[Trend in meat consumption patterns among Chinese children in nine provinces(autonomous region) aged 6 to 17 years between 1991 and 2011].

OBJECTIVE: To examine the trend in meat consumption patterns between 1991 and 2011 in Chinese children in nine provinces(autonomous region) aged 6 to 17 years. METHODS: A multistage, random cluster sampling process was used to investigate 2720, 2702, 2525, 2405, 1509, 1238, 1085, and 936 children and adolescents aged 6-17 years in 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011 respectively in 9 provinces (autonomous region) in China. Their consecutive 3 d 24 h dietary recall data were analyzed to compare meat intake pattern in children and adolescents with different characteristics and different years. RESULTS: The consumption rate increased from 60.9% (1657/2720) in 1991 to 87.2% (816/936) in 2011 for livestock meat (χ(2) = 458.23, P < 0.01), from 9.4% (257/2720) to 33.3% (312/936) for poultry (χ(2) = 446.07, P < 0.01) and from 27.3% (743/2720) to 40.6% (380/936) for seafood (χ(2) = 89.89, P < 0.01). The median of total meat intake increased from 47.4 g/d in 1991 to 100.0 g/d in 2011 (χ(2) = 516.77, P < 0.01), poultry intake from 33.3 g/d to 60.0 g/d (χ(2) = 420.13, P < 0.01), pork intake from 26.7 g/d to 50.0 g/d (χ(2) = 380.50, P < 0.01). The percentage of children whose livestock meat and poultry intakes higher than the recommended amount increased from 32.9% (896/2720) in 1991 to 59.8% (560/936) in 2011 (χ(2) = 392.97, P < 0.01); the percentage of children whose seafood intakes meeting the recommended amount increased from 6.9% (187/2720) in 1991 to 8.8% (82/936) in 2011 (χ(2) = 21.52, P < 0.01). The consumption rates of livestock meat in urban and rural children increased from 81.2% (536/660) and 54.4% (1121/2060) in 1991 to 94.7% (234/247) (χ(2) = 38.34, P < 0.01) and 84.5% (582/689) (χ(2) = 429.26, P < 0.01) in 2011. The intakes of livestock meat in rural children increased from 16.7 g/d in 1991 to 56.7 g/d in 2011 (χ(2) = 472.46, P < 0.01). CONCLUSION: The overall pattern of meat consumption in Chinese children in nine provinces(autonomous region) was unreasonable between 1991 and 2011. There was a significant improvement in meat consumption in rural children over time.

[Trends in dietary protein intake among Chinese children and adolescent between 1991 and 2009].

OBJECTIVE: To examine dietary protein intake and its trend between 1991 and 2009 among Chinese children and adolescents aged 6 to 17 years. METHODS: Consecutive 3 d-24 hr Dietary Recall and household income data of 14 053 children from the seven waves of the China Health and Nutrition Survey (CHNS), 1991, 1993, 1997, 2000, 2004, 2006 and 2009 were used to describe long-term changes in dietary protein intake, percentage energy, and food sources. RESULTS: The median of dietary protein intake of Chinese children and adolescents decreased from 60.0 g/d in 1991 to 52.6 g/d in 2009 (χ² = 109.0, P < 0.01). The dietary protein intake among children in rural areas and in low-income households decreased 8.8 g/d (χ² = 74.8, P < 0.01) and 9.8 g/d (χ² = 100.5, P < 0.01) respectively. The percentage of total energy intake from protein was 11.3%-13.0%. The percentage of protein intake equal or higher than Recommended Nutrient Intake of protein decreased from 29.5% in 1991 to 19.2% in 2009 (χ² = 259.6, P < 0.01). Furthermore, the proportion of high-quality dietary protein increased rapidly. The percentage of animal protein increased from 12.3% in 1991 to 32.2% in 2009 (χ² = 750.3, P < 0.01), while no big increase in soybean protein (lower than 5.0%). CONCLUSION: There is a decreasing trend in dietary protein intake among Chinese children from 1991 to 2009. The high-quality protein intake was improved but we should be concerned about the high proportion of animal protein. The children living in low-income households and in rural areas may be at risk of inadequate dietary protein.

[Trend of energy intake among Chinese children and adolescents in nine provinces from 1989 to 2009].

OBJECTIVE: To examine the trends of energy intake among Chinese children and adolescents in nine provinces from 1989 to 2009. METHOD: Stratified multi-stage cluster sampling method was used to recruit 488, 2807, 2802, 2580, 2520, 1604, 1305 and 1159 children and adolescents aged 6 - 17 years in each year of 1989, 1991, 1993, 1997, 2000, 2004, 2006 and 2009 in 9 provinces. The descriptive analyses were carried out for three days 24-h dietary recall data to compare energy intake by year and demographic characteristics. RESULTS: The median of dietary energy intake among Chinese children and adolescents aged 6 - 17 years in 1989, 1991, 1993, 1997, 2000, 2004, 2006 and 2009 were 6645.7, 8314.8, 7849.3, 8115.0, 7970.5, 7598.0, 7345.0 and 7051.9 kJ/d (χ(2) = 239.75, P < 0.01), respectively. In 2009, children and adolescents from city (7820.4 kJ/d) and county (7356.0 kJ/d) consumed more energy than that from suburb (7168.2 kJ/d) and village (6863.5 kJ/d) (χ(2) = 8.00, P < 0.05). Cereal was the main food source of energy intake. In 2009, the percentage of energy intake from cereal was 44.0%, 45.6%, 52.9% and 61.0% (χ(2) = 36.75, P < 0.01)for city, suburb, county and village respectively. The percentage of population with > 30% of energy intake from dietary fat increased yearly and that with more than 60% of energy from carbohydrate decreased, from 25.4% (124/488) and 54.1% (264/488) in 1989 to 58.1% (637/1159) and 15.9% (184/1159) (χ(2) values were 811.24, 919.35 respectively;both P values < 0.05) in 2009. The percentage of children and adolescents whose energy intake was more than 80% recommended nutrient intake (RNI) declined from 60.2% (294/488) in 1989 to 47.8% (554/1159) in 2009(χ(2) = 227.66, P < 0.05). CONCLUSION: The current study demonstrated that energy intake of Chinese children and adolescents increased at early stage and then declined in the recent years. Average energy intake was higher in city and county than suburb and village.

[Trend in dietary vitamin C intake among Chinese children and adolescents between 1991 and 2009].

OBJECTIVE: To examine status and trend in dietary vitamin C intake between 1991 and 2009 in Chinese children and adolescents aged 6 to 17 years. METHODS: A stratified multistage, random cluster sampling process was used to investigate 2716, 2691, 2507, 2358, 1490, 1218 and 1073 children and adolescents aged 6 - 17 years in 1991, 1993, 1997, 2000, 2004, 2006 and 2009 respectively in 9 provinces. Their consecutive 3 d 24 h dietary recall data were analyzed to compare vitamin C intake in children and adolescents with different characteristics and different years. RESULTS: The median of dietary vitamin C intake in Chinese children and adolescents decreased from 69.7 mg/d in 1991 to 53.4 mg/d in 2009 (χ(2) = 188.1, P < 0.01). Vitamin C intake of rural children and adolescents decreased from 73.7 mg/d in 1991 to 52.5 mg/d in 2009 (χ(2) = 96.7, P < 0.01); vitamin C intake of children and adolescents in the low-income household decreased from 74.3 mg/d in 1991 to 47.5 mg/d in 2009 (χ(2) = 172.9, P < 0.01). The percentage of children and adolescents whose vitamin C intake equal or higher than recommended nutrient intake of vitamin C decreased from 35.9% (974/2716) in 1991 to 18.5% (198/1073) in 2009 (χ(2) = 284.7, P < 0.01). CONCLUSION: There was a decreased trend in dietary vitamin C in Chinese children and adolescents during the past two decades. The children and adolescents of low-income household in rural areas may pose a higher risk of inadequate vitamin C intake.

[The status of dietary sodium intake of Chinese population in nine provinces (autonomous region) from 1991 to 2006].

OBJECTIVE: To analyze the status of dietary sodium intake of 18 - 65 years old Chinese people in nine provinces (autonomous region) in 1991 and 2006. METHODS: In 1991 and 2006, China Health and Nutrition Survey was carried out in nine provinces, including Liaoning, Heilongjiang, Shandong, Jiangsu, Henan, Hunan, Hubei, Guangxi and Guizhou, Subjects were selected by multi-stage stratified cluster random sampling method from 18 - 65 years old people and 8235 subjects in 1991 and 7788 subjects in 2006. Sodium intake analysis was conducted across gender, regions and rural(urban) residences. RESULTS: On average, sodium intake decreased from (6750.6 ± 3771.5) mg/d in 1991 to (4949.7 ± 2829.4) mg/d in 2006 (Z = -35.5, P < 0.01) among the 18 - 65 years old people. In 1991 and 2006, the main sources of dietary sodium were salt, soy sauce and vegetable. In 1991, the proportion were 79.6% ((5375.6 ± 3532) mg/d), 8.7% ((586.7 ± 721.7) mg/d) and 7.5% ((506.9 ± 906.1) mg/d), respectively. In 2006, the proportion were 71.5% ((3539.8 ± 2545) mg/d), 8.3% ((410.7 ± 547.9) mg/d) and 6.2% ((304.6 ± 610.7) mg/d), respectively. CONCLUSIONS: Among 18 - 65 years old residents, sodium intake in 2006 was significantly lower than that in 1991, but still far beyond the 2200 mg/d of adequate intake level (2200 mg/d). The major source of sodium intake in Chinese diet was condiments.

[The status and trend of cereal consumption among Chinese adults in nine provinces (municipality) from 1989 to 2006].

OBJECTIVE: To explore the status and trend of cereal consumption among Chinese adults aged 18 to 59 years in nine provinces (municipality) from 1989 to 2006. METHODS: The survey data were collected by consecutive 3 d 24 h dietary recall method in 1989, 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey Project. The subjects aged 18-59 years with complete information on dietary survey were included. The sample number of the subjects were 5978, 7566, 7492, 7738, 8439, 7484 and 7157 in the 7 round surveys from 1989 to 2006, respectively. The trends of their cereal consuming rate and daily intake were analyzed by year, gender, age and regions. RESULTS: The cereal intake of 18 - 59 years old Chinese adults in 9 provinces (municipality) decreased from 522.3 g/d in 1989 to 431.9 g/d in 2006 (χ(2) = 2421.76, P < 0.01). The cereal intake of males decreased from 545.6 g/d in 1989 to 471.6 g/d in 2006 (χ(2) = 861.21, P < 0.01) and females decreased from 500.3 g/d in 1989 to 395.5 g/d in 2006 (χ(2) = 1844.13, P < 0.01). Compared with 1989, the average cereal consumption were reduced to 104.8, 134.4, 103.3 and 98.2 g in the suburban, female, 18 to 29 years old age group and level of education for college and above separately in 2006. The rice consuming rate among 18 - 59 year-old residents increased from 79.9% (4776/5978) in 1989 to 87.3% (6248/7157) (Z = 18.45, P < 0.01) in 2006, the wheat consuming rate increased from 63.3% (3784/5978) in 1989 to 80.2% (5740/7157) (Z = 27.28, P < 0.01) in 2006. CONCLUSION: The present study indicated that there was a decreasing trend of cereal intake among Chinese adults aged 18 - 59 years in 9 provinces (municipality). In the stratified groups, cereal intake in groups of female, suburb, aged 18 - 59 years and higher educational level decreased significantly.

[Milk consumption and its changing trend of Chinese adult aged 18 - 44 in nine provinces (autonomous region) from 1991 to 2006].

OBJECTIVE: To investigate the age, gender and region specified milk consumption and its changing trends of Chinese 18 - 44 years old adults in 9 provinces (autonomous region) from 1991 to 2006. METHODS: The data of 18 - 44 aged old adults investigated in Chinese Health and Nutrition Survey from 1991 to 2006 in 9 provinces (autonomous region) were utilized. The numbers of the subjects selected in 1991, 1993, 1997, 2000, 2004 and 2006 were 5593, 5491, 5334, 4188 and 3908, respectively. Changes of the percentage of milk consumption, average intake of daily milk and dietary calcium intake were analyzed across different groups of gender, income levels, and areas. RESULTS: There was an increasing trend in the percentage of milk consumption and daily intake of milk from 1991 to 2006. The average percentage of Chinese adult milk consumption went up from 2.2% (123/5593) in 1991 to 7.6% (297/3908) in 2006 (Z = -22.16, P < 0.01). Specifically, urban adult and rural adult showed significant increase in the percentages from 9.7% (80/823) to 23.7% (112/472) (Z = -12.81, P < 0.01) and 0.1% (2/2937) to 1.8% (36/1987) (Z = -9.21, P < 0.01) respectively. Percentages of adult who ever drank milk at top income level and bottom income level increased from 4.7% (95/2006) to 14.6% (200/1373) (Z = -17.36, P < 0.01) and from 0.1% (2/1748) to 2.4% (28/1171) (Z = -9.58, P < 0.01), respectively. Meanwhile, the average daily intake of milk increased from (3.6 ± 24.6) g/d in 1991 to (11.8 ± 51.4) g/d in 2006 (F = 67.07, P < 0.01). The daily milk consumption among top income level adults and bottom income level adults increased from (8.5 ± 50.9) g/d to (23.1 ± 71.5) g/d and from (0.2 ± 6.5) g/d to (3.3 ± 23.5) g/d (F = 13.90, P < 0.01), respectively. From 1991 to 2006, milk consumers significantly promoted their percentage of achieving the Chinese dietary reference intake on calcium (800 mg/d) from 6.5% (8/123) to 12.8% (38/297) (Z = -1.67, P < 0.05), whereas this percentage increased from 1.6% (38/5470) to 3.6% (130/3611) among milk non-consumers (Z = -5.66, P < 0.01). CONCLUSION: Chinese adult milk intake still remains in quite low level, and the situation of milk consumption among rural adults requires further promotion.

[Milk consumption and effects on dietary nutrients and growth status among Chinese children in nine provinces (autonomous region) from 1991 to 2006].

OBJECTIVE: To investigate milk consumption and effects on dietary nutrients and growth status among 7 - 17 years-old Chinese children in 9 provinces (autonomous region) from 1991 to 2006. METHODS: Data was collected in 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey, and 11 691 subjects aged 7 to 17 years old were included. The subjects were divided into the following groups according to milk consumption per day, 0 (no milk drinking), 1 - 99, 100 - 199, 200 - 299 and ≥ 300 g/d. Variables from different years were compared, such as milk categories, energy, protein, calcium intake, body mass index (BMI), as well as that dietary nutrients, height and weight among different milk consumption groups. RESULTS: From 1991 to 2006, milk drinking rate and milk consumption among Chinese children had great improvement: milk drinking rate reached to 14.1% (161/1145) in 2006, while that was 3.0% (73/2441) in 1991; milk consumption reached to (26.7 ± 85.0) g/d in 2006, which was 6.8 times of that in 1991 (3.9 ± 31.9) g/d (χ(2) = 474.5, P < 0.01). BMI increased from (17.3 ± 2.9) kg/m(2) in 1991 to (18.5 ± 6.0) kg/m(2) in 2006 (χ(2) = 123.5, P < 0.01). Meanwhile, energy intake decreased from (8653.3 ± 2789.2) kJ/d in 1991 to (8058.3 ± 2866.6) kJ/d in 2006 (χ(2) = 72.6, P < 0.01); protein intake decreased from (63.0 ± 22.8) g/d in 1991 to (57.3 ± 23.1) g/d in 2006 (χ(2) = 71.9, P < 0.01). Average height of 0 (no milk drinking), 1 - 99, 100 - 199, 200 - 299 and ≥ 300 g/d groups were (142.9 ± 16.9), (146.9 ± 18.8), (147.6 ± 16.2), (148.8 ± 16.0), (149.9 ± 15.3) cm, respectively (χ(2) = 29.4, P < 0.01); average weight were (37.1 ± 13.2), (40.3 ± 13.9), (41.3 ± 16.9), (41.7 ± 14.6), (41.4 ± 12.2) kg, respectively (χ(2) = 25.7, P < 0.01). CONCLUSION: In the period of 1991 to 2006, milk drinking rate and milk consumption has improved greatly. Main nutrient intake, height and weight increased with milk consumption.

[Status and trend of alcohol consumption among adults in nine provinces (antonomous region) of China from 1993 to 2006].

OBJECTIVE: To understand the status and trend of alcohol consumption among adult people living in 9 provinces (autonomous region) of China from 1993 to 2006. METHODS: The data was collected at the China Health and Nutrition Survey in 1993, 1997, 2000, 2004 and 2006, the subjects with complete drinking data of adult residents were involved. The sample of subjects were 7994, 8625, 9283, 9780 and 9746 among 5 round surveys respectively. Alcohol intake, drinking frequency, drinking type, drinking amount and trends of changing was analyzed. RESULTS: The average drinking rates were 60.2% (13 201/21 919) and 9.7% (2269/23 509) among male and female respectively. The average alcohol intake was (32.2 ± 35.6) g in male and (14.0 ± 19.4) g in female drinkers. Male drinkers with primary and secondary schools or below education had the lowest level of drinking rate, which was 59.7% (985/1651), 58.7% (941/1604), 57.0% (889/1560), 55.4% (885/1599) and 53.1% (812/1529) in the 5 round surveys respectively. However, the average daily alcohol intake was the highest, which was (31.1 ± 38.2) g, (39.8 ± 42.1) g, (38.9 ± 41.3) g and (38.4 ± 43.3) g at 1997, 2000, 2004, 2006 respectively. The male drinkers with college or above education had the lowest alcohol intake, which was (21.9 ± 24.5) g, (28.8 ± 30.9) g, (24.6 ± 22.0) g and (25.0 ± 26.4) g in 1997, 2000, 2004 and 2006 respectively. Female drinkers with college or above education had the highest drinking rate, which was 21.0% (13/62), 24.5% (26/106), 16.6% (27/163), 19.7% (38/193) and 18.8% (46/245) at 5 round surveys respectively. But their average daily alcohol intake was lowest, which was (4.7 ± 3.3) g, (12.5 ± 31.9) g, (9.9 ± 18.7) g and (8.2 ± 8.5) g at 1997, 2000, 2004, 2006 respectively. And the average daily alcohol intake was the highest among female drinkers with primary and secondary schools or below education, which was (13.4 ± 16.9) g, (16.3 ± 22.4) g, (19.9 ± 26.1) g and (16.4 ± 18.0) g respectively. According to the regional distribution, the highest drinking rate of female drinker was occurred at urban female, which was 17.4% (110/631), 19.9% (147/740), 17.4% (129/741), 14.4% (117/814) and 11.3% (88/781) at 5 round surveys. Drinking every day was most popular in male drinkers, the proportion was 32.6% (3533/10 844). Drinking 1 to 2 times per week, 1 to 2 times per month, no more than 1 time per month was most popular in female drinkers, the proportion was 23.0% (410/1786), 24.6% (440/1786) and 21.2% (379/1786) respectively. Male drinkers liked liquor more (drinking rate was 81.8%, 8875/10 844). The wine drinking rate of female (22.3%, 399/1786) is far higher than that of male's (9.0%, 976/10 844) (χ(2) = 280.4, P < 0.01). The daily alcohol intake equal to or greater than 25 g of male drinkers was 42.0% (4058/9654), and the daily alcohol intake equal to or greater than 15 g of female drinkers was 25.3% (349/1378). CONCLUSION: The drinking rate of adults among 9 provinces (autonomous region) was higher than that of national average level. The drinking rate and the average alcohol consumption among male and female was significantly different. Same differences was observed among education level and different regions.

[Trends of the dietary fiber intake among Chinese aged 18 - 45 in nine provinces (autonomous region) from 1989 to 2006].

OBJECTIVE: To analyze the status and trend of dietary fiber intake and its food sources among Chinese residents aged 18 - 45 years old in 9 provinces (autonomous region), from 1989 to 2006. METHODS: Twenty-four-hour dietary recall data of three consecutive days from China Health and Nutrition Survey (1989, 1991, 1993, 1997, 2000, 2004 and 2006) were used. And the 18 - 45 years old subjects with complete information on dietary survey were included. The sample size of these 7 surveys were 5597, 5596, 5323, 5485, 5308, 4144 and 3889, respectively. The trends of dietary fiber intake and food sources by time and sex were studied. RESULTS: From 1989 to 2000, the total of daily dietary fiber intake of 18 - 45 years old healthy residents decreased from 15.1 g/d to 11.6 g/d, insoluble dietary fiber intake decreased from 22.6 g/d to 17.8 g/d. In villages, from 1989 to 2000, the insoluble dietary fiber intake decreased 5.1 g/d in males and 5.2 g/d in females(13.2, 11.8 g in 2000, respectively;18.3, 17.0 g in 1989, respectively). In 2006, the insoluble dietary intake was 12.6 g/d in males and 11.2 g/d in females in villages. In cities, from 1989 to 2006, the insoluble dietary fiber intake was 9.4 - 11.8 g/d in males and 8.3 - 10.8 g/d in females. The total dietary fiber intake was 15.7 - 17.6 g/d in males and 13.5 - 16.4 g/d in females. The difference of insoluble and total dietary fiber intake between city and village was decreasing. In 2006, 70.6% (8.4/11.9) insoluble dietary fiber came from vegetables ((4.1 ± 3.1) g/d), wheat flour and its products ((2.6 ± 3.6) g/d), rice and its products ((1.7 ± 1.3) g/d). CONCLUSION: Dietary fiber intake among Chinese aged 18 - 45 in 9 provinces (autonomous region) decreased from 1989 to 2006. Vegetables, wheat flour, rice and their products were the major food sources of insoluble dietary fiber.

[Food consumption trend of Chinese adults in nine provinces (autonomous region) from 1989 to 2006].

OBJECTIVE: To analyze the trends of food consumption among Chinese residents aged from 18 to 59 years old in 9 provinces (autonomous region) from 1989 to 2006. METHODS: The paper was based on data collected in 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey of Chinese residents of 24 h in three consecutive day dietary recall data. The healthy residents aged 18 - 59 years with twenty-four-hour dietary recall data were selected as study subjects. The sample sizes of these seven surveys were 5766, 7296, 7019, 7599, 8143, 7168 and 6827, respectively. The trends of their food consumption in each year were analyzed through Kruskal-wallis method. RESULTS: The intake of cereals decreased significantly from (528.5 ± 192.9) g/d in 1989 to (427.7 ± 173.8) g/d in 2006 (χ(2) = 2833.13, P < 0.01). The minor variation of soybean food intake was observed. The average intake was (22.3 ± 39.4) g/d in 1989 and (18.9 ± 30.5) g/d in 2006 which was still at a low level. The trend of vegetables intake showed a small decrease. It was (374.5 ± 205.9) g/d in males and (346.4 ± 187.6) g/d in females in 2006, respectively. Both quantity and rate of fruits consumption showed an increase trend. Its consumption rate reached at 22.5% (741/3296) in males and 27.7% (1004/3619) in females in 2006, respectively. The average intake increased from (122.4 ± 126.9) g/d in 1989 to (228.5 ± 267.3) g/d in 2006 (χ(2) = 539.66, P < 0.01). At the same time, the daily intake of meat and egg showed a large increase, the average meat intake increased from (97.0 ± 111.5) g/d in males and (80.2 ± 97.0) g/d in females in 1989 to (141.5 ± 125.2) g/d in males and (118.4 ± 111.8) g/d in females in 2006, respectively. The oil consumption showed a significant increase. The average intake increased from (30.4 ± 37.9) g/d in 1989 to (42.8 ± 32.3) g/d in 2006 (χ(2) = 1646.94, P < 0.01). CONCLUSIONS: There have been noticeable changes in the Chinese dietary pattern in the past 17 years. Some changes would be helpful for nutritional improvement in Chinese people, but it also caused some adverse effects on health because of improper food consumption.

[Impact of metabolic syndrome with hyperglycemia on prevalence of stroke in Chinese].

OBJECTIVE: To investigate the impact of metabolic syndrome (MS) with or without hyperglycemia on stroke prevalence compared to that of diabetes alone. METHODS: 44 100 subjects, 20 570 males and 23 530 females, aged 25 - 75, who had participated in the Chinese Residents Nutrition and Health Examination Survey held in the mainland of China 2002, underwent anthropometry, measurement of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), high density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), and 2 hour plasma glucose (2 h PG) after 75 g oral glucose tolerance test (OGTT). 22 570 subjects, 10 698 males and 11 872 females, were divided into 5 groups: control group without MS risk factors (n = 17 518), Group of diabetes mellitus (DM) without MS (n = 638), group of MS with normoglycemia (n = 2501), Group of MS with mild hyperglycemia (n = 1058), and group MS with DM (n = 855). The relationship between MS and stroke was studied by multiple logistic regression analysis. RESULTS: The prevalence of MS increased along with age. The MS prevalence rates of the subjects with FPG > or = 5.6 mmol/L in the age groups 25 - 34, 35 - 44, 45 - 54, and > or = 55 were 23.5%, 37.2%, 45.7%, and 53.0% respectively, all significantly higher than those of the subjects with the FPG < 5.6 mmol/L (2.2%, 4.7%, 7.8%, and 9.5% respectively, all P < 0.01). The prevalence rates of stroke of the groups of DM, normal blood sugar with MS, mild hyperglycemia with MS, and DM with MS were 2.94%, 2.27%, 2.89%, and 4.11%, respectively, all significantly higher than that of the control group (0.19%, all P < 0.01). After adjustment for age, sex, smoking status, and LDL-C, no significant difference was observed between the neighboring MS groups (all P > 0.05). Compared to the group of MS with normoglycemia, the OR value for stroke of the DM with MS was 1.84 (95% CI 1.20 - 2.83, P < 0.01), which was still significant after adjusting for LDL-C (P < 0.05). CONCLUSION: (1) People with glucose intolerance had very high prevalence of stroke than novmoglgcemic people. (2) Hyperglycemia in MS has an extremely important role in the impact of MS on stroke in Chinese. (3) Diabetes by itself has the same significance as the combination of MS components in the development of stroke.

[Do isolated hypertension and metabolic syndrome have equal risk of stroke in Chinese adults?].

OBJECTIVE: To analyze whether isolated hypertension and metabolic syndrome ( Based on the 2005 IDF criteria) have equal risk on stroke in Chinese adults. METHODS: 25194 subjects (25-75 years old) from Chinese National Health and Nutrition Survey in 2002 were divided into control group, isolated hypertension ( i-HTN) group, metabolic syndrome (MS) without hypertension ( non-HTN/MS) group , MS with hypertension (HTN/MS) group. The clinical features and risk for stroke ( using multiple logistic stepwise regression analysis) were compared among 4 groups. RESULTS: (1) The clinic features in the i-HTN group was non-central obesity, and its plasma glucose, triglyceride 9TG), high density lipoprotein cholesterol ( HDL-C) levels were normal . (2) The prevalence of stroke in control group , i-HTN group, non-HTN/MS group and HTN/MS group was 0.14%, 1.27%, 1.19% and 2.14%, respectively. (3) After adjustment for age, sex, smoking, low density lipoprotein cholesterol level, logistic regression analysis showed that the i-HTN group, non-HTN/MS group and HTN/MS group had higher risk of stroke compared with the controls, the odd ratio (OR) were 4.18, 8.00, 8.69 (P < 0.01), respectively. Compared with i-HTN group, OR in HTN/MS group was 2.05, while no difference was found between i-HTN group and non-HTN/MS group ( P>0.05). (4) Among different components of the MS, hypertension (OR 2.33), central obesity (OR 2.09), low HDL-C (OR 1.69), hyperglycemia (OR 1.66) except hypertriglyceridemia were all significantly related to stroke (P < 0.01). CONCLUSION: (1) MS and hypertension were an independent risk factor for the development of stroke in Chinese adults. (2) Though there was no clinical features of insulin resistance in i-HTN group, it was observed that the i-HTN and non-HTN/MS had equal contribution to stroke. The risk of stroke will be further increased if hypertension included in the MS.

[Analysis on influence factors of dietary supplement used in population aged above 45 years in Beijing].

OBJECTIVE: To explore influence factors of dietary supplement used in population aged above 45 years in Beijing. METHODS: Utilizing the data of the survey of dietary supplement (DS) used in Beijing in 2006 was to investigate the influence factors by using multi-factorial logistic regression analysis. RESULTS: All 2487 samples were included in the analysis. Sex, age, average income of each month for each member of the family, experiences of deficiency of nutrition, attitude to nutrition knowledge, attitude to the need of DS and city-or-rural resident had shown effects on DS using. The percentage of using DS in female was higher than that in male being 19.3% and 11.8% respectively. The percentage grew up as the age became older. The same trend appeared as the economic-status going up, but not as education level change. Use of DS was greater in urban population (16.9%) than in rural population (14.6%). The percentage of using DS in people who had or just been diagnosed as malnutrition/deficiency disease or chronic disease, or those who thought themselves having got these diseases only by their own feeling were higher than those did not. CONCLUSION: People the female, the elder, or those having higher income, having experiences of deficiency of nutrition, are more interested in nutrition knowledge, and more positive in need of DS and those living in rural should be the target population of nutrition education for DS use.

New Chinese dietary guidelines: healthy eating patterns and food-based dietary recommendations.

BACKGROUND AND OBJECTIVES: The Chinese Dietary Guidelines (CDGs) were first released to the public in 1989 by the Chinese Nutrition Society (CNS). In 2016, the Ministry of Health commissioned the CNS to revise and publish new CDGs. METHODS AND STUDY DESIGN: The CNS convened an expert committee of leaders in the fields of nutrition, epidemiology, public health, preventive medicine, and food science. The CDGs were revised according to the World Health Organization Handbook for Guideline Development procedures. The expert committee recommended key inclusions for the CDGs on the basis of the current status of public health and priority health challenges affecting the Chinese population, as well as the quality of scientific evidence. RESULTS: The CDGs (2016) provide six key dietary recommendations for the general Chinese population aged 2 years and above. In addition to a newly revised Chinese Food Guide Pagoda, both the Chinese Food Guide Plate and Chinese Food Guide Abacus are newly created pictorial models in the CDGs (2016); the Chinese Food Guide Abacus is specifically designed for children. Seven additional dietary guidelines targeting specific populations are included; these guidelines emphasize the different physiological and nutritional requirements of particular populations, including dietary guidelines for vegetarians for the first time. CONCLUSIONS: The CDGs (2016) is an official document published by the National Health Commission of China. Its content highlights the current status of public health and offers advice to address health concerns faced by the Chinese population. The CDGs (2016) have been widely disseminated and accepted in the Chinese population; the National Nutrition Week is a major national event in which the CDG are used as its core to increase public awareness towards a healthy diet and lifestyle.

[The relationship of milk consumption and development of 3 - 6 years old preschool children].

OBJECTIVE: To study the relationship between milk intake of 3 - 6 years old preschool children and their growth. METHODS: The data bank of 2002 China National and Health Survey were used to analyze the relationship of milk consumption and the growth of children aged 3 - 6 in urban and rural areas. RESULTS: The percentages of the diet with milk in urban and rural areas were 46.9% and 8.2% respectively, there was significant difference between the urban and rural areas. The averaged milk intake of preschool children were 23.8 g/d, the milk intake of urban children was significantly higher than that in the rural areas (P < 0.01). The height and weight of children with milk or its products in their diets in the group aged 4, 5 and 6 years were significantly higher than those of children without milk or its products in their diets (P < 0.05). CONCLUSION: There was close relationship between milk intake of children 3 - 6 years old and their growth, the volume of milk intake of preschool children should be improved in urban and rural areas.

[Incidence of low birth weight of neonates and the influencing factors in China].

OBJECTIVE: To analyze the incidence of low birth weight and identify the influencing factors in China in 2006. METHODS: The national survey was performed by stratified random cluster sampling method in 43 cities and counties in 14 provinces. The subjects were all live neonates during May to October in 2006. Their body weight was measured according to the standardization conducted by the national research team, while the information of all infants was investigated by questionnaires. Non-conditional logistic regression was used to analyze the influencing factors. RESULTS: Among 18 554 infants investigated, the incidence of low birth weight was 4.6% in 2006 in China, being 3.2%, 4.4%, and 6.3% in eastern middle and western areas respectively. The incidence of low birth weight were 3.9% in urban and 4.8% in rural. The results of logistic regression analysis suggested that maternal education (OR = 1.48; 95% CI: 1.181 approximately 1.861), body mass index (BMI) before pregnancy (OR = 1.52; 95% CI: 1.229 - 1.876), body weight gain in gestation period (OR = 1.57; 95% CI: 1.246 - 1.965), gestational weeks (OR = 20.16; 95% CI: 15.456 - 26.297), multiple birth (OR = 12.11; 95% CI: 9.229 - 15.893), gestation syndrome, and nutrition instruction (OR = 0.66; 95% CI: 0.550 - 0.798) were associated with low birth weight significantly. CONCLUSION: The main factors resulting in low birth weight in neonates are maternal education, BMI before pregnancy, body weight gain in gestation period, pregnancy age, multiple birth, gestation syndrome, and nutrition instruction.

[Relationship between physical activity and metabolic syndrome].

OBJECTIVE: To investigate the relationship between physical activity and metabolic syndrome (MS). METHODS: A multi-stage stratified cluster sampling was conducted in 132 sampling 218,920 residents, aged 44.3 +/- 15.3 (15 - 96), in the 31 provinces, autonomous regions, and municipalities of the mainland China according to the program of the National Nutrition and Health Survey. Questionnaire survey, interview, physical examination, measurement of biochemical indices, and dietary investigation were done. Information of physical activity and measurement of fasting glucose and/or glucose 2 hours after meal, blood pressure, triglycerides, high-density lipoprotein cholesterol were obtained in 50,494 participants. Metabolic syndrome was defined according to the Chinese Medical Association's definition. The intensity of physical activity was divided into 3 categories according to the Center for Disease Control and Prevention of US/American College of Sports Medicine criteria. RESULTS: 50,495 subjects, 23,932 males (47.4%) and 26,562 females (52.6%), were diagnosed as with MS. The MS incidence of those with high intensity of physical activity was lower by 60% in comparison with those with low intensity of physical activity (odds ratio 0.60, 95% CI: 0.362 - 0.443) adjusted for age, sex, smoking, and alcohol intake. The risk of MS in those with moderate intensity of physical activity of 151 - 300 minutes/week was slightly decreased compared to those with moderate intensity of physical activity of 90 - 150 minutes/week, (odds ratio 0.935, 95% CI: 0.685 - 1.277), however, the risk of MS in those with the moderate intensity of physical activity over 300 minutes/week increased slightly (OR = 1.269, 95% CI: 0.923 - 1.745). The risk of MS in those with low-level physical activity of 301 - 420 minutes/week was lower by 35% in comparison with those with the low-level physical activity of 90 - 150 minutes/week (95% CI: 0.451 - 0.933), however, the risk of MS in those with the low-level physical activity over 420 minutes/week was 0.871, not significantly different from that of the subjects with the low-level physical activity of other intensity (odd ratio = 0.871, 95% CI: 0.643 - 1.181). The risk of MS of those with the vigorous physical activity odds rations for having MS of vigorous activity over 150 minutes/week was 0.757, lower by 25% in comparison with those with the vigorous physical activity of 10 - 60 minutes/week (95% CI: 0.603 - 0.951), adjusted for sex, age, smoking, alcohol intake and BMI. CONCLUSION: MS risk can be decreased by low level physical activity of 300 - 420 minutes/week, moderate physical activity of 90 - 300 minutes/week and vigorous physical activity of over 150 minutes/week.

[Comparison of assessment of food intakes by using 3 dietary survey methods].

OBJECTIVE: To analyze the difference and correlation of food intakes assessed by Food Weighted Record, 24 Hours Recall and Food Frequency Questionnaire (FFQ) methods. SUBJECTS: The data of 2002 China National Nutrition and Health Survey were used. All 23,198 subjects (male 11,107, female 12,091) finished all three dietary survey methods. Food Weighted Record method weighted all food items consumed at home by all family members in last 3 days; 24 Hours Recall recorded all food items the subjects consumed at and out home in last 3 days; FFQ recorded the main 33 categories food items that the subjects consumed at and out home in last year. RESULTS: Compared to Food Weighted Record method, food intakes assessed by 24 hours recall were similar, and the relative differences were less than 10% of most food items. The proportion of over-report and under-report (+/- 25%) by 24 Hours Recall were less than 40%. The correlation coefficients of food intakes between Food Weighted Record and 24 Hours Recall methods ranged from 0.58 to 0.88. The results from Food Weighted Record and FFQ were similar among the high frequently consumed food items. The relative differences of the food intakes investigated between Food Weighted Record and FFQ were less than 15% and the proportion of over-report and under-report (+/- 25%) by FFQ were more than 50%. The correlation coefficients of food intakes between Food Weighted Record and FFQ ranged from 0.08 to 0.76. CONCLUSION: Food intakes might be assessed accurately by the Food Weighted Record revised 24 Hours Recall method, and FFQ method be also used to assess the food intakes, especially for the frequently consumed food items, as to studying the relationship between food consumption and health.

[Control the increasing of the prevalence of overweight and obesity by covering the energy gap of Chinese population].

OBJECTIVE: To estimate the quantity of the excess energy accumulation according to the weight change in a follow up population. Confirm the energy gap and give the quantitative goal for how much change in energy balance is needed. METHODS: This paper was based on data collected in the China Health and Nutrition Survey. We selected the adults, 20-45 years old healthy men and women, who took part in the survey in 1989 and were followed up in 2000. RESULTS AND CONCLUSION: From 1989 to 2000, the weight average of this population increased from 55.4 kg to 59.1 kg. The medium of the increasing rate was 0.33 kg/y. The prevalence of overweight has increased dramatically from 9.0% to 23.2% from 1989 to 2000. Assuming that each kilogram of body weight gained represents 32284.6 kJ. We estimated that the medium of the excess energy accumulation was 29.3 kJ/d and the 90th percentile was 94.2 kJ/d. Moreover energy derived from mixed composition diets is stored with an efficiency of at least 50% for nearly everyone. So we can estimated the energy gap should be 188.3 kJ/d. This estimate suggests that the behavior change needed to close the energy gap may be small and achievable without drastically altering current life-styles. For example, intaking 2%-3% less of the energy everyday or walk 10 minutes could offset weight gain in about 90% of the population.