesity compared to those with a stable-low SEP. Among females, stable high SEP in both childhood and adulthood was associated with lower risks of progressive obesity (OR = 0.63, 95% CI: 0.43-0.94). Higher risks of obesity were associated with the life-course cumulative SEP score among males, while the opposite relationship was observed among females. CONCLUSIONS: The associations between life-course SEP and BMI development trajectories differed significantly by gender. Special emphasis should be placed on males experiencing upward and stable high socioeconomic change.

Geographical specific association between lifestyles and multimorbidity among adults in China.

The relationship between lifestyles and multimorbidity is well established, but previous studies have often neglected the role of spatial heterogeneity. Thus, this study is the first to explore this association in Chinese adults from a spatial perspective using a geographically weighted logistic regression (GWLR) model and describe the geographical characteristics across different regions. According to 2018 China Health and Retirement Longitudinal Study (CHARLS) database, a total of 7101 subjects were finally included, with 124 prefecture-level administrative regions in China. Non-spatial and GWLR model were used for analysis, and gender stratification analysis was also performed. Data were visualized through ArcGIS 10.7. The results showed that a total prevalence of approximately 5.13% of multimorbidity, and among participants with multimorbidity, the separate prevalence of hypertension, diabetes or high blood sugar, heart disease, and stroke were 4.45%, 2.32%, 3.02%, and 1.41%, respectively. The GWLR model indicated that current (OR: 1.202-1.220) and former smokers (OR: 1.168-1.206) may be important risk factors for multimorbidity in adults, especially in north and west among male. Past drinkers (OR: 1.233-1.240), especially in eastern China, contribute to the development of the multimorbidity in men but not in women. Vigorous-intensity activities (OR: 0.761-0.799) were negatively associated with multimorbidity in the west, with no gender difference. Depression (OR: 1.266-1.293) appeared to increase the risk for multimorbidity, with the weakest effects in central China and no gender difference. There was an interaction between light activities and gender (P = 0.024). The prevalence of multimorbidity differed across various areas of the province. The role of geographical variations in lifestyles and multimorbidity may provide valuable information for developing site-specific intervention strategies.

Genetic and Probiotic Characteristics of Urolithin A Producing Enterococcus faecium FUA027.

Enterococcus faecium FUA027 transforms ellagic acid (EA) to urolithin A (UA), which makes it a potential application in the preparation of UA by industrial fermentation. Here, the genetic and probiotic characteristics of E. faecium FUA027 were evaluated through whole-genome sequence analysis and phenotypic assays. The chromosome size of this strain was 2,718,096 bp, with a GC content of 38.27%. The whole-genome analysis revealed that the genome contained 18 antibiotic resistance genes and seven putative virulence factor genes. E. faecium FUA027 does not contain plasmids and mobile genetic elements (MGEs), and so the transmissibility of antibiotic resistance genes or putative virulence factors should not occur. Phenotypic testing further indicated that E. faecium FUA027 is sensitive to clinically relevant antibiotics. In addition, this bacterium exhibited no hemolytic activity, no biogenic amine production, and could significantly inhibit the growth of the quality control strain. In vitro viability was >60% in all simulated gastrointestinal environments, with good antioxidant activity. The study results suggest that E. faecium FUA027 has the potential to be used in industrial fermentation for the production of urolithin A.

Longitudinal associations between specific types/amounts social contact and cognitive function among middle-aged and elderly Chinese: A causal inference and longitudinal targeted maximum likelihood estimation analysis.

BACKGROUND: Social contact has demonstrated associations with cognitive function, while the literature on the effect of specific social relationship subdomains on cognitive function is limited. This study aimed to examine the causal effects of specific types/amounts of social contact on cognitive function among middle-aged and elderly Chinese. METHODS: A total of 38,883 middle-aged and elderly adults from the China Health and Retirement Longitudinal Study were involved. Social contact in this study included interaction with families, taking care of grandchildren, interaction with friends, and participation in three types of social activities. We performed the linear mixed-effects model analysis with propensity score approach and the longitudinal targeted maximum likelihood-based estimation analysis after adjusting for potential covariates and confounders. RESULTS: Interaction with families, caring for grandchildren, interaction with friends and participation in social activities were all associated with cognitive z-scores. Participants who interacted with families "2-3 times a week" and "once a week" versus "almost every day" had higher cognitive z-scores. Those who interacted with friends and participated in social activities "almost every week" versus "almost daily" had higher cognitive z-scores. LIMITATIONS: The assessment of cognition was biased against people with poor education due to elements of language and mathematical testing, and against those with visual impairment. CONCLUSIONS: Social contact was associated with better cognitive function among middle-aged and elderly Chinese. Social contact "1-3 times a week" was optimal for cognitive function. More social contact in middle-aged and elderly Chinese led to less cognitive decline in later life than in their inactive peers.

Predicting Six-Month Re-Admission Risk in Heart Failure Patients Using Multiple Machine Learning Methods: A Study Based on the Chinese Heart Failure Population Database.

Since most patients with heart failure are re-admitted to the hospital, accurately identifying the risk of re-admission of patients with heart failure is important for clinical decision making and management. This study plans to develop an interpretable predictive model based on a Chinese population for predicting six-month re-admission rates in heart failure patients. Research data were obtained from the PhysioNet portal. To ensure robustness, we used three approaches for variable selection. Six different machine learning models were estimated based on selected variables. The ROC curve, prediction accuracy, sensitivity, and specificity were used to evaluate the performance of the established models. In addition, we visualized the optimized model with a nomogram. In all, 2002 patients with heart failure were included in this study. Of these, 773 patients experienced re-admission and a six-month re-admission incidence of 38.61%. Based on evaluation metrics, the logistic regression model performed best in the validation cohort, with an AUC of 0.634 (95%CI: 0.599-0.646) and an accuracy of 0.652. A nomogram was also generated. The established prediction model has good discrimination ability in predicting. Our findings are helpful and could provide useful information for the allocation of healthcare resources and for improving the quality of survival of heart failure patients.

Associations between trajectories of cardiovascular risk factor change and cognitive impairment in Chinese elderly: A nationwide cohort study.

Objectives: This study aimed to investigate the relationship between long-term trajectories of changes in cardiovascular risk factors (CVRFs) and the risk of cognitive impairment among Chinese adults over 60 years old. Methods: Data were obtained from the Chinese Longitudinal Healthy Longevity Survey 2005-2018. Cognitive function was evaluated longitudinally through the Chinese version of the Mini-Mental State Examination (C-MMSE), and cognitive impairment (C-MMSE ≤23) was used as the main outcome variable. The cardiovascular risk factors, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), and body mass index (BMI), were continuously measured in the follow-up duration. The patterns of trajectories of changes in CVRFs were derived from the latent growth mixture model (LGMM). The Cox regression model was used to evaluate the cognitive impairment hazard ratio (HR) across different CVRF trajectories. Results: A total of 5,164 participants aged ≥60 years with normal cognitive function at baseline were included in the study. After a median follow-up of 8 years, 2,071 participants (40.1%) developed cognitive impairment (C-MMSE ≤ 23). The four-class trajectories of SBP and BMI were obtained by means of LGMM, and the trajectories of DBP, MAP, and PP were grouped into a three-class subgroup. In the final adjusted Cox model, the lowered SBP [adjusted HR (aHR): 1.59; 95% CI: 1.17-2.16], lowered PP (aHR: 2.64; 95% CI: 1.66-4.19), and progressively obese (aHR: 1.28; 95% CI: 1.02-1.62) and stable slim (aHR: 1.13; 95% CI: 1.02-1.25) were associated with the higher risk of cognitive impairment. Low stable DBP (aHR: 0.80; 95% CI: 0.66-0.96) and elevated PP (aHR: 0.76; 95% CI: 0.63-0.92) decreased the risk for cognitive impairment among participants. Conclusion: Lowered SBP, lowered PP, progressive obesity, and stable slim increased the risk for cognitive impairment in the Chinese elderly. Low stable DBP and elevated PP were protective against cognitive impairment, but more DBP lowering and ≥25 mmHg growth in PP contributed to a higher risk of cognitive impairment. The findings have important implications for preventing cognitive impairment in elder adults based on the long-term trajectories of changes in CVRFs.

Implementing a novel capture and ligation probe-PCR method in mass screen and treatment to support malaria elimination efforts in the China-Myanmar border region.

BACKGROUND: Mass screening and treatment (MSAT) for malaria elimination lacks an ideal diagnostic tool to allow sensitive and affordable test of the target population in the field. This study evaluated whether Capture and Ligation Probe-PCR (CLIP-PCR) could be used in a field MSAT in Laiza City, Myanmar. METHODS: On day 0, two dried blood spots were collected from each participant. On day 1, all samples were screened for Plasmodium in a 20 m2 laboratory with workbench, a biosafety cabinet, a refrigerator, a benchtop shaking incubator and a qPCR machine, by four technicians using CLIP-PCR with sample pooling, at a health clinic of the Chinese bordering town of Nabang. On day 2, all positives were followed up and treated. RESULTS: Of 15,038 persons (65% of the total population) screened, 204 (1.36%) were CLIP-PCR positives. Among them, 188, 14, and 2 were infected with Plasmodium vivax, Plasmodium falciparum, and P. vivax/P. falciparum mix, respectively. The testing capacity was 538 persons/day, with a cost of US$0.92 /person. The proportion of submicroscopic infection was 64.7%. All positive individuals received treatment within 72 h after blood collection. CONCLUSION: Using CLIP-PCR in MSAT in low transmission settings can support the malaria elimination efforts in the China-Myanmar border region.

Toward ultra-tough and heat-resistant biodegradable polylactide/core-shell rubber blends by regulating the distribution of rubber particles with stereocomplex crystallites.

Ultra-tough and heat-resistant poly(l-lactide)/core-shell rubber (PLLA/CSR) blends were fabricated by utilizing stereocomplex (SC) crystallites to effectively regulate the CSR distribution in PLLA matrix. Linear and 3-11 armed poly(d-lactide)s (PDLAs) were synthesized and then melt-mixed with PLLA/CSR blend. Interestingly, the incorporated PDLA chains could collaborate with PLLA chains to form dense SC crystallites network in PLLA/PDLA/CSR blends, thus inducing the CSR particles to transform from uniform distribution structure to network-like structure. With increasing the PDLA arm numbers, the size of CSR clusters in the network-like structure first increased and then decreased, and the continuity of the network-like structure first remained at a high level and then decreased obviously. The formation of CSR network-like structure could remarkably improve the impact strength of PLLA/PDLA/CSR blends without deteriorating their strength and modulus (compared with PLLA/CSR blend), and the CSR network-like structure with larger-sized CSR clusters and higher continuity could help obtain higher impact strength (78.3 kJ/m2). Moreover, the heat resistance of PLLA/PDLA/CSR blends could also be significantly improved (the highest Vicat softening temperature was 131 °C) by the SC crystallites network and CSR network-like structure. This work provides an effective strategy for controlling the rubber network-like morphology and thereby preparing high-performance PLLA materials.

Association of Egg Consumption Frequency and Quantity with Dyslipidemia in Chinese Rural Adults.

OBJECTIVE: The aim was to estimate the association of egg consumption with dyslipidemia and its subtypes in Chinese adults. METHODS: The cross-sectional health survey was conducted in Hanzhong city of Shaanxi province in 2010.Consumption of eggs (alone and mixed in foods) and nutrients were assessed using a semi-quantitative 81-item food frequency questionnaire (FFQ). Serum lipids and other physical measurements were measured by trained medical staff. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from multivariable logistic regressions. Restricted cubic spline was used to visualize the possible non-linear association. RESULTS: A total of 2241 participants (mean age, 48.0 years; 34.5% men) were included. The age- and gender- standardization dyslipidemia prevalence was 21.1% in men and 18.4% in women, respectively. Approximately 42.1% of individuals never or rarely consumed egg, while 9.4% consumed ≥2 times/week. The mean egg intake was 21.5 g/d in men and 17.4 in women. In women, after adjustment for demographics and lifestyle factors, the ORs (95%CI) for dyslipidemia and hypertriglyceridemia were 0.57(0.32-1.05) and 0.38 (0.17-0.85) for individuals consuming egg ≥2 times/week, compared with never or rarely consumers. When further adjustment of BMI and dietary factors, the inverse relation persisted for hypertriglyceridemia but attenuated to margin of significance for dyslipidemia (P-trend = 0.050). Increment of 25 g/d was associated with 15% (OR: 0.85, (0.71-1.00)) lower risk of dyslipidemia. Results from restricted cubic splines showed a substantial reduction of the risk within lower range of consumption, which reached the minimum risk around 20-50 g/d (P-nonlinearity = 0.069). No associations were observed in men. CONCLUSION: Egg consumption was associated with decreased risk of dyslipidemia among Chinese women but not men. Additionally, the beneficial effect tended to be stronger at 20-50 g egg per day. Further study is warranted to validate these findings and clarify the causality.

Isolation and characterization of a novel human intestinal Enterococcus faecium FUA027 capable of producing urolithin A from ellagic acid.

Urolithin A (UA) has received considerable research attention because of its health benefits. However, only a few strains have been reported to produce UA from ellagic acid (EA), and the molecular mechanisms underlying the gut microbiota-mediated transformation of ellagic acid into urolithin A is limited. In the present study, a single strain FUA027 capable of converting ellagic acid into UA in vitro was isolated from the fecal samples. The strain was identified as Enterococcus faecium through the morphological, physiological, biochemical and genetic tests. UA was produced at the beginning of the stationary phase and its levels peaked at 50 h, with the highest concentration being 10.80 µM. The strain Enterococcus faecium FUA027 is the first isolated strain of Enterococcus sp. producing urolithin A from ellagic acid, which may be developed as probiotics and used to explore molecular mechanisms underlying the biotransformation of ellagic acid into UA.

Characterization of a Novel Myrosinase with High Activity from Marine Bacterium Shewanella baltica Myr-37.

Myrosinase can hydrolyze glucosinolates to generate isothiocyanates, which have cancer prevention and anti-cancer properties. The main sources of myrosinase are cruciferous plants. To further improve the efficiency of isothiocyanates preparation, it is necessary to explore novel sources of myrosinases. In this study, we described a bacterium, Shewanella baltica Myr-37, isolated from marine mud, capable of producing a novel myrosinase (Smyr37) with a molecular weight of 100 kDa. The crude enzyme of Smyr37 showed the highest activity at 50 °C and pH 8.0. The sinigrin- and glucoraphanin-hydrolyzing activities of Smyr37 were 6.95 and 5.87 U/mg, respectively. Moreover, when the reaction temperature was 40 °C and pH was 7.0, the crude enzyme of Smyr37 could efficiently degrade glucoraphanin into sulforaphane within 25 min with a yield of 0.57 mg/mL. The corresponding conversion efficiency of sulforaphane from glucoraphanin was 89%. In summary, S. baltica Myr-37 myrosinase Smyr37, a novel myrosinase, can be used in the preparation of isothiocyanates.

The association between social engagement and depressive symptoms in middle-aged and elderly Chinese: A longitudinal subgroup identification analysis under causal inference frame.

Background: Studies have suggested that there is a significant association between social engagement and depression symptoms. However, this association may differ in people with different features such as different sociodemographic characteristics and health conditions. Methods: Research data were obtained from the CHARLS database. The causal inference was performed with the propensity score. We used the linear mixed-effects model tree algorithm under the causal inference frame for subgroup identification analysis. Results: We included 13,521 participants, and the median follow-up time is 4 years. Under the casual inference frame, the association between social engagement and depression symptoms is confirmed for all included individuals (OR = 0.957, P = 0.016; 95%CI: 0.923-0.992). Using the linear mixed-effects model tree, we found two subgroups, including middle-aged and elderly residents who live in rural areas with <6 h of sleep and those living in urban areas, could benefit more from social engagement. After using the propensity score method, all the two subgroups selected are statistically significant (P = 0.007; P = 0.013) and have a larger effect size (OR = 0.897, 95%CI: 0.830-0.971; OR = 0.916, 95%CI: 0.854-0.981) than the whole participants. As for sex difference, this associations are statistically significant in male (OR: 0.935, P = 0.011, 95%CI: 0.888-0.985) but not in female (OR: 0.979, P = 0.399, 95%CI: 0.931-1.029). Conclusions: Our findings indicate that social engagement may reduce the risks of depressive symptoms among all individuals. The identified subgroups of middle-aged and elderly residents who live in rural areas with <6 h of sleep and those who live in urban areas may benefit more from the social engagement than the whole participants.

Effects of potential risk factors on the development of cardiometabolic multimorbidity and mortality among the elders in China.

Objectives: To examine the impact of demographic, socioeconomic, and behavioral factors on the development of cardiometabolic multimorbidity and mortality in Chinese elders. Methods: Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2002-2018 was used in the study. Cardiometabolic multimorbidity was defined as the presence of two or more cardiometabolic disorders, such as hypertension, diabetes, cardiovascular disease (CVD), heart disease, or stroke. Cox regression model and multi-state Markov model were developed to evaluate the association of the study factors with the progression of cardiometabolic conditions and mortality. The outcomes included three states (first cardiometabolic disease, cardiometabolic multimorbidity, and all-cause mortality) and five possible transitions among the three states. Results: Of the 13,933 eligible individuals, 7,917 (56.8%) were female, and 9,540 (68.50%) were over 80 years old. 2,766 (19.9%) participants had their first cardiometabolic disease, 975 (7.0%) participants suffered from cardiometabolic multimorbidity, and 9,365 (67.2%) participants died. The progression to cardiometabolic multimorbidity was positively associated with being female (HR = 1.42; 95%CI, 1.10 - 1.85), living in the city (HR = 1.41; 95%CI, 1.04 - 1.93), overweight (HR = 1.43; 95%CI, 1.08 - 1.90), and obesity (HR = 1.75; 95% CI, 1.03 - 2.98). A higher risk for the first cardiometabolic disease was associated with being female (HR = 1.26; 95% CI, 1.15 - 1.39), higher socioeconomic status (SES, HR = 1.17; 95%CI, 1.07 - 1.28), lack of regular physical activity (HR = 1.13; 95%CI, 1.04 - 1.23), smoking (HR = 1.20; 95%CI, 1.08 - 1.33), ≤ 5 h sleep time (HR = 1.15; 95%CI, 1.02 - 1.30), overweight (HR = 1.48; 95% CI, 1.32 - 1.66), and obesity (HR = 1.34; 95%CI, 1.06 - 1.69). It also should be noted that not in marriage, lower SES and unhealthy behavioral patterns were risk factors for mortality. Conclusion: This study emphasized the importance of lifestyle and SES in tackling the development of cardiometabolic conditions among Chinese elders and provided a reference for policy-makers to develop a tailored stage-specific intervention strategy.

Lactococcus garvieae FUA009, a Novel Intestinal Bacterium Capable of Producing the Bioactive Metabolite Urolithin A from Ellagic Acid.

Dietary polyphenol ellagic acid has anti-cancer and anti-inflammatory activities, and these biological activities require the conversion of ellagic acid to urolithins by intestinal microbes. However, few gut microbes are capable of metabolizing ellagic acid to produce urolithins, limiting the beneficial effects of ellagic acid on health. Here, we describe an intestinal bacterium Lactococcus garvieae FUA009 isolated from the feces of a healthy volunteer. It was demonstrated via HPLC and UPLC-MS analysis that the end product of ellagic acid metabolism of FUA009 was urolithin A. In addition, we also examined the whole genome sequence of FUA009 and then assessed the safety and probiotic properties of FUA009 based on a complete genome and phenotype analysis. We indicated that FUA009 was safe, which was confirmed by FUA009 being sensitive to multiple antibiotics, having no hemolytic activity, and being free of aggressive putative virulence factors. Moreover, 19 stress-responsive protein genes and 8 adhesion-related genes were predicted in the FUA009 genome. Furthermore, we demonstrated that FUA009 was tolerant to acid and bile salt by determining the cell viability in a stress environment. In summary, Lactococcus garvieae FUA009, as a novel UA-producing bacterium, not only contributes to the study of the metabolic pathway of ellagic acid but is also expected to be a novel probiotic candidate.

Long-term waist circumference trajectories and body mass index with all-cause mortality in older Chinese adults: a prospective nationwide cohort study.

BACKGROUNDS: Abdominal obesity has been linked to risk of mortality, but whether and how trajectory of waist circumstance (WC) underpins this association remains unclear. The study aimed to identify long-term WC change trajectories and examine their association and joint effect with body mass index (BMI) on mortality among Chinese older adults. METHODS: This present study included participants 60 years of age or older from China Health and Nutrition Survey (CHNS) from 1991 to 2015. The duration of follow-up was defined as period from the first to latest visit date attended with information on mortality, end of follow-up, or loss to follow-up (censoring). Latent class trajectory analysis (LCTA) was used to assess the changes of WC trajectories overtime. Cox proportional hazard models were used to assess hazard ratios (HRs) and corresponding 95% confidence internal (CIs) for mortality. RESULTS: A total of 2601 participants with 8700 visits were included, and 562 mortality (21.6%) occurred during a median follow-up of 8.7 years. Using a group-based modeling approach, four distinct trajectories of WC change among Chinese older adults were identified as loss (13.5%), stable (46.8%), moderate gain (31.2%) and substantial gain (8.5%). With WC stable group as reference, the multivariable adjusted HRs for mortality were 1.34(95%CI:1.01-1.78) in loss group, 1.13(0.91-1.41) in moderate gain and 1.54(1.12-2.12) in substantial gain group. Compared with participants with normal BMI at baseline and maintained WC stable, the risk of mortality generally increased for all WC change group in initial overweight/obesity individuals, and the highest risk were observed for WC loss and stable pattern (HR:2.43, 95%CI: 1.41-4.19; HR:1.67 (1.07-2.60)). CONCLUSIONS: In older Chinese, both long-term WC loss and substantial gain conferred excess risk for mortality. The baseline BMI might modify the effect as overweight individuals had a greater risk imposed by WC loss than those in normal weight. Maintaining stable WC and normal weight might be necessary to reduce the risk of mortality.

Association between Long-Term Changes in Dietary Percentage of Energy from Fat and Obesity: Evidence from over 20 Years of Longitudinal Data.

Objectives: This study assessed the associations between long-term trajectories of percentage of energy from fat (PEF) and obesity among Chinese adults. Methods: Longitudinal data collected by the China Health and Nutrition Survey from 1991 to 2015 were analyzed. A body mass index ≥28.0 was defined as general obesity. Participants' baseline PEF levels were categorized as lower than the recommendation of the Chinese Dietary Guideline (<20%), meeting the recommendation (20−30%), and higher than the recommendation (>30%). Patterns of PEF trajectories were identified by latent class trajectory analysis for overall participants and participants in different baseline PEF groups, respectively. Cox proportional hazards regression models with shared frailty were used to estimate associations between PEF and obesity. Results: Data on 13,025 participants with 72,191 visits were analyzed. Four patterns of PEF trajectory were identified for overall participants and participants in three different baseline PEF groups, respectively. Among overall participants, compared with "Baseline Low then Increase Pattern" (from 12% to 20%), participants with "Baseline Normal-Low then Increase-to-High Pattern" (from 20% to 32%) had a higher hazard of obesity (hazard ratio (HR) and 95% confident interval (CI) at 1.18 (1.01−1.37)). Compared with the "Stable Pattern" group (stable at around 18% and 22%, respectively), participants with "Sudden-Increase Pattern" (from 18% to 30%) in the baseline group whose PEF levels were lower than the recommendation and those with "Sudden-Increase then Decrease Pattern" (rapidly increased from 25% to 40%, and then decreased) in the baseline group who met the recommendation had higher hazards of obesity (HRs and 95% CIs being 1.65 (1.13−2.41) and 1.59 (1.03−2.46), respectively). Conclusions: Adults with a trajectory that involved a sudden increase to a high-level PEF had a higher risk of general obesity. People should avoid increasing PEF suddenly.