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Li X, Huang M, Xiao J, Duan C, Chen Q, Xiao S, Tu H, Zhang JJ. Transition of cooking fuels and obesity risk in Chinese adults. ENVIRONMENT INTERNATIONAL 2024; 190:108856. [PMID: 38970981 DOI: 10.1016/j.envint.2024.108856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 06/11/2024] [Accepted: 06/27/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Since 1990 s, China has witnessed a widespread transition to clean cooking fuels, presenting an opportunity to investigate whether household fuel transition could mitigate obesity risk and reconcile inconsistencies in the literature regarding the association between cooking fuels and obesity. METHODS The China Health and Nutrition Survey (CHNS) is a prospective cohort study covering 12 provinces of China (1989-2015). Participants were classified into persistent cleaner fuel users, fuel transitioners, and persistent polluting fuel users according to self-reported primary cooking fuels. Obesity and central obesity were defined as BMI ≥ 28.0 kg/m2 and waist circumference ≥ 90 cm in men and ≥ 85 cm in women according to Chinese criteria. FINDINGS Among 13,032 participants, 3657 (28.06 %) were persistent cleaner fuel users; 5264 (40.39 %) transitioned from using polluting fuels to cleaner fuels after the baseline survey; and 4111 (31.55 %) were persistent polluting fuel users. During the period of follow-up of 9.0 ± 6.8 years, 1248 (9.58 %) participants were classified into the obesity category, and 4703 (36.09 %) into the central obesity category. Persistent polluting fuel users had a significantly higher risk of developing obesity (hazard ratio [HR]: 1.45, 95 %CI: 1.22-1.72) and central obesity (HR: 1.32, 95 %CI: 1.21-1.44), compared to persistent cleaner fuel users. Persistent polluting fuel use was positively associated with developing obesity in women (HR: 1.64, 95 %CI: 1.30-2.06), but not in men. Subgroup analyses showed higher HR of persistent polluting fuel use among individuals aged 18-44 years (HR: 2.04, 95 %CI: 1.62-2.56). In contrast, the transitioners did not exhibit a significantly different risk of developing obesity (HR: 0.94, 95 %CI: 0.80-1.10) compared to persistent cleaner fuel users, which was consistent across different sex, age and urbanicity. Similar trends were observed for developing central obesity. INTERPRETATION Persistent polluting fuel use increased obesity risk while the obesity risk of the transition to cleaner fuels was similar to persistent use of cleaner fuels. The finding underscores the significance of advocating for the adoption of cleaner fuels as a strategy to mitigate the disease burden associated with obesity.
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Affiliation(s)
- Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China.
| | - Miaoling Huang
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China
| | - Chongyang Duan
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Shu Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou City, Guangdong Province, China
| | - Hongwei Tu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China
| | - Junfeng Jim Zhang
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA; Duke Kunshan University, Kunshan, Jiangsu Province, China.
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Spangler HB, Lynch DH, Howard AG, Tien HC, Du S, Zhang B, Wang H, Gordon Larsen P, Batsis JA. Association Between Mid-arm Muscle Circumference and Cognitive Function: A Longitudinal Study of Chinese Adults. J Geriatr Psychiatry Neurol 2024; 37:272-281. [PMID: 37993115 PMCID: PMC11089828 DOI: 10.1177/08919887231218087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Dementia affects 55 million people worldwide and low muscle mass may be associated with cognitive decline. Mid-arm muscle circumference (MAMC) correlates with dual-energy Xray absorptiometry and bioelectrical impedance analyses, yet are not routinely available. Therefore, we examined the association between MAMC and cognitive performance in older adults. METHODS We included community-dwelling adults ≥55 years from the China Health and Nutrition Survey. Cognitive function was estimated based on a subset of the modified Telephone Interview for Cognitive Status (0-27, low-high) during years (1991, 1993, 1997, 2000, 2004, 2006, 2009, 2011, 2015, 2018). A multivariable linear mixed-effects model was used to test whether MAMC was associated with rate of cognitive decline across age groups and cognitive function overall. RESULTS Of 3702 adults (53% female, 63.2 ± 7.3 years), mean MAMC was 21.4 cm ± 3.0 and baseline cognitive score was 13.6 points ±6.6. We found no evidence that the age-related rate of cognitive decline differed by MAMC (P = .77). Declines between 5-year age groups ranged from -.80 [SE (standard error) .18] to -1.09 [.22] for those at a mean MAMC, as compared to -.86 [.25] to -1.24 [.31] for those at a 1 MAMC 1 standard deviation above the mean. Higher MAMC was associated with better cognitive function with .13 [.06] higher scores for each corresponding 1 standard deviation increase in MAMC across all ages. CONCLUSION Higher MAMC at any age was associated with better cognitive performance in older adults. Understanding the relationship between muscle mass and cognition may identify at-risk subgroups needing targeted interventions to preserve cognition.
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Affiliation(s)
- Hillary B. Spangler
- Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - David H. Lynch
- Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - Annie Green Howard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hsiao-Chuan Tien
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shufa Du
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Penny Gordon Larsen
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John A. Batsis
- Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Tang X, Yu Y, Wu X, Xu C, Zhang Z, Lu Y. Dose-response relationship between weekly physical activity level and the frequency of colds in Chinese middle-aged and elderly individuals. PeerJ 2024; 12:e17459. [PMID: 38827311 PMCID: PMC11143968 DOI: 10.7717/peerj.17459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/03/2024] [Indexed: 06/04/2024] Open
Abstract
Background Engaging in appropriate physical activity can significantly lower the risk of various diseases among middle-aged and older adults. Investigating optimal levels of physical activity (PA) is crucial for enhancing the health of this demographic. This study aims to explore the dose-response relationship between weekly PA levels and the frequency of colds among Chinese middle-aged and elderly individuals, identifying the necessary PA level to effectively diminish the risk of colds. Methods We conducted a cross-sectional study using a web-based survey targeting individuals aged 40 and older (n = 1, 683) in China. The survey collected information on PA and the frequency of colds. Data was analyzed using Kruskal-Wallis test and the χ2 test. We explored the dose-response relationship between weekly PA and cold frequency over the past year through an ordered multivariate logistic regression model and a restricted cubic spline model. Results (1) Brisk walking emerged as the preferred physical exercise for those over 40. The findings suggest that engaging in moderate (odds ratio (OR) = 0.64, P < 0.001, 95% confidence interval (CI) [0.50-0.81]) and high (OR = 0.64, P < 0.001, 95% CI [0.51-0.79]) levels of PA weekly significantly reduces the risk of catching a cold. Individuals with one (OR = 1.47, P < 0.001, 95% CI [1.20-1.80]) or multiple chronic diseases (OR = 1.56, P < 0.001, 95% CI [1.21-2.00]) were at increased risk. Those residing in central (OR = 1.64, P < 0.001, 95% CI [1.33-02.01]) and western China (OR = 1.49, P = 0.008, 95% CI [1.11-02.00]) faced a higher risk compared to their counterparts in eastern China. (2) According to the restricted cubic spline model, adults who experienced one cold in the past year had a weekly PA level of 537.29 metabolic equivalent-minutes per week (MET-min/wk) with an OR value of 1. For those reporting two or more colds, the PA level was 537.76 MET-min/wk with an OR of 1. Conclusions (1) Brisk walking is the most favored exercise among the Chinese middle-aged and elderly, with the prevalence of colds being affected by the number of chronic diseases and the geographic location. (2) Regular, moderate exercise is linked to a lower risk of colds. To effectively reduce cold frequency, it is recommended that middle-aged and elderly Chinese individuals engage in a minimum of 538 MET-min/wk of exercise.
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Affiliation(s)
- Xiaona Tang
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sport University, Beijing, China
| | - Yichao Yu
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sport University, Beijing, China
- The School of Sports Coaching, Beijing Sports University, Beijing, China
| | - Xiaoxue Wu
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sport University, Beijing, China
| | - Chengru Xu
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sport University, Beijing, China
| | - Zhao Zhang
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sport University, Beijing, China
| | - Yifan Lu
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sport University, Beijing, China
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Fu H, Zhang D, Li Y. NHANES-based analysis of the correlation between leisure-time physical activity, serum cotinine levels and periodontitis risk. BMC Oral Health 2024; 24:466. [PMID: 38632582 PMCID: PMC11022427 DOI: 10.1186/s12903-024-04141-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/13/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To investigate the association of leisure-time physical activity and serum cotinine levels with the risk of periodontitis in the general population and to further analyze the interaction between leisure-time physical activity and serum cotinine levels on the risk of periodontitis. METHODS This was a cross-sectional study, extracting data from 9605 (56.19%) participants in the National Health and Nutrition Examination Survey (NHANES) database from 2009 to 2014, and analyzing the relationship and interaction effects of serum cotinine level, leisure time physical activity, and risk of periodontitis by weighted univariate logistic modeling; Effect sizes were determined using ratio of ratios (OR), 95% confidence intervals (95% CI). RESULTS 5,397 (56.19%) of 9,605 participants had periodontitis; an increased risk of periodontitis was found in those in the leisure time physical activity intensity < 750 MET × min/week group (OR = 1.44, 95% CI: 1.17-1.78). Serum cotinine levels ≥ 0.05 ng/ml were associated with an increased risk of periodontitis (OR = 1.99, 95% CI: 1.69-2.33). The group with low leisure physical activity and serum cotinine levels ≥ 0.05 ng/ml had an increased risk of periodontitis compared to the group with high leisure physical activity and serum cotinine levels < 0.05 ng/ml (OR = 2.48, 95% CI: 1.88-3.27). Interaction metrics RERI = 0.90 (95% CI: 0.44-1.36) and API = 0.36 (95% CI: 0.18-0.55); CI for SI = 2.55 (95% CI: 1.03-6.28). for API 0.36. CONCLUSION Leisure time physical activity intensity interacted with smoking exposure on periodontitis risk and may provide the general population with the opportunity to Increasing leisure-time physical activity and smoking cessation may provide recommendations for the general population.
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Affiliation(s)
- Hua Fu
- Shangyu people's Hospital, Shaoxing City, Zhejiang Province, 312300, China.
| | - Diya Zhang
- Run Run Shaw Hospital, Zhejiang University, Hangzhou City, Zhejiang Province, China
| | - Yining Li
- Zhejiang University Affiliated Stomatology Hospital, Hangzhou City, Zhejiang Province, China
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Zhang Y, Zhang X, Han J, Liu X. Study on the outdoor thermal comfort of college students under different activity intensities in a high-altitude climate zone. Front Public Health 2024; 12:1365470. [PMID: 38562254 PMCID: PMC10982489 DOI: 10.3389/fpubh.2024.1365470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Research on the outdoor thermal comfort (OTC) of a university campus is beneficial to the physical and mental health of college students. Methods In this study, the OTC of students attending Tibet University in Lhasa, which experiences high-altitude cold climate conditions, under different activity intensities was studied using field measurements and a questionnaire survey. Results With the increase in activity intensity, the comfort physiologically equivalent temperature (PET) value gradually increased in summer, while the comfortable PET value gradually decreased in winter. The most comfortable PET value is 17.6°C in summer and 11.5°C in winter. The neutral PET of Tibetan college students during outdoor activities in summer was 16.3°C, and the neutral PET of outdoor activities in winter was 12.1°C. Gender and ethnicity had different effects on thermal sensation under different activity intensities. Under vigorous-intensity activities, PET in winter and summer had the greatest influence on thermal sensation. The situation was different under moderate-intensity activity. PET had the greatest influence on thermal sensation in summer, and Tmrt had the greatest influence on thermal sensation in winter. Discussion These findings provide a basis for an improved design of the outdoor environment under different outdoor activity intensities in high-altitude areas.
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Affiliation(s)
| | | | - Jiaqin Han
- School of Architecture, Southwest Jiaotong University, Chengdu, China
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Guan T, Cao M, Zheng C, Zhou H, Wang X, Chen Z, Zhang L, Cao X, Tian Y, Guo J, Han X, Wang Z. Dose-response association between physical activity and blood pressure among Chinese adults: a nationwide cross-sectional study. J Hypertens 2024; 42:360-370. [PMID: 38037282 PMCID: PMC10763713 DOI: 10.1097/hjh.0000000000003587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/25/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVES The aim of this study was to examine the dose-response associations of physical activity with blood pressure (BP) and hypertension risk among Chinese adults. METHODS Derived from the national community-based China Hypertension Survey database during 2012--2015, a total of 203 108 residents aged at least 18 years were included. Individual-level physical activity was evaluated using a standardized questionnaire, and minutes of metabolic equivalent tasks per week (MET-min/week) were calculated, integrating domain, intensity, frequency, and duration. Multivariable linear and logistic regressions were used to estimate associations of physical activity with BP and hypertension risk, and restricted cubic spline regressions were performed for their nonlinear dose-response relationships. RESULTS Overall, the median total physical activity (TPA) was 3213.0 MET-min/week and the prevalence of physical inactivity was 14.8%. TPA was negatively associated with BP. Increasing TPA levels was related to a steep decrease in systolic BP, up to approximately 2500 MET-min/week, with more modest benefits above that level of TPA. Higher levels of domain-specific and intensity-specific physical activity were found to be associated with lower BP levels and hypertension risk, except for the association between vigorous-intensity physical activity and systolic BP. We found that TPA within the range of 2000--4000 MET-min/week, a higher frequency and shorter duration were inversely associated with diastolic BP levels. CONCLUSION Total, domain-specific, and intensity-specific physical activity were inversely related to BP levels, respectively, in a dose-response fashion. Of a given amount, higher-frequency, shorter-duration, and lower-intensity physical activity produced more beneficial effects.
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Affiliation(s)
| | - Man Cao
- School of Health Policy and Management
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Haoqi Zhou
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Xue Cao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Yixin Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Jian Guo
- Medical Research Center
- Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | | | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
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Wu C, Liu P, Yuan Z. Prospective association between fruit and vegetable intake and the risk of type 2 diabetes amongst Chinese adults: the China Health and Nutrition Survey. Int J Food Sci Nutr 2024; 75:81-91. [PMID: 37933616 DOI: 10.1080/09637486.2023.2278418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
This study aimed to prospectively explore the relationship between fruit and vegetable intake (FVI) and type 2 diabetes (T2D) risk amongst 13,175 Chinese adults. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of T2D events in relation to FVI. Results showed that the highest quintile of FVI was inversely associated with T2D risk in men (HR = 0.72, 95% CI: 0.50, 0.98) and women (HR = 0.74, 95% CI: 0.55, 0.97), whereas no such associations were observed between total vegetable intake and T2D in either men (HR = 0.92, 95% CI: 0.65, 1.26) or women (HR = 1.02, 95% CI: 0.77, 1.38). In addition, greater fruit intake was inversely associated with T2D risk in men (HR = 0.42, 95% CI: 0.28, 0.63) and women (HR = 0.64, 95% CI: 0.45, 0.90). Overall, FVI and total fruit intake were inversely associated with T2D risk amongst Chinese adults.
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Affiliation(s)
- Caifeng Wu
- Research Center, Chengdu Medical College, Chengdu, China
| | - Pingping Liu
- Hefei Yaohai District Center for Disease Control and Prevention, Hefei, China
| | - Zhanpeng Yuan
- School of Public Health, Wuhan University, Wuhan, China
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Zhang L, Li P, Ge Q, Sun Z, Cai J, Xiao C, Yu C, Nosarti C, Liao J, Liu Z. Maternal Prenatal Depressive Symptoms and Fetal Growth During the Critical Rapid Growth Stage. JAMA Netw Open 2023; 6:e2346018. [PMID: 38048129 PMCID: PMC10696489 DOI: 10.1001/jamanetworkopen.2023.46018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/23/2023] [Indexed: 12/05/2023] Open
Abstract
Importance Fetal growth in the critical rapid growth stage (CRGS) before delivery, approximately between 30 to 37 gestational weeks, carries significant implications for subsequent overweight, obesity, and arterial health. Previous evidence has demonstrated the association between maternal depressive symptoms and fetal growth trajectories from early to late pregnancy, but there remains limited understanding of the association of these symptoms with the longitudinal fetal growth change within the CRGS. Objective To investigate the association between maternal depressive symptoms and fetal growth during the CRGS before delivery. Design, Setting, and Participants This prospective birth cohort study was conducted from January 2018 to December 2020. Volunteer pregnant women were enrolled in their first trimester of prenatal visits. Women with severe disease before pregnancy and multiple births, fetuses with congenital anomalies, and preterm or postterm births were excluded. This multicenter study was based in 13 hospitals covering 81 counties across 12 cities in Sichuan Province, China. Follow-up visits were performed at the second trimester, the third trimester, and 24 hours after delivery. The analysis was conducted from January to May 2023. Exposures Maternal depressive symptoms, as a continuous variable, measured by the Edinburgh Postpartum Depression Scale (EPDS) at a median gestational week of 24 (range, 14 to 27) weeks of gestation. A higher score on the EPDS indicates worse depressive symptoms. Main Outcomes and Measures The main outcomes included ultrasonography-measured biparietal diameter (BPD), femur length (FL), and abdominal circumference (AC), along with calculated estimated fetal weight (EFW). These parameters were evaluated longitudinally at a median gestational week of 30 (range, 28 to 32) and 37 (range, 35 to 39) weeks. Linear mixed models were used to estimate the associations between maternal depressive symptoms and fetal growth parameters. Results A total of 2676 mother-offspring dyads were included, in which the mean (SD) age of mothers was 28.0 (4.4) years, and 1294 (48.4%) of the offspring were female. The median (IQR) maternal EPDS score was 5.0 (4.0 to 9.0). After adjustment for confounders, a significant correlation was found between a higher score of depressive symptoms in mothers and a slower rate of fetal growth across FL (β = -0.40; 95% CI, -0.58 to -0.22), AC (β = -1.97; 95% CI, -2.90 to -1.03), and EFW (β = -50.11; 95% CI, -68.46 to -31.75). These associations were stronger in female fetuses or those with better family socioeconomic conditions. Conclusions and Relevance In this prospective cohort study, maternal depressive symptoms were associated with slower fetal growth rate in the CRGS before delivery. Early screening for depressive disorders in pregnant women appears to be essential for fetal growth and later health.
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Affiliation(s)
- Lu Zhang
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ping Li
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiaoyue Ge
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zeyuan Sun
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, United Kingdom
| | - Jiarui Cai
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chenghan Xiao
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chuan Yu
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chiara Nosarti
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, United Kingdom
| | - Jiaqiang Liao
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenmi Liu
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Guan Q, Zhu C, Zhang G, Wang J, Xiang H, Chen Y, Cui H. Association of land urbanization and type 2 diabetes mellitus prevalence and mediation of greenness and physical activity in Chinese adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 337:122579. [PMID: 37741540 DOI: 10.1016/j.envpol.2023.122579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 09/25/2023]
Abstract
The prevalence of type 2 diabetes (T2D) is higher in urban than in rural areas. Limited information is available on the association between T2D and Land urbanization (LU) while LU influences not only greenness and Particulate Matter 2.5 (PM2.5) but also inhabitant behavior. We aimed to explore the association between the LU level and T2D prevalence, as well as whether greenness, PM2.5, or conscious physical activity mediated any of the observed associations. This study encompassed 27,633 adult participants from Shandong Province who completed the sixth National Health Service Survey in 2018. Ambient LU exposure was estimated by spatial characteristics, including the existing impervious surface area (ISA), road density (RD), and annual night light (NL). Exposures were estimated using satellite images and OpenStreetMap, with 1000 m used as the main analysis buffer. Two-level logistic regression models were used to investigate the association between the LU metrics and T2D. Additionally, we explored potential mechanisms of the association through mediation analysis. The prevalence of T2D among participants was 5.14%, with average exposures to ISA_1000m of 1.441 km2, RD_1000m of 3.856 km/km2, and NL_1000m of 9.821 nW/cm2/sr. Higher levels of LU exposure were associated with higher T2D ORs [for each interquartile of ISA_1000m, RD_1000m, and NL_1000m, the adjusted OR (95% CI) for the T2D prevalence were 1.29 (1.19-1.4), 1.25 (1.15-1.36), and 1.25 (1.15-1.36), respectively]. This relationship persisted in several sensitivity analyses including use of different buffer sizes. We observed stronger associations among participants younger than 65 years or in men. Greenness mediated a 20.78%-65.36% of the estimated associations, conscious physical activity mediated a 10.35%-15.85%, while PM2.5 mediated insignificantly. These results suggest a deleterious association between higher levels of LU and T2D among adult residents in a developing country. Greenness and conscious physical activity mediate the association.
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Affiliation(s)
- Qing Guan
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Chunyang Zhu
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Guo Zhang
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan 430072, China.
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.
| | - Yujia Chen
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Hao Cui
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
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10
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Wu M, Li S, Lv Y, Liu K, Wang Y, Cui Z, Wang X, Meng H. Associations between the inflammatory potential of diets with adherence to plant-based dietary patterns and the risk of new-onset cardiometabolic diseases in Chinese adults: findings from a nation-wide prospective cohort study. Food Funct 2023; 14:9018-9034. [PMID: 37740363 DOI: 10.1039/d3fo02579a] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Aims: convincing evidence is still limited for the validation of associations between the inflammatory potential of diets, based on the dietary inflammatory index (DII), and cardiometabolic outcomes. We aimed to investigate the associations between the DII with adherence to plant-based dietary patterns and the risk of new-onset cardiometabolic diseases (CMDs), including stroke, type 2 diabetes mellitus (T2DM) and myocardial infarction (MI). Methods: adults (N = 14 652) from the China Health and Nutrition Survey (1997-2015) were included in the current analysis. Dietary intake data were collected using a combination of 3 day consecutive 24 h dietary recalls and the food weighing method. The DII was calculated with established and validated methods. CMDs were identified using validated self-reported questionnaires. The Cox proportional hazard regression model was used for statistical analysis. Results: during a mean follow-up of 10 years, a total of 404 new-onset stroke, 1051 new-onset T2DM and 280 new-onset MI cases were identified. Lower PDI, hPDI, ERD, WISH and PHDI scores and higher uPDI scores were associated with higher DII scores (all P-trend < 0. 0001). A pro-inflammatory diet, as reflected by relatively higher DII scores, was positively associated with an increased risk of stroke (Q5 vs. Q1: HR = 1.90; 95% CI: 1.26-2.88; P-trend = 0.0006), T2DM (Q5 vs. Q1: HR = 2.08; 95% CI: 1.61-2.69; P-trend < 0.0001) and MI (Q5 vs. Q1: HR = 1.70; 95% CI: 1.04-2.76; P-trend = 0.0114) in the entire cohort. Sex and BMI significantly modified the association between the DII and the risk of T2DM, and sex significantly modified the association between the DII and the risk of MI. Conclusions: lower adherence to healthy and sustainable plant-based dietary patterns and higher adherence to unhealthy plant-based dietary patterns were associated with higher DII scores. With the use of the DII, we reported long-term positive associations between a pro-inflammatory diet and an increased risk of new-onset stroke, T2DM and MI in Chinese adults who were free from CMDs and cancer at the baseline. These findings provided evidence for the validation of associations between the DII and cardiometabolic health, and contributed to the current literature suggesting careful evaluations of whether the DII should be incorporated into dietary guidelines and utilized as an effective tool for improving the diet quality and CMD prevention in the Chinese population.
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Affiliation(s)
- Man Wu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Shun Li
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Yiqian Lv
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Ke Liu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Yin Wang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Zhixin Cui
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Xiaoling Wang
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518033, China
| | - Huicui Meng
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong 510080, China
- Guangdong Province Engineering Laboratory for Nutrition Translation, Guangzhou, Guangdong 510080, China
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11
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Zhang M, Zhu S, Chen L, Wu Y, Ye Y, Wang G, Gui Z, Zhang C, Zhang M. Knowledge mapping of early-onset colorectal cancer from 2000 to 2022: A bibliometric analysis. Heliyon 2023; 9:e18499. [PMID: 37560685 PMCID: PMC10407048 DOI: 10.1016/j.heliyon.2023.e18499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023] Open
Abstract
The incidence of early-onset colorectal cancer (EO-CRC), diagnosed in patients younger than 50 years, has increased in incidence alarmingly over the past few decades, while overall incidence and mortality of colorectal cancer are stabilizing or declining in many high-income countries. These unfavorable changes have raised significant concerns and led to extensive research, resulting in a surge in studies on EO-CRC. Our aim was to obtain a more comprehensive understanding of the current state of this field and to identify prospective research directions by performing a bibliometric analysis of EO-CRC. A total of 1952 papers on EO-CRC published from 2000 to 2022 were identified after a thorough search of the Web of Science Core Collection. The United States dominated this field, with Harvard University contributing the greatest number of papers, while the journal Familial Cancer (n = 52) published the most articles. Cooperation network analysis revealed close internal cooperation among countries, institutions and authors. Based on reference and keyword analysis, high-frequency keywords showed several popular research directions, including epidemiology (incidence, young patients, age of onset, etc.), risk factors (obesity, family history, lynch syndrome, etc.) and molecular characterization (germline mutation, genome wide association, MLH1, etc.). Overall, our research provides an overview of the current status in this field, which we hope will give researchers a comprehensive perspective on the present trends within this domain.
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Affiliation(s)
- Mengmeng Zhang
- Department of Integrated Chinese and Western Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, 230031, Hefei, Anhui, China
- The Traditional and Western Medicine (TCM)-Integrated Cancer Center of Anhui Medical University, 230031, Hefei, Anhui, China
| | - Shentao Zhu
- Department of Integrated Chinese and Western Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, 230031, Hefei, Anhui, China
- Graduate School of Anhui University of Traditional Chinese Medicine, 230031, Hefei, Anhui, China
| | - Lili Chen
- Department of Integrated Chinese and Western Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, 230031, Hefei, Anhui, China
- Graduate School of Anhui University of Traditional Chinese Medicine, 230031, Hefei, Anhui, China
| | - Yue Wu
- Department of Integrated Chinese and Western Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, 230031, Hefei, Anhui, China
- The Traditional and Western Medicine (TCM)-Integrated Cancer Center of Anhui Medical University, 230031, Hefei, Anhui, China
| | - Yingquan Ye
- Department of Integrated Chinese and Western Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, 230031, Hefei, Anhui, China
- The Traditional and Western Medicine (TCM)-Integrated Cancer Center of Anhui Medical University, 230031, Hefei, Anhui, China
| | - Gaoxiang Wang
- Department of Integrated Chinese and Western Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, 230031, Hefei, Anhui, China
- The Traditional and Western Medicine (TCM)-Integrated Cancer Center of Anhui Medical University, 230031, Hefei, Anhui, China
| | - Zhongxuan Gui
- Department of Integrated Chinese and Western Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, 230031, Hefei, Anhui, China
- The Traditional and Western Medicine (TCM)-Integrated Cancer Center of Anhui Medical University, 230031, Hefei, Anhui, China
| | - Congjun Zhang
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, 230031, Hefei, Anhui, China
| | - Mei Zhang
- Department of Integrated Chinese and Western Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, 230031, Hefei, Anhui, China
- The Traditional and Western Medicine (TCM)-Integrated Cancer Center of Anhui Medical University, 230031, Hefei, Anhui, China
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12
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Song Y, Li H, Yu H. Effects of green space on physical activity and body weight status among Chinese adults: a systematic review. Front Public Health 2023; 11:1198439. [PMID: 37546310 PMCID: PMC10399589 DOI: 10.3389/fpubh.2023.1198439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 06/29/2023] [Indexed: 08/08/2023] Open
Abstract
Background Green space may provide many benefits to residents' health behaviors and body weight status, but the evidence is still relatively scattered among Chinese adults. The purpose of this study was to review the scientific evidence on the effects of green space on physical activity (PA) and body weight status among Chinese adults. Methods A keyword and reference search was conducted in Pubmed, Web of Science, MEDLINE, and PsycINFO. Studies examining the associations between green space and PA, body mass index (BMI) among Chinese adults were included. The quality of the included literature was evaluated using the National Institutes of Health's Observational Cohort and Cross-Sectional Study Quality Assessment Tool. Results A total of 31 studies were included that met the inclusion criteria, including 25 studies with a cross-sectional design, 3 studies with a longitudinal design, and 3 studies with an experimental design. Street-level green view index and green space accessibility were found to be positively associated with PA, but negatively associated with BMI. In most studies, there was a correlation between green space ratio in local areas and BMI. In addition, green space interventions were effective in increasing PA and decreasing BMI among Chinese adults. In contrast, further evidence is needed to support the association between the design characteristics of green space and PA and BMI. Conclusion Preliminary evidence suggests that green space has a positive effect on PA and BMI among Chinese adults. However, there are contradictory findings, and future studies adopting longitudinal and quasi-experimental studies are needed to further explore the causal relationship between green space and PA and BMI to provide a relevant theoretical basis for policymakers.
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Affiliation(s)
| | | | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing, China
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13
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Wang Y, Steenbergen B, van der Krabben E, Kooij HJ, Raaphorst K, Hoekman R. The Impact of the Built Environment and Social Environment on Physical Activity: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6189. [PMID: 37372774 DOI: 10.3390/ijerph20126189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
This scoping review aims to provide an overview of the current state of physical activity research, focusing on the interplay between built and social environments and their respective influences on physical activity. We comprehensively searched electronic databases to identify relevant studies published between 2000 and 2022. A total of 35 articles have been reviewed based on the research question. The review found that built and social environments influence physical activity, and consideration of people's perceptions of their surroundings can provide further insight. The literature was summarized, and recommendations were made for future research. Findings suggest that interventions targeting built and social environments can promote physical activity effectively. However, limitations in the literature exist, including a need for more standardization in research methods and consistency in measurement tools.
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Affiliation(s)
- Yiyu Wang
- Behavioral Science Institute, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Bert Steenbergen
- Behavioral Science Institute, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Erwin van der Krabben
- Department of Geography, Planning, and Environment, Institute for Management Research, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Henk-Jan Kooij
- Department of Geography, Planning, and Environment, Institute for Management Research, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Kevin Raaphorst
- Department of Geography, Planning, and Environment, Institute for Management Research, Radboud University, 6525 XZ Nijmegen, The Netherlands
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14
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Lynch D, Howard A, Tien HC, Du S, Zhang B, Wang H, Gordon-Larsen P, Batsis J. Association Between Weight Status and Rate of Cognitive Decline: China Health and Nutrition Survey 1997-2018. J Gerontol A Biol Sci Med Sci 2023; 78:958-965. [PMID: 36754372 PMCID: PMC10235196 DOI: 10.1093/gerona/glad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND There is a close relationship between weight status and cognitive impairment in older adults. This study examined the association between weight status and the trajectory of cognitive decline over time in a population-based cohort of older adults in China. METHODS We used data from adults aged ≥55 years participating in the China health and nutrition survey (1997-2018). Underweight (body mass index [BMI] ≤ 18.5 kg/m2), normal weight (18.5-23 kg/m2), overweight (23-27.5 kg/m2), and obesity (BMI ≥ 27.5 kg/m2) were defined using the World Health Organization Asian cutpoints. Global cognition was estimated every 2-4 years through a face-to-face interview using a modified telephone interview for cognitive status (scores 0-27). The association between BMI and the rate of global cognitive decline, using a restricted cubic spline for age and age category, was examined with linear mixed-effects models accounting for correlation within communities and individuals. RESULTS We included 5 992 adults (53% female participants, mean age of 62 at baseline). We found differences in the adjusted rate of global cognitive decline by weight status (p = .01 in the cubic spline model). Models were adjusted for sex, marital status, current employment status, income, region, urbanization, education status, birth cohort, leisure activity, smoking status, and self-reported diagnosis of hypertension, diabetes, or Myocardial Infarction (MI)/stroke. In addition, significant declines by age in global cognitive function were found for all weight status categories except individuals with obesity. CONCLUSIONS In a cohort of adults in China, cognitive decline trajectory differed by weight status. A slower rate of change was observed in participants classified as having obesity.
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Affiliation(s)
- David H Lynch
- Division of Geriatric Medicine and Center for Aging and Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Annie Green Howard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Hsiao-Chuan Tien
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Shufa Du
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Penny Gordon-Larsen
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - John A Batsis
- Division of Geriatric Medicine and Center for Aging and Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
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15
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Wang J, Zhou L, Yin W, Hu C, Zuo X. Trends of the burden of type 2 diabetes mellitus attributable to high body mass index from 1990 to 2019 in China. Front Endocrinol (Lausanne) 2023; 14:1193884. [PMID: 37324264 PMCID: PMC10264794 DOI: 10.3389/fendo.2023.1193884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Background Overweight and obesity are well-known risk factors for developing type 2 diabetes (T2DM). However, details on the evolution of the T2DM burden attributed to China's high body mass index (BMI) in China have not been thoroughly studied. This study aimed to investigate the temporal trends of the T2DM burden attributable to a high BMI in China from 1990 to 2019 and to evaluate the independent effects of age, period, and cohort on the burden of T2DM attributed to a high BMI. Methods Data on T2DM burden attributable to a high BMI from 1990 to 2019 were obtained from the Global Burden of Disease Study 2019. Deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) of T2DM attributable to a high BMI were estimated by age and sex. The joinpoint regression model was performed to calculate the annual percentage change (APC) and the average annual percentage change (AAPC) in the burden of T2DM attributed to a high BMI. The age-period-cohort analysis was applied to estimate the independent effects of age, period, and cohort on the temporal trends of mortality and the DALY rate. Results In 2019, deaths and DALYs from T2DM attributable to a high BMI in China were 47.53 thousand and 3.74 million, respectively, five times higher than in 1990. Among those under 60 years of age, men had higher deaths and DALYs than women, while the gender differences reversed in those over 60 years of age. Furthermore, the ASMR and ASDR in 2019 were 2.39 per 100,000 (95%UI 1.12-3.90) and 181.54 per 100,000 (95%UI 93.71-286.33), respectively, representing a 91% and 126% increase since 1990. In China, women previously had a higher ASMR and ASDR than men, while the differences in the ASMR and ASDR between the sexes were reversed in recent years. From 1990 to 2019, the ASMR in women increased before 2004 and then decreased from 2004 to 2015, and increased again after, with an overall AAPC value of 1.6%. In contrast, the ASMR in men continued to increase, with an overall AAPC value of 3.2%. The ASDR continued to increase in men and women, with AAPCs of 2.2% and 3.5%, respectively. The age effect showed that the relative risk of mortality increased with age in both men and women, except for the 75-84 age group. The impact of the age on the DALY rate revealed a trend of first rising and then decreasing, peaking at 65-69 years. The effect of the period on the burden of T2DM attributable to a high BMI increased from 1990 to 2019. The cohort effect generally showed a downward trend. Conclusion The burden of T2DM attributed to a high BMI in China increased substantially from 1990 to 2019, particularly in men. Therefore, there is an urgent need for gender- and age-based public health guidelines on prevention strategies, early diagnosis, and effective management of T2DM, overweight, and obesity in China.
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Affiliation(s)
- Jianglin Wang
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Lingyun Zhou
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Wenjun Yin
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Can Hu
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Xiaocong Zuo
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Hunan, Changsha, China
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Hunan, Changsha, China
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16
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Qin X, Song L, Fan G, Liu Q, Wu M, Bi J, Fang Q, Wan Z, Lv Y, Wang Y. Sex-specific associations of single metal and metal mixture with handgrip strength: a cross-sectional study among Chinese adults. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:66585-66597. [PMID: 37097571 DOI: 10.1007/s11356-023-26926-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/06/2023] [Indexed: 05/25/2023]
Abstract
Metallic elements are ubiquitous in the natural environment and always collaborate to affect human health. The relationship of handgrip strength, a marker of functional ability or disability, with metal co-exposure remains vague. In this study, we aimed to investigate the effect of metal co-exposure on sex-specific handgrip strength. A total of 3594 participants (2296 men and 1298 women) aged 21 to 79 years recruited from Tongji Hospital were included in the present study. Urinary concentrations of 21 metals were measured by inductively coupled plasma mass spectrometer (ICP-MS). We used linear regression, restricted cubic spline (RCS) model, and weighted quantile sum (WQS) regression to evaluate the association of single metal as well as metal mixture with handgrip strength. After adjusting for important confounding factors, the results of linear regression showed that vanadium (V), zinc (Zn), arsenic (As), rubidium (Rb), cadmium (Cd), thallium (Tl), and uranium (U) were adversely associated with handgrip strength in men. The results of RCS showed a non-linear association between selenium (Se), silver (Ag), and nickel (Ni) with handgrip strength in women. The results of WQS regression revealed that metal co-exposure was inversely related to handgrip strength for men (β = -0.65, 95% CI: -0.98, -0.32). Cd was the critical metal in men (weighted 0.33). In conclusion, co-exposure to a higher level of metals is associated with lower handgrip strength, especially among men, and Cd may contribute most to the conjunct risk.
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Affiliation(s)
- Xiya Qin
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lulu Song
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Gaojie Fan
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qing Liu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mingyang Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianing Bi
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qing Fang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhengce Wan
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yongman Lv
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Youjie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, 430030, Hubei, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Yang H, An R, Clarke CV, Shen J. Impact of economic growth on physical activity and sedentary behaviors: a Systematic Review. Public Health 2023; 215:17-26. [PMID: 36608601 DOI: 10.1016/j.puhe.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/20/2022] [Accepted: 11/25/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVES This study systematically reviewed scientific evidence regarding the impact of economic growth on physical activity (PA) and sedentary behaviors. METHODS A keyword and reference search was conducted in PubMed, Web of Science, Cochrane Library, Scopus, and EBSCO from the inception of an electronic bibliographic database to November 2021. Studies that met all of the following criteria were included in the review: (1) study designs: observational studies; (2) study subjects: people of all ages; (3) exposure: macroeconomic growth; (4) outcomes: PA or sedentary behaviors/sitting time. RESULTS 15 studies were identified. Eight among 12 studies found economic growth positively associated with at least one domain/measure of PA, whereas the remaining four found an inverse relationship. One of two studies examined the association of economic growth and physical inactivity found a positive relationship, while another found no significant relationship. Four studies examined the associations between economic growth and sedentary behaviors, and the results were inconclusive. The impact of economic growth on PA is through three main pathways-(a) building and maintaining parks and green spaces, (b) adoption of the modern workplace and high technology, and (c) motorized transportation. CONCLUSION Building and maintaining parks and green spaces can effectively promote leisure time physical activity and active commute in developed countries, whereas promoting workplace and transportation-related PA could be prioritized in developing nations. Future research calls for longitudinal study design and further exploration of macro-environmental factors. Policymakers and stakeholders should be informed about the potential PA reduction resulting from economic growth and develop preventive strategies to alleviate the problem.
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Affiliation(s)
- H Yang
- Department of Physical Education, Capital University of Economics and Business, China
| | - R An
- Brown School, Washington University in St. Louis, United States
| | - C V Clarke
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, United states
| | - J Shen
- Department of Physical Education, China University of Geosciences (Beijing), China.
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18
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Cui Z, Wu M, Liu K, Wang Y, Kang T, Meng S, Meng H. Associations between Conventional and Emerging Indicators of Dietary Carbohydrate Quality and New-Onset Type 2 Diabetes Mellitus in Chinese Adults. Nutrients 2023; 15:647. [PMID: 36771355 PMCID: PMC9919288 DOI: 10.3390/nu15030647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
Dietary glycemic index (GI), carbohydrate to fiber ratio (CF) and carbohydrate quality index (CQI) are conventional and emerging indicators for carbohydrate quality. We aimed to investigate the associations between these indicators and new-onset type 2 diabetes mellitus (T2DM) risk among Chinese adults. This prospective cohort study included 14,590 adults from the China Health and Nutrition Survey without cardiometabolic diseases at baseline. The associations between dietary GI, CF and CQI and T2DM risk were assessed using Cox proportional hazard regression analysis and dose-response relationships were explored using restricted cubic spline and threshold analysis. After a mean follow-up duration of 10 years, a total of 1053 new-onset T2DM cases occurred. There were U-shaped associations between dietary GI and CF and T2DM risk (both P-nonlinear < 0.0001), and T2DM risk was lowest when dietary GI was 72.85 (71.40, 74.05) and CF was 20.55 (17.92, 21.91), respectively (both P-log likelihood ratio < 0.0001). Inverse associations between CQI and T2DM risk specifically existed in participants < 60 y or attended middle school or above (both P-trend < 0.05). These findings indicated that moderate dietary GI and CF range and a higher dietary CQI score may be suggested for T2DM prevention in Chinese adults.
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Affiliation(s)
- Zhixin Cui
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
- Shenzhen Health Development Research and Data Management Center, Shenzhen 518028, China
| | - Man Wu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Ke Liu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Yin Wang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Tong Kang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Shuangli Meng
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
| | - Huicui Meng
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou 510080, China
- Guangdong Province Engineering Laboratory for Nutrition Translation, Guangzhou 510080, China
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19
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Boakye K, Bovbjerg M, Schuna J, Branscum A, Varma RP, Ismail R, Barbarash O, Dominguez J, Altuntas Y, Anjana RM, Yusuf R, Kelishadi R, Lopez-Jaramillo P, Iqbal R, Serón P, Rosengren A, Poirier P, Lakshmi PVM, Khatib R, Zatonska K, Hu B, Yin L, Wang C, Yeates K, Chifamba J, Alhabib KF, Avezum Á, Dans A, Lear SA, Yusuf S, Hystad P. Urbanization and physical activity in the global Prospective Urban and Rural Epidemiology study. Sci Rep 2023; 13:290. [PMID: 36609613 PMCID: PMC9822998 DOI: 10.1038/s41598-022-26406-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 12/14/2022] [Indexed: 01/09/2023] Open
Abstract
Urbanization may influence physical activity (PA) levels, although little evidence is available for low- and middle- income countries where urbanization is occurring fastest. We evaluated associations between urbanization and total PA, as well as work-, leisure-, home-, and transport-specific PA, for 138,206 adults living in 698 communities across 22 countries within the Prospective Urban and Rural Epidemiology (PURE) study. The 1-week long-form International PA Questionnaire was administered at baseline (2003-2015). We used satellite-derived population density and impervious surface area estimates to quantify baseline urbanization levels for study communities, as well as change measures for 5- and 10-years prior to PA surveys. We used generalized linear mixed effects models to examine associations between urbanization measures and PA levels, controlling for individual, household and community factors. Higher community baseline levels of population density (- 12.4% per IQR, 95% CI - 16.0, - 8.7) and impervious surface area (- 29.2% per IQR, 95% CI - 37.5, - 19.7), as well as the rate of change in 5-year population density (- 17.2% per IQR, 95% CI - 25.7, - 7.7), were associated with lower total PA levels. Important differences in the associations between urbanization and PA were observed between PA domains, country-income levels, urban/rural status, and sex. These findings provide new information on the complex associations between urbanization and PA.
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Affiliation(s)
- Kwadwo Boakye
- Department of Public Health and Health Services Administration, California State University, Chico, CA, USA
| | - Marit Bovbjerg
- College of Public Health and Human Sciences, Oregon State University, 2520 SW Campus Way, Corvallis, OR, 97331, USA
| | - John Schuna
- College of Public Health and Human Sciences, Oregon State University, 2520 SW Campus Way, Corvallis, OR, 97331, USA
| | - Adam Branscum
- College of Public Health and Human Sciences, Oregon State University, 2520 SW Campus Way, Corvallis, OR, 97331, USA
| | - Ravi Prasad Varma
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Health Action By People, Thiruvananthapuram, India
| | - Rosnah Ismail
- Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Medical Center, Kuala Lumpur, Malaysia
| | - Olga Barbarash
- Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
| | - Juan Dominguez
- Estudios Clínicos Latino América, 160, Rosario, Argentina
- Instituto Cardiovascular de Rosario, Oroño 450, Rosario, Argentina
| | - Yuksel Altuntas
- Department of Endocrinology and Metabolism, University of Health Sciences, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul, Turkey
| | | | - Rita Yusuf
- School of Life Sciences, Independent University, Dhaka, Bangladesh
| | - Roya Kelishadi
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Patricio Lopez-Jaramillo
- Masira Research Institute, Medical School, Universidad de Santander (UDES), Bucaramanga, Colombia
| | - Romaina Iqbal
- Department of Community Health Sciences and Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan
| | - Pamela Serón
- Faculty of Medicine, Universidad de La Frontera, Claro Solar 115, Temuco, Chile
| | - Annika Rosengren
- Sahlgrenska University Hospital, Göteborg, Sweden
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Paul Poirier
- Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Québec, Canada
| | - P V M Lakshmi
- Department of Community Medicine & School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rasha Khatib
- Advocate Aurora Research Institute, Advocate Aurora Health, Downers Grove, IL, USA
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Katarzyna Zatonska
- Department of Social Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Bo Hu
- Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing, China
| | - Lu Yin
- Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing, China
| | - Chuangshi Wang
- Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing, China
| | - Karen Yeates
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Jephat Chifamba
- Physiology Department, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Khalid F Alhabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Álvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz, Avenida Paulista, São Paulo, Brazil
| | - Antonio Dans
- Department of Medicine, University of the Philippines, Manila, Philippines
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, 2520 SW Campus Way, Corvallis, OR, 97331, USA.
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20
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Chen X, Giles J, Yao Y, Yip W, Meng Q, Berkman L, Chen H, Chen X, Feng J, Feng Z, Glinskaya E, Gong J, Hu P, Kan H, Lei X, Liu X, Steptoe A, Wang G, Wang H, Wang H, Wang X, Wang Y, Yang L, Zhang L, Zhang Q, Wu J, Wu Z, Strauss J, Smith J, Zhao Y. The path to healthy ageing in China: a Peking University-Lancet Commission. Lancet 2022; 400:1967-2006. [PMID: 36423650 PMCID: PMC9801271 DOI: 10.1016/s0140-6736(22)01546-x] [Citation(s) in RCA: 157] [Impact Index Per Article: 78.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/07/2022] [Accepted: 08/12/2022] [Indexed: 11/22/2022]
Abstract
Around the world, populations are ageing at a faster pace than in the past and this demographic transition will have impacts on all aspects of societies. In May 2020, the UN General Assembly declared 2021–2030 the Decade of Healthy Ageing, highlighting the importance for policymakers across the world to focus policy on improving the lives of older people, both today and in the future. While rapid population ageing poses challenges, China’s rapid economic growth over the last forty years has created space for policy to assist older persons and families in their efforts to improve health and well-being at older ages. As China is home to 1/5 of the world’s older people, China is often held up as an example for other middle-income countries. This Commission Report aims to help readers to understand the process of healthy ageing in China as a means of drawing lessons from the China experience. In addition, with the purpose of informing the ongoing policy dialogue within China, the Commission Report highlights the policy challenges on the horizon and draws lessons from international experience.
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Affiliation(s)
- Xinxin Chen
- Institute of Social Science Survey, Peking University, Beijing, China
| | | | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Winnie Yip
- Department of Global Health and Population, Harvard University, Boston, MA, USA
| | - Qinqin Meng
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Harvard University, Boston, MA, USA; Division of Geriatric Medicine, UCLA, Los Angeles, CA, USA
| | - He Chen
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Xi Chen
- Department of Health Policy and Management, Department of Economics, Yale School of Public Health, New Haven, CT, USA
| | - Jin Feng
- School of Economics, Fudan University, Shanghai, China
| | | | | | - Jinquan Gong
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Perry Hu
- Division of Geriatric Medicine, UCLA, Los Angeles, CA, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Xiaoyan Lei
- National School of Development, Peking University, Beijing, China
| | - Xiao Liu
- School of Labor Economics, Capital University of Economics and Business, Beijing, China
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Gewei Wang
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Harold Wang
- Program in Bioinformatics, UCLA, Los Angeles, CA, USA
| | - Huali Wang
- Dementia Care & Research Center, Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xiaoyu Wang
- Institute of Population and Labor Economics, Chinese Academy of Social Sciences, Beijing, China
| | - Yafeng Wang
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Li Yang
- Department of Health Policy and Management, Peking University, Beijing, China
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital and National Institute of Health Data Science, Peking University, Beijing, China
| | - Quan Zhang
- National School of Development, Peking University, Beijing, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Zunyou Wu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - John Strauss
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | | | - Yaohui Zhao
- National School of Development, Peking University, Beijing, China.
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21
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Ouyang Y, Huang F, Zhang X, Li L, Zhang B, Wang Z, Wang H. Association of Dietary Protein Intake with Muscle Mass in Elderly Chinese: A Cross-Sectional Study. Nutrients 2022; 14:nu14235130. [PMID: 36501159 PMCID: PMC9738702 DOI: 10.3390/nu14235130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/25/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022] Open
Abstract
Most data regarding the association between dietary protein intake and muscle mass come from developed Western countries. This cross-sectional study investigates the association between the amount and distribution of dietary protein intake and muscle mass in elderly Chinese adults. This analysis includes 4826 participants aged 60 years and above from the dataset of the China Health and Nutrition Survey (CHNS) 2018. Protein intake data were assessed using 3-day, 24 h dietary recalls. Appendicular skeletal muscle mass (ASM) was obtained using the bioelectrical impedance analysis (BIA). Two-thirds of dietary protein intake comes from plant sources in the elderly Chinese population. The median total dietary protein intake was 60.5 g/d in low muscle mass participants for males and 52.5 g/d for females, which was lower than for their respective counterparts. Compared to the lowest quartile of protein intake, the highest total protein intake group had increased muscle mass by 0.96 kg among men and by 0.48 kg among women (p < 0.0001), and the highest vegetable protein intake group had increased muscle mass by 0.76 kg among men and by 0.35 kg among women (p < 0.0001). The amount of dietary protein intake with each meal was less than 20 g. High total protein intake and high plant-based protein intake were positively associated with higher muscle mass. A U-shape was observed between total dietary protein intake and low muscle mass risk in elderly Chinese adults. It should be encouraged to increase total daily protein intake to maintain muscle health.
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22
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Wang Q, Duoji Z, Feng C, Fei T, Ma H, Wang S, Ciren W, Yang T, Ling H, Ma B, Yu W, Liu H, Zhou J, Zhao X, Jia P, Yang S. Associations and pathways between residential greenness and hyperuricemia among adults in rural and urban China. ENVIRONMENTAL RESEARCH 2022; 215:114406. [PMID: 36152883 DOI: 10.1016/j.envres.2022.114406] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 09/01/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Residential greenness may decrease the risk for hyperuricemia in rural areas, but the urban-rural disparities in this association and underlying pathways have not been studied. OBJECTIVES To investigate the associations and potential pathways between residential greenness and hyperuricemia in urban and rural areas. METHODS The baseline survey of the China Multi-Ethnic Cohort (CMEC) was used. Hyperuricemia was defined as serum uric acid (SUA) > 417 μmol/L for men and >357 μmol/L for women. The satellite-based normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were used to capture residential greenness. A propensity score inverse-probability weighting method was used to assess urban-rural differences in the associations between residential greenness and hyperuricemia, with possible mediation effects of physical activity (PA), body mass index (BMI), PM2.5, and NO2 examined by causal mediation analyses. RESULTS A total of 72,372 participants were included. The increases in the EVI500m and NDVI500m residential greenness were associated with a decreased risk for hyperuricemia and the SUA level in both urban and rural areas. For example, each 0.1-unit increase in EVI500m was associated with a decreased hyperuricemia risk of 7% (OR = 0.93 [0.91, 0.96]) and a decreased SUA level of -1.77 μmol/L [-2.60, -0.93], respectively; such associations were stronger in urban areas for both the risk for hyperuricemia (OR = 0.84 [0.83, 0.86]) and SUA level (-7.18 μmol/L [-7.91, -6.46]). The subgroup analysis showed that the greenness-hyperuricemia/SUA association varied by age, sex, and annual household income. The percentage of the joint mediation effect of PA, BMI, PM2.5, and NO2 on the association between EVI500m and the risk for hyperuricemia was higher in urban (34.92%) than rural areas (15.40%). BMI, PM2.5, and PA showed significantly independently mediation effects for the greenness-hyperuricemia association in both rural and urban areas. CONCLUSIONS Exposure to residential greenness was associated with a decreased risk for hyperuricemia, partially through the pathways of PA, BMI, PM2.5, and NO2, which varied in urban and rural areas.
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Affiliation(s)
- Qinjian Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zhuoma Duoji
- School of Medicine, Tibet University, Lhasa, China
| | - Chuanteng Feng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Institute for Disaster Management and Reconstruction, Sichuan University-The Hongkong Polytechnic University, Chengdu, China
| | - Teng Fei
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
| | - Hua Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Songmei Wang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Wangla Ciren
- Lhasa Chengguan District Center for Disease Control and Prevention, Lhasa, China
| | - Tingting Yang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Hua Ling
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Bangjing Ma
- Qingbaijiang District Center for Disease Control and Prevention, Chengdu, China
| | - Wanqi Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Hongyun Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
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23
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Li R, Li Q, Zhang S, Zhang Y, He P, Zhang Z, Liu M, Zhou C, Ye Z, Wu Q, Yang S, Zhang Y, Li H, Liu C, Qin X. Domestic Physical Activity and New-Onset Hypertension: A Nationwide Cohort Study in China. Am J Med 2022; 135:1362-1370.e6. [PMID: 35584787 DOI: 10.1016/j.amjmed.2022.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/03/2022] [Accepted: 04/26/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND The relation of domestic physical activity with hypertension remains uncertain. We aimed to evaluate the prospective relation of domestic physical activity and new-onset hypertension among Chinese males and females. METHODS A total of 9254 adults who were free of hypertension at baseline were enrolled from the China Health and Nutrition Survey. Data on domestic physical activity were obtained by using self-reported questionnaires, and calculated as metabolic equivalent task (MET)-hours/week. Metabolic equivalent task-hours/week may account for both intensity and time spent on activities. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or diagnosed by physician or under antihypertensive treatment during the follow-up. RESULTS A total of 2892 participants developed hypertension during 81996 person-years of follow-up. Overall, there were reversed J-shaped associations between the domestic physical activity and new-onset hypertension in both males and females (both P values for nonlinearity < .001). Consistently, when domestic physical activity was assessed as categories (<10, 10 -< 20, 20 -< 30, 30 -< 40, 40 -< 50, 50 -< 60, 60 -<70, 70 -< 80, 80 -< 90, 90 -< 100, ≥100 MET-hours/week), compared with those with domestic physical activity < 10 MET-hours/week, the lower and similar risks of new-onset hypertension were found in participants with domestic physical activity 30 -< 90 MET-hours/week in both males and females. CONCLUSIONS Moderate domestic physical activity was associated with a lower risk of new-onset hypertension among both males and females.
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Affiliation(s)
- Rui Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Qinqin Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Shaojie Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Qimeng Wu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Huan Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Chengzhang Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Institute of Biomedicine, Anhui Medical University, Hefei, China.
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Institute of Biomedicine, Anhui Medical University, Hefei, China.
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Association between waist circumference change and incident chronic obstructive pulmonary disease among Chinese adults: a 10-year cohort study. Sci Rep 2022; 12:18402. [PMID: 36319731 PMCID: PMC9626450 DOI: 10.1038/s41598-022-23248-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022] Open
Abstract
The aim of our study was to investigate waist circumference (WC) change and the risk of incident chronic obstructive pulmonary disease (COPD) among Chinese adults. A total of 8164 participants aged > 18 years who attended health examinations with repeat measurements of WC and lung function [forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1)] from 2010 to 2019 were recruited. WC change was categorized as ≤ - 2.5%, - 2.5 to 2.5%, 2.5% to 5% and > 5% according to sex. Modified Poisson regression models were used to assess the association of WC gain and the risk of COPD. During the 10-year follow-up, a total of 917 COPD cases were identified. From baseline to follow-up, the mean FEV1 decreased from 3.20 to 2.79L among male participants and 2.28-1.95L among female participants. Compared with participants who did not have abdominal obesity, at either, baseline or follow-up, participants with abdominal obesity of both sexes after the follow-up were associated with a greater risk of COPD regardless of abdominal obesity at baseline. The risk of incident COPD increased 19% among male participants (RR = 1.19, 95%CI = 1.04-1.48) and 14% among female participants (RR = 1.14, 95%CI = 1.01-1.40) when WC gain increased > 5% during the 10-year follow-up. The COPD risk decreased 18% among male participants with a WC change ≤ - 2.5% (RR = 0.82, 95%CI = 0.67-0.99). The risk of incident COPD was positively associated with increasing WC among Chinese adults of both sexes.
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Liu R, Dang S, Zhao Y, Yan H, Han Y, Mi B. Long-term waist circumference trajectories and body mass index with all-cause mortality in older Chinese adults: a prospective nationwide cohort study. Arch Public Health 2022; 80:94. [PMID: 36088350 PMCID: PMC9463814 DOI: 10.1186/s13690-022-00861-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/18/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUNDS Abdominal obesity has been linked to risk of mortality, but whether and how trajectory of waist circumstance (WC) underpins this association remains unclear. The study aimed to identify long-term WC change trajectories and examine their association and joint effect with body mass index (BMI) on mortality among Chinese older adults. METHODS This present study included participants 60 years of age or older from China Health and Nutrition Survey (CHNS) from 1991 to 2015. The duration of follow-up was defined as period from the first to latest visit date attended with information on mortality, end of follow-up, or loss to follow-up (censoring). Latent class trajectory analysis (LCTA) was used to assess the changes of WC trajectories overtime. Cox proportional hazard models were used to assess hazard ratios (HRs) and corresponding 95% confidence internal (CIs) for mortality. RESULTS A total of 2601 participants with 8700 visits were included, and 562 mortality (21.6%) occurred during a median follow-up of 8.7 years. Using a group-based modeling approach, four distinct trajectories of WC change among Chinese older adults were identified as loss (13.5%), stable (46.8%), moderate gain (31.2%) and substantial gain (8.5%). With WC stable group as reference, the multivariable adjusted HRs for mortality were 1.34(95%CI:1.01-1.78) in loss group, 1.13(0.91-1.41) in moderate gain and 1.54(1.12-2.12) in substantial gain group. Compared with participants with normal BMI at baseline and maintained WC stable, the risk of mortality generally increased for all WC change group in initial overweight/obesity individuals, and the highest risk were observed for WC loss and stable pattern (HR:2.43, 95%CI: 1.41-4.19; HR:1.67 (1.07-2.60)). CONCLUSIONS In older Chinese, both long-term WC loss and substantial gain conferred excess risk for mortality. The baseline BMI might modify the effect as overweight individuals had a greater risk imposed by WC loss than those in normal weight. Maintaining stable WC and normal weight might be necessary to reduce the risk of mortality.
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Affiliation(s)
- Ruru Liu
- Department of Disinfection, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi Province, 710054, China
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi Province, 710061, China
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi Province, 710061, China
| | - Yaling Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi Province, 710061, China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi Province, 710061, China
| | - Yuewen Han
- Department of Disinfection, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi Province, 710054, China
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi Province, 710061, China.
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Cyr-Scully A, Howard AG, Sanzone E, Meyer KA, Du S, Zhang B, Wang H, Gordon-Larsen P. Characterizing the urban diet: development of an urbanized diet index. Nutr J 2022; 21:55. [PMID: 36085037 PMCID: PMC9463720 DOI: 10.1186/s12937-022-00807-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 08/30/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND In recent decades China has experienced rapid urbanization leading to a major nutrition transition, with increased refined carbohydrates, added sweeteners, edible oils, and animal-source foods, and reduced legumes, vegetables, and fruits. These changes have accompanied increased prevalence of cardiometabolic disease (CMD). There is no single dietary measure that summarizes the distinct food changes across regions and levels of urbanization. METHODS Using a sample of adults (≥18 years) in the 2015 wave of the China Health and Nutrition Survey (CHNS; n = 14,024), we selected literature-based candidate dietary variables and tested their univariate associations with overall and within-region urbanization. Using iterative exclusion of select diet-related variables, we created six potential urbanized diet indices, which we examined relative to overall urbanization to select a final urbanized diet index based on a priori considerations, strength of association with urbanization, and minimal missingness. We tested stability of the final urbanized diet index across sociodemographic factors. To examine whether our new measure reflected health risk, we used mixed effects logistic regression models to examine associations between the final urbanized diet index and CMD risk factors - hypertension (HTN), overweight, and type 2 diabetes mellitus (T2DM), adjusting for sociodemographics, overall urbanization, physical activity, and including random intercepts to account for correlation at community and household level. RESULTS We identified a final urbanized diet index that captured dietary information unique to consumption of an urbanized diet and performed well across regions. We found a positive association (R2 = 0.17, 0.01 SE) between the final urbanized diet index and overall urbanization in the fully adjusted model. The new measure was negatively associated with HTN [OR (95% CI) = 0.93 (0.88-0.99)] and positively associated with T2D [OR = 1.13; 1.05-1.21] in minimally adjusted models, but not in the fully adjusted models. CONCLUSION We derived an urbanized diet index that captured dietary urbanization that was distinct from overall urbanization and performed well across all regions of China. This urbanized diet index provides an alternative to measures of traditional versus urbanized diet that vary across regions due to different cultural dietary traditions. In addition, the new measure is best used in combination with diet quality measures, sociodemographic, and lifestyle measures to examine distinct pathways from urbanization to health in urbanizing countries.
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Affiliation(s)
- Ali Cyr-Scully
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Annie Green Howard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 123 W. Franklin Street, CB #8120, Chapel Hill, NC, 27514, USA.
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin Street, CB #8120, Chapel Hill, NC, 27514, USA.
| | - Erin Sanzone
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katie A Meyer
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Shufa Du
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin Street, CB #8120, Chapel Hill, NC, 27514, USA
| | - Bing Zhang
- National Institute for Nutrition and Health, China Center for Disease Control and Prevention, Beijing, China
| | - Huijun Wang
- National Institute for Nutrition and Health, China Center for Disease Control and Prevention, Beijing, China
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin Street, CB #8120, Chapel Hill, NC, 27514, USA
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Wang X, Bodirsky BL, Müller C, Chen KZ, Yuan C. The triple benefits of slimming and greening the Chinese food system. NATURE FOOD 2022; 3:686-693. [PMID: 37118140 DOI: 10.1038/s43016-022-00580-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/22/2022] [Indexed: 04/30/2023]
Abstract
The Chinese food system has undergone a transition of unprecedented speed, leading to complex interactions with China's economy, health and environment. Structural changes experienced by the country over the past few decades have boosted economic development but have worsened the mismatch between food supply and demand, deteriorated the environment, driven obesity and overnutrition levels up, and increased the risk for pathogen spread. Here we propose a strategy for slimming and greening the Chinese food system towards sustainability targets. This strategy takes into account the interlinkages between agricultural production and food consumption across the food system, going beyond agriculture-focused perspectives. We call for a food-system approach with integrated analysis of potential triple benefits for the economy, health and the environment, as well as multisector collaboration in support of evidence-based policymaking.
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Affiliation(s)
- Xiaoxi Wang
- China Academy for Rural Development, Department of Agricultural Economics and Management, Zhejiang University, Hangzhou, China.
- Potsdam Institute for Climate Impact Research, Member of the Leibniz Association, Potsdam, Germany.
| | - Benjamin Leon Bodirsky
- Potsdam Institute for Climate Impact Research, Member of the Leibniz Association, Potsdam, Germany.
| | - Christoph Müller
- China Academy for Rural Development, Department of Agricultural Economics and Management, Zhejiang University, Hangzhou, China
- Potsdam Institute for Climate Impact Research, Member of the Leibniz Association, Potsdam, Germany
| | - Kevin Z Chen
- China Academy for Rural Development, Department of Agricultural Economics and Management, Zhejiang University, Hangzhou, China
- International Food Policy Research Institute, Washington, DC, USA
| | - Changzheng Yuan
- School of Public Health, the Children's Hospital, and National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China.
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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28
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Yan Y, Wu T, Zhang M, Li C, Liu Q, Li F. Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population. BMC Public Health 2022; 22:1382. [PMID: 35854279 PMCID: PMC9295461 DOI: 10.1186/s12889-022-13759-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/29/2022] [Indexed: 12/20/2022] Open
Abstract
Background Type 2 diabetes mellitus is an expanding global public health issue, especially in developing countries. This study aimed to investigate the prevalence, awareness and control rate of type 2 diabetes mellitus, and assess its risk factors in elderly Chinese individuals. Methods The health screening data of 376,702 individuals aged ≥ 65 years in Wuhan, China, were collected to analyse the prevalence, awareness, and control rates of diabetes. Indices, including fasting plasma glucose and other biochemical indicators, were measured for all participants using standard methods at the central laboratory. Multilevel logistic regression analysis was performed to assess the key determinants of the prevalence, awareness, and control rates of diabetes. Results The prevalence, awareness, and control rates of diabetes in the Chinese individuals aged ≥ 65 years were 18.80%, 77.14%, and 41.33%, respectively. There were statistically significant differences in the prevalence, awareness, and control rates by gender. Factors associated with diabetes prevalence were age, body mass index (BMI), and central obesity; while those associated with awareness and control were gender, education level, marital status, physical activity, alcohol consumption, BMI, and central obesity. Conclusions Diabetes is an important public health problem in the elderly in China. The awareness and control rates have improved, but overall remained poor. Therefore, effective measures to raise awareness and control the rates of diabetes should be undertaken to circumvent the growing disease burden in elderly Chinese people. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13759-9.
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Affiliation(s)
- Yaqiong Yan
- Wuhan Centers for Disease Control & Prevention, 288# Machang Road, Wuhan, China
| | - Tingting Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China
| | - Miao Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China
| | - Changfeng Li
- Wuhan Centers for Disease Control & Prevention, 288# Machang Road, Wuhan, China
| | - Qing Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China.
| | - Fang Li
- Wuhan Centers for Disease Control & Prevention, 288# Machang Road, Wuhan, China.
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Li R, Zhang S, Li Q, Meng Q, Zu C, Zhang Y, He P, Liu M, Zhou C, Ye Z, Wu Q, Yang S, Zhang Y, Liu C, Qin X. Transportation physical activity and new-onset hypertension: A nationwide cohort study in China. Hypertens Res 2022; 45:1430-1440. [PMID: 35831583 DOI: 10.1038/s41440-022-00973-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/26/2022] [Accepted: 06/23/2022] [Indexed: 12/28/2022]
Abstract
The association between transportation physical activity (PA) and the risk of hypertension remains uncertain. We aimed to evaluated the prospective relation of transportation PA and new-onset hypertension among Chinese adults. A total of 9350 adults who were free of hypertension at baseline were enrolled from the China Health and Nutrition Survey (CHNS). Data on transportation PA were obtained by using self-reported questionnaires, and calculated as metabolic equivalent task (MET)-minutes/week. MET-minutes/week may account for both intensity and time spent on activities. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg or diagnosed by physician or under antihypertensive treatment during the follow-up. During a median of 8.0 years (82,410 person-years) of follow-up, a total of 2949 participants developed hypertension. Overall, there was a U-shaped association between transportation PA and new-onset hypertension (P values for nonlinearity <0.001). Accordingly, compared with those with moderate transportation PA (213-<394 MET-minutes/week, the second quartile), significantly higher risks of new-onset hypertension were observed not only in participants with transportation PA < 213 MET-minutes/week (the first quartile) (HR, 1.29; 95%CI: 1.15-1.44), but in those with transportation PA ≥ 394 MET-minutes/ week (the 3-4 quartiles) (HR, 1.15; 95%CI: 1.04-1.27). Similar U-shaped correlations were found for various types of transportation PA (walking, bicycling, and motorized PA) and new-onset hypertension. In summary, moderate transportation PA is associated with a lower risk of new-onset hypertension among Chinese adults.
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Affiliation(s)
- Rui Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China.,Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Shaojie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China.,Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Qinqin Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China.,Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Qiguo Meng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China.,Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Cheng Zu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China.,Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Qimeng Wu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Chengzhang Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China. .,Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China. .,Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China.
| | - Xianhui Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China. .,Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China. .,Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China.
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30
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Zhang YB, Li Y, Geng TT, Pan XF, Zhou YF, Liu G, Pan A. Overall lifestyles and socioeconomic inequity in mortality and life expectancy in China: the China health and nutrition survey. Age Ageing 2022; 51:6632481. [PMID: 35796136 DOI: 10.1093/ageing/afac167] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/19/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND socioeconomic inequity in mortality and life expectancy remains inconclusive in low- and middle-income countries, and to what extent the associations are mediated or modified by lifestyles remains debatable. METHODS we included 21,133 adults from China Health and Nutrition Survey (1991-2011) and constructed three parameters to reflect participants' overall individual- (synthesising income, education and occupation) and area-level (urbanisation index) socioeconomic status (SES) and lifestyles (counting the number of smoking, physical inactivity and unhealthy diet and bodyweight). HRs for mortality and life expectancy were estimated by time-dependent Cox model and life table method, respectively. RESULTS during a median follow-up of 15.2 years, 1,352 deaths were recorded. HRs (95% CIs) for mortality comparing low versus high individual- and area-level SES were 2.38 (1.75-3.24) and 1.84 (1.51-2.24), respectively, corresponding to 5.7 (2.7-8.6) and 5.0 (3.6-6.3) life-year lost at age 50. Lifestyles explained ≤11.5% of socioeconomic disparity in mortality. Higher lifestyle risk scores were associated with higher mortality across all socioeconomic groups. HR (95% CI) for mortality comparing adults with low individual-level SES and 3-4 lifestyle risk factors versus those with high SES and 0-1 lifestyle risk factors was 7.06 (3.47-14.36), corresponding to 19.1 (2.6-35.7) life-year lost at age 50. CONCLUSION this is the first nationwide cohort study reporting that disadvantaged SES was associated with higher mortality and shorter life expectancy in China, which was slightly mediated by lifestyles. Risk lifestyles were related to higher mortality across all socioeconomic groups, and those with risk lifestyles and disadvantaged SES had much higher mortality risks.
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Affiliation(s)
- Yan-Bo Zhang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Li
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting-Ting Geng
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiong-Fei Pan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yan-Feng Zhou
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Association between Selenium Status and Chronic Kidney Disease in Middle-Aged and Older Chinese Based on CHNS Data. Nutrients 2022; 14:nu14132695. [PMID: 35807874 PMCID: PMC9269073 DOI: 10.3390/nu14132695] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 12/24/2022] Open
Abstract
Background: The association between selenium and chronic kidney disease (CKD) remains controversial. Population studies with large samples facilitate the reliability of conclusions. Objective: In this study, we aimed to describe the prevalence of a CKD association with selenium intake in middle-aged and older Chinese. Methods: Data for this study were obtained from the China Health and Nutrition Survey (CHNS). A total of 5381 participants (aged ≥ 45) with biochemical test data were included in the study. Logistic regression models were used to examine the association between diet selenium intake (quartile) and the prevalence of CKD. Results: A total of 942 (17.01%) participants had CKD. The prevalence of CKD was 23.33%, 20.32%, 14.98%, and 9.25% among participants with average selenium intakes of 21.5 ± 4.82, 33.1 ± 2.79, 43.8 ± 3.70, and 67.0 ± 13.97 µg/day, respectively. In the fully adjusted model (Model 3), across the quartiles of selenium intake, the ORs for the prevalence of CKD were 1.00, 1.09 (95% CI 0.69–1.73), 0.82 (95% CI 0.49–1.38), and 0.43 (95% CI 0.22–0.85). The protein intake had a certain diagnostic significance for the selenium intake. Conclusions: An adequate selenium intake may have a positive effect on CKD. The influence of individual weight and location on the effect of selenium on CKD needs to be further explored.
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Wang M, Shen X, Deng L, Yu F, Lou Y, Liu J, Huang Y. Mediating Effects of Adolescent Physical Activity, Self-Rated Health and Family Income. Front Public Health 2022; 10:940141. [PMID: 35812513 PMCID: PMC9258192 DOI: 10.3389/fpubh.2022.940141] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 05/25/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate and analyse the situation and relationship between adolescent physical activity and self-assessment of health to provide a reference for adolescent physical activity research. Methods A questionnaire was used to investigate the physical activity and self-rated health of 1,804 adolescents aged 14–18 years. Results There was a significant relationship between adolescents' physical activity and self-rated health. The coefficient was 0.109 (P < 0.01) in urban areas and 0.127 (P < 0.01) in rural areas. At the same time, it was found that when family income was used as the intermediary variable between physical activity and self-rated health, the intermediary effect was 0.12 (P < 0.01), and the intermediary effect accounted for 25.97%. Conclusion Adolescent obesity, physical activity, smoking, wellbeing and physical activity can affect adolescents' self-rated health status. At the same time, it is also found that adolescents' family income is an intermediary variable between physical activity and self-rated health. Suggestions (1) Increase the methods of sports venues, sports organizations and sports activities, improve the possibility of teenagers participating in physical activities, and improve teenagers' self-rated health; (2) There is a large gap between the physical activity and self-rated health of urban and rural adolescents. Increasing the guidance of physical activity of adolescents in rural areas promotes the balance of self-rated health of urban and rural adolescents. (3) Family income is the intermediary variable of teenagers' physical activities and self-rated health. Reducing family expenditure through financial transfer payments or reducing taxes and fees can increase the level of teenagers' physical and mental health.
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Affiliation(s)
- Meng Wang
- Department of Health Education, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Xi Shen
- Department of Student Manager and Education, Hangzhou Medical College, Hangzhou, China
- *Correspondence: Xi Shen
| | - Lamei Deng
- Department of Student Manager and Education, Hangzhou Medical College, Hangzhou, China
| | - Feng Yu
- Department of Health Education, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Yin Lou
- Department of Health Education, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - JunJi Liu
- Department of Student Manager and Education, Hangzhou Medical College, Hangzhou, China
| | - Yibing Huang
- Department of Student Manager and Education, Hangzhou Medical College, Hangzhou, China
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The Association between Physical Activity and Cognitive Function: Data from the China Health and Nutrition Survey. Behav Neurol 2022; 2022:3438078. [PMID: 35769517 PMCID: PMC9236826 DOI: 10.1155/2022/3438078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/17/2022] [Accepted: 05/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background Decreased cognitive function is a common problem in the old adults, which has high risk of progression to Alzheimer's diseases (AD) and other dementias. This study was aimed at finding out the association between physical activity and cognitive function. Methods In total, 1514 participants with the age ≥ 55 years old registered in the China Health and Nutrition Survey (CHNS) database were selected in this study. The association between physical activity and cognitive function was analyzed via the generalized additive model. The association between the variables and the cognitive function score was expressed as β coefficient with 95% confidence intervals (CIs). Results After adjusting age, ethnicity, stratum, marital status, education, memory status, and memory changes, the cognitive function score was increased by 0.011 points for every 1-point increase in domestic score (β = 0.011, P = 0.043). Subgroup analysis indicated that in the female group, for every 1-point increase in the domestic score, the cognitive function score increased by 0.019 points (β = 0.019, P = 0.017). In people with good memory status, each 1-point increase in domestic score increased the cognitive function score of 0.020 points (β = 0.020, P = 0.017). Conclusions The decreased cognitive function was correlated with decreased domestic physical activity. The increased domestic physical activity was associated with an increased cognitive function in females and people with good memory status. The findings might offer a reference for deep understanding of the association between physical activity and cognitive function.
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Perera M, Arambepola C, Gillison F, Peacock O, Thompson D. Perceived barriers and facilitators of physical activity in adults living in activity-friendly urban environments: A qualitative study in Sri Lanka. PLoS One 2022; 17:e0268817. [PMID: 35653333 PMCID: PMC9162315 DOI: 10.1371/journal.pone.0268817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background Despite reforming health policies to create more enabling environments, insufficient physical activity in Sri Lanka remains a major public health issue. Socio-culture specific determinants underlying the physical activity of adults living in such environments need to be identified. The aim of this study was to explore the barriers and facilitators for physical activity, as perceived by adult urban dwellers in activity-friendly environments in Colombo District, Sri Lanka. Methods A qualitative study using in-depth interviews was conducted among adults aged 20–60 years living in an urban area which has been recently re-designed for recreational and rejuvenating purposes in Sri Lanka. Recruitment targeted varying socio-economic status and risk of non-communicable diseases; and was continued until the data saturation point was reached. Interviews were conducted in homes, primary healthcare units and fitness centres, and were transcribed verbatim and analysed using framework analysis. Results A total of 31 eligible and consenting adults were interviewed. Of the reported barriers to physical activity, lack of time was very common. Other frequently reported barriers included unpleasant experiences following exercise and misconceptions about exercise, whereas physical environmental factors, weather and road safety were reported less frequently. All participants reported at least one facilitator for engaging in exercise. Expectations of preventing diseases, improving health, physical fitness, psycho-social wellbeing, optimising body functions and increasing lifespan were frequently cited as reasons to be active, while social factors such as positive attitudes of family members and the influence of peers were found to be motivating. Conclusions The study showed that while participants valued the health benefits of physical activity and refurbished activity-friendly urban environments, these were not sufficient to support them to overcome key perceived barriers to being physically active.
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Affiliation(s)
- Madhawa Perera
- Department of Gynaecology and Obstetrics, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
- * E-mail:
| | - Carukshi Arambepola
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Fiona Gillison
- Department for Health, University of Bath, Bath, United Kingdom
| | - Oliver Peacock
- Department for Health, University of Bath, Bath, United Kingdom
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, United Kingdom
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Tu R, Lu Y, Tao K. Regular Physical Activities Inhibit Risk Factors of the Common Cold Among Chinese Adults. Front Psychol 2022; 13:864515. [PMID: 35686081 PMCID: PMC9171135 DOI: 10.3389/fpsyg.2022.864515] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/19/2022] [Indexed: 11/26/2022] Open
Abstract
Background Physical activity (PA) has a significant health impact worldwide and has been linked to a lower risk of the common cold. Objective The aim of this study was to estimate the form of PA among Chinese adults and the correlation between PA and number of the common cold in China's eastern, central, and western areas. Design A cross-sectional study. Setting China's eastern, central, and western regions from 30 November 2020 to 30 March 2021. Patients A total of 1,920 healthy participants, who aged over 18 years old, with Internet access, were enrolled, and then self-reported PA behaviors and number of the common cold were collected. Measurements The authors calculated preference, intensity, frequency, and duration of PA in Chinese based on gender, age, and broad occupational categories and explored the potential effect between these factors and the common cold. Results Approximately 20.4% of participants reported not participating in sports regularly. Except for gender, there were significant differences in PA preference and intensity among the remaining individuals (P <0.05). Sixteen common exercises were divided into three intensity levels by the Borg CR10 Scale: low- (5), moderate- (8), and high-intensity exercises (3), and the corresponding intensity, frequency, and duration were computed with significant differences (P <0.05). The most popular workouts are “Brisk walking” and “Running.” Age, sex, and occupation had no significant effect on colds (P > 0.05). However, intensity shows a U-shaped dose-response relationship with colds, whereas the frequency and duration have an inverse dose-response relationship (P <0.05). High intensity combined with high frequency increased colds the most. Nevertheless, non-exercise groups always have the most colds in each comparison. Limitations The result may be vulnerable to recall bias. Conclusion Intensity showed that U-shape, frequency, and duration showed inverse response to the number of colds last year, but age, sex, and occupation had no significant effects. High intensity and high frequency mixed increased colds the most, regardless of duration.
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Affiliation(s)
- Renjie Tu
- School of Sport Medicine and Physical Therapy, Beijing Sport University, Beijing, China
| | - Yifan Lu
- School of Sport Medicine and Physical Therapy, Beijing Sport University, Beijing, China
| | - Kuan Tao
- School of Sports Engineering, Beijing Sport University, Beijing, China
- *Correspondence: Kuan Tao
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Dietary Copper and Selenium Intakes and the Risk of Type 2 Diabetes Mellitus: Findings from the China Health and Nutrition Survey. Nutrients 2022; 14:nu14102055. [PMID: 35631196 PMCID: PMC9142999 DOI: 10.3390/nu14102055] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/08/2022] [Accepted: 05/10/2022] [Indexed: 11/17/2022] Open
Abstract
The long-term associations between dietary copper (Cu) and selenium (Se) intakes and type 2 diabetes mellitus (T2DM) risk are unclear. We aimed to examine the prospective associations between dietary Cu and Se intakes and T2DM risk in Chinese adults. A total of 14,711 adults from the China Health and Nutrition Survey (1997–2015) were included. Nutrient intakes were assessed by 3 consecutive 24 h recalls and food-weighing methods. T2DM was identified by a validated questionnaire and laboratory examination. Cox regression models were used for statistical analysis. A total of 1040 T2DM cases were diagnosed during 147,142 person-years of follow-up. In fully adjusted models, dietary Cu or Se intake was not associated with T2DM risk. Dietary Se intake significantly modified the association between dietary Cu intake and T2DM risk, and dietary Cu intake was positively associated with T2DM risk when Se intake was lower than the median (p-interaction = 0.0292). There were no significant effect modifications on the associations by age, sex, BMI, or region. Although dietary Cu or Se intake was not independently associated with T2DM risk in Chinese adults free from cardiometabolic diseases and cancer at the baseline, there was a significant interaction between dietary Cu and Se intakes on T2DM risk.
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Mo Z, Wang H, Zhang B, Ding G, Popkin BM, Du S. The Effects of Physical Activity and Sedentary Behaviors on Overweight and Obesity among Boys may Differ from those among Girls in China: An Open Cohort Study. J Nutr 2022; 152:1274-1282. [PMID: 35018425 PMCID: PMC9071318 DOI: 10.1093/jn/nxab446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/04/2021] [Accepted: 12/24/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Childhood overweight and obesity are increasing steadily in China, yet few studies have focused on exploring the risk factors associated with sex differences. OBJECTIVES We tested the hypothesis that the effects of physical activity and sedentary behaviors on overweight and obesity differ between boys and girls. METHODS We used data collected from 4520 children and adolescents aged 6-18 y from 2004 to 2015 in an ongoing open-cohort study, the China Health and Nutrition Survey, to explore the effects of physical activity and sedentary behaviors on the risk of overweight and obesity in Chinese children and adolescents. We collected detailed information on physical activity and sedentary behavior along with dietary data, and we measured height and weight with standardized methods. We used random-effects logistic regression models to analyze the associations between total physical activity and sedentary behavior and overweight and obesity. RESULTS The effects of sedentary behaviors and vigorous physical activity were only significant among girls. Vigorous physical activity decreased the risk of overweight and obesity by 63% (OR: 0.37; 95% CI: 0.20, 0.67) among girls ages 6-11 y and by 54% (OR: 0.46; 95% CI: 0.25, 0.85) among girls ages 12-18 y. High sedentary-hour values increased the risk by 96% (OR: 1.96; 95% CI: 1.09, 3.54) among girls ages 12-18 y. None of the effects were significant among boys. CONCLUSION Low physical activity and high sedentary time increase the risk of overweight and obesity, particularly among adolescent girls. The effects of physical activity and sedentary behaviors on overweight and obesity among boys may differ from those among girls. Sex effects should be taken into consideration when promoting physical activity. Whether this sex difference is a result of high male preferences in China that preclude many activities among boys or other factors requires further study.
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Affiliation(s)
- Zhe Mo
- Zhejiang Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Barry M Popkin
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shufa Du
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Wang J, Li R, Zhang L, Gao X, Zhou M, Zhang X, Ma Y. Associations between sedentary behaviour patterns and depression among people aged 60 and older in Hebei Province of China. BMC Public Health 2022; 22:283. [PMID: 35148744 PMCID: PMC8840782 DOI: 10.1186/s12889-022-12727-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sedentary behaviours (SBs) are now considered a risk factor for depression. Older adults are sedentary most of the time and are at a high risk of depression. However, not all types of SBs have adverse effects on mental health. Passive SBs (such as watching TV) increase the risk of depression, whereas mentally active SBs (such as using the internet and reading) decrease the risk of depression. The aim of this study was to explore the associations between type of SBs (i.e., passive and mentally active SBs) and depression among people aged 60 years and older in the Hebei Province of China. METHODS This cross-sectional study used data from the baseline survey of the Community-based Cohort Study on Nervous System Diseases. A total of 2679 older adults aged ≥60 years from the Hebei Province of China were included in this study. The type and time spent on SBs were self-reported. Watching TV was defined as a passive SB, whereas internet use, reading, and social SBs (including communicating with others and playing chess) were defined as mentally active SBs. Depression was evaluated using the Geriatric Depression Scale. The maximal possible score was 30 points, and ≥ 11 points indicated depression. Logistic regression analysis was used to assess the relationship between SBs and depression. Covariates included sex, age, education, employment, smoking, alcohol consumption, sleep duration, domestic work, physical exercise, body mass index (BMI), and chronic diseases. RESULTS At baseline, the participants who spent two or more hours and 0 h on passive SBs (i.e., TV viewing) had a greater risk of depression (=0 h: adjusted OR = 2.09, 95% CI = 1.18-3.76; 2-3 h: OR = 2.21, 95% CI = 1.16-4.16; > 3 h: OR = 3.59, 95% CI = 1.93-6.68) than the participants who spent 1-2 h on passive SBs. The participants who spent > 1 h on mentally active SBs had a lower risk of depression (adjusted OR = 0.26, 95% CI = 0.06-0.71) than the participants who did not engage in mentally active SBs. Not all mentally active SBs were linked to depression. The participants who engaged in social SBs had a lower risk of depression (adjusted OR: 0.24, 95% CI: 0.06-0.66) than the participants who did not engage in social SBs. CONCLUSIONS Spending 2 h or more per day on passive SBs (watching TV) was associated with a high risk of depression among people aged 60 years and older in the Hebei Province of China. Mentally active SBs (predominantly social SBs) could reduce the risk of depression. Some participants with depression probably did not watch TV. These findings suggested that spending more time on social SBs (such as communicating with others and playing chess) rather than watching TV may have important public health implications for preventing and managing depression among older Chinese adults. Moreover, society should attend to the mental health of elderly adults who do not watch TV as they may be more prone to suffer from depressive symptoms.
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Affiliation(s)
- Jiaqi Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Ruiqiang Li
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Limin Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Xian Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Meiqi Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Xinjing Zhang
- Circulating Chemical Industry Park Hospital, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yuxia Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China.
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Liu L, Li X, Wu M, Yu M, Wang L, Hu L, Li Y, Song L, Wang Y, Mei S. Individual and joint effects of metal exposure on metabolic syndrome among Chinese adults. CHEMOSPHERE 2022; 287:132295. [PMID: 34563779 DOI: 10.1016/j.chemosphere.2021.132295] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Abstract
Growing evidence suggests that metal exposure contributes to metabolic syndrome (MetS), but little is known about the effects of combined exposure to metal mixtures. This cross-sectional study included 3748 adults who were recruited from the Medical Physical Examination Center of Tongji Hospital, Wuhan, China. The levels of 21 metal(loid)s in urine were measured by inductively coupled plasma mass spectrometry. MetS was diagnosed according to National Cholesterol Education Program's Adult Treatment Panel III recommendations. Multivariate logistic regression model was uesd to explore the effects of single-metal and multi-metal exposures. The elastic net (ENET) regularization with an environmental risk score (ERS) was performed to estimate the joint effects of exposure to metal mixtures. A total of 636 participants (17%) were diagnosed with MetS. In single metal models, MetS was positively associated with zinc (Zn) and negatively associated with nickel (Ni). In multiple metal models, the associations remained significant after adjusting for the other metals. In the joint association analysis, the ENET models selected Zn as the strongest predictor of MetS. Compared to the lowest quartile, the highest quartile of ERS was associated with an elevated risk of MetS (OR = 3.72; 95% CI: 2.77, 5.91; P-trend < 0.001). Overall, we identified that the combined effect of multiple metals was related to an increased MetS risk, with Zn being the major contributor. These findings need further validation in prospective studies.
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Affiliation(s)
- Ling Liu
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hongkong Road, Wuhan, Hubei, 430030, China
| | - Xiang Li
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hongkong Road, Wuhan, Hubei, 430030, China
| | - Mingyang Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Meng Yu
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hongkong Road, Wuhan, Hubei, 430030, China
| | - Limei Wang
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hongkong Road, Wuhan, Hubei, 430030, China
| | - Liqin Hu
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hongkong Road, Wuhan, Hubei, 430030, China
| | - Yaping Li
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hongkong Road, Wuhan, Hubei, 430030, China
| | - Lulu Song
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Youjie Wang
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hongkong Road, Wuhan, Hubei, 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Surong Mei
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hongkong Road, Wuhan, Hubei, 430030, China.
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Popkin BM, Ng SW. The nutrition transition to a stage of high obesity and noncommunicable disease prevalence dominated by ultra-processed foods is not inevitable. Obes Rev 2022; 23:e13366. [PMID: 34632692 PMCID: PMC8639733 DOI: 10.1111/obr.13366] [Citation(s) in RCA: 119] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/24/2021] [Accepted: 09/05/2021] [Indexed: 12/18/2022]
Abstract
The Nutrition Transition model is presented with the nature and pace of change in key stages varying by location and subpopulations. At present, all high-income and many low- and middle-income countries are in a stage of the transition where nutrition-related noncommunicable diseases including obesity, type 2 diabetes, and hypertension are dominating adult morbidity and mortality and are very high or growing rapidly in prevalence. Some countries still have key subpopulations facing hunger and undernutrition defined by stunting or extreme thinness among adults. We call these double burden of malnutrition countries. All low- and middle-income countries face rapid growth in consumption of ultra-processed food and beverages, but it is not inevitable that these countries will reach the same high levels of consumption seen in high-income countries, with all the negative impacts of this diet on health. With great political and civil society commitment to adoption of policies shown in other countries to have improved dietary choices and social norms around foods, we can arrest and even reverse the rapid shift to diets dominated by a stage of high ultra-processed food intake and increasing prevalence of nutrition-related noncommunicable diseases.
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Affiliation(s)
- Barry M Popkin
- Department of Nutrition, Gillings School of Global Public Health and the Carolina Population Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shu Wen Ng
- Department of Nutrition, Gillings School of Global Public Health and the Carolina Population Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
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Association of Obesity and Hypertension: A Cohort Study in China. Int J Hypertens 2021; 2021:1607475. [PMID: 34925914 PMCID: PMC8683188 DOI: 10.1155/2021/1607475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 11/03/2021] [Indexed: 11/17/2022] Open
Abstract
The prevalence of general and central obesity has increased rapidly in China for decades, while little is known on obesity-normal weight-central obesity (NWCO) in China. In this study, we aim to depict the trend of the three kinds of obesity and to explore their associations with hypertension in a cohort study in China. We used data from eight waves of the China Health and Nutrition Survey (CHNS) in 1993, 1997, 2000, 2004, 2006, 2009, 2011, and 2015 for analysis. The Cochran–Armitage test was used for trend of the three kinds of obesity or hypertension. Mixed logistic regression was used to explore their relationship. In this study, we found the prevalence of general obesity increased from 20.81% in 1993 to 50.57% in 2015 in China, which was from 19.23% to 56.15% for central obesity and from 27.20% to 49.07% for NWCO, respectively. Males had the highest increase among all the subgroups. The RR for hypertension and general obesity was 3.71 (95%CI: 3.26–4.22), 3.62 (95%CI 3.19–4.12) for central obesity, and 1.60 (95%CI 1.23–2.06) for NWCO after adjusted for age, sex, education, smoking, alcohol drinking, marriage status, urbanicity and income. Both prevalence of obesity and hypertension have increased significantly in China for the two decades. The general obesity was most likely to develop hypertension compared to central or NOCWO in this study.
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Zuraini NZA, Sekar M, Wu YS, Gan SH, Bonam SR, Mat Rani NNI, Begum MY, Lum PT, Subramaniyan V, Fuloria NK, Fuloria S. Promising Nutritional Fruits Against Cardiovascular Diseases: An Overview of Experimental Evidence and Understanding Their Mechanisms of Action. Vasc Health Risk Manag 2021; 17:739-769. [PMID: 34858028 PMCID: PMC8631183 DOI: 10.2147/vhrm.s328096] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/06/2021] [Indexed: 12/22/2022] Open
Abstract
Cardiovascular diseases (CVDs) are one of the leading causes of morbidity and mortality in both developed and developing countries, affecting millions of individuals each year. Despite the fact that successful therapeutic drugs for the management and treatment of CVDs are available on the market, nutritional fruits appear to offer the greatest benefits to the heart and have been proved to alleviate CVDs. Experimental studies have also demonstrated that nutritional fruits have potential protective effects against CVDs. The aim of the review was to provide a comprehensive summary of scientific evidence on the effect of 10 of the most commonly available nutritional fruits reported against CVDs and describe the associated mechanisms of action. Relevant literatures were searched and collected from several scientific databases including PubMed, ScienceDirect, Google Scholar and Scopus. In the context of CVDs, 10 commonly consumed nutritious fruits including apple, avocado, grapes, mango, orange, kiwi, pomegranate, papaya, pineapple, and watermelon were analysed and addressed. The cardioprotective mechanisms of the 10 nutritional fruits were also compiled and highlighted. Overall, the present review found that the nutritious fruits and their constituents have significant benefits for the management and treatment of CVDs such as myocardial infarction, hypertension, peripheral artery disease, coronary artery disease, cardiomyopathies, dyslipidemias, ischemic stroke, aortic aneurysm, atherosclerosis, cardiac hypertrophy and heart failure, diabetic cardiovascular complications, drug-induced cardiotoxicity and cardiomyopathy. Among the 10 nutritional fruits, pomegranate and grapes have been well explored, and the mechanisms of action are well documented against CVDs. All of the nutritional fruits mentioned are edible and readily accessible on the market. Consuming these fruits, which may contain varying amounts of active constituents depending on the food source and season, the development of nutritious fruits-based health supplements would be more realistic for consistent CVD protection.
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Affiliation(s)
- Nur Zulaikha Azwa Zuraini
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Perak, 30450, Malaysia
| | - Mahendran Sekar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Perak, 30450, Malaysia
| | - Yuan Seng Wu
- Centre for Virus and Vaccine Research, School of Medical and Life Sciences, Sunway University, Selangor, 47500, Malaysia
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Selangor, 47500, Malaysia
| | - Siew Hua Gan
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor Darul Ehsan, 47500, Malaysia
| | - Srinivasa Reddy Bonam
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherché des Cordeliers, Sorbonne Université, Université de Paris, Paris, France
| | - Nur Najihah Izzati Mat Rani
- Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Perak, 30450, Malaysia
| | - M Yasmin Begum
- Department of Pharmaceutics, College of Pharmacy, King Khalid University (KKU), Asir-Abha, 61421, Saudi Arabia
| | - Pei Teng Lum
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Perak, 30450, Malaysia
| | | | - Neeraj Kumar Fuloria
- Faculty of Pharmacy & Centre of Excellence for Biomaterials Engineering, AIMST University, Kedah, 08100, Malaysia
| | - Shivkanya Fuloria
- Faculty of Pharmacy & Centre of Excellence for Biomaterials Engineering, AIMST University, Kedah, 08100, Malaysia
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Shi L, Leung W, Zheng Q, Wu J. Level of engagement of recreational physical activity of urban villagers in Luohu, Shenzhen, China. PLoS One 2021; 16:e0258085. [PMID: 34710111 PMCID: PMC8553036 DOI: 10.1371/journal.pone.0258085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 09/20/2021] [Indexed: 11/19/2022] Open
Abstract
Physical activity is important for health. However, there is a lack of literature related to the physical activity levels of adults living in urban villagers, which is a vulnerable population in China. The aim of this study is to compare the physical activity and sedentary behavior engagements between urban villagers and non-urban villagers using the 2019 Luohu Shenzhen, China Community Diagnosis Questionnaire. A total of 1205 adults living in urban villages and non-urban villages were included in the analysis. Unadjusted and multiple multivariate logistic regression were conducted for the dependent variable of engagement in recreational physical activity, frequency of recreational physical activity per week, and hours spent in sedentary behaviors per day. Descriptive analysis was conducted to identify the reasons for not engaging in physical activity among urban villagers and non-urban villagers. Across the included sample, 29.05% were urban villagers and 70.95% were non-urban villagers. The results suggested that urban villagers are more likely to engage in physical activity than non-urban villager (OR = 1.90, 95% CI [1.40, 2.59], p < 0.001). However, it was also found that urban village status had no significant association for frequency in engaging in physical activity and average hours spent in sedentary behaviors. Both urban villagers and non-urban villages indicated that lack of time, lack of safe and appropriate environment, and working in labor intensive occupations as some of the reasons for not engaging in physical activity. There is a need for tailed interventions and policies for promoting physical activity among urban villagers and non-urban villagers. Additional studies are needed to further our understanding of the physical activity behaviors among urban villagers in China.
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Affiliation(s)
- Lu Shi
- Public Health, School of Social and Behavioral Health Science, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States of America
- * E-mail:
| | - Willie Leung
- Department of Health Sciences and Human Performance, College of Natural and Health Sciences, The University of Tampa, Tampa, FL, United States of America
| | - Qingming Zheng
- Shenzhen Luohu Disease Prevention and Control Center, Shenzhen, Guangdong, China
| | - Jie Wu
- Shenzhen Luohu Disease Prevention and Control Center, Shenzhen, Guangdong, China
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Socioeconomic gradients in the Westernization of diet in China over 20 years. SSM Popul Health 2021; 16:100943. [PMID: 34703875 PMCID: PMC8526760 DOI: 10.1016/j.ssmph.2021.100943] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/07/2021] [Accepted: 10/10/2021] [Indexed: 10/31/2022] Open
Abstract
Introduction In low-middle income countries, urbanization leads to changes from traditional to Western diet, which are often accompanied by reductions in cardiometabolic health. Whether socioeconomic status buffers these urbanization-related diet changes over time is unknown. Objective To examine whether the association between urbanization and a key indicator of Western diet, percent of calories from animal-source foods (1) varies depending on income and (2) whether this association changes over time. Materials and methods We used data from nine waves of the longitudinal, population-based China Health and Nutrition Survey [n = 22,360 Chinese adults (1991-2015)], followed across 24 years, including diet data from 3 repeated 24-h dietary recalls. We used simultaneous year-stratified linear regression models to examine whether changes in the association between urbanization level and percent of calories from animal-source foods differed by income. Models allowed for variation in associations across the 24 years of urbanization, accounting for within-individual correlation over time and controlling for age, sex, region, physical activity, and caloric intake. Results In 1991, on average 15% of calories for Chinese adults came from animal source foods and by 2015, this percentage rose to approximately one quarter of total calories. Over the 24 years of follow-up, urbanization and income were each strongly related to percent of calories from animal-source foods with differential association across income levels (p < 0.0001). We also found evidence that this association changed over time (p < 0.0001). Income gradients in animal source food consumption were smallest in the most urban areas in early years with some temporal variation, but over time income gradients narrowed in some later years in low and moderately urbanized areas. However, by 2015 there were few income differences in animal source food consumption across urbanization levels. Conclusions Throughout 24-years of urbanization, income seemed to buffer the transition from traditional to Western diet. However, the degree to which income buffered these urbanization-related changes depended on the level and history of community urbanization. At later stages of urbanization when Western diet behaviors were more widespread, urban-rural differences in Western diet behaviors varied little by income.
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Secular trends in the prevalence of abdominal obesity among Chinese adults with normal weight, 1993-2015. Sci Rep 2021; 11:16404. [PMID: 34385525 PMCID: PMC8360975 DOI: 10.1038/s41598-021-95777-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 07/20/2021] [Indexed: 02/02/2023] Open
Abstract
A considerable chronic disease burden existed in people with normal body mass index (BMI), it is imperative to study the prevailing trends in abdominal obesity among Chinese people with normal BMI. Hence, we aimed to analyze updated prevalence data on abdominal obesity trends among Chinese adults with a normal BMI. We used data from the China Health and Nutrition Survey (CHNS) conducted between 1993 and 2015. Abdominal obesity is defined as waist circumference (WC) ≥ 90 cm for men and ≥ 80 cm for women following the International Diabetes Federation recommendations for Asians. Over the 23-year period, the age-standardized mean WC values showed a significant increasing trend among Chinese adults with BMI < 25 kg/m2, with the mean value increased from 74.0 cm to 78.5 cm (P for trend < 0.0001). During the period of 1993-2015, the age-standardized prevalence of abdominal obesity increased from 12.1 to 26.0% (P for trend < 0.0001). Significant increases were observed in both sexes, all age groups, rural and urban residents, and all educational attainment groups (all P for trends < 0.0001), with a greater relative increase noted among men, younger participants, and rural residents. Similar significant trends were noted when a more stringent BMI < 23 kg/m2 cut point (Asian cut point) was applied. A low magnitude of overlap existed between abdominal obesity and general obesity, irrespective of the criteria used. The mean WC and the prevalence of abdominal obesity among Chinese adults with normal BMI increased continuously from 1993 to 2015. The upward trends were noted in both sexes, all age groups, rural and urban regions, and all educational attainment groups. Our estimates emphasize the importance of adding WC in addition to BMI as measures to monitor obesity prevalence.
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Li Q, Li R, Zhang S, Zhang Y, He P, Zhang Z, Liu M, Zhou C, Li H, Liu C, Qin X. Occupational Physical Activity and New-Onset Hypertension: A Nationwide Cohort Study in China. Hypertension 2021; 78:220-229. [PMID: 34058853 DOI: 10.1161/hypertensionaha.121.17281] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Qinqin Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.).,Institute of Biomedicine, Anhui Medical University, Hefei, China (Q.L., R.L., S.Z., C.L., X.Q.)
| | - Rui Li
- Institute of Biomedicine, Anhui Medical University, Hefei, China (Q.L., R.L., S.Z., C.L., X.Q.)
| | - Shaojie Zhang
- Institute of Biomedicine, Anhui Medical University, Hefei, China (Q.L., R.L., S.Z., C.L., X.Q.)
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Huan Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei, China (Q.L., R.L., S.Z., C.L., X.Q.)
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.).,Institute of Biomedicine, Anhui Medical University, Hefei, China (Q.L., R.L., S.Z., C.L., X.Q.)
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Liu R, Mi B, Zhao Y, Dang S, Yan H. Long-term body mass trajectories and hypertension by sex among Chinese adults: a 24-year open cohort study. Sci Rep 2021; 11:12915. [PMID: 34155269 PMCID: PMC8217242 DOI: 10.1038/s41598-021-92319-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 06/08/2021] [Indexed: 02/05/2023] Open
Abstract
Evidence was limited on trajectory of body mass index (BMI) through adulthood and its association with hypertension. We aimed to evaluate their association by sex in large-scale study. Data were obtained from the China Health and Nutrition Survey (CHNS) from 1991 to 2015. Latent class trajectory analysis (LCTA) was used to capture BMI change trajectories. Hazard risks (HRs) were estimated from Cox proportion hazard regression. Among 14,262 participants (mean age, 38.8; 47.8% men), 5138 hypertension occurred (2687 men and 2451 women) occurred during a mean follow-up 9.6 years. Four body mass trajectory groups were identified as BMI loss, stable, moderate and substantial gain. Appropriately half of participants (48.0%) followed 1 of the 2 BMI gain trajectories, where BMI increased at least 3 kg/m2 overtime. Compared with participants with stable BMI, those gaining BMI substantially had higher risk of hypertension by 65% (HR 1.65, 95% CI 1.45-1.86) in male and 83% (HR 1.83, 95% CI 1.58-2.12) in female. The HRs in BMI loss patterns were 0.74 (0.62-0.89) in men and 0.87 (0.75-1.00) in women. Our findings imply that majority of Chinese adults transited up to a higher BMI level during follow-up. Avoiding excessive weight gain and maintaining stable weight might be important for hypertension prevention.
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Affiliation(s)
- Ruru Liu
- Xi'an Center for Disease Control and Prevention, Xi'an, 710054, Shaanxi, China
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Yaling Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76, Yanta West Road, Xi'an, 710061, Shaanxi, China.
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76, Yanta West Road, Xi'an, 710061, Shaanxi, China.
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Pan XF, Wang L, Pan A. Epidemiology and determinants of obesity in China. Lancet Diabetes Endocrinol 2021; 9:373-392. [PMID: 34022156 DOI: 10.1016/s2213-8587(21)00045-0] [Citation(s) in RCA: 649] [Impact Index Per Article: 216.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 01/15/2021] [Accepted: 02/12/2021] [Indexed: 12/11/2022]
Abstract
Obesity has become a major public health issue in China. Overweight and obesity have increased rapidly in the past four decades, and the latest national prevalence estimates for 2015-19, based on Chinese criteria, were 6·8% for overweight and 3·6% for obesity in children younger than 6 years, 11·1% for overweight and 7·9% for obesity in children and adolescents aged 6-17 years, and 34·3% for overweight and 16·4% for obesity in adults (≥18 years). Prevalence differed by sex, age group, and geographical location, but was substantial in all subpopulations. Strong evidence from prospective cohort studies has linked overweight and obesity to increased risks of major non-communicable diseases and premature mortality in Chinese populations. The growing burden of overweight and obesity could be driven by economic developments, sociocultural norms, and policies that have shaped individual-level risk factors for obesity through urbanisation, urban planning and built environments, and food systems and environments. Substantial changes in dietary patterns have occurred in China, with increased consumption of animal-source foods, refined grains, and highly processed, high-sugar, and high-fat foods, while physical activity levels in all major domains have decreased with increasing sedentary behaviours. The effects of dietary factors and physical inactivity intersect with other individual-level risk factors such as genetic susceptibility, psychosocial factors, obesogens, and in-utero and early-life exposures. In view of the scarcity of research around the individual and collective roles of these upstream and downstream factors, multidisciplinary and transdisciplinary studies are urgently needed to identify systemic approaches that target both the population-level determinants and individual-level risk factors for obesity in China.
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Affiliation(s)
- Xiong-Fei Pan
- Department of Epidemiology and Biostatistics and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - An Pan
- Department of Epidemiology and Biostatistics and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Cheng J, Yu H. The relationship between neighborhood environment and physical activity in Chinese youth: a retrospective cross-sectional study. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01547-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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50
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Yu X, Zhu C, Zhang H, Shen Z, Chen J, Gu Y, Lv S, Zhang D, Wang Y, Ding X, Zhang X. Association between urbanisation and the risk of hyperuricaemia among Chinese adults: a cross-sectional study from the China Health and Nutrition Survey (CHNS). BMJ Open 2021; 11:e044905. [PMID: 33692186 PMCID: PMC7949434 DOI: 10.1136/bmjopen-2020-044905] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/04/2021] [Accepted: 02/09/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To explore the association between urbanicity and hyperuricaemia (HUA) and whether urbanicity is an independent risk factor for HUA in Chinese adults. DESIGN Data analysis from a cross-sectional survey. SETTING AND PARTICIPANTS 8579 subjects aged 18 years or older were enrolled in the study from the 2009 wave of the China Health and Nutrition Survey to analyse the association between urbanicity and HUA. We divided them into three categories according to urbanisation index (low, medium and highly urbanised groups). MAIN OUTCOME MEASURES HUA was defined as serum uric acid ≥7 mg/dL in men and ≥6 mg/dL in women. RESULTS The prevalence of HUA in low, medium and highly urbanised groups was 12.2%, 14.6% and 19.8%, respectively. The independent factors influencing serum uric acid included age, gender, hypertension, diabetes, chronic kidney disease, drinking, obesity and community-level urbanisation index (β=0.016, p<0.001). The risk of HUA in the highly urbanised group was significantly higher than that of the low urbanised group (OR 1.771, 95% CI 1.545 to 2.029, p<0.001), even after adjusting for other covariates (OR 1.661, 95% CI 1.246 to 2.212, p=0.001). In a subgroup analysis, we found that age, gender, comorbidity (such as hypertension, diabetes, obesity and chronic kidney disease) and physical activity affected the association between urbanisation and the risk of HUA. CONCLUSIONS Our findings suggest that living in highly urbanised areas is linked with higher risk of HUA independent of cardiometabolic and health-related behavioural risk factors, which have been shown to increase along with urbanisation.
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Affiliation(s)
- Xixi Yu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Institute of Kidney and Dialysis, Shanghai, China
| | - Cheng Zhu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Han Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Institute of Kidney and Dialysis, Shanghai, China
| | - Ziyan Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Institute of Kidney and Dialysis, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yulu Gu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Shiqi Lv
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Institute of Kidney and Dialysis, Shanghai, China
| | - Di Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yulin Wang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Institute of Kidney and Dialysis, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xiaoyan Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Institute of Kidney and Dialysis, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
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