Secular trends in salt and soy sauce intake among Chinese adults, 1997–2011

Association between Eating Habits and Sodium Intake among Chinese University Students

(1) Background: Insufficient evidence exists regarding the dietary habits that may contribute to high sodium intake among college students in China. This cross-sectional study aimed to investigate the dietary sodium intake of college students in Hunan and its association with their dietary habits. (2) Methods: In total, 585 university students from Hunan were recruited for this study. The sodium Food Frequency Questionnaire (sodium-FFQ) and dietary habits were assessed. (3) Results: Excluding cooking salt and high-sodium seasonings, the daily dietary sodium intake among college students in Changsha, Hunan Province, was 1183.74 (563.38, 2054.86) mg/day. A vast majority (89%) of college students reported eating outside of school at least once a week, and approximately one-third (34%) ordered takeaways at least once a week. After adjusting for confounding factors, the associations between the frequency of eating out and ordering takeaways with college students' sodium intake remained significant. (4) Conclusions: The findings indicate that excessive dietary sodium intake among college students in Hunan is a growing concern. College students who frequently eat out and order takeaways tend to have a higher sodium intake. Future research should focus on identifying the main sources of dietary sodium and developing interventions that promote healthy dietary habits among college students.

The Potential of Condiments, Seasonings, and Bouillon Cubes to Deliver Essential Micronutrients in Asia: Scenario Analyses of Iodine and Iron Fortification

Micronutrient deficiencies are still highly prevalent in Asia. Fortification of cooking aids, such as condiments (fish and soy sauces), seasonings, and bouillon cubes, may be an additional strategy to improve micronutrient intake. The current study evaluated the potential impact of iodine and iron fortification of cooking aids on micronutrient intake in Asian countries. A systematic literature search was performed to collect consumption data from different countries in Asia. Data from 18 studies in nine Asian countries were included. Scenario analyses were performed using different fortification levels based on regulations and literature. Mean intake of cooking aids ranged from 3.2-15.9 g/day for condiments and 0.4-11.7 g/day for seasonings and bouillon cubes. When replacing salt with iodized salt (30 µg of iodine/g of salt), iodine intake would increase by 13-119 µg/day for soy and fish sauces (9-80% of the Nutrient Reference Value (NRV)), and 5-83 µg/day for bouillon cubes and seasonings (4-56% of the NRV). Fortification with iron 0.5 mg/g food product for condiments or 1 mg/g food product for bouillon cubes and seasonings improved iron intake for soy and fish sauces by 1.6-8.0 mg/day (11-57% of the NRV), and for bouillon cubes and seasonings by 0.4-5.6 mg/day (3-40% of the NRV). These results indicate that, depending on the consumption pattern, fortification of cooking aids can be a suitable strategy to increase intake of micronutrients.

Mycotoxins in soybean-based foods fermented with filamentous fungi: Occurrence and preventive strategies

Fermented soybean products are widely consumed worldwide, and their popularity is increasing. Filamentous fungi, such as Actinomucor, Aspergillus, Monascus, Mucor, Penicillium, Rhizopus, and Zymomonas, play critical roles in the fermentation processes of many soybean foods. However, besides producing essential enzymes for food fermentation, filamentous fungi can release undesirable or even toxic metabolites into the food. Mycotoxins are toxic secondary metabolites produced by certain filamentous fungi and may be detected during the food production process. Without effective prevention strategies, mycotoxin contamination in fermented soybean products poses a risk to human health. This review focused on the changes in mycotoxigenic fungal abundance and mycotoxin contamination at different stages during the production of soybean-based fermented foods, as well as effective strategies for preventing mycotoxin contamination in such products. Data from relevant studies demonstrated a tendency of change in the genera of mycotoxigenic fungi and types of mycotoxins (aflatoxins, alternariol, alternariol monomethyl ether, deoxynivalenol, fumonisins, ochratoxin A, rhizoxins, T-2 toxin, and zearalenone) present in the raw materials and the middle and final products. The applicability of traditional chemical and physical mitigation strategies and novel eco-friendly biocontrol approaches to prevent mycotoxin contamination in soybean-based fermented foods were discussed. The present review highlights the risks of mycotoxin contamination during the production of fermented soybean products and recommends promising strategies for eliminating mycotoxin contamination risk in soybean-based fermented foods.

Associations of combined lifestyle behaviors with all-cause and cardiovascular mortality in adults: A population-based cohort study in Jiangxi Province of China

Background

Data are limited on the impact of combined lifestyle behaviors on mortality in Jiangxi Province, China.

Objective

The study examined the association between combined lifestyle behaviors and all-cause and cardiovascular disease (CVD) mortality in Jiangxi province.

Methods

The baseline survey was completed in Jiangxi Province from November 2013 to August 2014. We conducted a follow-up on 12,608 participants of 35 years of age or older from July 2019 to October 2020. Four known lifestyle behaviors were evaluated: alcohol consumption, smoking, diet (AHEI scores), and physical activity. Cox regression analysis was performed to determine the association of combined lifestyle behaviors with all-cause and CVD mortality.

Results

During 65,083 person-years of follow-up, among the 11,622 participants (mean age 59.1 years; 40.1% men) 794 deaths occurred, including 375 deaths from CVD disease in this study. Compared to the favorable lifestyle group, the adjusted HR of all-cause mortality was 1.25 (95% CI, 1.03-1.53) for the intermediate lifestyle group and 1.37 (95% CI, 1.11-1.71) for the unfavorable lifestyle group. Compared to the favorable lifestyle group, the adjusted HR of CVD mortality was 1.50 (95% CI, 1.11-2.03) for the intermediate lifestyle group and 1.58 (95% CI, 1.14-2.20) for the unfavorable lifestyle group. Significant interactions of lifestyle and BMI (P for interaction <0.05) with the risk of all-cause mortality and CVD mortality were observed.

Conclusion

In the current study, we reaffirm the associations of combined lifestyle factors with total and CVD mortality in Jiangxi Province, our data suggest that an unfavorable lifestyle was associated with a substantially increased risk of all-cause and CVD mortality.

Time Trend of Upper Gastrointestinal Cancer Incidence in China from 1990 to 2019 and Analysis Using an Age-Period-Cohort Model

The aim of this study was to investigate the upper gastrointestinal cancer incidence trend in China from 1990 to 2019 with Joinpoint software and to evaluate the age effect, cohort effect, and period effect using the age-period-cohort model, with the data obtained from the Global Burden of Disease, Injuries, and Risk Factors Study. The crude incidence rate (CR) of upper gastrointestinal cancer in China increased from 41.48/100,000 in 1990 to 62.64/100,000 in 2019, and the average annual percent change (AAPC) was 1.42 (p < 0.05). The age-standardized incidence rate (ASIR) decreased from 50.77/100,000 to 37.42/100,000, and the AAPC was -1.12 (p < 0.05). The net drift was -0.83 (p < 0.05), and the local drifts in the 35-79 age groups of males and all age groups of females were less than 0 (p < 0.05). The age effect showed that the upper gastrointestinal cancer onset risk gradually increased with age, the period effect was fundamentally manifested as a downward trend in onset risk after 2000, and the cohort effect indicated the decreased onset risk of the overall birth cohort after 1926. The ASIR of upper gastrointestinal cancer in China from 1990 to 2019 showed a downward trend, and the onset risk indicated the age, period, and cohort effects.

National and sub-national trends of salt intake in Iranians from 2000 to 2016: a systematic analysis

Background

One fifth of the global burden of cardiovascular diseases (CVDs) in 2017 was attributable to excessive salt intake. As a member of the World Health Organization (WHO), Iran has committed itself to a 30% reduction in salt intake by 2025. Evidence on the amount and trend of salt intake among the Iranian population at national and sub-national levels is scarce. This study aimed to estimate the Iranian population’s salt intake during 2000–2016 at the national and sub-national levels, by sex and age groups.

Methods

Data on national and sub-national mean salt intake was obtained through systematically searching the literature and contacting the research studies’ principal investigators. Data collected through various methods were harmonized using the cross-walk method. Bayesian hierarchical and spatio-temporal-age regression models and simulation analysis were used to estimate the mean salt intake and its uncertainty interval across sex, age, year, and province.

Results

National age-sex standardized mean salt intake decreased from 10·53 g/day (95% uncertainty interval [UI]: 10·2 to 10·9) in 2000 to 9·41 (9·2 to 10·6) in 2016 (percent change: − 9·8% [− 21·1–3·1]). The age-standardized mean salt intake in women had decreased from 9·8 g/day (95% UI: 9·0–10·6) in 2000 to 9·1 g/day (8·6–9·7) in 2016 (percent change: − 6·6% [− 19·0–7·9]). The same measure in men was 11·1 g/day in 2000 (95% UI: 10·3–11·8) and 9·7 g/day (9·1–10·2) in 2016 (percent change: − 12·7% [− 23·0 – -0·9]).

Age-sex standardized mean salt intake at the sub-national level in 2016 varied from 8·0 (95% UI: 7·0–9·0) to 10·5 (10·0–11·1). The difference between the provinces with the highest and the lowest levels of salt intake in 2016 was 31·3%.

Conclusion

Salt intake decreased in Iran from 2000 to 2016, while persistently exceeding the recommended values. This declining trend was more pronounced between 2010 and 2016, which might be attributed to Iran’s compliance to WHO’s Action Plan for reducing NCDs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-022-00871-w.

Chinese Traditional Fermented Soy Sauce Exerts Protective Effects against High-Fat and High-Salt Diet-Induced Hypertension in Sprague-Dawley Rats by Improving Adipogenesis and Renin-Angiotensin-Aldosterone System Activity

Although high-fat and high-salt diets are considered risk factors for hypertension, the intake of salty soybean-based fermented foods has beneficial effects. This study explored the potential of Chinese traditional fermented soy sauce (CTFSS) in preventing hypertension by analyzing its effects on adipogenesis and the renin-angiotensin-aldosterone system (RAAS). Male Sprague-Dawley (SD) rats were divided into four groups (n = 6): normal diet (ND), high-fat diet (HD), high-fat diet with saline (HDS, NaCl-8%), and high-fat diet with Chinese traditional soy sauce (HDCTS, NaCl-8%). Each group is administrated 12 weeks by oral gavage as 10 mL/kg dose, respectively. CTFSS supplementation resulted in significantly lower body weight, epididymal fat weight, and systolic blood pressure. Additionally, it decreased the serum total cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), renin, angiotensin II (Ang II), angiotensin-converting enzyme (ACE), and aldosterone levels. It also increased the urinary volume and improved sodium and potassium ion balance. The gene levels showed significant enhancements in the mRNA levels of renin-angiotensin-aldosterone system-related and adipogenesis-related genes. In addition, CTFSS may prevent hypertension-associated kidney injury. Therefore, this study demonstrates that CTFSS has no harmful effects on hypertension. In contrast, the beneficial effects of CTFSS intake in ameliorating hypertension were shown.

The Potential of Iodine and Iron Double-Fortified Salt Compared with Iron-Fortified Staple Foods to Increase Population Iron Status

The potential of double-fortified salt (DFS) to improve population iron status is compared with the potential of iron-fortified wheat flour, maize flour, rice grains, and milk products. The potential for a positive impact on iron status is based on reported efficacy studies, consumption patterns, the extent of industrialization, and whether there are remaining technical issues with the fortification technologies. Efficacy studies with DFS, and with iron-fortified wheat flour, maize flour, and rice, have all reported good potential to improve population iron status. Iron-fortified milk powder has shown good impact in young children. When these foods are industrially fortified in modern, automated facilities, with high-level quality control and assurance practices, high-quality raw materials, and a wide population coverage, all vehicles have good potential to improve iron status. Relative to other fortification vehicles, fortification practices with wheat flour are the most advanced and iron-fortified wheat flour has the highest potential for impact in the short- to medium-term in countries where wheat flour is consumed as a staple. Liquid milk has the least potential, mainly because an acceptable iron fortification technology has not yet been developed. Maize is still predominantly milled in small-scale local mills and, although the extruded rice premix technology holds great promise, it is still under development. Salt has a proven record as an excellent vehicle for iodine fortification and has demonstrated good potential for iron fortification. However, technical issues remain with DFS and further studies are needed to better understand and avoid color formation and iron-catalyzed iodine losses in both high- and low-quality salts under different storage conditions. There is currently a risk that the introduction of DFS may jeopardize the success of existing salt iodization programs because the addition of iron may increase iodine losses and cause unacceptable color formation.

Breakfast preferences and consumption location among children at a median age of 7 in Shenzhen: Implications for managing overweight and obesity

BACKGROUND

Breakfast is commonly described as the most important meal of the day; however, we have little information regarding its relevance for childhood overweight and obesity in southern mainland China. This study aimed to assess the association between breakfast preferences, consumption location and overweight and obesity for children in Shenzhen.

METHODS

Among 6126 children (median age 7.2 years) at primary schools, 3504 were finally included after a questionnaire survey and physical examination. Ten commonly consumed foods/beverages for breakfast in southern China were exposure variables, and consumption location, total energy demographic and other dietary characteristics were covariates in logistic regression to determine the effect of breakfast preferences on overweight and obesity, estimating odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Probability of overweight/general obesity was inversely associated with children eating plain congee for breakfast (adjusted OR 0.689, 95% CI 0.566-0.838), restricted to boys after stratification. Probability of overweight/general obesity and central obesity was positively associated with usually eating steamed rice roll for breakfast (OR 1.309, 95% CI 1.090-1.571 and OR 1.351, 95% CI 1.064-1.717, respectively), but the effect on overweight/obesity remained statistically significant for only boys after stratification. Eating steamed rice roll for breakfast and eating out for breakfast had an additive interaction on overweight/obesity. Additionally, eating bread for breakfast had a mild favorable effect on overweight/obesity but only for girls.

CONCLUSIONS

Keeping a healthy weight might benefit children who eat plain congee or bread for breakfast in China. However, frequent consumption of steamed rice roll for breakfast and especially eating out could contribute to overweight and obesity. Thus, we need to promote a healthier breakfast pattern among children in southern China to reduce the odds of obesity.

The role of sodium in modulating immune cell function

Sodium intake is undoubtedly indispensable for normal body functions but can be detrimental when taken in excess of dietary requirements. The consequences of excessive salt intake are becoming increasingly clear as high salt consumption persists across the globe. Salt has long been suspected to promote the development of hypertension and cardiovascular diseases and is now also recognized as a potential modulator of inflammatory and autoimmune diseases through its direct and indirect effects on immune cells. The finding that, in addition to the kidneys, other organs such as the skin regulate sodium levels in the body prompted new hypotheses, including the concept that skin-resident macrophages might participate in tissue sodium regulation through their interactions with lymphatic vessels. Moreover, immune cells such as macrophages and different T cell subsets are found in sodium-rich interstitial microenvironments, where sodium levels modulate their function. Alterations to the intestinal bacterial community induced by excess dietary salt represent another relevant axis whereby salt indirectly modulates immune cell function. Depending on the inflammatory context, sodium might either contribute to protective immunity (for example, by enhancing host responses against cutaneous pathogens) or it might contribute to immune dysregulation and promote the development of cardiovascular and autoimmune diseases.

Short sleep duration is associated with specific food intake increase among school-aged children in China: a national cross-sectional study

Background

The relationship between sleep duration and food intake is unclear. This study aims to examine the relationship among children aged 6–17 years in China.

Methods

The sample consisted of 70,519 children aged 6–17 years, which were randomly selected from 7 representative areas from China, from September to November, 2013. In the structured questionnaire, children reported daily sleep hours (less than 7 h, 7–9 h and more than 9 h), weekly food intake amount (including vegetables, fruit, sugar beverages and meat), physical activity and sedentary time. The relationship of sleep duration with vegetable, sugar beverage, fruit and meat intake was evaluated by multi-nominal logistic regression and multi-variable adjusted.

Results

A total of 62,517 children (51.6% boys) completed the study. Short sleep duration (SSD, < 7 h) was independently associated with increased sugar beverage intake (SBI, Odd Ratio, OR: 1.29, 95% CI: 1.19–1.40) but decreased vegetable (VI, OR: 0.94, 95% CI: 0.90–0.98) & fruit intake (FI, OR: 0.94, 95% CI: 0.88–0.99). Stratified by age and gender, SSD increased SBI for boys of both young (6–12 years) & older (13–17 years) groups and older girls (ORs: 1.25, 1.25, 1.49, 95% CI: 1.08–1.44, 1.04–1.50, 1.22–1.81, respectively), but decreased VI and FI for older girls (ORs: 0.84& 0.81, 95% CI: 0.74–0.96& 0.68–0.96, respectively).

Conclusions

Among school-aged children in China, short sleep duration was associated with increased risks of more sugar beverage intake among those younger and boys but less vegetable & fruit intake among those older and girls. Longitudinal research is needed to clarify the causation in between.

Gaps in awareness and control of hypertension: a cross-sectional study in Chinese urban adults

Hypertension is a serious public health threat worldwide. This study sought to explore gaps in urban Chinese adults' awareness and control of hypertension. A cross-sectional study was carried out in eight Chinese cities in 2016. Participants were organized into four groups on the basis of blood pressure (BP) and self-reported disease history: healthy group (63.0%), well-controlled BP group (9.1%), unaware hypertension group (14.0%), and poorly controlled BP group (13.9%). Multinomial logistic regression with the healthy group as the reference group showed that younger age and body mass index <24 kg/m² were negatively associated with lack of awareness of hypertension and poor control of BP. Lower salt intake, but not sodium intake, was associated with poor control of BP. Other factors associated with lack of awareness of hypertension included low fish and seafood intake. Low sodium intake contributed to good control of BP. In conclusion, there are gaps in urban Chinese adults' awareness and control of hypertension. A comprehensive strategy for enhancing awareness of hypertension and changing behaviors associated with the condition should be developed and implemented.