The effect of self-perceived stress, the history of smoking and drinking on weight status in Chinese adults - evidence from the 2015 China Health and Nutrition Survey: A cross-sectional study in Chongqing, China

Association between perceived stress and hypertension in Chinese adults: a population-based survey

It still remains unclear whether perceived stress is associated with hypertension. We aimed to investigate the association between perceived stress with hypertension in Chinese adults. Data on 10,823 participants aged 18 years or older were obtained from the 2015 China Health and Nutrition Survey (CHNS). Hypertension was defined as a mean systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, self-reported physician diagnosis of hypertension, and/or use of antihypertensive medications. Perceived stress was assessed by the 14-item perceived stress scale, with the scale data then divided into quartiles. Logistic regression models and restricted cubic spline regression were performed to evaluate the association between perceived stress and hypertension. After adjustment for age, gender, marital status, education level, per capita household income, employment status, residential areas, current smoking and alcohol consumption, the odds ratio (OR) [95% confidence interval (CI)] for every standard deviation (SD) increment in perceived stress was 0.94 (0.90-0.98); compared to the lowest quartile of perceived stress (Q1), the ORs (95% CIs) for hypertension were 0.88 (0.78-1.01) for Q2, 0.91 (0.81-1.03) for Q3, and 0.82 (0.72-0.92) for Q4 (P for trend < 0.001). The inverse association between perceived stress and hypertension was persistent in the subgroup analyses stratified by age, gender, employment status, residential areas, smoking status, and alcohol consumption. In addition, the restricted cubic spline curve revealed a linear and negative association between perceived stress and hypertension (P for nonlinearity = 0.872). Because this study was a cross-sectional design, future prospective studies are needed to confirm these findings.

Indoor Air Purification and Residents' Self-Rated Health: Evidence from the China Health and Nutrition Survey

Indoor air pollution is injurious to human health, even worse than outdoor air pollution. However, there is a lack of empirical evidence using large samples in developing countries regarding whether indoor air purification can improve human health by reducing indoor air pollutants. Using the data from the China Health and Nutrition Survey in 2015, this study analyzes the relationship between indoor air purification and residents' self-rated health. We apply the generalized ordered logit model and find that indoor air purification has a significantly positive effect on residents' self-rated health. This positive effect is limited to improving the probability of residents' health level being rated "good", and there is no significant movement between the two levels of "bad" and "fair". The results also show that, as an important source of indoor air pollutants, solid fuels used in cooking significantly reduced residents' self-rated health level. Additional results show the heterogeneity of the relationship between indoor air purification and resident health among groups with different characteristics. This study provides empirical evidence for further optimizing the indoor air environment.

Association between alcohol intake and overweight and obesity: a systematic review and dose-response meta-analysis of 127 observational studies

Several studies have assessed the relationship between alcohol intake and overweight/obesity; however, the reported results are inconsistent. Therefore, the present systematic review and dose-response meta-analysis of observational studies was designed to investigate the association between alcohol intake and general and abdominal obesity among the adults. Literature search was conducted in the PubMed/Medline and Web of Science databases up to August 2020. Odds ratio (OR), risk ratio (RR), or hazard ratio (HR) with 95% confidence interval (95% CI) were used to pool effect size. To conduct dose-response meta-analysis, amount of alcohol intake was classified into three categories including light (<14 g/d), moderate (14-28 g/d), and heavy (>28 g/d). In the present study, 127 eligible studies were included. In cohort studies, there was no significant association between alcohol drinking and risk of overweight (OR: 0.93, 95% CI: 0.46 to 1.89), obesity (OR: 0.84, 95% CI: 0.52 to 1.37), overweight/obesity (OR: 1.15, 95% CI: 0.84 to 1.58), and abdominal obesity (OR: 1.13, 95% CI: 0.90 to 1.41). In cross-sectional studies, alcohol intake was associated with the increased odds of overweight (OR: 1.11, 95% CI: 1.05 to 1.18), overweight/obesity (OR: 1.23, 95% CI: 1.11 to 1.37), and abdominal obesity (OR: 1.19, 95% CI: 1.09 to 1.29); but not obesity (OR: 1.03, 95% CI: 0.95 to 1.12). Results of dose-response analysis indicated that heavy alcohol drinking was positively associated with odds of overweight (OR: 1.12, 95% CI: 1.01 to 1.24), overweight/obesity (OR: 1.32, 95% CI: 1.16 to 1.51), and abdominal obesity (OR: 1.25, 95% CI: 1.12 to 1.38) compared to non- or light alcohol drinking. There was no publication bias among studied on outcomes of interest. In conclusion, our results revealed alcohol drinkers, especially heavy alcohol drinkers, had increased odds of overweight, overweight/obesity, and abdominal obesity than non-alcohol drinker or light alcohol drinkers among cross-sectional studies but not cohort studies.