Associations of dietary advanced glycation end products with liver steatosis via vibration controlled transient elastography in the United States: a nationwide cross-sectional study.

PURPOSE: Large population-based studies for the associations between dietary advanced glycation end products (dAGEs) intake and liver steatosis remain lacking. It is necessary to clarify the relationship of dAGEsintake with liver steatosis through the National Health and Nutrition Survey (NHANES). METHODS: A total of 5856 participants in the NHANES 2017-2018 were included. The dietary AGEs intake, including ε-(carboxymethyl)lysine(CML), Nε-(1-carboxyethyl)lysine (CEL), and Nδ-(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MG-H1) were estimated using the combination of ultra-performance LC-tandem MS dietary AGEs database and two 24-h dietary recall interviews. Liver steatosis was assessed by controlled attenuation parameter via transient elastography. Logistic regression model was adopted to explore the relationships between dAGEs intake and hepatic steatosis. RESULTS: Compared with individuals of total dAGEs, CML, MG-H1 in the lowest tertile, those in the highest tertile had highest risk of hepatic steatosis, and the corresponding odds radios(ORs) (95% confidence interval(CI)) were 1.37 (1.01, 1.84), 1.36 (1.04,1.78) and 1.40 (1.06, 1.85), respectively. Subgroups analysis found that the positive association between dAGEs, CML, CEL and MG-H1 and hepatic steatosis appeared stronger in subjects with obesity and those with abnormal waist circumference (WC). CONCLUSION: There was a positive correlation between dAGEs, CML, MG-H1, and hepatic steatosis, and this association mainly existed in subjects with obesity and those with abnormal WC. Dietary AGEs restriction might be of high priority for subjects with obesity for the prevention of fatty liver disease. Further longitudinal studies are required to confirm the causal associations and explore the potential mechanisms.

Association between Serum Klotho and Kidney Stones in US Middle-Aged and Older Individuals with Diabetes Mellitus: Results from 2007 to 2016 National Health and Nutrition Survey.

INTRODUCTION: Kidney stones (KSs) are associated with hematuria and renal failure and pose a significant clinical and public health concern. Diabetes is associated with a higher risk of KSs. In addition, α-Klotho (Klotho), as a novel antiaging protein, is associated with kidney disease, diabetes, and complications and may participate in the pathological mechanism of KSs. However, studies that used large population-based database research are limited. Therefore, this study aimed to investigate whether or not KS prevalence is associated with serum Klotho levels in diabetic adults in the USA. METHODS: This nationally representative cross-sectional study used data on diabetic adults in the USA aged 40-79 years from the National Health and Nutrition Examination Survey 2007-2016 cycles. Multivariate logistic regression models were used to calculate the association between Klotho and KS. Restricted cubic splines were used to further test for linearity and explore the shape of the dose-response association. Moreover, we performed stratified and interaction analyses to see if the relationship was stable in different subgroups. RESULTS: Among the 3,537 diabetic patients included in this study (mean age of 61.4 years, consisting of 51.3% males), 543 participants (15.4%) suffered from KS. In the fully adjusted model, Klotho was negatively associated with KS (OR = 0.72; 95% CI: 0.54-0.96; p = 0.027). A negative relationship was observed between the occurrence of KS and Klotho (nonlinear: p = 0.560). Some differences in the association between Klotho and KS were found in stratified analyses; however, these differences lacked statistical significance. CONCLUSIONS: Serum Klotho was negatively associated with the incidence of KS; when ln-transformed Klotho concentration increased by 1 unit, the risk of KS was 28% lower.

Association of daily nutrient intake with breakfast and snack consumption among young Japanese adults aged 20-39 years: data from the 2012 National Health and Nutrition Survey.

Eating frequency has been associated with nutrient intake and diet quality. The aim of this study was to examine the association between daily nutrient and food group intake and consumption of breakfast and/or snacks among young Japanese adults, as secondary analysis of the 2012 National Health and Nutrition Survey in Japan involved 1420 men and 1659 women aged 20-39 years. Dietary intake data were collected using a one-day semi-weighed household dietary record. Participants were classified into four groups based their breakfast and snack consumption, defined as the consumption of any food or beverage that contained energy based on participant-defined eating occasions; both breakfast and snack consumption (B+S+), breakfast consumption without snacking (B+S-), breakfast skipping and snack consumption (B-S+) and breakfast skipping without snacking (B-S-). The proportion of breakfast skippers among men and women was 11·8 % and 6·6 %, whereas that of snack consumers among men and women was 55·3 % and 68·2 %, respectively. Energy, Mg potassium (in both sexes), vitamin B2, Ca, (only men) and folate and dietary fibre (only women) intakes were higher among breakfast and snack consumers than in the B+S- group. The nutrient intake level of the B+S- group was similar to that of the B-S+ group, whereas the B-S- group had lower energy (both sexes), Cu, dietary fibre and potassium (only women) intakes than the B+S- group. Snack consumption could supplement nutrients that may not be adequately consumed by three meals among young Japanese adults.

Pediatric Reference Centiles of Bone Mineral Density and Body Composition of Lower Limbs.

Localized neurological diseases such as spina bifida are often accompanied by normal upper limb and spinal bone mineral density (BMD), whereas regional BMD of the lower limbs may be decreased. Therefore, regional BMD measurements may be more accurate to quantify regional bone health. Until now, no pediatric reference centiles of bone mineral density and body composition of the lower extremities are available for Hologic DXA systems. The objective was to generate age-and sex specific reference centiles of DXA scans of lower limbs for Hologic DXA systems. Data from the National Health and Nutrition Examination Survey of the period 1999-2004 (age 8 - 20 years) were used to generate age-specific and sex-specific reference centiles for the non-Hispanic Black, non-Hispanic White and Mexican-American NHANES study population. The LMS method was used to calculate the reference centiles. Data of DXA scans of 2233 non-Hispanic black children (880 females), 1869 non-Hispanic white children (803 females) and 2350 Mexican American children (925 females) were used to create age-specific and sex-specific reference curves. We presented age-and sex-specific reference centiles for regional bone mineral density, bone mineral content, lean body mass and fat mass at the lower limbs for children and adolescents which were ethnicity specific and directly applicable to Hologic QDR-4500A fan-beam densitometer.

Dietary sodium:potassium ratio and CVD risk factors among Japanese adults: a retrospective cross-sectional study of pooled data from the National Health and Nutrition Survey, 2003-2017.

Few studies have reported associations between the Na:K ratio and risk factors related to CVD among the general population in Asian countries. This study aimed to investigate the dietary Na:K ratio association with CVD risk factors among Japanese adults. This retrospective cross-sectional study included 48 800 Japanese participants (19 386 men and 29 414 women) aged ≥20 years, registered in the 2003-2017 National Health and Nutrition Survey. Multivariate OR and 95 % CI for risk of hypertension, high glycated HbA1c levels, hypercholesterolaemia, low serum levels of HDL-cholesterol and high non-HDL-cholesterol levels according to the Na:K ratio were estimated using logistic regression models. Dietary Na:K ratio decreased for both men and women from 2003 to 2017. Higher Na:K ratio and higher hypertension prevalence were observed (multivariate OR (fifth v. first quintiles) 1·27, 95 % CI 1·15, 1·40; Pfor trend < 0·001 for men and 1·12, 95 % CI 1·01, 1·23; Pfor trend = 0·007 for women). Higher Na:K ratio was associated with higher prevalence of high HbA1c levels in men (multivariate OR 1·56, 95 % CI 1·24, 1·96). Prevalence of low HDL-cholesterol levels was increased with higher Na:K ratio (Pfor trend =0·002 for men and <0·001 for women). No significant associations were found between Na:K ratio and hypercholesterolaemia in men or high non-HDL-cholesterol levels in both men and women. Our findings suggest that dietary Na:K ratio is associated with several CVD risk factors among Japanese adults.

Prevalence and predictors of elevated liver enzyme levels in Mexico: The Mexican National Health and Nutrition Survey, 2016.

INTRODUCTION AND OBJECTIVE: To determine the prevalence of elevated liver enzyme levels and the fatty liver index according to specific sociodemographic, clinical, anthropometric, and metabolic risk factors in Mexican adult population. MATERIAL AND METHODS: The present analysis was conducted using data from the Mexican National Health and Nutrition Survey 2016. For the present study, 3,490 adults with complete information on liver enzymes, sociodemographic, lifestyle, and metabolic factors were analyzed. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) levels were determined from blood samples. We computed the fatty liver Index (FLI), as a surrogate marker of non-alcoholic fatty liver disease. The associations are reported as adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: At the national level, the prevalence of high serum levels of ALT, AST, and GGT were 7.9%, 13.5, and 12.9 respectively. We observed that men had higher prevalences of altered ALT, GGT and FLI compared to women. Additionally, we observe that individuals with obesity, metabolic syndrome and insulin resistance are significantly more likely to present elevated concentrations of AST, ALT, GGT and FLI. Finally, we found that the subjects of the lowest socioeconomic level and indigenous population were more likely to present elevated levels of AST, ALT, GGT, and FLI. CONCLUSION: In Mexico, non-alcoholic fatty liver disease affect people with obesity, diabetes, and metabolic syndrome as well as men, subjects of low socioeconomic status, subjects who live in rural areas and indigenous population. Interventions to reduce this condition should be a public health priority.

Trends in the dietary patterns of Mexican adults by sociodemographic characteristics.

BACKGROUND: Sociodemographic characteristics are associated with the dietary patterns of populations. However, the direction of the association is not consistent among countries: it is contingent on the nutritional transition phase, level of economic development, cultural contexts and both the social and health policies prevailing in each country. The objective of this study was to identify the trends in dietary patterns observed in 2006, 2012 and 2016 among Mexican adults by sociodemographic characteristic. METHODS: To determine and compare dietary patterns, we performed a secondary analysis of dietary and sociodemographic data for adults 20-59 years old. Data were drawn from the 2006 and 2012 National Health and Nutrition Surveys (ENSANUTs) together with the 2016 Half-Way National Health and Nutrition Survey (ENSANUTMC). To estimate the dietary patterns, we used an adapted version of the Healthy Eating Index-2015 (HEI-2015) and a quantile-based regression model to compare the HEI medians by sociodemographic characteristic. RESULTS: From 2006 to 2016, the quality of the diet of Mexican adults scored under 50 points on a scale of 0 to 100, markedly below the maximum scores for the majority of HEI-2015 components. Diet quality varied according to age, sex, socioeconomic status (SES), area (urban/rural) and region of residence, with the highest quality observed among older individuals (within the 40-59 age group), women, people of lower SES and residents of rural areas, particularly in southern Mexico. Although this trend remained constant overall throughout 2006, 2012 and 2016, specific HEI-2015 components showed an opposite trend by sociodemographic strata. CONCLUSION: The diet quality of Mexican adults was suboptimal from 2006 to 2016, with notorious disparities persisting over time among sociodemographic strata. Our results can serve as a basis for formulating recommendations on ways to improve the population diet, where those components diverging the most from adequate scores could be highlighted in public-health messages.

Trends in BMI among elderly Japanese population: findings from 1973 to 2016 Japan National Health and Nutrition Survey.

OBJECTIVE: To examine 44-year trends in height, weight and BMI, and the prevalence of overweight/obesity and underweight in the elderly Japanese population because Japan, the country with the longest life expectancy, has the highest ageing population. DESIGN: Using the nationally representative cumulative data from the Japan National Health and Nutrition Survey 1973-2016, sex-specific and age-adjusted mean height, weight and BMI, and the prevalence of overweight/obesity and underweight were calculated for each year. Trend analyses were performed using the Joinpoint Regression Program. Next, changes in height, weight and BMI, and the prevalence of overweight/obesity and underweight were estimated for each age group (65-69, 70-79 and >80 years) according to the birth year groups. SETTING: Japan. PARTICIPANTS: Individuals aged ≥65 years with complete data on height and body weight measurements (N 94 508). RESULTS: Trends in average height and weight increased over the four decades in both men and women. The prevalence of overweight/obesity dramatically increased and nearly tripled in men, accompanied with significantly decreased underweight prevalence. Furthermore, the increasing trend in average BMI and overweight/obesity prevalence in women reached a peak in 2002 and showed a decreasing trend thereafter, while a downward trend in underweight prevalence showed a gradual increase in women since 2003. CONCLUSIONS: Trends in height, weight and BMI among the elderly population should continue to be closely monitored in parallel with the effects of dietary changes, energy intake and physical activity (step counts).

Diet quality of Japanese adults with respect to age, sex, and income level in the National Health and Nutrition Survey, Japan.

OBJECTIVE: Although several studies in Western countries show that higher socioeconomic status is associated with higher diet quality, no study has observed this association in Japan. In the current study, we examined the association between diet quality and the combinations of age, sex, and household income, and also compared the dietary intake between diet quality levels according to household income. DESIGN: Cross-sectional study. SETTING: National Health and Nutrition Survey, Japan in 2014. PARTICIPANTS: 2785 men and 3215 women. RESULTS: Higher Japanese Food Guide Spinning Top scores (better diet quality) were observed in older women, especially those with higher household income, whereas lower scores were observed in younger men with lower household income. Those having low quality diet, especially in low income households, had higher odds of not meeting the recommended amounts of the Japanese dietary guidelines, than those having high quality diet. CONCLUSIONS: Diet quality in Japanese adults differed by age and sex as well as by household income level. A different approach to diet quality improvement is needed according to population characteristics including not only age and sex but also social economic status.

Dietary patterns and abnormal glucose tolerance among Japanese: findings from the National Health and Nutrition Survey, 2012.

OBJECTIVE: Previous studies have associated dietary patterns with diabetes risk in Western countries, but such studies among the Japanese population are scarce. The present study aimed to investigate dietary patterns associated with abnormal glucose tolerance determined by elevated glycated Hb (HbA1c) levels. DESIGN: The 2012 National Health and Nutrition Survey (NHNS) database was used for the cross-sectional study. Dietary patterns were analysed by factor analysis of twenty-five food items from the dietary intake survey and household-based semi-weighed dietary records. OR and 95 % CI for elevated HbA1c levels (≥6·5 %) according to dietary patterns were estimated using logistic regression models. SETTING: Japan. PARTICIPANTS: The study population comprised 9550 Japanese aged ≥40 years registered in the nationwide NHNS. RESULTS: Three dietary patterns were identified: (i) high-bread and low-rice; (ii) high-meat and low-fish; and (iii) vegetable. The high-bread and low-rice pattern, characterised by high frequent consumption of bread, milk and dairy products, and fruits, and low rice intake, was associated with marginally decreased prevalence of elevated HbA1c levels (Ptrend=0·047). The vegetable pattern, characterised by vegetables, mushrooms, soyabeans and soybean products, was significantly inversely associated with elevated HbA1c levels (4th v. 1st quartile: multivariable OR=0·68; 95 % CI 0·49, 0·95; Ptrend=0·007). CONCLUSIONS: Our findings suggest that the vegetable pattern is associated with decreased prevalence of elevated HbA1c levels among Japanese.

Nutrition intake among the Japanese elderly: an intergenerational comparison based on national health and nutrition survey scores.

Context: The average Japanese lifespan became the longest in the world in 1986. What factors give the Japanese this longevity? Washoku, or the traditional Japanese diet, is respected globally for its nutritionally-balanced and healthy eating habits. This uniquely Japanese way of eating may be one factor that helps extend the Japanese lifespan. Objective: To explain the nutrition intake characteristics of today's Japanese elderly compared with their children's generation and to discuss the association between nutrition intake and various diseases and health issues in the general adult population. Methods: This study compared the characteristics of nutrition status and nutrition intake among today's elderly and their children's generation by using National Health and Nutrition Survey scores. Results: Japanese elderly had high adequacy in all nutrients as well as a high intake of potatoes, pulses, vegetables, fruits, algae, and fish and shellfish compared with their children's generation. Conclusion: Nutrition intake among the Japanese elderly had the characteristics of washoku, but these characteristics were not passed on to the next generation. Extension of the average lifespan and improved health could be achieved by modifying nutrition intake, even after reaching the age of onset of lifestyle- and age-related diseases, typically the 50s.

Status of physical activity in Japanese adults and children.

Objective: To summarise the status of physical activity in Japanese adults and children. Methods: Results obtained by several nationwide surveys such as the National Health and Nutrition Survey of Japan carried out annually were reviewed. Moreover, relevant guidelines or summaries and results of papers were introduced. Results: Average step counts have decreased by about 1000 steps from peak values observed before the year 2000, but the decrease after 2010 was less than 200 steps in both sexes. Based on the results of a meta-analysis and national survey, a new physical activity guideline for Japanese, 'ActiveGuide', was published. The most important message is the '+10', which indicates an 'additional 10 minutes of moderate-to-vigorous PA per day to the status quo'. According to the Japan Report Card on Physical Activity for Children and Youth, there was no nationwide survey on the overall Physical Activity Levels for children. However, grades for Organised Sports Participation and Active Transportation were very good. The mean values of cardiorespiratory endurance for Japanese children were around the 90th centiles of the international criterion-referenced data. Conclusions: More accurate measures of daily physical activity, sedentary behaviour and sleep should be developed for a nationwide survey.

[Key variable combinations for identifying non-participants in the Japan National Health and Nutrition Survey through record linkage with the Comprehensive Survey of Living Conditions].

Objectives　The identification of non-participants in the Japan National Health and Nutrition Survey (NHNS) requires record linkage with its master sample from the Comprehensive Survey of Living Conditions (CSLC). In principle, we can merge individual records between the two surveys by using key identifiers including household ID, but false matches and nonmatches can occur. We examined combinations of key variables for improving record linkage to identify nonparticipants in the NHNS.Methods　We used individual-level data from the NHNS and the CSLC from 1988 to 2015 (except 2012). We extracted from CSLC data individuals in participating unit blocks in the NHNS to merge records between the two surveys. We used four combinations of key variables: prefecture ID, census enumeration district ID, unit block ID, household ID, and household member ID (A); household member ID in A was replaced with sex and birth year and month or age (B); sex and birth year and month or age were added to A (C); two-stage linkage of B and C (D). We classified a sample of individuals into matched participants, unmatched NHNS participants, and unmatched CSLC participants (a proxy for nonparticipants). We compared the percentages of matched NHNS participants and unmatched CSLC participants across the four combinations of key variables.Results　We obtained a sample of 455,854 participants from the CSLC and 335,010 from the NHNS. The percentage of matched NHNS participants was highest in A (the upper 90%), followed by D (the lower 90%), B (the lower 90%), and C (the 80%). Compared to C, the percentage of matched NHNS participants was higher by 8-14 percentage points in A and 5-10 percentage points in B. Compared to B, it was higher by 0.1-0.4 percentage points in D. The percentage of unmatched CSLC participants was highest in C, followed by B, D, and A. The percentage of unmatched CSLC participants increased in D from the 20% level in the late 1980s to around 30% in the 1990s and stayed between the 30% level and the lower 40% level in the 2000s.Conclusion　The highest percentage of accurate matches of NHNS participants was obtained by considering changes in household member ID and incorrect entries on sex and birth year/month and age, and same-sex multiple births. However, there are limitations in handling unmatched participants due to changes in household ID or other reasons. It is therefore necessary to consider the possibility of false nonmatches included in unmatched CSLC participants in regarding them as non-participants in the NHNS.

The trends in total energy, macronutrients and sodium intake among Japanese: findings from the 1995-2016 National Health and Nutrition Survey.

Monitoring nutritional status of the population is essential in the development and evaluation of national or local health policies. In this study, we aimed to demonstrate analysis on the trends in dietary intake of energy and macronutrients, as well as Na, in Japanese population using the data of series of cross-sectional national surveys - the National Nutrition Survey (NNS) and the National Health Nutrition Survey (NHNS) - during the period from 1995 to 2016. The NNS and NHNS participants aged 20-79 years were included in the analysis. Dietary intake was estimated using 1-d household-based dietary record. The trend in total energy intake, energy intake from macronutrients (fat and protein), Na intake and energy-adjusted Na intake were analysed using regression models adjusted to 2010 age distribution and anthropometry status. A total of 94 270 men and 107 890 women were included the analysis. Total energy intake showed a decreasing trend in both men and women. Similarly, energy intake from protein decreased, but energy intake (%) from fat increased in both sexes. Energy-adjusted Na intake showed a decreasing trend in both men and women. This study identified the decrease in total energy intake and energy intake from protein, whereas there were inverse trends in energy intake from fat among Japanese adults. Continued monitoring of trends in dietary intake will be needed, and there should be efforts to increase the accuracy of current survey procedures.

Energy density of the diets of Japanese adults in relation to food and nutrient intake and general and abdominal obesity: a cross-sectional analysis from the 2012 National Health and Nutrition Survey, Japan.

The associations of dietary energy density with dietary intake and obesity have been largely unexplored in non-Western populations. The present cross-sectional study examined the associations using data from the 2012 National Health and Nutrition Survey, Japan. Dietary intake was assessed using a 1-d semi-weighed dietary record in 15 618 Japanese adults aged ≥20 years. Mean dietary energy density (calculated on the basis of foods only) was 5·98 (sd 1·20) kJ/g in men and 5·72 (sd 1·16) kJ/g in women. Dietary energy density was positively associated with intakes of bread, noodles (only men), meat, fats and oils, and sugar and confectionery but inversely with intakes of white rice (only men), potatoes, pulses, vegetables, fruits, and fish and shellfish. For nutrient intake, dietary energy density was positively associated with total fat and SFA but inversely associated with all other nutrients examined such as protein, carbohydrate, alcohol (only women), dietary fibre, and several vitamins and minerals, including Na. After adjustment for potential confounding factors, dietary energy density was positively associated with abdominal obesity (waist circumference ≥80 cm) in women (adjusted prevalence ratio between the extreme tertiles 1·07; 95 % CI 1·02, 1·12; P for trend=0·003). Dietary energy density was also positively but non-significantly associated with general obesity (BMI≥25 kg/m2) in women (P for trend=0·08). There were no such associations in men. In conclusion, lower energy density of the diets of Japanese adults was associated with favourable food and nutrient intake patterns, except for higher Na, and, in only women, a lower prevalence of abdominal obesity.

Food intake patterns and cardiovascular risk factors in Japanese adults: analyses from the 2012 National Health and nutrition survey, Japan.

BACKGROUND: There is an increasing global interest in the role of Japanese diet as a possible explanation for the nation's healthy diet, which contributes to the world's highest life-expectancy enjoyed in Japan. However, nationwide studies on current food intake status among general Japanese population have not been established yet. This study examined the association between food intake patterns and cardiovascular risk factors (CVRF) such as waist circumference (WC), body mass index (BMI), blood pressure (SBP, DBP), HbA1c and blood lipid profiles among general Japanese adults. METHODS: De-identified data on the Japan National Health and Nutrition Survey (NHNS) 2012 with a total of 11,365 subjects aged 20-84 years were applied. Food intake patterns were derived by principal component analysis (PCA) based on 98 food groups. Generalized linear regression analysis was used to assess the relation between the food intake patterns and CVRF. RESULTS: We identified three food intake patterns: traditional Japanese, Westernized, and meat and fat patterns. Traditional Japanese pattern was significantly related to high WC and BMI in men, and high DBP in women. Westernized pattern was associated with lower SBP, but high total cholesterol and LDL cholesterol in both men and women. Meat and fat pattern was associated with high WC, high BMI, high blood pressure and blood lipid profiles in both men and women (trend P < 0.001). CONCLUSION: The significant association between cardiovascular disease risks and three food intake patterns derived from the NHNS, showed a similar tendency to other dietary survey methods.

Poor early childhood outcomes attributable to maternal depression in Mexican women.

We aimed to estimate the population fraction of poor early child health and developmental outcomes attributable to maternal depressive symptoms (DS) contrasting it between low- and middle/high-income households. We used a nationally representative probabilistic sample of 4240 children younger than 5 years old and their mothers, derived from the Mexican National Health and Nutrition Survey Data (ENSANUT 2012). Complex survey design, sampling, and analytic weights were taken into account in analyses. DS was measured by CESD-7. Child outcomes were as follows: breastfeeding, attending well-child check-ups, respiratory disease, diarrhea and general health problems, immunization, accidents, growth, obesity, and food insecurity. Prevalence of DS among mothers was 21.36%. In low-SES households, DS was associated with higher risk of never being breastfed (RR = 1.77; p < .05), health problems (RR = 1.37; p < .05), acute respiratory disease (RR = 1.51; p < .05), accidents requiring child hospitalization (RR = 2.16; p < .01), and moderate or severe food insecurity (RR = 1.58; p < .001). In medium- or high-SES households, DS was associated with higher risk of never attending a developmental check-up (RR = 2.14; p < .05) and moderate or severe food insecurity (RR = 1.75; p < .01). Population risks attributable to DS ranged from 2.30 to 17.45%. Prevention of DS could lead to reduction of problematic early childhood outcomes in both low and medium/high SES.

Differences in the lipid profile and hormone replacement therapy use in Korean postmenopausal women: the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012.

PURPOSE: Hormonal changes after menopause can cause dyslipidemia by the cessation of endogenous estrogen. We analyzed the lipid profile of the Korean healthy menopausal women according to the use of hormone replacement therapy (HRT). METHODS: Data obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012 were analyzed. The study included 428 healthy postmenopausal women with HRT (HRT group) and 1804 healthy postmenopausal women without HRT (NHRT group). RESULTS: After adjustment for confounding factors, total cholesterol (TC) and low-density lipoprotein (LDL) were lower in the HRT group than in the NHRT group (TC: 200.1 ± 2.0 vs. 204.9 ± 1.1, P = 0.04; LDL: 120.3 ± 1.0 vs. 124.5 ± 1.0 mg/ml, P = 0.033). Triglycerides (TG) were lower in the HRT group than in the NHRT group [106.8, (95 % CI 99.8-114.3) vs. 115.1 (95 % CI 111.8-118.5), P = 0.04]. Non-high-density lipoprotein (HDL) was lower in the HRT group than in the NHRT group (145.4 ± 1.9 vs. 151.2 ± 1.0 mg/ml, P = 0.008). Patients with HRT were lower in the LDL cholesterol level (OR 0.601, 95 % CI 0.397-0.917, P = 0.018), the total cholesterol to high-density lipoprotein ratio (OR 0.787, 95 % CI 0.617-0.997, P = 0.016), and the non-HDL level (OR 0.68, 95 % CI 0.509-0.907, P = 0.009). CONCLUSION: The results of this study suggest that the use of HRT may have a positive effect on dyslipidemia in postmenopausal women.

Relationship between Household Shared Meal Frequency and Dietary Intake among Men and Women Aged ≥20 Years: Cross-Sectional Analyses Based on 2018 and 2019 National Health and Nutrition Surveys in Japan.

This study aimed to examine the relationship between the frequency of household shared meals and the intake of 17 food groups and 21 nutrients. Participants were 3310 men and 3386 women ≥20 years old living in a household of ≥2 members from 2018 and 2019 National Health and Nutrition Surveys in Japan. A one-day household dietary record was used to classify an individual's shared meal frequency and dietary intake. A shared meal is defined as an eating occasion (i.e., breakfast, lunch, and dinner) where ≥1 food item-other than sugars, fats and oils, beverages, and condiments-was recorded with an assigned approximated shared proportion. The shared meal frequency for each individual was classified into one of four categories: 0, 1, 2, and 3 times/day. Dietary intake was compared across the shared meal categories adjusted for age, occupation, household size, meal skipping, snacking, residential areas, and within-household correlations. Both men and women who had more frequent shared meals showed higher intakes of potatoes, vegetables, mushrooms, and condiments but less confectioneries and beverages. A higher shared meal frequency was also related to a higher intake of many (12/21) nutrients (e.g., protein, dietary fiber, and potassium). However, in women, there was a positive association between shared meal frequency and sodium intake. A higher frequency of household shared meals may be related to a more favorable dietary intake; except for concerns about sodium intake in women.

Trends and Characteristics of Brown Rice Consumption among Adults in Japan: An Analysis of the National Health and Nutrition Surveys, 2012-2019.

Brown rice is a familiar whole grain in Japan. We examined national trends in brown rice consumption among Japanese adults aged ≥20 years old, using individual-level data from the National Health and Nutrition Surveys conducted between 2012 and 2019. We employed multivariable logistic regression to identify factors associated with brown rice consumption. The 95th percentile of daily brown rice intake remained at 0.0 g throughout the study period. The percentage of brown rice consumers increased from 1.8% (95% confidence interval: 1.6-2.1) in 2012 to 2.6% (95% confidence interval: 2.0-3.4) in 2019. Compared with individuals who consumed only white rice, brown rice consumers had significantly higher mean intake levels of macronutrients, legumes, vegetables, fruits, and nuts. Brown rice consumption was positively associated with certain sociodemographic characteristics (being female, older age, residing in a major city, living without very young children, and having higher education levels) and health behaviors (lower body mass index, engaging in regular exercise, and being a former or never smoker). Despite its potential nutritional benefits in balanced diets, only a small fraction of adults in Japan consume brown rice, indicating a need for further promotion, particularly among individuals with characteristics associated with brown rice consumption.