Associations between taste preferences and chronic diseases: a population-based exploratory study in China

Taste Preference for Salt Predicts Salt Intake in a Chinese Population

OBJECTIVE

This study describes the association between taste preference for salt and actual salt intake, thus guiding and refining personal and public health campaigns designed to lower salt intake in China.

METHODS

A cross-sectional survey of 1489 residents aged 18 to 69 years was conducted in 2017 in China. A multistage random sampling strategy was used, and a combination of questionnaires and physical and laboratory measurements were conducted to collect baseline characteristics and knowledge, attitudes, and behavior (KAB) related to salt. A 24 h urine collection was obtained for sodium and potassium excretion analysis. Participants were divided into two groups, light taste preference and salty taste preference, according to their answer to the question "Compared to others, how do you think your taste preference is for salt?".

RESULTS

The mean age of the 1489 participants was 46.26 years, 48.9% were males, over 1/3 (35.7%) were identified as hypertensive, and 317 (21.3%) self-reported a salty taste preference. The mean of 24 h urinary sodium excretion was 167.32 mmol/24 h, corresponding to 9.79 g salt/d intake, and the sodium-to-potassium ratio (Na/K) was 4.90. The 24 h urinary sodium excretion of salty taste preference (177.06 mmol/24 h) was significantly higher than that of light taste preference (164.69 mmol/24 h). The multiple logistic regression analysis showed that the salty taste preference group had significantly higher 24 h urinary sodium (ORa(95%CI) = 1.004(1.002-1.006)), diastolic blood pressure (DBP), proportion of greasy food preference, and drinking levels, but lower potassium excretion, response levels to most KAB questions, and regular physical activity compared to the light taste preference group.

CONCLUSION

Self-reported taste preference for salt predicted actual salt intake, which was verified by 24 h urinary sodium monitoring. Taste preference for salt could be used as a proxy for intake in terms of targeted salt intake, nutrition, and health education.

Relationship Between "Geosminophilia" (Liking the Smell of Earth) and Pica in Patients With Iron Deficiency

BACKGROUND

Iron deficiency is a critical global health issue. One of the intriguing manifestations linked to iron deficiency is the presence of pica. The physiological relationship between the senses of smell and taste suggests that pica may be accompanied by an inclination towards the smell of earth (geosmin). The smell of geosmin is distinct and generally recognized as a pleasing scent. The objective of this study is to explore this potential association. The sign of liking the smell of earth will now be referred to as "geosminophilia", for the first time, in this study.

METHODS

Patients aged 18 years and above who visited the Iron Deficiency Outpatient Clinic between September 2021 and August 2022 were chosen for this cross-sectional study. The dataset excluded those with ferritin concentrations over 100 mcg/L and transferrin saturation over 45%. Demographics, presence of pica, history of geosminophilia, and laboratory findings were documented in physical and digital patient data. The descriptive statistics, chi-square test, and independent group comparison tests were performed.

RESULTS

With a mean age of 38.7±11.7 years, the study sample comprised 280 patients, of which 263 were female and 17 were male. Ninety-six patients (34.3%) had geosminophilia, while 29 patients (10.4%) had pica. The only factors that significantly distinguished the groups based on the presence of geosminophilia were gender (p=0.04) and age (p=0.02). Using the chi-square test to compare the presence of pica and geosminophilia, a statistically significant relationship was identified (p<0.001). Additionally, 72.4% of patients who presented with pica had geosminophilia. Pica was absent in 96% of patients who did not have geosminophilia. A total of 93.8% (15/16) of pica cases with geophagia subtype exhibited the presence of geosminophilia. A significant correlation (r=0.27, p<0.001) was also observed between geosminophilia and pica.

CONCLUSION

In iron deficiency patients, geosminophilia and the presence of pica may accompany each other. Therefore, geosminophilia has the potential to be a new symptom of iron deficiency.

Research on care preferences for the elderly and influencing factors in Zhejiang Province: A statistical and geographical approach

The aging of the population is becoming an increasingly severe issue. How can we develop caring services for the elderly and promote healthy aging? Investigating care preferences is an essential step in addressing this issue. A self-designed questionnaire was employed to collect data online. The impact of personal circumstances on care preferences was ascertained using the chi-squared test and multivariate logistic regression. An optimal parameters-based geographical detector was introduced to examine the influence of spatially heterogeneous regional factors on care preferences. The online survey produced 1178 valid questionnaires. Home-based elderly care was the preference of 91.9% of respondents, followed by community-based care and medical-nursing care; institutional care was the least preferred alternative. Age, education, living style, and health states of the elderly significantly influenced the preferred care option. When compared to home-based elderly care, older respondents (odds ratio [OR] = 3.776) preferred institutional care, highly educated respondents preferred community-based care (higher education: OR = 5.206; secondary education: OR = 3.049) and medical-nursing care (higher education: OR = 4.484); the elderly living alone (OR = 0.101) excluded institutional care, and the elderly living with their children excluded non-family care method of institutional care (OR = 0.031) and medical-nursing care (OR = 0.391). Regional medical resources and old-age security significantly affect the preferences of the elderly (q-statistic [q] > 0.5); local economic development significantly affects community-based care (q > 0.6); the availability of financial subsidies significantly affects home-based care and medical-nursing care (q > 0.9); and the availability of institutional resources significantly affects the preference for institutional care (q > 0.8). We found that it is necessary to improve the level of medical care given by non-family members and care facilities, vigorously develop new methods of elderly care, promote humanistic care in non-family care settings, and increase available regional medical resources, financial subsidies, and social security. This study integrates economic and social perspectives to examine and analyze retirement willingness, thereby broadening the scope of social surveys and research methodologies, and offering valuable insights with potential directive implications.

Cultural inclusion and corporate sustainability: evidence from food culture and corporate total factor productivity in China

This article constructed a food taste deviation index using text analysis based on food culture as a measure of cultural inclusion. Cultural inclusion was related to corporate total factor productivity, aiming to investigate whether the cultural inclusion affects corporate sustainability. The findings showed uneven distribution of cultural inclusion in various areas of China, contributing to the unbalanced sustainable development of firms in different regions, as reflected by the higher total factor productivity of firms located in regions with higher cultural inclusion. A test using mountainous undulation as an instrumental variable verified the causal relationship between cultural inclusion and firm sustainability. Besides, a regression discontinuity design was employed to mitigate the impacts of the bidirectional causality. Moreover, a high level of cultural inclusion in top managers' hometown significantly improved corporate sustainability, suggesting that executives can transmit cultural inclusion in society. In addition, firms in more inclusive regions are more motivated to increase their social responsibility to staff as a way to promote their total factor productivity, suggesting that cultural inclusion promotes firm sustainability by increasing firms' care for staff. This article also found that cultural inclusion has heterogeneous effects across firms of different levels of industry competition, and different levels of analyst attention. The research reveals the impact of cultural inclusion on the real economy and help academics dissect the informal institutional reasons behind the sustainable development of firms in different geographies from a new perspective, contributing to the promotion of economic sustainability at the regional level and related policy formulation.

Preference for Stronger Taste Associated with a Higher Risk of Hypertension: Evidence from a Cross-Sectional Study in Northwest China

Background. Dietary modulation is a primary lifestyle approach for reducing the risk of hypertension. However, evidence of the potential role that a dietary taste preference plays in the risk of hypertension remains limited. Methods. A cross-sectional analysis was conducted based on the Shaanxi baseline survey of the Regional Ethnic Cohort Study. We used self-reported salt consumption and intensity preferences for sourness and spiciness to calculate the taste preference score, which was categorized into bland, moderate, and strong. A generalized linear mixed model and quantile regression were performed to estimate associations between taste preferences and hypertension/blood pressure. Results. Among 27,233 adults, 72.2% preferred a moderate taste and 21.4% preferred a strong taste. Compared with a bland taste, a stronger taste preference might be associated with a higher risk of hypertension (adjusted OR for a moderate taste = 1.25, 95% CI: 1.06, 1.49; adjusted OR for a strong taste = 1.41, 95% CI: 1.15, 1.71; Ptrend = 0.002), especially in females (adjusted OR for a moderate taste = 1.43, 95% CI: 1.24, 1.66; adjusted OR for a strong taste = 1.55, 95% CI: 1.32, 1.83; $P_{\mathrm{t}\mathrm{r}\mathrm{e}\mathrm{n}\mathrm{d}}<0.001$ ). Quantile regression showed that the taste preference was positively associated with diastolic blood pressure (DBP) (P5-P80) in females, with an average increase of 3.31 mmHg for a strong taste (β = 3.31, $P<0.001$ ) and 1.77 mmHg for a moderate taste (β = 1.77, P = 0.008). Conclusions. A preference for stronger multitastes of salty, sour, and spicy might be associated with a higher risk of hypertension, especially in females. This relationship possibly occurs through increasing DBP. Dietary modulation with the promotion of a bland taste is encouraged.

Food Culture and Sustainable Development: Evidence from Firm-Level Sustainable Total Factor Productivity in China

This article studied whether food culture plays an important role in affecting the firm-level sustainable development. We linked firm-level sustainable total factor productivity to spicy-taste related food culture in China and found that firms in regions in which spicy culture plays a more prominent role showed higher sustainable productivity. Tests using the regional sunshine as an instrument suggested a causal interpretation. Moreover, firms more exposed to spicy culture showed more frequent equity incentive behavior, higher equity incentive intensity, and higher proportion of female executives, which suggests that the more proactive management behavior can be led by regional spicy culture. We also found that, compared with small-size firms, non-state-owned firms, and non-export firms, regional spicy culture has a stronger impact on large firms, state-owned firms, and export firms. Our results reveal the impact of food culture on the firm-level sustainable development.

The Extraction, Functionalities and Applications of Plant Polysaccharides in Fermented Foods: A Review

Plant polysaccharides, as prebiotics, fat substitutes, stabilizers, thickeners, gelling agents, thickeners and emulsifiers, have been immensely studied for improving the texture, taste and stability of fermented foods. However, their biological activities in fermented foods are not yet properly addressed in the literature. This review summarizes the classification, chemical structure, extraction and purification methods of plant polysaccharides, investigates their functionalities in fermented foods, especially the biological activities and health benefits. This review may provide references for the development of innovative fermented foods containing plant polysaccharides that are beneficial to health.

Health-Related Quality of Life and Health Service Use among Multimorbid Middle-Aged and Older-Aged Adults in China: A Cross-Sectional Study in Shandong Province

(1) Background: The management of multiple chronic diseases challenges China's health system, but current research has neglected how multimorbidity is associated with poor health-related quality of life (HRQOL) and high health service demands by middle-aged and older adults. (2) Methods: A cross-sectional study was conducted in Shandong province, China in 2018 across three age groups: Middle-aged (45 to 59 years), young-old (60 to 74 years), and old-old (75 or above years). The information about socio-economic, health-related behaviors, HRQOL, and health service utilization was collected via face-to-face structured questionnaires. The EQ-5D-3L instrument, comprising a health description system and a visual analog scale (VAS), was used to measure participants' HRQOL, and χ² tests and the one-way ANOVA test were used to analyze differences in socio-demographic factors and HRQOL among the different age groups. Logistic regression models estimated the associations between lifestyle factors, health service utilization, and multimorbidity across age groups. (3) Results: There were 17,867 adults aged 45 or above in our sample, with 9259 (51.82%) female and 65.60% living in rural areas. Compared with the middle-aged adults, the young-old and old-old were more likely to be single and to have a lower level of education and income, with the old-old having lower levels than the young-old (P < 0.001). We found that 2465 (13.80%) suffered multimorbidities of whom 75.21% were older persons (aged 60 or above). As age increased, both the mean values of EQ-5D utility and the VAS scale decreased, displaying an inverse trend to the increase in the number of chronic diseases (P < 0.05). Ex-smokers and physical check-ups for middle or young-old respondents and overweight/obesity for all participants (P < 0.05) were positively correlated with multimorbidity. Drinking within the past month for all participants (P < 0.001), and daily tooth-brushing for middle (P < 0.05) and young-old participants (P < 0.001), were negatively associated with multimorbidity. Multimorbidities increased service utilization including outpatient and inpatient visits and taking self-medicine; and the probability of health utilization was the lowest for the old-old multimorbid patients (P < 0.001). (4) Conclusions: The prevalence and decline in HRQOL of multimorbid middle-aged and older-aged people were severe in Shandong province. Old patients also faced limited access to health services. We recommend early prevention and intervention to address the prevalence of middle-aged and old-aged multimorbidity. Further, the government should set-up special treatment channels for multiple chronic disease sufferers, improve medical insurance policies for the older-aged groups, and set-up multiple chronic disease insurance to effectively alleviate the costs of medical utilization caused by economic pressure for outpatients and inpatients with chronic diseases.

Exploring the Driving Factors of the Spatiotemporal Variation of Precipitation in the Jing–Jin–Ji Urban Agglomeration from 2000 to 2015

Urbanization has a significant impact on urban precipitation. Existing studies on precipitation pay more attention to the impact of natural and meteorological factors, and the research on the impact of urbanization on the spatial patterns of precipitation is still very deficient. Based on geographic detection, this study quantitatively analyzed the dominant, interaction, and sensitivity factors that affect precipitation changes in more than 150 urban units in Jing–Jin–Ji (Beijing–Tianjin–Hebei) during the process of urbanization. The research findings show the following: ① The dominant factors have seasonal differences in terms of the precipitation variation in Jing–Jin–Ji. The leading factors in summer were the change of radiation and relative humidity. The dominant factors in winter were the changes in radiation, relative humidity, and wind speed. On the annual scale, the dominant factors were the changes in relative humidity, aerosol optical depth, radiation, and wind speed. ② Whether in summer, in winter, or on the annual scale, urbanization can enhance the explanatory power of spatial variation of urban precipitation through interaction with natural/meteorological factors, and all the dominant interaction factors show a nonlinear enhancement trend. ③ The night light intensity and urban heat island can greatly amplify the explanatory power of other factors, thus becoming the most sensitive factor in urbanization precipitation changes. The above research can provide a theoretical basis for the formulation of urban climate policies and urban planning.