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Li L, Zhang W, Liu S, Wang W, Ji X, Zhao Y, Shima M, Yoda Y, Yang D, Huang J, Guo X, Deng F. Cardiorespiratory effects of indoor ozone exposure during sleep and the influencing factors: A prospective study among adults in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 924:171561. [PMID: 38458472 DOI: 10.1016/j.scitotenv.2024.171561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/16/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
Ambient ozone (O3) is recognized as a significant air pollutant with implications for cardiorespiratory health, yet the effects of indoor O3 exposure have received less consideration. Furthermore, while sleep occupies one-third of life, research on the health consequences of O3 exposure during this crucial period is scarce. This study aimed to investigate associations of indoor O3 during sleep with cardiorespiratory function and potential predisposing factors. A prospective study among 81 adults was conducted in Beijing, China. Repeated measurements of cardiorespiratory indices reflecting lung function, airway inflammation, cardiac autonomic function, blood pressure, systemic inflammation, platelet and glucose were performed on each subject. Real-time concentrations of indoor O3 during sleep were monitored. Associations of O3 with cardiorespiratory indices were evaluated using linear mixed-effect model. Effect modification by baseline lifestyles (diet, physical activity, sleep-related factors) and psychological status (stress and depression) were investigated through interaction analysis. The average indoor O3 concentration during sleep was 20.3 μg/m3, which was well below current Chinese indoor air quality standard of 160 μg/m3. O3 was associated with most respiratory indicators of decreased airway function except airway inflammation; whereas the cardiovascular effects were only manifested in autonomic dysfunction and not in others. An interquartile range increases in O3 at 6-h average was associated with changes of -3.60 % (95 % CI: -6.19 %, -0.93 %) and -9.60 % (95 % CI: -14.53 %, -4.39 %) in FVC and FEF25-75, respectively. Further, stronger effects were noted among participants with specific dietary patterns, poorer sleep and higher level of depression. This study provides the first general population-based evidence that low-level exposure to indoor O3 during sleep has greater effects on the respiratory system than on the cardiovascular system. Our findings identify the respiratory system as an important target for indoor O3 exposure, and particularly highlight the need for greater awareness of indoor air quality, especially during sleep.
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Affiliation(s)
- Luyi Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Shan Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xuezhao Ji
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yetong Zhao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Masayuki Shima
- Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshiko Yoda
- Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo 663-8501, Japan
| | - Di Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Center for Environment and Health, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China.
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Niu J, Li B, Zhang Q, Chen G, Papadaki A. Exploring the traditional Chinese diet and its association with health status-a systematic review. Nutr Rev 2024:nuae013. [PMID: 38452296 DOI: 10.1093/nutrit/nuae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
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.
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Affiliation(s)
- Jizhao Niu
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Bai Li
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Qing Zhang
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Ge Chen
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- Bristol Dental School, University of Bristol, Bristol, UK
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
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Wang Y, Liu Q, Tian Z, Cheng B, Guo X, Wang H, Zhang B, Xu Y, Sun L, Hu B, Chen G, Sheng J, Liang C, Tao F, Wei J, Yang L. Short-term effects of ambient PM 1, PM 2.5, and PM 10 on internal metal/metalloid profiles in older adults: A distributed lag analysis in China. ENVIRONMENT INTERNATIONAL 2023; 182:108341. [PMID: 38006770 DOI: 10.1016/j.envint.2023.108341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/24/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
There is limited evidence linking exposure to ambient particulate matter (PM) with internal doses of metals and metalloids (metal(loid)s). This study aimed to evaluate the effects of short-term exposure to ambient PM on urine metal(loid)s among Chinese older adults. Biological monitoring data of 15 urine metal(loid)s collected in 3, 970 community-dwelling older adults in Fuyang city, Anhui Province, China, from July to September 2018, were utilized. PMs with an aerodynamic diameter ≤ 1 µm (PM1), ≤ 2.5 µm (PM2.5), and ≤ 10 µm (PM10) up to eight days before urine collection were estimated by space-time extremely randomized trees (STET) model. Residential greenness was reflected by Normalized Difference Vegetation Index (NDVI). We used generalized additive model (GAM) combined with distributed lag linear/non-linear models (DLMs/DLNMs) to estimate the associations between short-term PM exposure and urine metal(loid)s. The results suggested that the cumulative exposures to PM1, PM2.5, or PM10 over two days (lag0-1 days) before urine collection were associated with elevated urine metal(loid)s in DLMs, while exhibited linear or "inverted U-shaped" relationships with seven urine metal(loid)s in DLNMs, including Gallium (Ga), Arsenic (As), Aluminum (Al), Magnesium (Mg), Calcium (Ca), Uranium (U), and Barium (Ba). Aforementioned results indicated robust rather than spurious associations between PMs and these seven metal(loid)s. After standardizations for three PMs, PM1 was the greatest contributor to U, PM2.5 made the greatest contributions to Ga, As, Al, and Ba, and PM10 contributed the most to Mg and Ca. Furthermore, the effects of three PMs on urine Ga, As, Al, Mg, Ca, and Ba were reduced when exposed to higher levels of NDVI. Overall, short-term exposures to ambient PMs contribute to elevated urinary metal(loid) levels in older adults, and three PMs exhibit various contributions to different urine metal(loid)s. Moreover, residential greenness may attenuate the effects of PMs on urine metal(loid)s.
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Affiliation(s)
- Yuan Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Qiang Liu
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Ziwei Tian
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Beijing Cheng
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Xianwei Guo
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Hongli Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Bo Zhang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Yan Xu
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Liang Sun
- Fuyang Center for Diseases Prevention and Control, Fuyang, Anhui 236069, China
| | - Bing Hu
- Fuyang Center for Diseases Prevention and Control, Fuyang, Anhui 236069, China
| | - Guimei Chen
- School of Health Services Management, Anhui Medical University, Hefei, Anhui 230032, China
| | - Jie Sheng
- Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Chunmei Liang
- School of Public Health, Department of Hygiene Inspection and Quarantine, Anhui Medical University, Hefei, Anhui 230032, China
| | - Fangbiao Tao
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, Anhui, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD 20740, USA.
| | - Linsheng Yang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China.
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Zhang J, Du W, Huang F, Li L, Bai J, Wei Y, Wang Z, Zhang B, Wang H. Longitudinal study of dietary patterns and hypertension in adults: China Health and Nutrition Survey 1991-2018. Hypertens Res 2023; 46:2264-2271. [PMID: 37337099 PMCID: PMC10550817 DOI: 10.1038/s41440-023-01322-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 06/21/2023]
Abstract
China is undergoing the nutrition transition that may explain partly the high prevalence of hypertension. We aimed to investigate the longitudinal association between dietary patterns and hypertension in Chinese adults over 28 years of follow-up. We used data collected in the China Health and Nutrition Survey from 1991 to 2018. Adults aged 18 years and above (n = 15,929) were included in the analysis, for whom questionnaires and anthropometric data were collected during at least two waves. Factor analysis was conducted to derive food patterns based on 18 foods or food groups. We constructed three-level mixed-effect linear regression models to estimate systolic blood pressure (SBP) and diastolic blood pressure (DBP) in relation to quartiles of dietary pattern score and performed three-level mixed-effect logistic regression models to assess the risk of hypertension. Participants in the top quartile of the modern pattern had a decrease in SBP (β = - 0.51; 95% CI -0.86, -0.16; P < 0.01) when adjusted for all potential confounders, whereas participants in the top quartile of the meat pattern had an increase in DBP (β = 0.31; 95% CI 0.08, 0.53; P < 0.01). Participants in the highest quartile of the meat pattern were more likely to have hypertension (OR = 1.14; 95% CI 1.03, 1.24; P < 0.01). Adherence to the modern pattern characterized by high intake of fruits and dairy products was inversely associated with SBP, whereas the meat pattern was positively associated with DBP and the risk of hypertension. These findings may well have important public health implications.
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Affiliation(s)
- Jiguo Zhang
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Wenwen Du
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Feifei Huang
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Li Li
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Jing Bai
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Yanli Wei
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Zhihong Wang
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Bing Zhang
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Huijun Wang
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China.
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5
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Lu J, Yang T, Tang D, Zhang Y, Hu Y, Dai S, Gao X, Zhang X, Zhang G, Zhao X, Xiao X. Associations between major dietary patterns and blood pressure among Southwest Chinese: A cross-sectional analysis based on the China Multi-Ethnic Cohort (CMEC) study. Nutr Metab Cardiovasc Dis 2023; 33:987-997. [PMID: 36958972 DOI: 10.1016/j.numecd.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND AND AIMS In the less developed multi-ethnic regions (LEMRs) of Southwest China, the associations between dietary patterns and blood pressure (BP) values remain unclear. We aimed to investigate such associations and related effect modifiers. METHODS AND RESULTS This study included 81,433 participants from the China Multi-Ethnic Cohort Study. Dietary intakes during the year before the interview were measured with the Quantitative Food Frequency Questionnaire. Three major dietary patterns that were highly in line with geographical and ethnic distributions of the study population, i.e., "Sichuan Basin," "Yunnan-Guizhou Plateau," and "Qinghai-Tibet Plateau," were derived using principal component factor analysis. The multilinear regression model combined with inverse probability of exposure weighting was used to estimate the associations between dietary patterns and BP values. Comparing the highest with the lowest quintiles, the Sichuan Basin dietary pattern (characterized by urban lifestyles) was associated with 2.67 mmHg lower systolic blood pressure (SBP) (95% CI: -3.07 to -2.27) and 0.89 mmHg lower diastolic blood pressure (95% CI: -1.12 to -0.65). In contrast, both the Yunnan-Guizhou Plateau (characterized by agricultural lifestyles) and the Qinghai-Tibet Plateau dietary patterns (characterized by nomadic lifestyles) showed positive associations with BP. In the stratified analysis, the associations between dietary patterns and SBP were significantly stronger in women than in men for all three kinds of dietary patterns. CONCLUSION Both major dietary patterns and their associations with BP showed a substantial disparity in LEMRs of Southwest China. Dietary patterns in regions of higher socioeconomic status are more conducive to reducing the rising of BP, especially for women and urban residents, which might provide insights into the BP control in LEMRs of Southwest China.
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Affiliation(s)
- Jiaojiao Lu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Tingting Yang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Dan Tang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuan Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yifan Hu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Suyao Dai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Xuehui Zhang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Guiting Zhang
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiong Xiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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Zheng X, Li Z, Berg Sen J, Samarah L, Deacon CS, Bernardo J, Machin DR. Western diet augments metabolic and arterial dysfunction in a sex-specific manner in outbred, genetically diverse mice. Front Nutr 2023; 9:1090023. [PMID: 36687716 PMCID: PMC9853899 DOI: 10.3389/fnut.2022.1090023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/23/2022] [Indexed: 01/07/2023] Open
Abstract
Western diet (WD), characterized by excess saturated fat and sugar intake, is a major contributor to obesity and metabolic and arterial dysfunction in humans. However, these phenotypes are not consistently observed in traditional inbred, genetically identical mice. Therefore, we sought to determine the effects of WD on visceral adiposity and metabolic/arterial function in UM-HET3 mice, an outbred, genetically diverse strain of mice. Male and female UM-HET3 mice underwent normal chow (NC) or WD for 12 weeks. Body mass and visceral adiposity were higher in WD compared to NC (P < 0.05). Female WD mice had greater visceral adiposity than male WD mice (P < 0.05). The results of glucose and insulin tolerance tests demonstrated that metabolic function was lower in WD compared to NC mice (P < 0.05). Metabolic dysfunction in WD as was driven by male mice, as metabolic function in female WD mice was unchanged (P > 0.05). Systolic blood pressure (BP) and aortic stiffness were increased in WD after 2 weeks compared to baseline and continued to increase through week 12 (P < 0.05). Systolic BP and aortic stiffness were higher from weeks 2-12 in WD compared to NC (P < 0.05). Aortic collagen content was higher in WD compared to NC (P < 0.05). Carotid artery endothelium-dependent dilation was lower in WD compared to NC (P < 0.05). These data suggest sex-related differences in visceral adiposity and metabolic dysfunction in response to WD. Despite this, arterial dysfunction was similar in male and female WD mice, indicating this model may provide unique translational insight into similar sex-related observations in humans that consume WD.
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Chen M, Xu Y, Wang X, Shan S, Cheng G. Association between the prudent dietary pattern and blood pressure in Chinese adults is partially mediated by body composition. Front Nutr 2023; 10:1131126. [PMID: 37032775 PMCID: PMC10076787 DOI: 10.3389/fnut.2023.1131126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
High blood pressure or hypertension is one of the major risks of cardiovascular disease, which is the leading cause of death in China. This study aimed to assess the relationship between dietary patterns and blood pressure among Chinese adults. Using factor analysis of 66-item food frequency questionnaire to identify dietary patterns. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured according to standardized guidelines. Multivariate linear regressions were performed in 6849 Chinese adults (46.5% female) aged 21-70 years considering sociodemographic characteristics, lifestyle behaviors, and anthropometry data. The vegetable-rich pattern, animal-food pattern, and prudent dietary pattern were identified. After adjustment for potential confounders including age, gender, alcohol consumption, smoking status, energy intake, and physical activity, only prudent dietary pattern was negatively related to SBP (β = -2.30, p for trend =0.0003) and DBP (β = -1.44, p for trend =0.0006). Body mass index, waist circumstance and body fat percentage explained, respectively, 42.5%/47.8, 14.8%/17.6 and 26.0%/29.1% of the association between prudent pattern and SBP/DBP in mediation analysis. There were no association were observed between other dietary patterns and blood pressure. In conclusion, Prudent dietary pattern was associated with lower SBP and DBP among Southwest Chinese and this association was partially explained by body composition.
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Affiliation(s)
- Mengxue Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yujie Xu
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoyu Wang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shufang Shan
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guo Cheng
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Guo Cheng,
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Ou-Yang H, Fu HY, Luo Y, Xu ZY, Liu J, Gao R, Duan JY, Mao YC, Li HJ, Du YR. Inflammation markers and the risk of hypertension in people living with HIV. Front Immunol 2023; 14:1133640. [PMID: 37025998 PMCID: PMC10071023 DOI: 10.3389/fimmu.2023.1133640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/03/2023] [Indexed: 04/08/2023] Open
Abstract
Background The incidence of hypertension is high in people living with HIV (PLWH). High-sensitivity C-reactive protein (hsCRP), systemic inflammation response index (SIRI), and neutrophil-to-monocyte ratio (NMR) are considered economic and convenient parameters that reflect the levels of inflammation in patients. Our aim was to explore whether indirect inflammation markers are associated with hypertension in PLWH. Methods This was a case-control study. The case group (hypertension) comprised PLWH with hypertension, and the control group (non-hypertension) comprised sex- and age-(± 3 years)-matched PLWH without hypertension. Demographic parameters, hsCRP, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune- inflammation index (SII), SIRI, lymphocyte-to-monocyte ratio (LMR), platelet-to-neutrophil ratio (PNR), platelet-to-monocyte ratio (PMR), NMR, time to HIV diagnosis, antiretroviral therapy (ART) duration, recent CD4+ and CD8+ cell counts, recent CD4+/CD8+ ratio, recent HIV viral load (HIV-RNA),and recent ART regimen were obtained from the patients' electronic medical records. A t-test or Wilcoxon rank-sum test was performed to compare differences between the two groups, and conditional logistic regression was used to analyze the risk factors of hypertension. Correlations between inflammation markers and CD4+ cell counts, CD8+ cell counts, and CD4+/CD8+ ratio were analyzed using Spearman's correlation. Results In the hypertension group, body mass index (BMI), hsCRP, NLR, SII, SIRI, NMR, time to HIV diagnosis, ART duration, CD4+ and CD8+ cell counts, and CD4+/CD8+ ratio, the ratio of HIV-RNA < 100 copies/mL were all higher than those in the non-hypertension group, while the PNR was lower than that in the non-hypertension group. ART duration, CD4+ cell counts, HIV-RNA < 100 copies/mL, hsCRP, SIRI, and NMR were positively associated with hypertensive risk in PLWH. CD8+ cell counts and CD4+/CD8+ ratio was negatively associated with hypertensive risk in PLWH. SIRI was negatively correlated with CD4+ cell counts and CD8+ cell counts, but positively correlated with CD4+/CD8+ ratio. Conclusions We identified positive associations between inflammation markers hsCRP, SIRI, NMR and hypertensive risk in PLWH. Alleviating inflammation may help control or delay the occurrence of hypertension in PLWH.
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Affiliation(s)
- Hui Ou-Yang
- Department of Cardiovascular Medicine, The Third People’s Hospital of Kunming, Yunnan Clinical Medicine Center for Infectious Diseases, Kunming, China
| | - Hai-Yan Fu
- Department of Hospice Care, The Third People’s Hospital of Kunming, Yunnan Clinical Medicine Center for Infectious Diseases, Kunming, China
| | - Yu Luo
- Department of Hospice Care, The Third People’s Hospital of Kunming, Yunnan Clinical Medicine Center for Infectious Diseases, Kunming, China
| | - Zhao-Yuan Xu
- Department of Cardiovascular Medicine, The Third People’s Hospital of Kunming, Yunnan Clinical Medicine Center for Infectious Diseases, Kunming, China
| | - Jun Liu
- Department of Infectious Diseases, The Third People’s Hospital of Kunming, Yunnan Clinical Medicine Center for Infectious Diseases, Kunming, China
| | - Rui Gao
- Department of Infectious Diseases, The Third People’s Hospital of Kunming, Yunnan Clinical Medicine Center for Infectious Diseases, Kunming, China
| | - Jin-Yu Duan
- Department of Infectious Diseases, The Third People’s Hospital of Kunming, Yunnan Clinical Medicine Center for Infectious Diseases, Kunming, China
| | - Ya-Chao Mao
- Department of Cardiovascular Medicine, The Third People’s Hospital of Kunming, Yunnan Clinical Medicine Center for Infectious Diseases, Kunming, China
| | - Hong-Juan Li
- Department of Hospice Care, The Third People’s Hospital of Kunming, Yunnan Clinical Medicine Center for Infectious Diseases, Kunming, China
- *Correspondence: Ying-Rong Du, ; Hong-Juan Li,
| | - Ying-Rong Du
- Department of Cardiovascular Medicine, The Third People’s Hospital of Kunming, Yunnan Clinical Medicine Center for Infectious Diseases, Kunming, China
- *Correspondence: Ying-Rong Du, ; Hong-Juan Li,
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Kumma WP, Loha E. Dietary patterns and their association with cardiovascular risk factors in Ethiopia: A community-based cross-sectional study. Front Nutr 2023; 10:1074296. [PMID: 37032774 PMCID: PMC10076605 DOI: 10.3389/fnut.2023.1074296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
Purpose To identify the dietary patterns and their association with cardiovascular risk factors among adult people in urban and rural areas of Wolaita, southern Ethiopia. Methods A total of 2,483 participants aged 25-64 years were selected using a three-stage random sampling. Data for this study were collected using structured questionnaires, the previous 24-h dietary intake assessment, anthropometric, blood pressure, and biochemical measurements. We used factor analysis to identify dietary patterns. Factors associated with dietary patterns were analyzed using multiple linear regression models. The adjusted regression coefficients with their 95% CI were used to ascertain the association. Result We identified three major dietary patterns that explained 51% of the variance in food consumption. The western dietary pattern was characterized by the consumption of meat/organ meat, biscuits/sweets, chicken stew, pasta-macaroni recipes, butter, white wheat bread, egg recipe, and Ethiopian dish shiro-wet, and was positively associated with urban residence, obesity, hypertension, blood glucose, and total cholesterol levels. Adherence to the consumption of tubers, whole-grain maize products, coffee leaves-and-herbs beverage, legumes, and sweet potatoes featured the traditional dietary pattern. The traditional dietary pattern showed a positive relationship with rural residence, physical activity, and obesity, and it had a negative relationship with hypertension. The healthy dietary pattern was characterized by the intake of green leafy vegetables, green pepper, and whole-grain maize products, and negatively related to obesity, and hypertension, while positively related to urban residence. Conclusion The coexistence of western, traditional, and healthy dietary patterns in the present study indicates the transition to a new dietary pattern in the study area. All dietary patterns were associated with one or more cardiovascular risk factors, but the western dietary pattern was associated with most of these, while the traditional diet showed fewer such associations. Therefore, it might be useful to promote healthy and traditional dietary patterns along with physical activity. Interventions related to the current findings, if initiated early in life, may benefit the public in preventing cardiovascular risk factors such as obesity, hypertension, and type 2-diabetes.
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Affiliation(s)
- Wondimagegn Paulos Kumma
- School of Public Health, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- *Correspondence: Wondimagegn Paulos Kumma,
| | - Eskindir Loha
- School of Public Health, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
- Chr. Michelsen Institute, Bergen, Norway
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Yang Y, Yu D, Piao W, Huang K, Zhao L. Nutrient-Derived Beneficial for Blood Pressure Dietary Pattern Associated with Hypertension Prevention and Control: Based on China Nutrition and Health Surveillance 2015–2017. Nutrients 2022; 14:nu14153108. [PMID: 35956285 PMCID: PMC9370233 DOI: 10.3390/nu14153108] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Greater adherence of Dietary Approach to Stop Hypertension (DASH) or the Mediterranean dietary pattern were reported to be beneficial for blood pressure. However, both were established based on Western populations. Our current study aimed to explore a dietary pattern which might be suitable for hypertension prevention and control among Chinese adults nationwide. Methods: A total of 61,747 Chinese adults aged over 18 years from China Nutrition and Health Surveillance 2015–2017 was included in this study. Using reduced-rank regression (RRR) method, a dietary pattern with higher intakes of those nutrients which are inversely associated with the risk of hypertension was identified. DASH-score was also calculated for each participant for further validate the dietary pattern derived by RRR method. Multi-adjustment logistic regression was applied to examine the association between above two dietary patterns and hypertension prevention and control. Results: Dietary pattern named Beneficial for Blood Pressure (BBP) diet was characterized by higher fresh vegetables and fruits, mushrooms/edible fungi, dairy products, seaweeds, fresh eggs, nuts and seeds, legumes and related products, aquatic products, coarse cereals, and less refined grains and alcohol consumption. After multiple adjustment, protective effects showed on both hypertension prevention and control (for prevention: Q5 vs. Q1, OR = 0.842, 95% CI = 0.791–0.896; for control: Q5 vs. Q1, OR = 0.762, 95% CI = 0.629–0.924). For the DASH-diet, significant results were also observed (for prevention: Q5 vs. Q1, OR = 0.912, 95% CI = 0.854–0.973; for control: Q5 vs. Q1, OR = 0.76, 95% CI = 0.616–0.938). Conclusions: BBP-diet derived from Chinese adults has high conformity with the DASH-diet, and it might serve as an adjuvant method for both hypertension prevention and control.
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Wang C, Zheng Y, Zhang Y, Liu D, Guo L, Wang B, Zuo H. Dietary Patterns in Association With Hypertension: A Community-Based Study in Eastern China. Front Nutr 2022; 9:926390. [PMID: 35873413 PMCID: PMC9305172 DOI: 10.3389/fnut.2022.926390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThis study aimed to explore the association between dietary patterns and hypertension based on a community–based survey in Suzhou, Eastern China.MethodsThis cross–sectional analysis was undertaken from the subset of the Suzhou Food Consumption and Health State Survey in 2018–2019. Adults aged ≥ 18 years were invited to participate in this survey. Dietary intake was collected by a 24–h dietary recall and a weighing method over three consecutive days (including two weekdays and one weekend day). Dietary patterns were defined using factor analysis. Association between the dietary patterns and hypertension was examined by multivariable logistic regression models with adjustment for covariates. Moreover, sensitivity analysis was used to reinforce our findings.ResultsA total of 2,718 participants were included in the final analysis. Rice-vegetable pattern, fast food pattern, fruit-dairy pattern, and wheat-meat pattern were identified. We observed that the fruit-dairy pattern was inversely associated with hypertension after adjustment for all the covariates (OR = 0.55; 95% CI: 0.40, 0.75; P = 0.002). The association between the wheat-meat pattern and hypertension was attenuated and became statistically nonsignificant in sensitivity analyses. The other two patterns were not significantly associated with hypertension (P > 0.05).ConclusionThe fruit-dairy pattern was inversely associated with the risk of hypertension among Chinese adults. Our findings further emphasize the important role of optimal diet combination in the prevention of hypertension.
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Affiliation(s)
- Cuicui Wang
- School of Public Health, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yanmin Zheng
- Department of Nutrition and Food Hygiene, Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Ya Zhang
- School of Public Health, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Dong Liu
- School of Public Health, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Li Guo
- Department of Disease Prevention and Health Care, Soochow University Hospital, Soochow University, Suzhou, China
| | - Bo Wang
- Department of Nutrition and Food Hygiene, Suzhou Center for Disease Control and Prevention, Suzhou, China
- *Correspondence: Bo Wang
| | - Hui Zuo
- School of Public Health, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
- Hui Zuo
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Guo H, Chen N, Yang Y, Zhou X, Li X, Jiang Y, Huang J, Du Q. Ethnic Disparity in the Incidence of Scoliosis Among Adolescents in Tianzhu Tibetan Autonomous County, China. Front Public Health 2022; 10:791550. [PMID: 35570980 PMCID: PMC9092046 DOI: 10.3389/fpubh.2022.791550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives To determine the influence of ethnic disparities, socioeconomic status (SES) and hukou on the incidence of scoliosis. Methods We enrolled 2,445 junior high school students (Han: 1,153; ethnic minorities: 1,292) aged 12–16 years from two schools in Tianzhu Tibetan Autonomous County, Gansu Province from November 2020 to February 2021. We measured the angle of trunk rotation (ATR) using a scoliometer. Two-factor analysis of variance was used to comparatively analyze differences in the ATR according to ethnicity, age, sex, body mass index (BMI), and SES between the groups. Associations between risk factors and scoliosis were estimated using odds ratios and 95% confidence intervals with an unconditional multivariate logistic regression model for the two groups. Results Adolescents with Han ethnicity were more likely to have scoliosis than their ethnic minority counterparts (10.8% vs. 7.1%, P < 0.05). The ATR value in the Han group decreased with age whereas the minority group showed an upward trend (P < 0.05). The difference between ethnic groups was not significant, only at level 3. In particular, the ATR values among Han girls were significantly higher than those of ethnic minority girls (P < 0.05). Compared with Han adolescents, the BMI of ethnic minorities had a greater impact on the ATR. A statistically significant difference in SES was found between the two ethnic groups (P < 0.05). Hukou and parents' occupation had an important influence on the onset of scoliosis. Conclusions Han adolescents had higher ATR values and were more likely to have scoliosis than ethnic minority adolescents in our study. Growth and development indicators (height and BMI) and differences in SES between the two groups played an important role.
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Affiliation(s)
- Haibin Guo
- Department of Rehabilitation Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nan Chen
- Department of Rehabilitation Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuqi Yang
- College of Global Public Health, New York University, New York, NY, United States
| | - Xuan Zhou
- Department of Rehabilitation Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Li
- Department of Rehabilitation Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Jiang
- Department of Rehabilitation Medicine, Third People's Hospital of Gansu Province, Lanzhou, China
| | - Jiaoling Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Du
- Department of Rehabilitation Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wang X, Zhao F, Zhao Q, Wang K, Kong S, Ma P, Huang B, Du C. Specific Types of Physical Exercises, Dietary Preferences, and Obesity Patterns With the Incidence of Hypertension: A 26-years Cohort Study. Int J Public Health 2022; 66:1604441. [PMID: 35153648 PMCID: PMC8830503 DOI: 10.3389/ijph.2021.1604441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To examine the associations of specific types of physical exercises, dietary preferences, and obesity patterns with incident hypertension.Methods: In this cohort study, obesity patterns were defined using general and abdominal obesity as G-/A-, G+/A- or G-/A+, and G+/A+. The type of physical exercises and dietary preferences were collected using a validated questionnaire. Participants with systemic blood pressure/diastolic blood pressure ≥140 mmHg/90 mmHg, use of antihypertensive medications, or a self-reported diagnosis were identified as hypertension.Results: There were 10,713 participants in this study. Martial arts, gymnastics, and ping pong could decrease the risk of hypertension (HR: 0.792, 0.884, and 0.855; and 95% CI: 0.743–0.845, 0.825–0.948, and 0.767–0.953, respectively). However, TV or computer usage, and consumption of fast food, soft/sugared drinks, and salty snack food could increase incident hypertension (HR: 1.418, 1.381, 1.233, and 1.225; and 95% CI: 1.315–1.529, 1.269–1.504, 1.157–1.314, and 1.139–1.316, respectively). Obese subjects had an increased risk of hypertension.Conclusion: The type of physical exercises, dietary preferences, and obesity patterns were associated with incident hypertension. More attention should be paid to these lifestyles to benefit health outcomes.
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Liu T, Yang X, Wu Y, Chen M, Yang Y, Chen Y, Wang Y, Zhou J, Xu K, Wang N, Fu C. Unhealthy Dietary Patterns Increased Risks of Incident Obesity: A Prospective Cohort Study in Southwest China. Diabetes Metab Syndr Obes 2022; 15:3111-3120. [PMID: 36237967 PMCID: PMC9553234 DOI: 10.2147/dmso.s377901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Few studies have explored the associations between diet patterns and incident obesity in China. This study aimed to explore associations between dietary patterns and incident obesity in a prospective community-population cohort in Southwest China. PATIENTS AND METHODS Totally, 5742 adult residents from Guizhou province were eligible for this analysis. Demographic characteristics, lifestyle, history of chronic diseases, and dietary patterns measured by hundred-item food frequency questionnaires (FFQs) were collected at the baseline study. Four dietary patterns were identified using factor analysis. Cox proportional hazard models stratified by physical activity were used to explore the association and estimate adjusted hazard ratio (aHR) and 95% confidence interval (CI). RESULTS Among 5742 subjects, the average age was 45.06 ± 15.21 years old and more than half were women. During the follow-up of 40,524.15 person years (PYs), the overall incidence rate of obesity was 10.54/1000PYs. After the adjustment for possible confounding factors, subjects with the third (aHR: 1.51, 95% CI: 1.14-2.00) and the fourth quartile (aHR: 1.46, 95% CI: 1.10-1.94) of junk food patterns had statistically increased risk of incident obesity compared to those with the first quartile. Also, subjects with the third quartile of the western pattern had significantly higher risk of incident obesity (aHR: 1.33, 95% CI: 1.01-1.75) than those with the first quartile. CONCLUSION There was a high risk in incident obesity among Chinese community population of Southwest China and unhealthy diet significantly increased risk of developing obesity. The findings indicated that effective and targeted measures to improve dietary patterns need to be undertaken urgently in Southwest China.
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Affiliation(s)
- Tao Liu
- Guizhou Center for Disease Control and Prevention, Guiyang, 550004, People’s Republic of China
| | - Xiulu Yang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Yanli Wu
- Guizhou Center for Disease Control and Prevention, Guiyang, 550004, People’s Republic of China
| | - Min Chen
- Guizhou Center for Disease Control and Prevention, Guiyang, 550004, People’s Republic of China
| | - Yu Yang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Yun Chen
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Yiying Wang
- Guizhou Center for Disease Control and Prevention, Guiyang, 550004, People’s Republic of China
| | - Jie Zhou
- Guizhou Center for Disease Control and Prevention, Guiyang, 550004, People’s Republic of China
| | - Kelin Xu
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Na Wang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Chaowei Fu
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, People’s Republic of China
- Correspondence: Chaowei Fu, School of Public Health; Key Laboratory of Public Health Safety; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, People’s Republic of China, Tel/Fax +86 21 33563933, Email
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Zhang Y, Wang Y, Chen Y, Zhou J, Xu L, Xu K, Wang N, Fu C, Liu T. Associations of Dietary Patterns and Risk of Hypertension in Southwest China: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312378. [PMID: 34886102 PMCID: PMC8656527 DOI: 10.3390/ijerph182312378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 12/17/2022]
Abstract
Empirical data on the association between diet and incident hypertension in Southwest China is lacking. We examined the associations between various dietary patterns and the risk of incident hypertension in this prospective population cohort of Southwest China. A total of 5442 eligible adults were included from Guizhou Province, China, since 2010. Dietary information was obtained using face-to-face interviews with a semi-quantitative food frequency questionnaire, and dietary patterns were characterized using factor analysis. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated for the associations between various dietary patterns and incident hypertension risk using a Cox proportional hazard model. Until 2020, a total of 1177 new hypertension cases were identified during an average follow-up of 6.97 years. In the multivariable-adjusted analysis, a low intake of the junk food pattern was significantly associated with the reducing risk of incident hypertension (HR: 0.772, 95% CI: 0.671, 0.887) and a high intake of the vegetable-grain pattern statistically lowered the risk of incident hypertension (HR: 0.774, 95% CI: 0.669, 0.894) compared with the medium intake of such patterns. Higher adherence to the vegetable-grain pattern and lower adherence to the junk food pattern significantly lowered the hypertension incidence among the population in Southwest China. Those findings suggested healthy diet guidelines should be developed for the prevention of hypertension.
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Affiliation(s)
- Yixia Zhang
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (Y.Z.); (J.Z.); (L.X.)
| | - Yanhuan Wang
- School of Public Health & Key Laboratory of Public Health Safety & NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China; (Y.W.); (Y.C.); (K.X.); (N.W.)
| | - Yun Chen
- School of Public Health & Key Laboratory of Public Health Safety & NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China; (Y.W.); (Y.C.); (K.X.); (N.W.)
| | - Jie Zhou
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (Y.Z.); (J.Z.); (L.X.)
| | - Lina Xu
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (Y.Z.); (J.Z.); (L.X.)
| | - Kelin Xu
- School of Public Health & Key Laboratory of Public Health Safety & NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China; (Y.W.); (Y.C.); (K.X.); (N.W.)
| | - Na Wang
- School of Public Health & Key Laboratory of Public Health Safety & NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China; (Y.W.); (Y.C.); (K.X.); (N.W.)
| | - Chaowei Fu
- School of Public Health & Key Laboratory of Public Health Safety & NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China; (Y.W.); (Y.C.); (K.X.); (N.W.)
- Correspondence: (C.F.); (T.L.)
| | - Tao Liu
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (Y.Z.); (J.Z.); (L.X.)
- Correspondence: (C.F.); (T.L.)
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The relationship between dietary patterns and grip strength in the general population: the TCLSIH cohort study. Eur J Nutr 2020; 60:2409-2421. [PMID: 33130949 DOI: 10.1007/s00394-020-02385-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 09/10/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Previous studies have shown that many nutrients play an essential role in maintaining skeletal muscle strength. Hand grip strength (HGS) is frequently used as an objective and reliable method to evaluate overall body muscle strength and physical function. Some studies have demonstrated that some specific single nutrients such as PUFA, fiber, vitamin C, fruits and vegetables are associated with muscle strength. However, few studies have explored the relationship between dietary patterns and HGS in the adult population. The aim of this study was to investigate how dietary patterns are related to HGS in a large-scale Chinese population. METHODS A cross-sectional study (n = 35,175) was performed in Tianjin, China. Adherence to dietary patterns was measured by a valid self-administered food frequency questionnaire with 81 food items. Principal-components analysis was used to derive three major dietary patterns: "sweet", "healthy" and "animal food". HGS was measured using a handheld digital dynamometer. Analysis of covariance and multiple logistic regression were employed to explore the relationship between dietary patterns and HGS. RESULTS After adjustment for potential confounders, the means (95% confidence interval) of HGS for increasing quartile of dietary patterns were as follows: "sweet", 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.48-0.51) (P value = 0.07); "healthy" 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.49-0.51) (P value < 0.0001); "animal food" 0.51(0.50-0.52), 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.49 (0.48-0.51) (P value < 0.0001), respectively. CONCLUSIONS The present study demonstrated a slight improvement between healthy dietary pattern and HGS across the quartiles. On the contrary, this study also showed higher adherence to the animal food dietary pattern (i.e., higher quartile) had lower grip strength. A long-term prospective study or randomized trials are required to clarify this association.
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Khamis AG, Senkoro M, Mwanri AW, Kreppel K, Mfinanga SG, Bonfoh B, Kwesigabo G. Prevalence and determinants of hypertension among pastoralists in Monduli District, Arusha region in Tanzania: a cross-sectional study. ACTA ACUST UNITED AC 2020; 78:99. [PMID: 33072318 PMCID: PMC7556965 DOI: 10.1186/s13690-020-00485-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/06/2020] [Indexed: 01/13/2023]
Abstract
Background Hypertension is among the growing non-communicable diseases (NCDs) in developing countries and the leading cause of death worldwide. Pastoral areas have been identified to be at a higher risk of diseases due to challenges in their daily food production, livelihoods or mobility. Unfortunately, the prevalence of hypertension and the risk factors particularly affecting rural and pastoral populations are not fully understood, making intervention efforts challenging. The aim of this study was to determine the prevalence of hypertension and identify the risk factors among adults living in Monduli district in Tanzania. The findings will be useful for the provision of tailored interventions focused on community-specific nutritional and behavioral practices. Methods We conducted a community based cross-sectional study involving a sample of 510 adults aged above 18 years selected using a multistage cluster sampling in the Monduli district of Arusha region, Tanzania. Data were collected by using interviewer-administered questionnaires containing socio-demographic, physical activity, smoking and alcohol consumption. Anthropometry, systolic (SBP) and diastolic blood pressure (DBP) levels were measured. A one-day 24 h diet recall was conducted to evaluate the dietary habits of all participants. Both linear and logistic regression analysis were used to identify the independent predictors for hypertension and blood pressure levels. Results The prevalence of hypertension in this study was 25.7% (n = 131, 95% CI; 22.1–29.7). The odds of hypertension increased with being male (AOR = 1.75, 95%CI, 1.06–2.88), belonging to the older age group of 30–39 year olds (AOR = 3.3, 95%CI, 1.76–6.38), 40–59 year olds (AOR = 3.34, 95%CI, 1.75–6.37) and ≥ 60 year olds (AOR = 4.2, 95%CI, 2.02–8.87), being overweight or obese (AOR = 3.37, 95%CI, 1.18–9.62), have more hours spent sedentary (AOR = 3.19, 95%CI, 1.61–6.32), and consumption of fatty foods (AOR = 2.23, 95%CI, 1.27–3.93). The odds for hypertension was significantly reduced among participants who reported higher income (AOR = 0.47, 95% CI, 0.25–0.91), high level of physical activity (AOR = 0.55, 95%CI, 0.31–0.96) and those reported to consume fruit (AOR = 0.37, 95% CI, 0.18–0.77). Consumption of cereals was negatively associated with levels of SBP (β = − 17.4, 95% CI, − 23.8; − 11.0) and DBP (β = − 6.6, 95% CI, − 11.5,-1.79). Conclusion About one in every four adults living in pastoral communities have been found to have hypertension in this study. Our findings suggest that older age, obesity or overweight, low physical activity, low income, and consumption of fatty foods increase the risk of hypertension among study population. Their diet was dominated by cereals with moderate intake of meat and milk and low fruits. There is a need to promote physical activities and consumption of fruits in the study population in order to fight against hypertension. Further research should be done to confirm the associations.
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Affiliation(s)
- Ahmed Gharib Khamis
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Mbazi Senkoro
- National Institute for Medical Research, Muhimbili Research Centre, Dar-es-Salaam, Tanzania
| | - Akwilina Wendelin Mwanri
- Department of Food Technology, Nutrition and Consumer Sciences, Sokoine University of Agriculture, Morogoro, Chuo Kikuu Tanzania
| | - Katharina Kreppel
- School of Life Sciences and Bio-Engineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania.,Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Dar-es-salaam, Tanzania
| | | | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Gideon Kwesigabo
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
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Yang Y, He D, Wei L, Wang S, Chen L, Luo M, Mao Z. Association between diet-related knowledge, attitudes, behaviors, and self-rated health in Chinese adult residents: a population-based study. BMC Public Health 2020; 20:720. [PMID: 32429957 PMCID: PMC7236185 DOI: 10.1186/s12889-020-08896-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/11/2020] [Indexed: 02/07/2023] Open
Abstract
Background Diet-related knowledge, attitudes, and behaviors (KABs) are important for building healthier dietary patterns. We conducted this study to (a) investigate diet conditions of Chinese adult residents from the perspective of knowledge, attitudes, and behaviors, and (b) assess the association between diet-related KABs and self-rated health. Methods We analyzed the 2015 China Health and Nutrition Survey (CHNS) data. Individuals aged 18 years and older were included as study subjects (n = 12,814), assessing their diet-related knowledge, attitudes, behaviors, and self-rated health. Comparison of diet-related KABs in urban and rural residents was conducted using chi-square test. Ordinal logistic regression analysis was adopted to examine the association between diet-related KABs and self-rated health. Results The proportion of knowing about the Chinese Food Pagoda (CFP) or the Dietary Guidelines for Chinese Residents (DGCR) was 27.1%. 34.3% of the participants were assessed as having adequate dietary knowledge literacy. 24.3% reported a positive attitude towards healthy eating. 27.6 and 65.9% of the participants reported proactively looking for nutrition knowledge and preferring eating fruits & vegetables, respectively. Chi-square test indicated that rural people experienced poorer diet-related knowledge, attitudes, and behaviors than urban residents (all p-values < 0.01). Regression analysis revealed that participants who knew about CFP/DGCR (OR = 1.11, 95% CI = 1.08–1.15), had adequate dietary knowledge literacy (OR = 1.12, 95% CI = 1.10–1.15), held positive attitude towards healthy eating (OR = 1.14, 95% CI = 1.09–1.19), proactively looked for nutrition knowledge (OR = 1.11, 95% CI = 1.08–1.15), and preferred eating fruits & vegetables (OR = 1.09, 95% CI = 1.07–1.12) had significantly better self-rated health. Conclusions Chinese adult residents experienced poor diet-related knowledge, attitudes, and behaviors. Rural people had significantly worse diet conditions than urban residents. Better diet-related knowledge, attitudes, and behaviors were associated with higher self-rated health in Chinese adult residents.
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Affiliation(s)
- Ying Yang
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.,Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Di He
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1095# Jiefang Avenue, Wuhan, 430030, China
| | - Liuyi Wei
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Shizhen Wang
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Lei Chen
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Mi Luo
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Zongfu Mao
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China. .,Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
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Wlosinska M, Nilsson AC, Hlebowicz J, Hauggaard A, Kjellin M, Fakhro M, Lindstedt S. The effect of aged garlic extract on the atherosclerotic process - a randomized double-blind placebo-controlled trial. BMC Complement Med Ther 2020; 20:132. [PMID: 32349742 PMCID: PMC7191741 DOI: 10.1186/s12906-020-02932-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 04/22/2020] [Indexed: 02/08/2023] Open
Abstract
Background One of the most serious secondary manifestations of Cardiovascular Disease (CVD) is coronary atherosclerosis. This study aimed to evaluate whether aged garlic extract (AGE) can influence coronary artery calcification (CAC) and to predict the individual effect of AGE using a standard process for data mining (CRISP–DM). Method This was a single-center parallel randomized controlled study in a university hospital in Europe. Patients were randomized, in a double-blind manner, through a computer-generated randomization chart. Patients with a Framingham risk score ≥ 10 after CT scan (n = 104) were randomized to an intake of placebo or AGE (2400 mg daily) for 1 year. Main outcome measures were changes in CAC score and secondary outcome measures changes in blood pressure, fasting blood glucose, blood lipids and inflammatory biomarkers. Result 104 patients were randomized and 46 in the active group and 47 in the placebo group were analyzed. There was a significant (p < 0.05) change in CAC progression (OR: 2.95 [1.05–8.27]), blood glucose (OR: 3.1 [1.09–8.85]) and IL-6 (OR 2.56 [1.00–6.53]) in favor of the active group. There was also a significant (p = 0.027) decrease in systolic blood pressure in the AGE group, from a mean of 148 (SD: 19) mmHg at 0 months, to 140 (SD: 15) mmHg after 12 months. The AGE Algorithm, at a selected probability cut-off value of 0.5, the accuracy score for CAC progression was 80%, precision score of 79% and recall score 83%. The score for blood pressure was 74% (accuracy, precision and recall). There were no side-effects in either group. Conclusions AGE inhibits CAC progression, lowers IL–6, glucose levels and blood pressure in patients at increased risk of cardiovascular events in a European cohort. An algorithm was made and was used to predict with 80% precision which patient will have a significantly reduced CAC progression using AGE. The algorithm could also predict with a 74% precision which patient will have a significant blood pressure lowering effect pressure using AGE. Trial registration Clinical trials NCT03860350, retrospectively registered (1/32019).
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Affiliation(s)
- Martiné Wlosinska
- Department of Cardiothoracic Surgery and Transplantation, Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden
| | - Ann-Christin Nilsson
- Department of Cardiothoracic Surgery and Transplantation, Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden
| | - Joanna Hlebowicz
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Anders Hauggaard
- Department of Radiology, Cardiac Imaging, Skåne Hospital Northwest, Helsingborg, Sweden
| | - Maria Kjellin
- Department of Radiology, Cardiac Imaging, Skåne Hospital Northwest, Helsingborg, Sweden
| | - Mohammed Fakhro
- Department of Cardiothoracic Surgery and Transplantation, Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden
| | - Sandra Lindstedt
- Department of Cardiothoracic Surgery and Transplantation, Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden.
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Metabolic syndrome and its relation to dietary patterns among a selected urbanised and semi-urbanised Tibetan population in transition from nomadic to settled living environment. Public Health Nutr 2020; 24:984-992. [PMID: 32312349 DOI: 10.1017/s1368980019004798] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore the scope of metabolic syndrome (MetS) and its relationship to the major dietary patterns among an urbanised and semi-urbanised Tibetan population in transition from nomadic to settled settings. DESIGN Cross-sectional. SETTING Community-based. PARTICIPANTS Urbanised and semi-urbanised Tibetan adults (n 920, aged 18-90 years), who have moved from nomadic to settled living environments, answered questionnaires on food consumption frequency and lifestyle characteristics through structured face-to-face interviews and completed anthropometric measurement and metabolic biomarker tests. RESULTS MetS prevalence was 30·1 % in males and 32·1 % in females. Low HDL-cholesterol and central obesity were the leading metabolic abnormalities (86·3 and 55·8 %, respectively). Three major dietary patterns - urban, western and pastoral - were identified. Beef/mutton was an important food group for all three identified dietary patterns. In addition, the urban dietary pattern was characterised by frequent consumption of vegetables, tubers/roots and refined carbohydrates; the western pattern was characterised by sweetened drinks, snacks and desserts; and the pastoral pattern featured tsamba (roasted Tibetan barley), Tibetan cheese, butter tea/milk tea and whole-fat dairy foods. Individuals in the highest quintile of urban dietary pattern scores were found to be at a higher risk of developing MetS (OR 2·43, 95 % CI 1·41, 4·18) and central obesity (OR 1·91, 95 % CI 1·16, 3·14) after controlling for potential confounders. CONCLUSIONS MetS was common among urbanised and semi-urbanised Tibetan adult population in transition. The urban dietary pattern, in particular, was a risk factor for MetS. To prevent MetS, nutrition interventions need to be tailored to address the variety of local diet patterns to promote healthy eating.
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Li L, Huang AP, Wang LQ, Yu XL. Empirically derived dietary patterns and constipation among a middle-aged population from China, 2016-2018. Nutr J 2019; 18:88. [PMID: 31878924 PMCID: PMC6933695 DOI: 10.1186/s12937-019-0512-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023] Open
Abstract
Background The association of dietary patterns with constipation is not well established, particularly in Chinese population. Therefore, the present study aimed to determine the relationship between dietary patterns and the risk of constipation in a middle-aged Chinese population. Methods A total of 2267 participants aged 45–59 years were recruited in Hangzhou city, the capital of Zhejiang Province, east China from August 2016 to October 2018. Dietary intake was estimated using a semi-quantitative food frequency questionnaire (FFQ) containing 138 food items. Constipation was defined using the Rome II criteria. Multivariate logistic regression was used to examine the association between dietary patterns and the risk of constipation. Results Three major dietary patterns were extracted by factor analysis and labeled as the traditional southern Chinese, Western and grains-vegetables patterns. The prevalence of constipation in our study population was 13.28%. Compared with the participants in the lowest quartile, the participants in the highest quartile of the traditional southern Chinese pattern were associated with reduced odds of constipation (odd ratios (OR) = 0.79; 95%confidence interval (CI): 0.626–0.981; P < 0.05), after adjusting for confounding variables. In contrast, we found no significant associations between the Western and grains-vegetables patterns and the risk of constipation (P > 0.05). Conclusions Our study demonstrated that the traditional southern Chinese pattern was associated with a reduced risk of constipation. Further longitudinal studies are needed to confirm our findings.
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Affiliation(s)
- Li Li
- Graduate Office, The First Hospital of Lanzhou University, Chengguan district, Lanzhou, 730000, Gansu, China
| | - Ai-Ping Huang
- Department of Blood donation service, Blood Center of Zhejiang Province, Xiacheng district, Hangzhou, 310006, Zhejiang, China
| | - Li-Qin Wang
- Department of Rheumatology, Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Chengguan district, Lanzhou, 730000, Gansu, China
| | - Xiao-Long Yu
- Department of Nutrition, Zhejiang Hospital, Xihu district, Hangzhou, 310013, Zhejiang, China.
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Abizari AR, Ali Z. Dietary patterns and associated factors of schooling Ghanaian adolescents. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2019; 38:5. [PMID: 30728067 PMCID: PMC6364425 DOI: 10.1186/s41043-019-0162-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/22/2019] [Indexed: 06/03/2023]
Abstract
BACKGROUND Assessment of single nutrients or foods does not normally reflect the diet of population groups. Dietary pattern analyses are useful in understanding the overall diet and its relationship with disease conditions. The objective of the present study was to determine the dietary patterns and associated factors among schooling adolescents in Northern Ghana. METHODS A cross-sectional study involving 366 pupils in 10 junior high schools in the Tamale metropolis was conducted. A Food Frequency Questionnaire (FFQ) which consisted of 60 commonly consumed foods was used to assess pupils' 7-day intake. Foods grouped (14) from FFQ data based on shared nutritional value were used to identify dietary patterns using principal component analysis (PCA). Bivariate and multivariate logistic regression analyses were used to determine the association between identified patterns and sociodemographic, anthropometric status, and household characteristics of pupils. RESULTS Half of the pupils were female (50.3%) and average age was 15.6 ± 2.0 years. PCA identified two dietary patterns which in total explained 49.7% of the variability of the diet of pupils. The patterns were sweet tooth pattern (STP) with high factor loadings for sugar sweetened snacks, energy and soft drinks, sweets, tea and coffee, and milk and milk products, and a traditional pattern (TP) which showed high factor loadings for cereals and grains, local beverages, nuts, seeds and legumes, vegetables, and fish and seafood. Logistic regression showed that pupils who lived with their parents [AOR = 1.95; 95% CI (1.1-3.4); p = 0.019], those who went to school with pocket money [AOR = 4.73; 95% CI (1.5-15.0); p = 0.008], and those who lived in the wealthiest homes [AOR = 3.4; 95% CI (1.6-7.5); p = 0.002)] had higher odds of following the STP. The TP was associated with high dietary diversity (p = 0.035) and household wealth [AOR = 3.518; 95% CI (1.763-7.017); p < 0.001)]. None of the patterns was associated with anthropometric status of pupils. CONCLUSION Adolescents in the present study followed a sweet tooth or a traditional diet pattern which associated more with household- and individual-level factors but not anthropometric status.
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Affiliation(s)
- Abdul-Razak Abizari
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box 1883, Tamale, Ghana
| | - Zakari Ali
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box 1883, Tamale, Ghana
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