Prevalence, awareness, treatment, and control of hypertension in China, 2004-18: findings from six rounds of a national survey.

OBJECTIVE: To assess the recent trends in prevalence and management of hypertension in China, nationally and by population subgroups. DESIGN: Six rounds of a national survey, China. SETTING: China Chronic Disease and Risk Factors Surveillance, 2004-18. PARTICIPANTS: 642 523 community dwelling adults aged 18-69 years (30 501 in 2004, 47 353 in 2007, 90 491 in 2010, 156 836 in 2013, 162 293 in 2015, and 155 049 in 2018). MAIN OUTCOME MEASURES: Hypertension was defined as a blood pressure of ≥140/90 mm Hg or taking antihypertensive drugs. The main outcome measures were hypertension prevalence and proportion of people with hypertension who were aware of their hypertension, who were treated for hypertension, and whose blood pressure was controlled below 140/90 mm Hg. RESULTS: The standardised prevalence of hypertension in adults aged 18-69 years in China increased from 20.8% (95% confidence interval 19.0% to 22.5%) in 2004 to 29.6% (27.8% to 31.3%) in 2010, then decreased to 24.7% (23.2% to 26.1%) in 2018. During 2010-18, the absolute annual decline in prevalence of hypertension among women was more than twice that among men (-0.83 percentage points (95% confidence interval -1.13 to -0.52) v -0.40 percentage points (-0.73 to -0.07)). Despite modest improvements in the awareness, treatment, and control of hypertension since 2004, rates remained low in 2018, at 38.3% (36.3% to 40.4%), 34.6% (32.6% to 36.7%), and 12.0% (10.6% to 13.4%). Of 274 million (95% confidence interval 238 to 311 million) adults aged 18-69 years with hypertension in 2018, control was inadequate in an estimated 240 million (215 to 264 million). Across all surveys, women with low educational attainment had higher prevalence of hypertension than those with higher education, but the finding was mixed for men. The gap in hypertension control between urban and rural areas persisted, despite larger improvements in diagnosis and control in rural than in urban areas. CONCLUSIONS: The prevalence of hypertension in China has slightly declined since 2010, but treatment and control remain low. The findings highlight the need for improving detection and treatment of hypertension through the strengthening of primary care in China, especially in rural areas.

Habitual intakes of sugar-sweetened beverages associated with gut microbiota-related metabolites and metabolic health outcomes in young Chinese adults.

BACKGROUND AND AIMS: Reducing consumption of sugar-sweetened beverages (SSBs) is a global public health priority because of their limited nutritional value and associations with increased risk of obesity and metabolic diseases. Gut microbiota-related metabolites emerged as quintessential effectors that may mediate impacts of dietary exposures on the modulation of host commensal microbiome and physiological status. METHODS AND RESULTS: This study assessed the associations among SSBs, circulating microbial metabolites, and gut microbiota-host co-metabolites, as well as metabolic health outcomes in young Chinese adults (n = 86), from the Carbohydrate Alternatives and Metabolic Phenotypes study in Shaanxi Province. Five principal component analysis-derived beverage drinking patterns were determined on self-reported SSB intakes, which were to a varying degree associated with 143 plasma levels of gut microbiota-related metabolites profiled by untargeted metabolomics. Moreover, carbonated beverages, fruit juice, energy drinks, and bubble tea exhibited positive associations with obesity-related markers and blood lipids, which were further validated in an independent cohort of 16,851 participants from the Regional Ethnic Cohort Study in Northwest China in Shaanxi Province. In contrast, presweetened coffee was negatively associated with the obesity-related traits. A total of 79 metabolites were associated with both SSBs and metabolic markers, particularly obesity markers. Pathway enrichment analysis identified the branched-chain amino acid catabolism and aminoacyl-tRNA biosynthesis as linking SSB intake with metabolic health outcomes. CONCLUSION: Our findings demonstrate the associations between habitual intakes of SSBs and several metabolic markers relevant to noncommunicable diseases, and highlight the critical involvement of gut microbiota-related metabolites in mediating such associations.

Gut microbiome modulation by probiotics, prebiotics, synbiotics and postbiotics: a novel strategy in food allergy prevention and treatment.

Food allergy has caused lots of global public health issues, particularly in developed countries. Presently, gut microbiota has been widely studied on allergy, while the role of dysbiosis in food allergy remains unknown. Scientists found that changes in gut microbial compositions and functions are strongly associated with a dramatic increase in the prevalence of food allergy. Altering microbial composition is crucial in modulating food antigens' immunogenicity. Thus, the potential roles of probiotics, prebiotics, synbiotics, and postbiotics in affecting gut bacteria communities and the immune system, as innovative strategies against food allergy, begins to attract high attention of scientists. This review briefly summarized the mechanisms of food allergy and discussed the role of the gut microbiota and the use of probiotics, prebiotics, synbiotics, and postbiotics as novel therapies for the prevention and treatment of food allergy. The perspective studies on the development of novel immunotherapy in food allergy were also described. A better understanding of these mechanisms will facilitate the development of preventive and therapeutic strategies for food allergy.

Photothermal Hydrogel Encapsulating Intelligently Bacteria-Capturing Bio-MOF for Infectious Wound Healing.

Chronic wounds are characterized by long-term inflammation and persistent infection, which make them difficult to heal. Therefore, an urgent desire is to develop a multifunctional wound dressing that can prevent wound infection and promote wound healing by creating a favorable microenvironment. In this study, a curcumin-based metal-organic framework (QCSMOF-Van), loaded with vancomycin and coated with quaternary ammonium salt chitosan (QCS), was prepared. Multifunctional composite hydrogels were conveniently synthesized by combining methacrylic anhydride modified gelatin and methacrylic anhydride modified oxidized sodium alginate with QCSMOF-Van through radical polymerization and Schiff base reaction. It is important to note that the QCSMOF-Van could capture bacteria through the positive charges on the surface of QCS. In this process, due to the synergistic effect of broad-spectrum antibacterial Zn2+ and vancomycin, the metabolism of bacteria was well inhibited, and the efficient capturing and rapid killing of bacteria were achieved. The QCSMOF-Van hydrogels could precisely regulate the balance of M1/M2 phenotypes of macrophages, thereby promoting the regeneration of nerves and blood vessels, which promotes the rapid healing of chronic wounds. This advanced cascade management strategy for tissue regeneration highlights the potential of multifunctional composite hydrogels in chronic wound dressings.

Longitudinal effects of school policies on children's eating behaviors and weight status: findings from the childhood obesity study in China megacities.

OBJECTIVES: To examine longitudinal effects of school policies on children's weight status and eating behaviors, and study how these effects may vary by children's age, sex, and baseline weight status in China. METHODS: Data were collected in 2015, 2016, and 2017 in an open cohort of 3298 children aged 6-17, their parents, and schools in five large cities across China (Beijing, Shanghai, Xi'an, Nanjing, and Chengdu). Children's weight, height, and waist circumference were measured, and their eating behaviors were self-reported. The 1691 children with such repeated measures in ≥ two waves were included in longitudinal data analysis with mixed effects models, testing the associations. RESULTS: Having school vicinity food stall policy was associated with less frequent consumption of fast food (ß = -0.14, p < 0.01) and snack (ß = -0.84, p < 0.01). More significant associations were found between school policies and unhealthy eating behaviors for girls and children aged 6-11 than their counterparts. Among children without overweight or central obesity at baseline, having school cafeteria food policy was associated with lower risks for overweight and obesity (OR = 0.33, 95% CI: 0.17-0.63) and central obesity (OR = 0.47, 95% CI: 0.26-0.85). This existed for girls, but not for boys. School vicinity food stall policy was associated with lower BMI (ß = -0.20, 95% CI: -0.37, -0.03) among all children and in girls (ß = -0.28, 95% CI: -0.50, -0.05) without overweight at baseline. CONCLUSIONS: School policies could reduce children's unhealthy eating behaviors and obesity risk in megacities in China. Children's age, sex, and baseline weight status modify the effects. School policies are important to fight the growing childhood obesity epidemic.

Inequalities of spatial primary healthcare accessibility in China.

A key step to the establishment of a tiered healthcare system is equitable access to basic primary healthcare services for all. However, no quantitative research on the national status quo of primary healthcare accessibility in China exists. We filled this gap by estimating spatial accessibility to primary healthcare centers (PHCs) and mapping its inequality across the mainland China. Four national datasets during 2015-2018, including administrative boundaries, residential communities, points-of-interest (including PHCs), and road networks, were collected to calculate the distance to the nearest PHC for each community. Five other national datasets including census, elevation, land use, vegetation, and nightlight, were collected to model 100m × 100 m population grids, based on which geographical modeling was used to calculate PHC accessibility of each community. Inequalities in PHC accessibility across China were described with concentration indices. About 44% of communities across China representing approximately 30% of the overall population had no access to PHCs within their 6-km catchment areas; about 78% of communities across China representing approximately 68.4% of the overall population had no access to PHCs within their 1.5-km catchment areas. Some municipalities/provinces like Shanghai, Beijing, Tianjin, Jiangsu, Shandong, and Zhejiang generally had higher proximity to the nearest PHCs, while others like Tibet, Guizhou, and Guangxi had lower proximity to the nearest PHCs. However, assuming similar basic service capacity across all PHCs, Shanghai, Tianjin, and Chongqing showed the lowest PHC accessibility due to high population density. Variations in PHC accessibility existed, with more inequalities observed in the north and northeastern provinces and less inequalities in southwestern and south-central provinces. This study demonstrates primary healthcare accessibility and inequality at province and city levels, and identifies communities with lower proximity and accessibility to PHCs in China. It would serve as a starting point to facilitate precise healthcare planning and preparedness for health emergencies in China.

Calcium Silicate Whiskers-Enforced Poly(Ether-Ether-Ketone) Composites with Improved Mechanical Properties and Biological Activities for Bearing Bone Reconstruction.

Poly (ether-ether-ketone) (PEEK) displays promising potential application in bone tissue repair and orthopedic surgery due to its good biocompatibility and chemical stability. However, the bio-inertness and poor mechanical strength of PEEK greatly limit its application in load-bearing bones. In this study, calcium silicate whiskers (CSws) are synthesized and then compounded with PEEK to fabricate the PEEK/CSw composites with excellent mechanical properties, biological activity. Compared with PEEK, the PEEK/CSw composites exhibited higher hydrophilicity and ability to deposit hydroxyapatite on the surface. CSws are evenly dispersed in the PEEK matrix at 10 wt% content and the mechanical strength of the PEEK/CSw composite is ≈96.9 ± 2.4 MPa, 136.3 ± 2.4 MPa, and 266.0 ± 3.2 MPa, corresponding to tensile strength, compressive strength, and bending strength, respectively, which is 20%, 18%, and 52% higher than that of pure PEEK. The composites improve the adhesion, proliferation, and osteogenic differentiation of BMSCs. Furthermore, PEEK/CSw composite remarkably improves bone formation and osteointegration, which has higher bone repair capacity than PEEK. These results demonstrate that the PEEK/CSw scaffolds display superior abilities to integrate with the host bone and promising potential in the field of load bearing bone repair.

Hydrophilic Covalent Organic Frameworks Coated Steel Sheet As a Mass Spectrometric Ionization Source for the Direct Determination of Zearalenone and Its Derivatives.

Zearalenone has attracted worldwide attention due to its toxic properties and threat to public health. A rapid determination method for zearalenone and its derivatives by hydrophilic covalent organic frameworks coated steel sheet (HCOFCS) combined with ambient mass spectrometry (AMS) was developed. The HCOFCS behaved as both a tip for solid-phase microextraction and a solid substrate for electrospray ionization mass spectrometry (ESI-MS). To evaluate the HCOFCS-ESI-MS method, five zearalenone and its derivatives in milk samples were determined, including zearalenone (ZEA), α-zearalenol (α-ZEL), ß-zearalenol (ß-ZEL), α-zearalanol (α-ZAL), and ß-zearalanol (ß-ZAL). After the extraction procedure, the HCOFCS was directly added with a high voltage for ESI-MS, and the analysis could be completed within 1 min. The developed method showed good linearity in the range 0.1-100 µg/L with a coefficient of determination (R2) > 0.9991. The limits of detection (LODs) and limits of quantitation (LOQs) ranged from 0.05 to 0.1 and 0.2 to 0.3 µg/L, respectively. The results demonstrated that the HCOFCS combined with ESI-MS can be used for the rapid and sensitive determination of trace ZEA and its derivatives in milk samples with satisfactory recoveries from 80.58% to 109.98% and reproducibility with relative standard deviations (RSDs) no more than 11.18%. Furthermore, HCOFCS showed good reusability, which could reuse at least 10 extraction cycles with satisfactory adsorption performance.

Excess diabetes mellitus-related deaths during the COVID-19 pandemic in the United States.

Background: Diabetes mellitus (DM) is a critical risk factor for severe SARS-CoV-2 infection, and SARS-CoV-2 infection contributes to worsening glycemic control. The COVID-19 pandemic profoundly disrupted the delivery of care for patients with diabetes. We aimed to determine the trend of DM-related deaths during the pandemic. Methods: In this serial population-based study between January 1, 2006 and December 31, 2021, mortality data of decedents aged ≥25 years from the National Vital Statistics System dataset was analyzed. Decedents with DM as the underlying or contributing cause of death on the death certificate were defined as DM-related deaths. Excess deaths were estimated by comparing observed versus expected age-standardized mortality rates derived from mortality during 2006-2019 with linear and polynomial regression models. The trends of mortality were quantified with joinpoint regression analysis. Subgroup analyses were performed by age, sex, race/ethnicity, and state. Findings: Among 4·25 million DM-related deaths during 2006-2021, there was a significant surge of more than 30% in mortality during the pandemic, from 106·8 (per 100,000 persons) in 2019 to 144·1 in 2020 and 148·3 in 2021. Adults aged 25-44 years had the most pronounced rise in mortality. Widened racial/ethnic disparity was observed, with Hispanics demonstrating the highest excess deaths (67·5%; 95% CI 60·9-74·7%), almost three times that of non-Hispanic whites (23·9%; 95% CI 21·2-26·7%). Interpretation: The United States saw an increase in DM-related mortality during the pandemic. The disproportionate rise in young adults and the widened racial/ethnic disparity warrant urgent preventative interventions from diverse stakeholders. Funding: National Natural Science Foundation of China.

Health consequences of obesity and projected future obesity health burden in China.

OBJECTIVE: This study examined the effects of overweight/obesity on mortality and morbidity outcomes and the disparities, time trends, and projected future obesity health burden in China. METHODS: Cohort studies that were conducted in China and published in English or Chinese between January 1, 1995, and July 31, 2021, were systematically searched. This study focused on overweight/obesity, type 2 diabetes mellitus (T2DM), hypertension, cardiovascular diseases, metabolic syndrome, cancers, and chronic kidney disease. RESULTS: A total of 31 cohorts and 50 cohort studies reporting on mortality (n = 20) and morbidities (n = 30) associated with obesity met study inclusion criteria. Overall, BMI was nonlinearly (U-shaped) associated with all-cause mortality and linearly associated with risks of T2DM, cardiovascular diseases, hypertension, cancer, metabolic syndrome, and chronic kidney disease. In 2018, among adults, the prevalence of overweight/obesity, hypertension, and T2DM was 51.2%, 27.5%, and 12.4%, respectively. Their future projected prevalence would be 70.5%, 35.4%, and 18.5% in 2030, respectively. The projected number of adults having these conditions would be 810.65 million, 416.47 million, and 217.64 million, respectively. The urban-rural disparity in overweight/obesity prevalence was projected to shrink and then reverse over time. CONCLUSIONS: The current health burden of obesity in China is high and it will sharply increase in coming years and affect population groups differently. China needs to implement vigorous interventions for obesity prevention and treatment.

Interactions between Self-Perceived Weight Status and Lifestyle Behaviors and Their Associations with Childhood Obesity: Results from the Childhood Obesity Study in China Mega-Cities.

This study investigated the interactions between self-perceived weight status and lifestyle behaviors, and their associations with childhood obesity among school children. Methods: Cross-sectional study data from a nationwide sample of 3258 participants (aged 8-15 years old) during 2015-2017 were used. Self-perceived weight status and lifestyle factors (dietary intake and physical activity) were assessed using self-administered questionnaires. Multivariable mixed-effects models tested the effect of interactions between weight self-perception and behavioral factors on overweight and obesity (ow/ob). Results: Overall ow/ob prevalence based on BMI was 30.9% (38.5% for boys, 23.0% for girls). Based on self-perceived weight status, ow/ob prevalence was 37.7% (35.8% for boys, 39.7% for girls). 41.2% of boys and 25.9% of girls underestimated their actual weight status. The interaction between self-perceived weight status and meat consumption was associated with ow/ob in boys, while the interaction between self-assessed weight status and protein foods and sedentary lifestyle were associated with ow/ob in girls. The attributable proportions of these three factors were 39.8%, 48.2%, and 34.6%, respectively. Conclusions: The self-perceived weight status was different from their actual weight status in children. The interactions between self-perceived weight status and lifestyle behaviors were associated with ow/ob. Health promotion programs that empower children to have appropriate self-awareness of weight status, eating, and physical activity behaviors need to be developed and implemented.

Time trends and disparities in combined overweight and obesity prevalence among children in China.

This study aims to examine the trends and disparities in the combined prevalence of overweight and obesity among children in China by regions and specific groups over the last 30 years. PubMed, Wanfang, CNKI, VIP database, official websites of national governments and professional institutions/associations were systematically searched, for related reports and studies published up until December 2021. Reports based on nationally representative survey data were also examined and included. In mainland China, overweight and obesity decreased in pre-school children (≤6 years old) and increased in school-aged children (7-18 years old) between 2010 and 2013 to 2015 and 2017, but long-term trends predict future increases in both groups. The prevalence of overweight and obesity in primary school students in Hong Kong dropped from 21.4% in 2007-2008 to 17.6% in 2016-2017. In Macao, the prevalence of overweight and obesity in children aged 6-18 years was reported by age stratification; the lowest and highest prevalence was 13.4%, 29.3% and 9.2%, 21.7% for boys and girls in latest survey in 2015, respectively. The prevalence of overweight and obesity in primary, middle and high school students in Taiwan dropped from 28.2%, 27.1% and 31.1% in 2010 to 26.7%, 25.2% and 26.7% in 2013, respectively. Furthermore, in mainland China, the prevalence in rural left-behind boys and girls was 10.7% and 7.0%, respectively, in 2011, and the prevalence among migrant pre-school children was about 5.0% around 2010. In summary, the prevalence of overweight and obesity in school-aged children has increased in mainland China and Macao, but decreased in Hong Kong and Taiwan prior to 2017. The projections suggest that the highest prevalence of overweight and obesity in pre-school children will be in rural children in the future. These factors need to be considered when formulating and implementing national policies and programmes to fight overweight and obesity.

Mesoporous hollow Fe3O4 nanoparticles regulate the behavior of neuro-associated cells through induction of macrophage polarization in an alternating magnetic field.

Magnetic iron oxide nanoparticles have shown great research value in the field of nerve regeneration because of their characteristics of satisfactory material properties and their ability to be stimulated by an external magnetic field to enhance the function of all aspects. Nevertheless, the impact of magnetic iron oxide nanoparticles on nerve regeneration regulated by macrophage polarization has not been well studied, and it is also not clear whether the introduction of the magnetic field has a further effect. Therefore, mesoporous hollow Fe3O4 nanoparticles (MHFPs) were synthesized. We selected an alternating magnetic field (AMF) because it may confer a stronger effect on MHFPs as compared to a static magnetic field, and then explored the field's ability to induce macrophage polarization. Furthermore, the effects of this regulation on other neuro-associated cells were also explored. Our results suggest that MHFPs can efficiently induce polarization of macrophages at the concentration of 40 µg mL-1, upregulate the expression of related genes and cytokines, and further promote the proliferation of neural stem cells and the subsequent migration of vascular endothelial cells. These effects were significantly enhanced after the application of an AMF. This work also showed that the internalization of particles is the starting point for polarization regulation.

A 3-Year Longitudinal Study of Effects of Parental Feeding Practices on Child Weight Status: The Childhood Obesity Study in China Mega-Cities.

This study examined the longitudinal associations between parental feeding practices and child weight status, and their potential modification effects by child sex, age, and maternal and paternal educations among children. Data were collected from 2015 to 2017 of 2139 children aged 6-17 years and their parents in five Chinese mega-cities. Parental feeding practices were assessed using 11-items from Child Feeding Questionnaire. Waist-to-height ratio (WHtR), body mass index (BMI), and general and central obesity were measured and analyzed using a mixed-effects model. Three parental feeding patterns were identified by factor analysis including "concern", "pressure to eat", and "control". Concern was associated with higher BMI z-score, WHtR (ßs ranged from 0.01 to 0.16), and general obesity (ORs ranged from 1.29 to 6.41) among children aged ≤12 years and >12 years, regardless of child sex and parental educations. Pressure to eat was associated with lower BMI z-score (ß = -0.08, p < 0.001), WHtR (ß = -0.004, p < 0.01), and general (OR = 0.53, 95%CI = 0.42, 0.66) and central obesity (OR = 0.72, 95%CI = 0.58, 0.90) among children aged ≤12 years. Further analyses showed that significant associations were found for children with maternal or paternal education of college and above. Control was associated with increased risk of general and central obesity among children with maternal education of college and above, regardless of age. Our study indicates that higher concern and lower pressure to eat were associated with increased risk of obesity among children. Control was associated with increased risk of obesity among children with maternal education of college and above. Future childhood obesity preventions may optimize parental feeding practices.

Prevalence, Management, and Associated Factors of Obesity, Hypertension, and Diabetes in Tibetan Population Compared with China Overall.

Tibetans' life expectancy lags behind China's average. Obesity and noncommunicable diseases (NCDs) contribute to health disparity, but NCD patterns among Tibetans are unknown. To examine the prevalence, management, and associated factors for obesity, hypertension, and diabetes among Tibetans, compared with China's average, we systematically searched PubMed and China National Knowledge Infrastructure databases for studies between January 2010 and April 2021. Thirty-nine studies were included for systematic review, among thirty-seven that qualified for meta-analysis, with 115,403 participants. Pooled prevalence was 47.9% (95% CI 38.0-57.8) for overweight/obesity among adults (BMI ≥ 24 kg/m2) and 15.4% (13.7-17.2) among children using Chinese criteria, which are lower than the national rates of 51.2% and 19.0%, respectively. The estimate for hypertension (31.4% [27.1-35.7]) exceeded China's average (27.5%), while diabetes (7.5% [5.2-9.8]) was lower than average (11.9%). Men had a higher prevalence of the three conditions than women. Residents in urban areas, rural areas, and Buddhist institutes had monotonically decreased prevalence in hypertension and diabetes. Awareness, treatment, and control rates for hypertension and diabetes were lower than China's average. Urban residence and high altitude were consistent risk factors for hypertension. Limited studies investigated factors for diabetes, yet none exist for obesity. Tibetans have high burdens of obesity and hypertension. Representative and longitudinal studies are needed for tailored interventions. There are considerable variations in study design, study sample selection, and data-analysis methods, as well as estimates of reviewed studies.

Increased Incidence of Hashimoto Thyroiditis in Selenium Deficiency: A Prospective 6-Year Cohort Study.

CONTEXT: In 2015, we reported an increased prevalence of thyroid disease in a county of low habitual selenium (Se) intake in comparison to a neighboring county with higher intake in a cross-sectional survey in Shaanxi Province, China. OBJECTIVE: To explore longitudinal effects of low Se status, a prospective cohort study was conducted in the same area from 2013 to 2019, and thyroid peroxidase autoantibodies (TPO-Abs) and disease incidence were compared. METHODS: A total 1254 individuals from 1500 reinvited participants were successfully enrolled. Venous blood, fingernails, and urine samples were collected and analyzed to evaluate thyroid status, TPO-Abs, serum Se, and urinary iodine. Diagnosis of Hashimoto thyroiditis (HT) was based on elevated thyrotropin, presence of TPO-Abs, and ultrasound characteristics. Se deficiency was categorized using a serum concentration of 80 µg/L as a threshold, and tested by logistic regression for a relationship to TPO-Abs and HT. RESULTS: Se deficiency was observed in 46.2% of participants from the adequate-Se county (Ziyang) and in 89.7% from the low-Se county (Ningshan). Se concentrations in fingernails differed strongly by residency (Ziyang vs Ningshan; 678.7 vs 364.3 µg/kg; Z = -9.552; P < .001). Newly diagnosed HT in Ziyang was less frequent than in Ningshan (0.09% vs 0.31%; χ 2 = 4.350; P = .037). The conversion rate to seropositive TPO-Abs was 10.2% in Ningshan vs 5.6% in Ziyang. Excluding iodine as confounding factor, low-Se was confirmed as a risk factor for HT (relative risk [95% CI]; 3.65 [1.03-12.90]; P < .05). CONCLUSION: The data indicate an increased incidence of TPO-Ab seroconversion with low Se supply and support the hypothesis that Se deficiency contributes to HT as a modifiable risk factor.

Dietary Intake and Nutritional Status among Refugees in Host Countries: A Systematic Review.

Refugees remain vulnerable to acute food insecurity, malnutrition, and critically inadequate food and nutrient intake after migration, regardless of the economic level of the host country. We conducted this systematic review to summarize and evaluate the dietary intake and nutritional status among refugees resettled in non-camp settings worldwide. We searched PubMed and Web of Science databases to review relevant studies published between 2009 and 2020 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We also conducted an additional manual search through PubMed and Google Scholar. Studies that evaluated both dietary intake and nutritional status of refugees in host countries were included. A total of 15 articles from 10 countries were included and assessed for study quality and outcomes. Poor dietary diversity and insufficient intake of specific food groups were reported. In addition to these dietary patterns, a high prevalence of stunting, underweight, and anemia was reported, particularly among children. A double burden of malnutrition was also observed across and within studies. Post-resettlement dietary intake and nutritional status of refugees are both influenced by factors at the pre- and post-resettlement stages as refugees transition to their host countries. Those factors, including pre-resettlement experiences, host country resources, socioeconomic status, acculturation, and food security, were summarized and presented in a conceptual model. There is a need for comprehensive dietary and health screening as well as culturally appropriate and sustainable nutrition education resources and interventions for refugees to improve their diet and nutrition. Longitudinal studies and novel methodological approaches are also suggested to measure changes in refugees' food intake and nutritional status as well as to further investigate factors associated with these 2 components.

Potentially modifiable mediators for socioeconomic disparities in childhood obesity in the United States.

OBJECTIVE: The aim of this study was to examine modifiable mediators for socioeconomic disparities in childhood obesity in the United States. METHODS: This study used the data of 1,211 mother-child dyads from a US national birth cohort from pregnancy to 6 years post partum. Socioeconomic status was indicated by maternal education (college graduate vs. less) and family income (>185% vs. ≤185% of the poverty line). Single- and multiple-factor mediation analyses were conducted for socioeconomic disparities in childhood obesity at 6 years, adjusting for demographics. RESULTS: The confounder-adjusted relative risk of childhood obesity was 1.79 for low maternal education and 1.42 for low family income. Low-maternal-education-related obesity was individually mediated by maternal preconception BMI (percentage of indirect effect, 8.8%), smoking during pregnancy (7.0%), infant weight gain (14.4%), child sleep duration (11.4%), and TV viewing during weekdays at 6 years (4.9%). Low-family-income-related obesity was mediated by maternal preconception BMI (18.5%), smoking during pregnancy (6.3%), child sleep duration (12.8%), and the home learning environment at 6 years (26.2%). In multiple-mediator analysis, significant mediators together mediated 54.0% of maternal-education-related or 39.4% of family-income-related disparities. CONCLUSIONS: Maternal preconception BMI, smoking during pregnancy, infant weight gain, child sleep, TV viewing, and the home learning environment substantially mediated socioeconomic disparities in childhood obesity in the United States.

National childhood obesity-related intervention systems and intervention programs in China in 1949 to 2020: A narrative review.

OBJECTIVE: This review examines main government and nongovernmental institutions for childhood obesity prevention and control in China, as well as major national interventions for childhood obesity. METHODS: PubMed, China National Knowledge Infrastructure (CNKI), Wanfang, official websites of national governments and professional institutions/associations, Baidu.com, and Google.com were systematically searched in March 2020 to April 2020. A total of 20 international and national experts on childhood obesity were surveyed. RESULTS: "Government-led multisector cooperation" obesity-related intervention systems have been formed. National-level interventions were mainly implemented by the Chinese State Council and its administrative departments, along with national professional institutions/associations. Provincial, municipal, and county governments and their subordinate departments coordinated local works. Actions taken by these sectors to fight childhood obesity included developing and implementing regulations and laws, health standards and practice guidelines, surveillance for obesity and related determinants, governmental budget and research funds, and interventions. A total of 14 major national childhood obesity-related interventions were found: comprehensive interventions (e.g., "Healthy Lifestyle for All campaign," 2007), diet and nutrition (e.g., "Chinese Rural Compulsory Education Student Nutrition Improvement Program," since 2011), and physical activity (e.g., "Happy 10 Minutes Program," 2006). CONCLUSIONS: Although obesity-related intervention systems and national interventions were implemented, more efforts and stronger government leadership and commitment are needed.