Dietary patterns and their associations with general obesity and abdominal obesity among young Chinese women

Food allergy in a changing dietary landscape: A focus on the Asia Pacific region

Recent studies have provided compelling evidence to suggest that various environmental factors play a significant role in the development of food allergies. As our society experiences rapid economic growth, increased urbanization, and a shift towards a more Westernized diet, the incidence of food allergies is also on the rise and the pattern is gradually evolving. This review will delve into the changes in the epidemiology of food allergies within the Asia-Pacific region and the various dietary practices and factors that are postulated to play a role in the rise in food allergies over the years. Although there have been important advancements in the field of food allergies, there are still numerous uncertainties regarding the intricate relationship between diet and food allergies. Specifically, the role of epigenetic factors in influencing the susceptibility to food allergies, as evidenced by studies that assessed the impact of migration and rural-urban dynamics, is not fully understood. Addressing this knowledge gap presents an opportunity to develop more effective prevention and treatment strategies that could greatly benefit individuals living with food allergies.

Analysis of Dietary and Nutritional Status of Tuberculosis Patients in Hulunbuir Region

Objective

Tuberculosis (TB) is a major public health problem that affects millions of people worldwide. Malnutrition is a common complication of TB and can worsen the disease outcome. The purpose of this study was to investigate the dietary and nutritional status, as well as the dietary structure, of TB patients in Hulunbuir City, Inner Mongolia, China. Additionally, the study aimed to analyze the factors that influence the nutritional status in order to provide a theoretical foundation for the prevention and treatment of TB and related issues.

Methods

A cross-sectional study was conducted on 334 randomly selected TB patients from Hulunbuir City Second Hospital. A questionnaire survey was administered to collect information on demographic characteristics, dietary habits, and food intake. Nutritional status was assessed by body mass index (BMI). Dietary diversity score (DDS) was calculated based on the number of food groups consumed in the previous 24 hours. Statistical analysis was performed using SPSS 20.0 software. Descriptive statistics employed rates and composition ratios, and categorical data was represented using frequencies and percentages. The chi-square test was used to analyze the association between nutritional status and other variables, with a significance level set at α=0.05. Multivariable ordinal logistic regression analysis was performed to identify the independent factors affecting the nutritional status of TB patients.

Results

The univariate analysis revealed statistically significant differences (P < 0.05) in the nutritional status (as measured by BMI) among tuberculosis patients, considering ethnicity, educational level, smoking, meat-based diet, vegetable consumption, and DDS grading. No statistically significant differences were found regarding gender, age, marital status, occupation, sleep duration, alcohol consumption, and consumption of rice and flour dishes. Statistically significant variables from the univariate analysis were included in a multivariable ordinal logistic regression analysis model. The findings highlighted that educational level (high school or below), smoking, meat-based diet, DDS scores of 1-3, and a primarily vegetable-based diet had independent effects on the nutritional status of tuberculosis patients (all P < 0.05). No significant difference was found in nutritional status between the Han ethnic group and other ethnicities.

Conclusion

The study revealed that the dietary and nutritional status of TB patients in Hulunbuir City was suboptimal and influenced by several factors. Smoking, meat-based diet, and low dietary diversity score were the primary risk factors for malnutrition among TB patients. The study suggests that nutritional education and intervention programs should be implemented for TB patients to improve their dietary quality and nutritional status.

Exploring the traditional Chinese diet and its association with health status-a systematic review

CONTEXT

Increased adherence to a traditional Chinese diet (TCD) could reduce the increasing prevalence of noncommunicable diseases. Currently, there is no consistent definition of the TCD in the literature, and its associations with health outcomes have not yet been identified.

OBJECTIVE

This systematic review aimed to assess the definition of the TCD, in the literature, and to evaluate whether the TCD, as described, is associated with health outcomes.

DATA SOURCES

Fourteen databases were searched up to April 25, 2022.

DATA EXTRACTION

Three reviewers (in pairs) independently screened and extracted data. A modified risk-of-bias tool was used to assess the quality of the studies assessing the TCD definition; the Newcastle-Ottawa Scale and the Cochrane Risk-of-Bias tool were used to assess the quality of the observational studies and randomized controlled trials assessing associations between the TCD and health outcomes.

DATA ANALYSIS

Ninety-nine studies were identified that assessed the TCD definition. In at least 75% of the studies, rice and leafy vegetables were consistently reported as food groups that characterize the TCD; the most frequently cited food items were white rice, spinach, bokchoy, and cabbage. Fish and seafood, pork, and pork products were consistently reported in studies exclusively referring to the TCD consumed in southern China (n = 21 studies), whereas wheat and wheat products were commonly reported in studies focusing on northern China (n = 14 studies). Fifteen studies reported on the quantities of food groups that are characteristic of the TCD, but their findings were inconsistent. Of the 99 studies, 54 assessed associations with health outcomes. The TCD was overall inversely associated with obesity risk and weight gain, while relationships between the TCD and other health outcomes were inconsistent.

CONCLUSION

Further studies are needed to determine the quantities of foods consumed in the TCD and to establish a consistent definition for further exploration of the TCD's potential role in preventing non-communicable diseases.

Association of dietary patterns with general and central obesity among Chinese adults: a longitudinal population-based study

BACKGROUND

Limited evidence exists for the association between dietary patterns and later obesity phenotypes among Chinese adults. This longitudinal study aimed to evaluate associations of dietary patterns with general and central obesity in Chinese adults.

METHODS

Based on the China Health and Nutrition Survey (CHNS) waves 2004 and 2015, the study was conducted on 4207 adult men and women (age range: 18-65 years). Dietary intakes were assessed by three consecutive 24-h dietary recalls, and dietary patterns were identified using exploratory factor analysis. Longitudinal associations of dietary patterns with general and central obesity were evaluated using logistic regression analyses.

RESULTS

The prevalence rates of general and central obesity were 14.2% and 42.1%, respectively. Factor analysis extracted three major dietary patterns: "traditional southern," "modern," and "traditional northern." After adjustment for potential confounders, adults in the highest quartile of the traditional southern dietary group were less likely to develop over 10 years general (odds ratio [OR] = 0.50, 95% confidence interval [95%CI]: 0.39, 0.65) and central (OR = 0.52, 95%CI: 0.43, 0.63) obesity compared to those in the lowest quartile group. The modern dietary pattern was not significantly associated with general and central obesity. Adherence to the traditional northern dietary pattern increased the chance of both general and central obesity (OR = 1.61, 95%CI: 1.23, 2.10; OR = 1.64, 95%CI: 1.36, 1.98) after 10 years.

CONCLUSIONS

Our study provides longitudinal evidence for associations between dietary patterns and later obesity phenotypes among Chinese adults. Our findings may guide the development of evidence-based preventive nutrition interventions to control the obesity epidemic.

Associations of dietary patterns with obesity and weight change for adults aged 18-65 years: Evidence from the China Health and Nutrition Survey (CHNS)

BACKGROUND

Obesity has become a significant public health problem within China. By observing dietary patterns, an individual's actual dietary habit of nutrients or foods in combination can be identified. We aimed to examine dietary patterns in relation to the risk of obesity (body mass index (BMI) ≥ 25 kg/m2) and weight change (average weight change per five years) within a Chinese cohort.

METHODS

We analyzed the data from 6,677 adults aged 18-65 years in the China Health and Nutrition Survey 1997-2015. Westernized, traditional Chinese, and high-starch plant-based dietary patterns were identified by principal components analysis. We estimated relative risks (RRs) and least-squares means (LS-means) with 95% confidence intervals (CIs) using the Cox proportional hazards models and the generalized linear models, respectively.

RESULTS

High adherence to the Westernized dietary pattern was associated with increased risks of obesity and weight gain. Comparing top with bottom quintiles, RR (95% CI) for obesity (BMI ≥ 25 kg/m2) was 1.57 (1.26-1.95; P for trend < 0.001). LS-means of weight change (kg/5 years) were 1.73 (0.98-2.47) and 1.13 (0.39-1.87; P for trend = 0.036) in the top and bottom quintiles, respectively. Increased weight gain among those following the Westernized dietary pattern was stronger in the Southern region than the Northern region. There was a slight hint of an inverse association between the traditional Chinese dietary pattern and obesity. We did not find any significant association for the high-starch plant-based dietary pattern.

CONCLUSIONS

The Westernized dietary pattern increased the risk of obesity among Chinese adults. Weight gain associated with Western dietary pattern was more pronounced in the Southern region than in the Northern region. Our study will provide helpful data in developing dietary guidelines for the prevention of obesity specific to different regions in China.

Staple Food Preference and Obesity Phenotypes: The Regional Ethnic Cohort Study in Northwest China

Staple food preference vary in populations, but evidence of its associations with obesity phenotypes are limited. Using baseline data (n = 105,840) of the Regional Ethnic Cohort Study in Northwest China, staple food preference was defined according to the intake frequency of rice and wheat. Overall and specifically abdominal fat accumulation were determined by excessive body fat percentage and waist circumference. Logistic regression and equal frequency substitution methods were used to evaluate the associations. We observed rice preference (consuming rice more frequently than wheat; 7.84% for men and 8.28% for women) was associated with a lower risk of excessive body fat (OR, 0.743; 95%CI, 0.669-0.826) and central obesity (OR, 0.886; 95%CI, 0.807-0.971) in men; and with lower risk of central obesity (OR, 0.898; 95%CI, 0.836-0.964) in women, compared with their wheat preference counterparties. Furthermore, similar but stronger inverse associations were observed in participants with normal body mass index. Wheat-to-rice (5 times/week) reallocations were associated with a 36.5% lower risk of normal-weight obesity in men and a 20.5% lower risk of normal-weight central obesity in women. Our data suggest that, compared with wheat, rice preference could be associated with lower odds ratios of certain obesity phenotypes in the Northwest Chinese population.

Dietary Patterns and Obesity in Chinese Adults: A Systematic Review and Meta-Analysis

Certain dietary patterns are associated with an increased risk of obesity and its comorbidities. However, these associations vary across populations. The prevalence of obesity has been rising amid a drastic nutrition transition in China during the country’s rapid economic growth. This systematic review and meta-analysis were conducted to summarize how dietary patterns are associated with obesity in the Chinese population. We searched for articles from 1 January 2000 to 1 February 2022 in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus that assessed the relationship between dietary patterns and obesity outcomes. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random effects model. From the 2556 articles identified from the search, 23 articles were included in the analysis. We found that the traditional Chinese dietary pattern was associated with a lower risk of overweight/obesity (OR = 0.69, 95% CI: 0.57, 0.84, p < 0.001), whereas the Western dietary pattern was associated with a higher OR of overweight/obesity, but not reaching statistical significance (OR = 1.34, 95% CI: 0.98, 1.84, p = 0.07). There were inconsistent results for other dietary patterns, such as meat/animal protein and plant/vegetarian patterns. In conclusion, the traditional Chinese diet characterized by vegetables, rice, and meat was associated with a lower risk of obesity. The heterogeneity in characterizing dietary patterns contributes to the inconsistency of how dietary patterns are associated with obesity in the Chinese population.

Inverse association of a traditional Korean diet composed of a multigrain rice-containing meal with fruits and nuts with metabolic syndrome risk: The KoGES

Background

Hansik, a traditional Korean diet, may have a beneficial impact on metabolic syndrome (MetS) risk as dietary westernization increases its prevalence. We examined the hypothesis that adherence to the hansik diet may be inversely associated with the risk of MetS and its components and sought to understand the gender differences in 58,701 men and women aged over 40.

Materials and methods

Hansik was defined using 14 components from which the Korean dietary pattern index (K_diet-index) was generated by summing their scores. Low-hansik intake was defined as the K_diet-index with <8. MetS was categorized based on the 2005 revised NCEP-ATP III criteria modified for Asians.

Results

The K_diet-index score was negatively associated with the dietary inflammation index and showed that the high intake of a meal with multigrain rice, fruits, and their products, and nuts, and low intake of fried foods were inversely associated with MetS by 0.707, 0.864, 0.769, and 0.918 times, respectively, after adjusting for covariates. More women and participants with more educated and lower income belonged to the high-hansik group, and participants with high self-rated health scores consumed more hansik. All participants on a high-hansik diet were associated with a 0.87 time lower risk of MetS. Specifically, the association between hansik intake and MetS risk was not significant among men following stratification by gender. Body composition, including the body mass index, waist circumference, and fat mass, was inversely associated with hansik intake, while the skeletal muscle mass index was positively associated with the hansik intake in each gender and all participants. In all the participants in the high-hansik group, no significant changes were seen in the serum glucose and HDL concentration. However, a high-hansik intake showed lower blood pressure and serum LDL and triglyceride concentrations only in men and a higher glomerular filtration rate in both genders.

Conclusions

Hansik intake might improve MetS risk, with its primary beneficial effects on body composition, dyslipidemia, and blood pressure gender-dependently.

The association between the dietary pattern in abdominal obesity based on visceral fat index and dyslipidaemia in the Henan Rural Cohort Study

The present study aimed to explore the association between dietary patterns in abdominal obesity obtained by reduced-rank regression (RRR) with visceral fat index (VFI) as a dependent variable and dyslipidemia in rural adults in Henan, China. A total of 29538 people aged 18-79 were selected from the Henan Rural Cohort Study. RRR analysis was used to identify dietary patterns; logistic regression analysis and restricted cubic spline regression models were applied to analyze the association between dietary patterns in abdominal obesity and dyslipidemia. VFI was used as a mediator to estimate the mediation effect. The dietary pattern in abdominal obesity was characterized by high carbohydrate and red meat intake and low consumption of fresh fruits, vegetables, milk, etc. After full adjustment, the highest quartile of dietary pattern scores was significantly associated with an increased risk of dyslipidemia (OR: 1·33, 95 % CI 1·23-1·44, P_trend < 0·001), there was a non-linear dose-response relationship between them (P_{overall-association} < 0·001, P_{non-lin-association} = 0·022). The result was similar in dose-response between the dietary pattern scores and VFI. The indirect effect partially mediated by VFI was significant (OR: 1·07, 95 % CI 1·06-1·08). VIF explained approximately 53·3 % of odds of dyslipidemia related to the dietary pattern. Abdominal obesity dietary pattern scores positively affected VFI and dyslipidemia; there was a dose-response in both relationships. Dyslipidemia progression increased with higher abdominal obesity dietary pattern scores. In addition, VFI played a partial mediating role in relationship between abdominal obesity dietary pattern and dyslipidemia.

Westernized and Diverse Dietary Patterns Are Associated With Overweight-Obesity and Abdominal Obesity in Mexican Adult Men

Introduction

The prevalence of overweight and obesity in Mexican adults is very high. To identify the dietary characteristics related with this disorder is necessary to design intervention. The objective was to analyze the association between dietary patterns and obesity in Mexican adults.

Materials and Methods

This is a cross-sectional study carried out in Mexican adults (20-59 years old) participating in the Halfway National Health and Nutrition Survey 2016. Participants (n = 5,735) were classified as having normal weight, overweight-obesity and by their abdominal circumference as having abdominal obesity or not. With information from a 7-day food frequency questionnaire, we used a K-means cluster analysis to derive dietary patterns and calculated a healthy diet indicator to evaluate quality. The association between dietary patterns and overweight-obesity and abdominal obesity was assessed with Poisson regression models adjusted by some characteristics.

Results

We identified a Rural pattern characterized by tortilla, legumes and egg consumption; a Diverse pattern, characterized by fruits, meat and poultry, vegetables, and dairy beverages, and desserts; and a Westernized pattern, characterized by sweetened non-dairy beverages, fast food, bakery and cookies, candies and salty snacks. In men, Westernized pattern was associated with overweight-obesity (PR = 1.11, 95% CI 0.97-1.27), and abdominal obesity (PR = 1.15, 95% CI 1.00-1.33), the Diverse pattern was associated with overweight-obesity (PR = 1.18, 95% CI 1.00-1.38), and abdominal obesity (PR = 1.27, 95% CI 1.07-1.50), compared with the Rural pattern. In women, these dietary patterns were not associated with obesity.

Discussion

Westernized and Diverse patterns are associated with overweight and obesity and abdominal obesity in men. Gender-specific recommendations and surveillance are necessary in the Mexican adult population.

Differential Association of Wheat and Rice Consumption With Overweight/Obesity in Chinese Adults: China Health and Nutrition Survey 1991–2015

Wheat and rice are the main staple foods in China and likely have a major influence on health. This analysis examined the potential association between wheat and rice consumption and the risk of overweight/obesity in Chinese adults. We used data collected in the China Health and Nutrition Survey (CHNS) from 1991 to 2015. Adults aged 18–80 years old (n = 11,503) were included in the present analysis, for whom questionnaires and anthropometric data were collected during at least two waves. We constructed three-level mixed-effect linear regression models to estimate body mass index (BMI) in relation to wheat and rice intakes and performed three-level mixed-effect logistic regression models to assess the risk of overweight/obesity. Women showed significant BMI increases of 0.14 (95% CI: 0.04, 0.24) from a higher intake of wheat but not from a higher intake of rice when adjusted for all potential confounders. Comparing the highest quartiles of intake of wheat with non-consumers in men and women, odds ratios (ORs; 95% CI) of overweight/obesity were 1.45 (1.15, 1.85) and 1.26 (1.00, 1.60), respectively. In men, there was an inverse association with the risk of overweight/obesity in the comparison of the highest quartiles of intake of rice (OR: 0.73; 95% CI: 0.55, 0.96) and non-consumers when adjusted for all potential confounders. Higher intake of wheat was positively associated with the risk of overweight/obesity among Chinese adults. Further, there was an inverse association between rice intake with overweight/obesity in Chinese men but not in women.

Comparison of different obesity indices associated with type 2 diabetes mellitus among different sex and age groups in Nantong, China: a cross-section study

Background

Obesity is associated with type 2 diabetes mellitus (T2DM). However, the obesity index that is most closely related to type 2 diabetes remains controversial. Therefore, the aim of this study was to compare the associations of five anthropometric indices (body mass index [BMI], body adiposity index, waist circumference [WC], waist-to-hip ratio, and waist-to-height ratio [WHtR]) with T2DM among Chinese adults divided into four groups according to sex and age.

Methods

A total of 4007 adult participants (1669 men and 2338 women) were included in the study. Odds ratios (ORs) and 95% confidence intervals were used with binary logistic regression models to estimate the risk of T2DM for each obesity index. Furthermore, we compared the area under the receiver operating characteristic curve (AUC) of each obesity index for the criterion of T2DM under the influence of risk factors.

Results

WC had the highest OR (3.211 and 1.452) and AUC (0.783 and 0.614) in both age groups of men. However, WHtR (OR = 2.366, AUC = 0.771) and BMI (OR = 1.596, AUC = 0.647) were the optimal criteria for predicting T2DM among females in the 18–59 and ≥ 60 years age groups, respectively.

Conclusions

This study suggests that there is a positive association between obesity-related anthropometric indices and T2DM in different sex and age groups. WC appears to be the optimal anthropometric index for predicting T2DM in men. The optimal obesity indices related to T2DM were WHtR and BMI for women aged 18–59 and ≥ 60 years, respectively.

Exposure-lag-response associations between extreme environmental conditions and primary Sjögren's syndrome

INTRODUCTION

Patients with primary Sjögren's syndrome (pSS) reportedly believe that their symptoms worsen on extreme weather days due to variations in environmental conditions. However, few studies have assessed the acute effects of environmental exposure on the onset of pSS. This study aimed to evaluate the exposure-response relationship between extreme environmental conditions and pSS outpatient visits.

METHOD

We obtained data on pSS outpatient visits from two provincial general hospitals in Hefei, China, during 2014-2019. A distributed lag non-linear model was used to estimate the exposure-lag-response relationship between environmental variables and pSS.

RESULTS

We detected significant and non-linear associations between extreme environments and pSS. The estimated relative risk (RR) for a lag of 3 days was 1.11 (95% CI: 1.03 to 1.19) for extreme cold and for a lag of 21 days was 1.07 (95% CI: 1.01 to 1.12) for extreme dampness. Long sunshine duration was positively correlated with pSS (lag 11, 1.05, 95% CI: 1.01 to 1.08). Moreover, female patients were more susceptible to these effects. Patients older than 65 years old were more vulnerable to frigid environments (lag 3, RR = 1.30, 95% CI: 1.09 to 1.54), while younger patients were more vulnerable to extreme dampness (lag 21, RR = 1.10, 95% CI: 1.03 to 1.16). Extreme cold and high humidity were negatively correlated with the same-day outpatient visits.

CONCLUSIONS

Our findings suggest a potential relationship between exposure to extreme environmental conditions and increased risk of pSS outpatient visits. We therefore suggest that policymakers and doctors aim to further our understanding of environmental effects on pSS and adopt adequate measures to alleviate pSS symptoms. Key Points • Extreme cold, extreme dampness, and long sunshine duration increased the risk of pSS outpatient visits, especially for females. • Young pSS patients are more susceptible to a rise in humidity. • Elderly pSS patients are more sensitive to extreme cold weather.

Trajectories of Dietary Patterns and Their Associations with Overweight/Obesity among Chinese Adults: China Health and Nutrition Survey 1991-2018

It is essential to understand the impact of different dietary pattern trajectories on health over time. Therefore, we aimed to explore the long-term trajectories of dietary patterns among Chinese adults and examine the prospective association between different trajectory groups and the risk of overweight/obesity. The sample was 9299 adults aged 18 years or older from the China Health and Nutrition Survey (CHNS) between 1991 and 2018. We used factor analysis to identify dietary patterns and group-based trajectory modeling to identify dietary pattern trajectories. Three trajectories of a southern pattern and a modern pattern and four trajectories of a meat pattern were identified. Participants who followed the highest initial score and a slight decrease trajectory (OR = 1.63; 95% CI: 1.04, 2.54) of the meat dietary pattern were positively associated with risk of overweight/obesity when compared with the lowest initial score trajectory. The southern dietary pattern and the modern dietary pattern trajectories of participants in Group 2 (OR = 0.64; 95% CI: 0.51, 0.81; OR = 0.76; 95% CI: 0.63, 0.91) and Group 3 (OR = 0.71; 95% CI: 0.54, 0.91; OR = 0.64; 95% CI: 0.44, 0.90) were associated with lower risk of overweight/obesity when compared with Group 1. We observed that dietary pattern trajectories have different associations with overweight/obesity among Chinese adults.

Regional Difference in the Association between the Trajectory of Selenium Intake and Hypertension: A 20-Year Cohort Study

The effect of selenium on hypertension is inconclusive. We aimed to study the relationship between selenium intake and incident hypertension. Adults (age ≥20 years) in the China Health and Nutrition Survey were followed up from 1991 to 2011 (N = 13,668). The latent class modeling method was used to identify trajectory groups of selenium intake. A total of 4039 respondents developed hypertension. The incidence of hypertension was 30.1, 30.5, 30.6, and 31.2 per 1000 person-years among participants with cumulative average selenium intake of 21.0 ± 5.1, 33.2 ± 2.8, 43.8 ± 3.6, and 68.3 ± 25.2 µg/day, respectively. Region and selenium intake interaction in relation to hypertension was significant. In the multivariable model, cumulative intake of selenium was only inversely associated with the incident hypertension in northern participants (low selenium zone), and not in southern participants. Compared to selenium intake trajectory Group 1 (stable low intake), all three trajectory groups had a low hazard ratio for hypertension among the northern participants. However, Group 4 (high intake and decreased) showed an increasing trend of hypertension risk in the south. In conclusion, the association between selenium intake and the incidence of hypertension varied according to regions in China. In the low soil selenium zone, high selenium intake might be beneficial for hypertension prevention.

Twenty-Five-Year Trends in Dietary Patterns among Chinese Adults from 1991 to 2015

Poor dietary habits have been shown to be associated with a range of chronic diseases and can potentially be a major contributor to non-communicable diseases (NCDs) mortality. We therefore aimed to identify the prevailing dietary patterns among Chinese adults and to evaluate trends in dietary patterns from 1991 to 2015. We used data collected in the China Health and Nutrition Survey (CHNS). Dietary patterns were identified using factor analysis of data from three consecutive 24 h dietary recalls. We studied 29,238 adults aged 18 and above with complete demo-graphic and dietary data. Three distinct dietary patterns were identified: southern (high intakes of rice, vegetables, and pork), modern (high intakes of fruits, dairy products, cakes, cookies, and pastries), and meat (high intakes of organ meats, poultry, and other livestock meat). The southern pattern score decreased (mean ± SD scores in 1991: 0.11 ± 1.13; scores in 2015: −0.22 ± 0.93). The modern pattern score (mean ± SD scores in 1991: −0.44 ± 0.59; scores in 2015: 0.21 ± 1.01) and meat pattern score (mean ± SD scores in 1991: −0.18 ± 0.98; scores in 2015: 0.27 ± 0.91) increased. We observed that China has experienced a shift from traditional dietary patterns to western dietary patterns.

Association of Nutrient Patterns and Their Relation with Obesity in Iranian Adults: a Population Based Study

In the present research, we have evaluated the association between patterns of nutrient intake and obesity. The present cross-sectional study recruited 850 adults aged between 20–59 years old. Dietary intakes were assessed with three 24-hour recalls. As well, data on anthropometric measures were collected. General obesity was specified as body mass index ≥ 30 kg/m². Factor analysis was conducted, and followed by a varimax rotation, was performed to extract major nutrient patterns. Our analysis identified three major nutrient patterns: The first nutrient pattern was characterized by the high consumption of saturated fatty acids (SFAs), protein, vitamins B₁, B₂, B₆, B₅, B₃, B₁₂, Zinc, and iron. The second nutrient pattern was rich in total fat, polyunsaturated fatty acids, monounsaturated fatty acids, SFAs, oleic acid, linolenic acid, zinc, vitamin E, α-tocopherol, and β-carotene. The third one was greatly loaded with protein, carbohydrate, potassium, magnesium, phosphorus, calcium, vitamin C, and folate. Women in the third quintile of the first pattern were less likely to be generally obese in the fully adjusted model (odds ratio, 0.44; 95% confidence interval, 0.25–0.75). None of the other nutrient patterns had a significant association with obesity, even after adjusting for confounders. Adherence to a nutrient pattern rich in water-soluble vitamins was significantly associated with a greater chance of general obesity among women. Further studies in other populations, along with future prospective studies, are required to confirm these findings.

Screening out important substances for distinguishing Chinese indigenous pork and hybrid pork and identifying different pork muscles by analyzing the fatty acid and nucleotide contents

Fatty acids and nucleotides are major contributors of pork flavor, which are key quality traits influencing consumers' preference. In this study, we investigated the contents of nucleotides (inosinic acid, inosine, and hypoxanthine) and 26 fatty acids by high-performance liquid chromatography and gas chromatography in longissimus dorsi and semimembranous muscle of four breeds (Dongbei Min pig, Beijing Black pig, Wuzhishan pig, and DLY pigs). Combining with multivariate statistics, we found significant differences in the nucleotides and fatty acids compositions among the breeds and muscles. Furthermore, the content of total unsaturated fatty acids and DHA were higher in native pigs than crossbred pigs. This study provides a theoretical basis for understanding the composition of flavor precursor substances, as well as for the identification of different muscles.

Dose-Response Relationship between Western Diet and Being Overweight among Teachers in Malaysia

The rising prevalence of overweight and obesity is partly due to nutrition transition. The reported association between dietary patterns and overweight/obesity has been controversial because of inconsistent results and weak observed associations. Although it has been hypothesized that an unhealthy diet can increase obesity risk, none of the previous studies have examined the dose-response association using nonlinear dose-response analyses. This study aimed to examine the dose-response association between major dietary patterns and overweight/obesity. This was a cross-sectional study involving teachers selected through stratified multistage sampling from public schools in three Malaysian states. Dietary intake was assessed using a food frequency questionnaire, and two major dietary patterns (Western and Prudent diet) were extracted using factor analysis. Logistic regression followed by trend analysis was used to test the difference in odds of overweight and obesity in each quintile of diet score. A further analysis using restricted cubic spline models was performed to examine the dose-response associations of dietary patterns with odds of overweight/obesity. The logistic regression analysis showed that participants with the highest quintile of Western diet score were 1.4 times more likely to be overweight/obese compared to those in the lowest quintile (95% CI: 1.11, 1.83, p-trend < 0.001). The odds of overweight/obesity showed a significant increasing trend across quintiles of Western diet among both men and women (p-trend < 0.001). In the dose-response analysis, a positive linear association (P_nonlinearity = 0.6139) was observed where overweight/obesity was more likely to occur among participants with a Western diet score greater than a mean score of zero. There was an inverse trend of odds of overweight/obesity across quintiles of Prudent diet score, significant only for men (p for trend < 0.001). Linear association was found between Prudent diet score and odds of overweight/obesity among both men (P_nonlinearity = 0.6685) and women (P_nonlinearity = 0.3684) in the dose-response analysis. No threshold at the level of adherence to Prudent diet was linked to odds of overweight/obesity. Dose-response analysis indicated that women with a Western diet score greater than zero were more likely to be overweight or obese among women. In men, higher adherence to Western diet was associated with increased odds of overweight/obesity, while greater adherence to Prudent diet decreased the odds of overweight/obesity. Promoting and enhancing the consumption of Prudent diet and limit in Western diet may be used to guide the development of evidence-based diet interventions to curb overweight and obesity.

Cross-country comparison of dietary patterns and overweight and obesity among adult women in urban Sub-Saharan Africa

OBJECTIVE

To derive dietary patterns (DP) among women of reproductive age (WRA) and older women in urban Sub-Saharan Africa (SSA), and to examine their association with body mass index (BMI), overweight and obesity.

DESIGN

We used principal component analysis to derive DP. Their association with BMI, overweight and obesity was assessed using linear and multinomial logistic regression models controlling for age, marital status, education and wealth.

SETTING

Cross-sectional data from prospective studies in Accra, Ghana (2008-2009), Dar es Salaam, Tanzania (2014) and Lilongwe and Kasungu, Malawi (2017-2018) were used.

PARTICIPANTS

We compared WRA in Ghana (18-54 years, n 1762) and Malawi (19-48 years, n 137), and older women in Ghana (≥55 years, n 514) and Tanzania (≥50 years, n 134).

RESULTS

Among WRA, protein and healthy DP were identified in both Ghana and Malawi. In Ghana, the protein DP was associated with higher odds of overweight or obesity (adjusted OR 1·82, 95 % CI 1·27, 2·60 for quintile 2). Among older women, three DP were identified in Ghana (cereal, protein and healthy) and two DP in Tanzania (protein and healthy). The protein DP was associated with higher BMI in Ghana (adjusted mean difference 2·83, 95 % CI 0·95, 4·71 for quartile 3).

CONCLUSIONS

Higher quintiles of the protein DP were associated with higher BMI and odds of overweight or obesity among women in urban Ghana, but not in Malawi or Tanzania. Further research is needed to understand how DP influence overweight and obesity among adult women in urban SSA.

Empirically derived dietary patterns and obesity among Iranian Adults: Yazd Health Study-TAMYZ and Shahedieh cohort study

The aim was to determine the relationship between dietary patterns derived by principal component analysis (PCA) in association with obesity from a large group of Iranian adults in the urban and suburb areas. A cross-sectional study was conducted on 10,693 Iranian adults. The data were collected from two cohort studies: Shahedieh city annexed to Yazd area as well as Yazd Health Study (YaHS)-TAMYZ (Yazd Nutrition Survey in Persian) in urban area. Dietary intakes were assessed using a validated semi-quantitative food frequency questionnaire. The PCA was applied to identify the dietary patterns. Multiple logistic regressions were run to assess the relationship between dietary patterns and obesity. In Shahedieh cohort study, three major dietary patterns were identified traditional, unhealthy, and prudent pattern. Prudent pattern was associated with lower odds of obesity (OR: 0.68; 95% CI: 0.53, 0.88). Higher adherence to the unhealthy (OR: 1.24; 95% CI: 1.02, 1.50) and traditional (OR: 1.38; 95% CI: 1.11, 1.72) patterns was related to greater odds of obesity. Moreover, we identified traditional and unhealthy dietary patterns in YaHS study. Higher adherence to the unhealthy dietary pattern was associated with greater odds of obesity (OR: 1.21 95% CI: 1.02, 1.44). Greater adherence to unhealthy dietary patterns was associated with higher odds of obesity in participants. Greater adherence to traditional and prudent dietary patterns increased and decreased the obesity odds, respectively. Further prospective studies are needed to find out the causal relationship between the variables.

Dietary Micronutrients Intake Status among Chinese Elderly People Living at Home: Data from CNNHS 2010-2012

The aim of this study was to examine the status of usual dietary micronutrient intakes among Chinese elderly living at home. The data was based on China National Nutrition and Health Survey (CNNHS) 2010-2012. We analyzed data from the participants aged 60-year-old and more (n = 16,612) living at home, who provided dietary data on three days 24 h dietary survey combining with the household weighing method. The means and distribution percentiles for usual intakes of dietary micronutrients were estimated using the Multiple Source Method (MSM). The prevalence of inadequacy for the selected micronutrients was expressed using the proportion of individuals with usual intakes below the Estimated Average Requirement (EAR). For vitamin E, sodium and potassium, the means and the distribution of intakes were compared to the Adequate Intake (AI) level. Usual dietary intakes of most micronutrients were inadequate in the participants, especially folate, calcium, vitamin B6 and vitamin B2, with the prevalence of inadequacy more than 90%. However, dietary sodium intake was extremely high with an average usual intake of 4702 mg/day. The usual dietary intakes of all selected micronutrients in old males were higher than females, and the prevalence of inadequacy of most micronutrients was higher in old women (p < 0.01). The subjects aged 60-74 years tended to have higher usual dietary micronutrient intakes and lower prevalence of inadequate micronutrients than those aged 75 years and over (p < 0.01). Higher usual dietary intakes and lower prevalence of inadequacy of most micronutrients were found in the elderly living in the southern region (p < 0.01). The average usual intakes of most micronutrients declined with socioeconomic status. The prevalence of inadequate vitamin A, B2, C, calcium and selenium below EAR increased with socioeconomic status (p < 0.01, p for trend < 0.01). Thus, essential micronutrients insufficient intake is a public health concern among Chinese community-dwelling old population, especially the females, older people, the elderly in undeveloped areas or living in northern regions. Nutrition education and appropriate approach should be undertaken to address these problems.

Structural and Functional Brain Connectivity Changes Between People With Abdominal and Non-abdominal Obesity and Their Association With Behaviors of Eating Disorders

Abdominal obesity is important for understanding obesity, which is a worldwide medical problem. We explored structural and functional brain differences in people with abdominal and non-abdominal obesity by using multimodal neuroimaging and up-to-date analysis methods. A total of 274 overweight people, whose body mass index exceeded 25, were enrolled in this study. Participants were divided into abdominal and non-abdominal obesity groups using a waist–hip ratio threshold of 0.9 for males and 0.85 for females. Structural and functional brain differences were assessed with diffusion tensor imaging and resting-state functional magnetic resonance imaging. Centrality measures were computed from structural fiber tractography, and static and dynamic functional connectivity matrices. Significant inter-group differences in structural and functional connectivity were found using degree centrality (DC) values. The associations between the DC values of the identified regions/networks and behaviors of eating disorder scores were explored. The highest association was achieved by combining DC values of the cerebral peduncle, anterior corona radiata, posterior corona radiata (from structural connectivity), frontoparietal network (from static connectivity), and executive control network (from dynamic connectivity) compared to the use of structural or functional connectivity only. Our results demonstrated the effectiveness of multimodal imaging data and found brain regions or networks that may be responsible for behaviors of eating disorders in people with abdominal obesity.

Diet quality and its association with type 2 diabetes and major cardiometabolic risk factors among adults in China

AIM

We examined the association between diet quality and diabetes and major cardiometabolic risks among adults in China.

METHODS AND RESULTS

We developed the China Dietary Guideline Index (CDGI) based on the 2007 Chinese dietary guidelines and tailored the Alternate Healthy Eating Index 2010 (which we call the tAHEI) to assess diet quality. Our analysis linked the dietary intake and covariates measured in 2006 with CM risk factors measured in 2009. We used diet data the longitudinal China Health and Nutrition Survey 2006 collected in 3 consecutive 24-h recalls from 4440 adults aged 18 to 65 to calculate both the tAHEI and the CDGI scores. We performed multivariable logistic regressions to analyze the association of each 2006 score with diabetes, abdominal obesity, elevated blood pressure, and lipid-related cardiometabolic risk factors in 2009. After we adjusted for potential confounders, adults in the top quintile compared with the bottom quintile of the tAHEI scores showed 36% lower odds of high low-density lipoprotein cholesterol (LDL-C) (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.46, 0.90] in men and 33% lower odds (OR 0.67; 95% CI 0.49, 0.91) in women, while the CDGI scores showed 35% lower odds of high LDL-C (OR 0.65; 95% CI 0.46, 0.92) in men only. Further, the CDGI scores indicated 55% lower odds of diabetes in the top versus the bottom quintile (OR 0.45; 95% CI 0.23, 0.87) in men only, whereas a null association was observed for the tAHEI scores for both sexes. Both index scores showed null associations with other cardiometabolic risk factors.

CONCLUSIONS

Chinese diets that scored high on both the CDGI and the tAHEI showed similarly negative associations with high LDL-C risk, whereas only CDGI score was negatively related to diabetes risk in men.

New Evidence on the Effect of Medical Insurance on the Obesity Risk of Rural Residents: Findings from the China Health and Nutrition Survey (CHNS, 2004-2011)

The obesity rate in China has risen significantly in the past few decades. While a number of causes for the rise in obesity have been explored, little attention has been paid to the role of health insurance per se. This study aims to investigate the impact of health insurance on the risk of obesity in rural China using longitudinal data from the China Health and Nutrition Survey (CHNS). We employed pooled ordinary least squares (OLS), probit estimation, and pooled two-stage least squares (2SLS) for an instrumental variable (IV). The IV model revealed that New rural cooperative medical insurance (NRCMS) participation had a significant positive impact on people's tendency towards unhealthy lifestyles, for instances, high-fat food (8.01% for female and 7.35% for male), cigarette smoking (25% for male), heavy drinking (25% for female), sedentary activity (6.48 h/w for female and 6.48 h/w for male), waist circumference (1.97 cm for female and 1.80 cm for male), body mass index (0.58 kg/m² for female), which in turn leads to an elevated probability of general obesity (51% for female) and abdominal obesity (24% for female and 20% for male). An "ex ante moral hazard" is prevalent in rural China, which should not be ignored by policymakers so as to minimize the related low efficiency in the process of promoting the universal coverage of insurance.

Secular Trends in Energy and Macronutrient Intakes and Distribution among Adult Females (1991-2015): Results from the China Health and Nutrition Survey

With rapid nutrition transition in China, dietary intake and nutritional status of women has gained more and more attention in the past decades. This study aimed to investigate temporal trends of total energy and macronutrient intakes among Chinese adult females. The longitudinal data are from the Chinese Health and Nutrition Survey (CHNS, 1991-2015). Information on the intake of energy and macronutrient was obtained from consecutive three-day dietary recall techniques and compared with the Chinese Dietary Reference Intakes (DRI). Mixed-effect models were performed to evaluate temporal trends of total energy and macronutrient intake. From 1991 to 2015, a significant reduction in daily energy, protein and carbohydrate intakes was seen among all adult females (p < 0.001). Daily fat intake, the proportion of energy from fat, the proportion of females consuming more than 30% of energy from fat and less than 50% of energy from carbohydrate were observed significant increment in the present study (p < 0.001). In 2015, the proportion met the DRI for energy and protein intakes were 47.0% and 48.0%, respectively; the proportion with lower carbohydrate and higher fat intakes compare with the DRI were 45.5% and 66.9%, respectively. Further nutritional education and policy interventions still needed to improve nutrition status for Chinese females.

Relationship between dietary factors and the number of altered metabolic syndrome components in Chinese adults: a cross-sectional study using data from the China Health and Nutrition Survey

OBJECTIVES

To study the correlation between dietary factors and the number of altered metabolic syndrome components (MetS) in Chinese adults systematically.

SETTING

A cross-sectional study using demographic and dietary data of adults aged 18-75 years from the China Health and Nutrition Survey (2009) was conducted in nine provinces in China.

PARTICIPANTS

There were 6034 eligible subjects (2800 men and 3234 women) in this study.

OUTCOMES

The primary outcome of this study were diet assessments and the number of altered MetS components. Dietary intake was measured using a combination of a 3-day period with 24-hour and household food inventory; average daily intakes of nutrients were estimated according to the Chinese Food Composition Table. Blood samples were analysed in a national central laboratory and the number of clustering MetS components was calculated by adding the presence of each MetS component.

RESULTS

After adjusting for covariates, and taking zero MetS as comparison, the high risk factors correlating with increased numbers of altered MetS components in men were higher intake of protein (70.4-73.4 g; Ptrend=0.0004), cholesterol (238.7-266.6 mg; Ptrend=0.004), meat (90.6-105.7 g; Ptrend=0.016), fish/seafood (30.4-42.3 g; Ptrend=0.001), and lower intake of coarse cereals (16.5-12.7 g; Ptrend=0.051), tubers (37.3-32.7 g; Ptrend=0.030), and dietary fibre (11.7-11.5 g; ANCOVA p=0.058). Meanwhile, the high risk factors correlating with the increased number of altered MetS components in women were higher intake of wheat (101.9-112.6 g; Ptrend=0.066) and sodium (3862.3-4005.7 mg, Ptrend=0.032), and lower intake of β-carotene (1578.6-1382.7 µg; Ptrend=0.007), milk, and dairy products (17.8-11.5 g; Ptrend=0.002).

CONCLUSIONS

Some foods and nutritional factors correlate with an increased number of altered MetS components in Chinese adults. More prospective, multicentre and clinical research work to further examine these associations is underway.

Dietary Patterns and Obesity among Chinese Adults: Results from a Household-Based Cross-Sectional Study

The key dietary pattern other than dietary factors influencing obesity has been reported by several large epidemiological studies. This study was carried out between 2010 and 2012 including 1613 adult residents in Zhejiang Province. Dietary patterns were extracted by factor analysis based on 24-h dietary recall. Associations with dietary patterns and obesity were examined and adjusted for age and gender by logistic regression. Five dietary patterns were identified by factor analysis with their eigenvalues greater than 1: 'cereal, animal, and plant food', 'high protein food', 'plant food', 'poultry', and 'beverage'. After adjustment for age and gender, the 'cereal, animal, and plant food' and 'beverage' pattern was associated with obesity (OR = 2.924, 3.257; 95% CI = 1.147-7.463, 1.372-7.692). In conclusion, 'cereal, animal, and plant food' and 'beverage' dietary patterns may be associated with increased risk of obesity. 'Cereal, animal, and plant food' dietary patterns may be associated with increased risk of obesity resulting from increased total energy intake by increased protein and fat intake; while a 'beverage' dietary pattern may be associated with increased risk of obesity resulting from increased total energy intake by increased carbohydrate intake. The findings are valuable in targeting future nutrition education.

Geography of Food Consumption Patterns between South and North China

The geographical environment, food culture, and dietary habits are substantially different between the southern and northern regions in China. We investigated the associations with dietary patterns and metabolic syndrome between Chinese adult from the southern and northern regions (North: 1249; South: 1849) using data from the Chinese Health and Nutrition 2009 survey. Respectively, four dietary patterns were identified by factor analysis in each of the two regions. Using factor analysis, each dietary pattern of factor score was calculated for three groups by tertile (T1 < T2 < T3). In the northern region, the association between the Alcohol and Western pattern and the risk of abdominal obesity (OR: 1.31; 95%: 1.01, 1.68) (OR: Odds Ratio), hypertriglyceridemia (OR: 1.35; 95%: 1.05, 1.74), high fasting blood glucose (OR: 1.37; 95%: 1.05, 1.80), and hypertension (OR: 1.55; 95%: 1.45, 1.99) was increased compared T1 to T3. In the southern region, the Convenience Food pattern was positively associated with hypertriglyceridemia (OR: 1.53; 95%: 1.03, 2.26), low high density lipoprotein (HDL)-cholesterol (OR: 1.96; 95%: 1.12, 3.43), and metabolic syndrome (OR: 1.79; 95%: 1.03, 3.11). The Alcohol dietary pattern was positively associated with high fasting blood glucose (OR: 1.83, 95%: 1.13, 2.97). There are some dietary pattern differences in the two regions. It is necessary to consider the factors of food culture and food intake habits in order to provide nutrition education to Chinese individuals from different regions in the future.

Elevated High Sensitivity C-Reactive Protein Increases the Risk of Microalbuminuria in Subjects With Cardiovascular Disease Risk Factors

Microalbuminuria is an early biomarker of kidney injury, the aim of this study was to investigate the impact of high sensitivity C-reactive protein (hs-CRP) on microalbuminuria in adults with cardiovascular disease (CVD) risk factors. A total of 5667 subjects who voluntarily attended annual health screenings in the Third Xiangya Hospital of Central South University were included in the study. Logistic regression was used to determine the validity of hs-CRP to predict the presence of microalbuminuria. In the unadjusted regression analysis, male gender (OR 2.23), age (OR 1.71), smoking status (OR 1.48), obesity (OR 2.41), hypertension(OR 4.03), diabetes (OR 4.61), hyperuricemia (OR 1.83), and high hs-CRP(OR 1.61) were associated with microalbuminuria. Multivariate logistic regression analysis showed that the adjusted odds ratios (OR) of diabetes, hypertension, male, abdominal obesity, and high hs-CRP for microalbuminuria were 2.71, 2.57, 1.51, 1.28 and 1.41 in all subjects, respectively (P < 0.01). ROC analysis indicated that the cut-off for hs-CRP with better properties for screening of microalbuminuria was identified as ≥0.85 mg/L. The ORs of microalbuminuria were 1.97, 1.49, 1.32 and 1.71 times in male, abdominal obesity, diabetes and hypertension subjects with hs-CRP ≥ 0.85 mg/L, respectively, compared with those without elevated hs-CRP (P < 0.01). Elevated hs-CRP level was associated with microalbuminuria independent of cardiovascular risk factors. In addition, elevated hs-CRP increased the risk of developing microalbuminuria in subjects with CVD risk factors, indicating that chronic inflammation could amplify the deterioration of kidney by effect of CVD risk factors.

Dietary Patterns in Relation to General and Central Obesity among Adults in Southwest China

Dietary patterns represent a broader picture of food consumption, and are better correlated with a variety of health outcomes. However, few studies have been conducted to explore the associations between dietary patterns and obesity in Southwest China. Data from the 2010-2012 National Nutrition Survey in the province of Yunnan, Southwest China, were analyzed (n = 1604, aged 18-80 years). Dietary data were collected using the 24 h dietary recall over three consecutive days. Height, weight, and waist circumference were measured following standard methods. Exploratory factor analysis was used to identify dietary patterns. Logistic regression was used to explore the association between dietary patterns and obesity. Three distinct dietary patterns were identified, which were labeled as traditional, modern, and tuber according to their key components. With potential confounders adjusted, adults in the highest quartile of the modern pattern were at higher risk of general and central obesity (odds ratio (OR) 1.95, 95% confidence interval (CI) 1.15-3.48; OR 2.01, 95% CI 1.37-2.93). In contrast, adults in the highest quartile of the tuber pattern were at lower risk of general and central obesity (OR 0.34, 95% CI 0.15-0.61; OR 0.64, 95% CI 0.43-0.95) but at higher risk of underweight (OR 2.57, 95% CI 1.20-6.45). No significant association was found between the traditional pattern and obesity. Moreover, dietary pattern differences occurred due to the differences in socio-demographic characteristics. In conclusion, the modern dietary pattern was positively, and the tuber pattern negatively, associated with general and central obesity among adults in Southwest China.

Dietary intakes and dietary patterns among pregnant women in Northwest China

OBJECTIVE

To describe nutrient intakes, characterize dietary patterns and analyse their associations with sociodemographic characteristics among pregnant women in Shaanxi, China.

DESIGN

Population-based cross-sectional survey.

SETTING

Twenty counties and ten districts in Shaanxi Province of Northwest China, 2013.

SUBJECTS

Women (n 7462) were recruited using a stratified multistage random sampling method to report diets during pregnancy, at 0-12 months (median 3 months; 10th-90th percentile, 0-7 months) after delivery.

RESULTS

Pregnant women had higher intakes of fat, niacin and vitamin E than the nutrient reference values, while most micronutrients such as vitamin A, folate, Ca and Zn were reportedly low. Women in the highest education, occupation and household income groups had higher nutrient intakes than those in the lowest groups. Nutrient intake differences also existed by geographic area, residence and maternal age at delivery. Three dietary patterns were identified: balanced pattern, vegetarian pattern and snacks pattern. Participants with high balanced pattern scores tended to be better educated, wealthier, 25-29 years old at delivery, working outside and living in urban areas and central Shaanxi. Women with high scores on the vegetarian pattern and snacks pattern tended to be in low balanced pattern score groups, and had lower nutrient intakes than those in the high balanced pattern score groups.

CONCLUSIONS

The study suggested that pregnant women in Shaanxi, China had low intakes of most nutrients such as vitamin A, folate and Ca. Dietary patterns and most nutrient intakes varied by sociodemographic characteristics. Targeted programmes are needed to improve dietary intakes and dietary patterns among sociodemographically disadvantaged groups.

Association between dietary patterns and blood lipid profiles among Chinese women

OBJECTIVE

The present study aimed to identify dietary patterns and explore their associations with blood lipid profiles among Chinese women.

DESIGN

In a cross-sectional study, we identified dietary patterns using principal component analysis of data from three consecutive 24 h dietary recalls. The China Health and Nutrition Survey (CHNS) collected blood samples in the morning after an overnight fast and measured total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C) and TAG.

SETTING

Data were from the 2009 wave of the CHNS.

SUBJECTS

We studied 2468 women aged 18-80 years from the CHNS.

RESULTS

We identified three dietary patterns: traditional southern (high intakes of rice, pork and vegetables), snack (high intakes of fruits, eggs and cakes) and Western (high intakes of poultry, fast foods and milk). The traditional southern pattern was inversely associated with HDL-C (β=-0·68; 95 % CI -1·22, -0·14; P<0·05). The snack pattern was significantly associated with higher TAG (β=4·14; 95 % CI 0·44, 7·84; P<0·05). The Western pattern was positively associated with TC (β=2·52; 95 % CI 1·03, 4·02; P<0·01) and LDL-C (β=2·26; 95 % CI 0·86, 3·66; P<0·01).

CONCLUSIONS

We identified three dietary patterns that are significantly associated with blood lipid profiles. This information is important for developing interventions and policies addressing dyslipidaemia prevention among Chinese women.

Cereal Crops Are not Created Equal: Wheat Consumption Associated with Obesity Prevalence Globally and Regionally

BACKGROUND

Cereals have been extensively advocated as the beneficial food group in terms of body weight management, but each staple cereal crop may contribute in different ways. Studies of the association between wheat availability and risk of obesity are controversial. This study aimed to test the global and regional association between wheat availability as reported by FAO and obesity prevalence at a population level. FAO does not distinguish between whole grain wheat and refined wheat.

METHODS

Population-specific data from 170 countries on prevalence of obesity, availabilities of mixed cereals, wheat, rice, maize, meat, sugar, fat, soy and calories and GDP are obtained from the UN agencies. All variables were measured as per capita per day (or per year). Each country is treated as an individual subject. SPSS v. 22 is used to analyse these data for all the 170 countries and official country groupings (regions) using non parametric and parametric correlations, including partial correlation analysis.

RESULTS

Pearson's correlation coefficient analysis showed that obesity prevalence is positively associated with wheat availability (r = 0.500, p < 0.001), but is inversely associated with availabilities of total cereals (r = -0.132, p = 0.087), rice (r = -0.405, p < 0.001) and maize (r = -0.227, p = 0.004). These associations remain in partial correlation model when we keep availabilities of meat, fat, sugar, soy, caloric intake and GDP statistically constant. Overall, positive associations between wheat availability and obesity prevalence remain in different regions. Maize and mixed cereal availabilities do not show independent associations with the obesity prevalence.

CONCLUSIONS

Our study suggests that wheat availability is an independent predictor of the obesity prevalence both worldwide and with special regard to the regions of Africa, Americas and Asia. Future studies should distinguish between possible influence of whole grain and ultra-processed refined wheat products.

Associations between Dietary Patterns and Impaired Fasting Glucose in Chinese Men: A Cross-Sectional Study

Few studies have examined the association between Asian dietary pattern and prediabetes, in particular, the Chinese diet. We conducted a cross-sectional study to identify dietary patterns associated with impaired fasting glucose (IFG) which considered a state of prediabetes in Chinese men. The study included 1495 Chinese men aged 20 to 75 years. Information about diet was obtained using an 81-item food frequency questionnaire (FFQ), and 21 predefined food groups were considered in a factor analysis. Three dietary patterns were generated by factor analysis: (1) a vegetables-fruits pattern; (2) an animal offal-dessert pattern; and (3) a white rice-red meat pattern. The multivariate-adjusted odds ratio (OR) of IFG for the highest tertile of the animal offal-dessert pattern in comparison with the lowest tertile was 3.15 (95% confidence intervals (CI): 1.87-5.30). The vegetables-fruits dietary pattern was negatively associated with the risk of IFG, but a significant association was observed only in the third tertile. There was no significant association between IFG and the white rice-red meat pattern. Our findings indicated that the vegetables-fruits dietary pattern was inversely associated with IFG, whereas the animal offal-dessert pattern was associated with an increased risk of IFG in Chinese men. Further prospective studies are needed to elucidate the diet-prediabetes relationships.

Major Dietary Patterns in Relation to General and Central Obesity among Chinese Adults

Limited evidence exists for the association between diet pattern and obesity phenotypes among Chinese adults. In the present study, we analyzed the cross-sectional data from 474,192 adults aged 30-79 years from the China Kadoorie Biobank baseline survey. Food consumption was collected by an interviewer-administered questionnaire. Three dietary patterns were extracted by factor analysis combined with cluster analysis. After being adjusted for potential confounders, individuals following a traditional southern dietary pattern had the lowest body mass index (BMI) and waist circumference (WC); the Western/new affluence dietary pattern had the highest BMI; and the traditional northern dietary pattern had the highest WC. Compared to the traditional southern dietary pattern in multivariable adjusted logistic models, individuals following a Western/new affluence dietary pattern had a significantly increased risk of general obesity (prevalence ratio (PR): 1.06, 95% confidence interval (CI): 1.03-1.08) and central obesity (PR: 1.07, 95% CI: 1.06-1.08). The corresponding risks for the traditional northern dietary pattern were 1.05 (1.02-1.09) and 1.17 (1.25-1.18), respectively. In addition, the associations were modified by lifestyle behaviors, and the combined effects with alcohol drinking, tobacco smoking, and physical activity were analyzed. Further prospective studies are needed to elucidate the diet-obesity relationships.