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Chang SH, Chang YY, Jeng WJ, Wai JPM. Efficacy of a multidimensional self-management intervention on low-education women with metabolic syndrome: a cluster randomized controlled trial. Sci Rep 2023; 13:10358. [PMID: 37365208 DOI: 10.1038/s41598-023-36971-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
Low-education women, a substantially older population, are subject to increased risks of metabolic syndrome and consequent cardiometabolic diseases; early detection and effective management were urgently needed. Ninety-nine women with metabolic syndrome, age 61 and education ≤ 6 years, from four community units were randomly assigned to either a self-management intervention (n = 51) or a control arm (n = 48). The intervention consisted of five dimensions, physical activity and diet modifications (daily exercise classes and two nutrition courses), goal setting, coaching and peer support, problem-solving, and self-monitoring. The control arm received an education leaflet. Assessments were performed at baseline, six months, and 18 months. Compared with the control, the intervention participants improved the overall rate of meeting the recommended servings for six health foods, including vegetables, dairy products, and nuts (except whole grains, fruits, and protein); the rate of meeting regular leisure-time physical activity; and criteria biomarkers-waist circumference, fasting blood glucose, high-density lipoprotein cholesterol (except blood pressure and triglycerides); as well as body weight and body mass index; consequently decreased the number of risk factors and rate of metabolic syndrome. In conclusion, the multidimensional self-management intervention improved physical activity, healthy eating, and metabolic syndrome risks among low-education women with metabolic syndrome.
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Affiliation(s)
- Shu-Hung Chang
- Graduate Institute of Gerontology and Health Care Management, Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Gastroenterology and Hepatology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Ya Chang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Wen-Juei Jeng
- Department of Gastroenterology and Hepatology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jackson Pui Man Wai
- Department of Nutrition Science, Fu Jen Catholic University, New Taipei City, Taiwan.
- Graduate Institute of Sport Science, National Taiwan Sport University, Taoyuan, Taiwan.
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Lin R, Chien KL, Tsai MC, Wang YJ, Hsu LY. Association between a priori and a posteriori dietary patterns and the risk of type 2 diabetes: a representative cohort study in Taiwan. J Nutr Sci 2023; 12:e16. [PMID: 36843973 PMCID: PMC9947633 DOI: 10.1017/jns.2023.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 02/10/2023] Open
Abstract
The present study aimed to investigate the relationship between dietary patterns and the risk of type 2 diabetes mellitus (T2DM) among Taiwanese individuals. Data were collected using a nationwide cohort study (2001-15) from the Triple-High Database. Dietary intake was assessed using the twenty-group food frequency questionnaire and used to calculate alternate Mediterranean diet (aMED) and Dietary Approaches to Stop Hypertension (DASH) scores. Principal component analysis (PCA) and partial least-squares (PLS) regression were used to derive dietary patterns, with incident T2DM as the outcome. Multivariable-adjusted hazard ratios and 95 % confidence intervals were calculated using time-dependent Cox proportional hazards (Cox PH) regression analysis, and subgroup analyses were performed. A total of 4705 participants were enrolled in the study, and 995 had newly developed T2DM during the median 5⋅28-year follow-up period (30⋅7 per 1000 person-years). Six dietary patterns were extracted (PCA: Western, prudent, dairy and plant-based; PLS: health-conscious, fish-vegetable and fruit-seafood). The highest aMED score quartile had a 25 % (hazard ratio 0⋅75; 95 % CI 0⋅61, 0⋅92; P = 0⋅039) lower risk of T2DM than the lowest quartile. This association remained significant after adjustment (adjusted hazard ratio 0⋅74; 95 % CI 0⋅60, 0⋅91; P = 0⋅010), and no effect modifier was found for aMED. The DASH scores, PCA and PLS dietary patterns were not significant after adjustment. In conclusion, high adherence to a MED-type dietary pattern by Taiwanese foods was associated with a lower risk of T2DM in the Taiwanese population, regardless of unhealthy lifestyle habits.
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Affiliation(s)
- Rong Lin
- Division of Endocrinology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Chieh Tsai
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- Division of Endocrinology, Department of Internal Medicine, MacKay Memorial Hospital, Tamsui Branch, New Taipei City, Taiwan
| | - Yi-Jie Wang
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- Department of Dietetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Le-Yin Hsu
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Program of Data Science, National Taiwan University and Academia Sinica, Taipei, Taiwan
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Tsai TJ, Li MC. Adherence to the Taiwan Daily Food Guide and the Risk of Type 2 Diabetes: A Populational Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2246. [PMID: 36767612 PMCID: PMC9915098 DOI: 10.3390/ijerph20032246] [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: 12/10/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
This study aims to examine whether adherence to the Taiwan Daily Food Guide relates to the risk of type 2 diabetes. A population-based study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013-2016. Dietary intakes were assessed using a validated food-frequency questionnaire. Type 2 diabetes was defined as a fasting serum HbA1c level of 6.5% or higher or participants who have received treatment for type 2 diabetes or have reported a physician diagnosis of type 2 diabetes. A total of 2534 Taiwanese adults aged 19 and above were included. We found that the Daily Food Guide adherence was negatively associated with the prevalence of type 2 diabetes. The odds ratios (ORs) for those in the fourth quartile of the recommended total servings was 0.67 (95% confidence interval (CI) = 0.45-0.99) compared with those in the first quartile. In addition, those who were men (OR = 1.46, 95% CI = 1.07-1.98), aged more than 50 to 65 (OR = 6.48, 95% CI = 2.57-16.35), or more than 65 (OR = 6.81, 95% CI = 2.56-18.08), with body mass index (BMI) of 24 to less than 27 (OR = 2.08, 95% CI = 1.55-2.79), had BMI of more than 27 (OR = 3.63, 95% CI = 2.73-4.83), had an education level of junior high and high school (OR = 1.68, 95% CI = 1.03-2.74), were divorced, separated, widowed, or refused to answer (OR = 1.39, 95% CI = 1.03-1.88) were associated with an increased prevalence of type 2 diabetes. In conclusion, people who adhere better to the Taiwan Daily Food Guide were found to have a reduced risk of type 2 diabetes.
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Affiliation(s)
- Tsung-Ju Tsai
- Department of Traditional Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Ming-Chieh Li
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei 10610, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan
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Fang PJ, Kuo PH, Chen WL, Kao TW, Wu LW, Yang HF, Peng TC. Prevalence of Ideal Cardiovascular Health Metrics among Young Asian Adults over 5 Years of Follow-Up. Nutrients 2023; 15:645. [PMID: 36771352 PMCID: PMC9920953 DOI: 10.3390/nu15030645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/13/2023] [Accepted: 01/24/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Ideal cardiovascular health (CVH) metrics play an important role in preventing cardiovascular disease (CVD). However, there is a lack of cohort studies on CVH metrics among young Asian adults. The aims of this study were to describe early changes in CVH among young Asian adults and to investigate the association between CVH metrics and sociodemographic variables. METHODS A total of 10,000 young adults (aged 21-30 years) were recruited between 2000 and 2016. There were two CVH measurements taken from these participants over the study period. One measurement was taken at the beginning, and the other was taken five years later. Subgroup analysis of the changes in CVH metrics was divided by education level and marital status. RESULTS The mean age of the participants was 26.8 years. The initial prevalence of ideal CVH metrics was 52.3% and 86.8% and decreased to 43.8% and 81.2% after five years for males and females, respectively. In the subgroup analysis, males with less than a university education had a smaller ideal CVH metric decrease (6.2%) than males with more than a university education (8.9%), while females with more than a university education had a smaller ideal CVH metric decrease (5.4%) than females with less than a university education (7.3%). Married males had a smaller ideal CVH metric decrease (6.1%) than single males (9.1%), while single females had a smaller ideal CVH metric decrease (5.3%) than married females (6.2%). CONCLUSIONS The prevalence of ideal CVH metrics among young adults gradually decreased as age increased. Higher educational attainment and unmarried status were associated with a greater prevalence of ideal CVH metrics regardless of sex, but early CVH changes differed by sex, education level, and marital status. The prevalence of CVH changes found early among young adults can be used to monitor CVH changes quickly. Effective health promotion programs are needed to maintain CVH metrics among young adults.
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Affiliation(s)
- Pu-Jun Fang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Ping-Hsuan Kuo
- Department of Internal Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 11490, Taiwan
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan
| | - Hui-Fang Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
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Lin SP, Fang HY, Li MC. Relationship between overweight and obesity and insufficient micronutrient intake: a nationwide study in Taiwan. J Nutr Sci 2023; 12:e48. [PMID: 37123393 PMCID: PMC10131054 DOI: 10.1017/jns.2023.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/04/2023] [Accepted: 03/15/2023] [Indexed: 05/02/2023] Open
Abstract
The aim of the present study is to examine whether overweight or obese people in Taiwan have an inadequate intake of selected micronutrients. A population-based study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013-2016. We evaluated fourteen nutrient intakes using the 24 h dietary recall method. The dietary reference intake (DRI) adherence was estimated by the prevalence of participants whose intake was lower than the recommended dietary allowance (RDA) or adequate intakes (AIs) for selected micronutrients. Body mass index (BMI) ≥ 27 kg/m2 and waist circumference (WC), with men having WC ≥ 90 cm or women having WC ≥ 80 cm, were defined as obesity. A total of 3075 participants aged 19 years and above were included. After adjusting for confounders, we found that obese women have a lower DRI adherence of vitamin C (odds ratio (OR) 0⋅73, 95 % confidence interval (CI) 0⋅56, 0⋅95) and magnesium (OR 0⋅72, 95 % CI 0⋅54, 0⋅95), compared with normal-weight women. Obese men have a higher DRI adherence of vitamin B3 (OR 1⋅70, 95 % CI 1⋅29, 2⋅23), iron (OR 1⋅46, 95 % CI 1⋅06, 2⋅00) and zinc (OR 1⋅41, 95 % CI 1⋅07, 1⋅85), compared with normal-weight men. Similar findings were found using WC to define obesity. We conclude that obese women may have insufficient intakes of vitamin A, vitamin C and magnesium.
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Affiliation(s)
- Shih-Pi Lin
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hsin-Yu Fang
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Ming-Chieh Li
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan
- Corresponding author: Ming-Chieh Li, email
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Li MC. Better Adherence to the Taiwan Daily Food Guide is Associated with a Reduced Risk of Osteoporosis: A Population-Based Study in Taiwan. Risk Manag Healthc Policy 2022; 15:2023-2030. [PMID: 36348758 PMCID: PMC9637361 DOI: 10.2147/rmhp.s387506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/14/2022] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION We conducted a study to examine whether adherence to the Taiwan Daily Food Guide was associated with bone mineral density (BMD). METHODS A population-based cross-sectional study was conducted utilizing data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013-2016. A total of seven BMD sites were evaluated, including the head, arms, legs, trunk, ribs, pelvis, and spine BMD. Besides, we further examined the association between the Daily Food Guide adherence score and osteoporosis (T-score of ≤ -2.5 standard deviation (SD) of a measured total BMD). A validated food-frequency questionnaire (FFQ) was used for dietary assessment. RESULTS We included a total of 555 participants with osteoporosis and 1977 without osteoporosis in the final analysis. We found negative associations between levels of adherence to the Daily Food Guide and the risk of osteoporosis. The odds ratio (OR) for participants in the highest quartile of the adherence level was 0.61 (95% CI = 0.42-0.88), compared with those in the lowest quartile. When participants had total servings of six food groups higher than the recommendation, the protective effect still existed (OR = 0.59, 95% CI = 0.42-0.84). CONCLUSION Better adherence to the Taiwan Daily Food Guide is associated with a lower risk of osteoporosis.
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Affiliation(s)
- Ming-Chieh Li
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan,Correspondence: Ming-Chieh Li, Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei, 106, Taiwan, Tel +886277491698, Email
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Li MC. Associations between Adherence to the Taiwan Dietary Reference Intakes of Micronutrients and the Risk of Type 2 Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12242. [PMID: 36231543 PMCID: PMC9566350 DOI: 10.3390/ijerph191912242] [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: 08/18/2022] [Revised: 09/19/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
The dietary reference intakes (DRIs) were established as guidance for the intake of micronutrients and other nutrients. However, how DRIs affect disease status has not been thoroughly examined. The aim of this study is to examine the associations between adherence to the DRIs of selected micronutrients and type 2 diabetes. A populational and cross-sectional study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013-2016. A total of 14 nutrient intakes, including those for vitamin A, C, D, E, B1, B2, B3, B6, B12, iron, magnesium, zinc, calcium, and phosphorus, were evaluated using the 24 h dietary recall method. Type 2 diabetes was defined as a fasting serum HbA1c level of 6.5% or higher and excluded participants who had received treatments for type 2 diabetes or reported a diagnosis of type 2 diabetes by physicians to avoid the possible inverse association. A total of 2685 participants aged 19 and above were included in the final analysis. After adjusting for confounders, we found that adherence to the DRI of vitamin A was associated with a reduced risk of type 2 diabetes among men. The odds ratio (OR) was 0.64 (95% confidence interval (CI) = 0.42-0.99) compared with men who did not adhere to the DRI. As for women, we found that adherence to the DRI of vitamin B1 was associated with a reduced risk of type 2 diabetes. The OR was 0.59 (95% CI = 0.35-0.97) compared with that for women who did not adhere to the DRI. This study showed that adherence to Taiwan DRIs of vitamin A for men and vitamin B1 for women might have beneficial effects on type 2 diabetes.
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Affiliation(s)
- Ming-Chieh Li
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei City 106, Taiwan
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Yu H, Wen Q, Lv J, Sun D, Ma Y, Man S, Yin J, Tong M, Wang B, Yu C, Li L. Association between Dietary Patterns Reflecting C-Reactive Protein and Metabolic Syndrome in the Chinese Population. Nutrients 2022; 14:nu14132566. [PMID: 35807747 PMCID: PMC9268474 DOI: 10.3390/nu14132566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/17/2022] [Accepted: 06/19/2022] [Indexed: 02/01/2023] Open
Abstract
It is unclear how the dietary patterns reflecting C-reactive protein (CRP) affect metabolic syndrome (MetS) in the Chinese population. To examine the effect of the dietary pattern reflecting CRP with MetS, a cross-sectional study was based on the health checkup data from the Beijing MJ Health Screening Centers between 2008 and 2018. The CRP-related dietary pattern was derived from 17 food groups using reduced-rank regression. Participants were divided into five groups according to the quintiles of dietary pattern score. Multivariate logistic regression was then applied to estimate the odds ratios (OR) and 95% confidence intervals (CIs) for the quintiles of diet pattern score related to MetS and its four components. Of the 90,130 participants included in this study, 11,209 had MetS. A CRP-related dietary pattern was derived, characterized by a higher consumption of staple food, fresh meat, processed products, and sugar-sweetened beverages but a lower intake of honey and jam, fruits, and dairy products. Compared with participants in the lowest quintile (Q1), participants in the higher quintiles were associated with increased risks of MetS in a dose−response manner after adjustment for potential confounders (p for linear trend < 0.001), the ORs for Q2 to Q5 were 1.10 (95% CI: 1.02−1.19), 1.14 (95% CI: 1.05−1.22), 1.23 (95% CI: 1.15−1.33), and 1.49 (95% CI: 1.38−1.61), respectively. Moreover, the effects were stronger among individuals aged 50 years or older. A CRP-related dietary pattern was associated with the risk of MetS. It provides new insights that dietary intervention to achieve a lower inflammatory level could potentially prevent MetS.
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Affiliation(s)
- Huan Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (H.Y.); (Q.W.); (J.L.); (D.S.); (S.M.); (L.L.)
| | - Qiaorui Wen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (H.Y.); (Q.W.); (J.L.); (D.S.); (S.M.); (L.L.)
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (H.Y.); (Q.W.); (J.L.); (D.S.); (S.M.); (L.L.)
- Peking University Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing 100191, China
- Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; (Y.M.); (M.T.)
| | - Dianjianyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (H.Y.); (Q.W.); (J.L.); (D.S.); (S.M.); (L.L.)
- Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; (Y.M.); (M.T.)
| | - Yuan Ma
- Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; (Y.M.); (M.T.)
- MJ Health Care Group, Shanghai 200041, China;
| | - Sailimai Man
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (H.Y.); (Q.W.); (J.L.); (D.S.); (S.M.); (L.L.)
- MJ Health Care Group, Shanghai 200041, China;
| | | | - Mingkun Tong
- Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; (Y.M.); (M.T.)
- MJ Health Care Group, Shanghai 200041, China;
| | - Bo Wang
- Peking University Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing 100191, China
- Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; (Y.M.); (M.T.)
- MJ Health Care Group, Shanghai 200041, China;
- Correspondence: (B.W.); (C.Y.)
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (H.Y.); (Q.W.); (J.L.); (D.S.); (S.M.); (L.L.)
- Peking University Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing 100191, China
- Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; (Y.M.); (M.T.)
- Correspondence: (B.W.); (C.Y.)
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (H.Y.); (Q.W.); (J.L.); (D.S.); (S.M.); (L.L.)
- Peking University Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing 100191, China
- Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; (Y.M.); (M.T.)
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Differences between Sexes in Cardiopulmonary Fitness among Children and Adolescents with Kawasaki Disease. Healthcare (Basel) 2022; 10:healthcare10020353. [PMID: 35206966 PMCID: PMC8872070 DOI: 10.3390/healthcare10020353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/31/2022] [Accepted: 02/09/2022] [Indexed: 11/22/2022] Open
Abstract
It is known that children and adolescents with Kawasaki disease (KD) can maintain normal cardiopulmonary fitness (CPF) after the disease’s acute stage has subsided. This study aimed to investigate whether gender differences affect CPF in children and adolescents with KD. We retrospectively reviewed a cohort of 204 participants (120 boys and 84 girls) with KD. All participants were instructed to complete a symptom-limited cardiopulmonary exercise test (CPET) adapted to assess their CPF. Based on body mass index (BMI), boys and girls were categorized into groups of underweight (19 boys and 12 girls), normal (62 boys and 59 girls), and overweight (39 boys and 13 girls). Although a similarity in body composition was found among both genders for KD subjects and normal Taiwanese peers, the percentage of overweight subjects was higher in KD boys than the normal Taiwanese boys. When comparing CPF for different BMI groups, the whole KD group showed no discrepancy, but a significantly lower peak VO2 for the overweight KD boys group was observed, representing poorer CPF. In conclusion, girls with KD had better CPF than boys, and gender stereotypes affect sports participation as well as self-efficacy, and may be contributing to poorer CPF in KD boys.
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Li MC. Associations between adherence to the Taiwan Daily Food Guide and psychiatric morbidity: A population-based study in Taiwan. Front Psychiatry 2022; 13:1022892. [PMID: 36386970 PMCID: PMC9664218 DOI: 10.3389/fpsyt.2022.1022892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/17/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Mental health has become a public health concern worldwide, and the number of affected individuals is rising. Therefore, further research must be conducted to identify potential risk factors to develop optimal prevention strategies to mitigate mental health disorders. METHODS Using Taiwanese Nutrition and Health Survey data collected from 2013-2016, we conducted a cross-sectional study to examine whether adherence to the Taiwan Daily Food Guide affects mental health conditions. Study participants were adults aged ≥19 years. The dietary assessment was conducted using a validated food frequency questionnaire. The presence of psychiatric morbidity was defined as a five-item Brief Symptom Rating Scale (BSRS-5) score of ≥10. Logistic regression models were used to determine whether Taiwan Daily Food Guide adherence was related to the presence of psychiatric morbidity. RESULTS After adjusting for potential confounders, we observed protective associations between adherence to the Taiwan Daily Food Guide and psychiatric morbidity risk. CONCLUSION The Taiwan Daily Food Guide might reduce the risk associated with psychiatric morbidity and could be a reference for developing a national food guide for mental health.
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Affiliation(s)
- Ming-Chieh Li
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan
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Lim KY, Chen IC, Chan YC, Cheong IF, Wang YY, Jian ZR, Lee SD, Chou CC, Yang FL. Novel Healthy Eating Index to Examine Daily Food Guides Adherence and Frailty in Older Taiwanese. Nutrients 2021; 13:nu13124210. [PMID: 34959762 PMCID: PMC8707448 DOI: 10.3390/nu13124210] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 11/19/2022] Open
Abstract
This study was conducted to investigate the adherence of Daily Food Guides (DFGs) among older Taiwanese, and the relationship of dietary quality and frailty. 154 functional independent older adults who were retirement home residents or community dwellers involved in congregate meal services were recruited. DFGs adherence was measured using a novel Taiwanese Healthy Index (T-HEI). Dietary quality was further assessed using Dietary Approach to Stop Hypertension (DASH) and Mediterranean Diet Score (MDS). Frailty was defined using modified Fried’s criteria. Of the total participants, 12.3% were considered non-frail individuals, while 77.3% were prefrail, and 10.4% were frail. Compared to non-frail participants, prefrail and frail individuals indicated significantly lower adherence to DFGs (ptrend = 0.025). Intake of dark or orange vegetables (ptrend = 0.010), whole grains (ptrend = 0.007), as well as nuts and seeds (ptrend = 0.029) by non-frail individuals were significantly higher than the levels by prefrail and frail individuals. Linear regression model adjusted for age, gender, and functional ability showed that T-HEI was inversely associated with frailty status (β = −0.16 ± 0, p = 0.047), but additional adjustment for nutritional status attenuated the association (β = −0.14 ± 0, p = 0.103). A similar relationship was observed for DASH but not MDS (DASH: β = −0.18 ± 0.01, p = 0.024; MDS: β = −0.06 ± 0.02, p = 0.465). After adjustment for confounders, the association was not observed. However, the distribution of whole grains component in both DASH and MDS was significantly higher in non-frail than prefrail and frail individuals, indicating the importance of whole grains intake in frailty prevention. In conclusion, higher adherence to DFGs and better dietary quality were associated with a lower prevalence of frailty. Higher nutrient-dense foods intake such as whole grains, dark or orange vegetables, nuts, and seeds mark a watershed in frailty prevention.
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Affiliation(s)
- Kian-Yuan Lim
- Ph.D. Program in Nutrition and Food Science, College of Human Ecology, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
| | - I-Chen Chen
- Department of Nutritional Science, College of Human Ecology, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (I.-C.C.); (Y.-C.C.); (I.-F.C.); (Y.-Y.W.); (Z.-R.J.)
| | - Yun-Chun Chan
- Department of Nutritional Science, College of Human Ecology, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (I.-C.C.); (Y.-C.C.); (I.-F.C.); (Y.-Y.W.); (Z.-R.J.)
| | - In-Fai Cheong
- Department of Nutritional Science, College of Human Ecology, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (I.-C.C.); (Y.-C.C.); (I.-F.C.); (Y.-Y.W.); (Z.-R.J.)
| | - Yi-Yen Wang
- Department of Nutritional Science, College of Human Ecology, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (I.-C.C.); (Y.-C.C.); (I.-F.C.); (Y.-Y.W.); (Z.-R.J.)
| | - Zi-Rong Jian
- Department of Nutritional Science, College of Human Ecology, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (I.-C.C.); (Y.-C.C.); (I.-F.C.); (Y.-Y.W.); (Z.-R.J.)
| | - Shyh-Dye Lee
- Department of Family Medicine, Fu Jen Catholic University Hospital, New Taipei City 243089, Taiwan;
| | - Chi-Chun Chou
- Department of Otorhinolaryngology, Yonghe Cardinal Tien Hospital, New Taipei City 234408, Taiwan;
| | - Feili Lo Yang
- Ph.D. Program in Nutrition and Food Science, College of Human Ecology, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
- Department of Nutritional Science, College of Human Ecology, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (I.-C.C.); (Y.-C.C.); (I.-F.C.); (Y.-Y.W.); (Z.-R.J.)
- Correspondence: ; Tel.: +88-62-2905-3611
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Behavioral Factors Associated with Medication Nonadherence in Patients with Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189614. [PMID: 34574540 PMCID: PMC8469687 DOI: 10.3390/ijerph18189614] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 11/26/2022]
Abstract
Medication nonadherence is associated with an increased risk of complications in hypertensive patients. We investigated behavioral factors associated with medication nonadherence in hypertensive patients in southern Taiwan. Using questionnaires, we collected data regarding clinicodemographic characteristics and nonadherence behaviors from 238 hypertensive patients. We assessed the self-reported prevalence of specific behaviors of medication nonadherence and investigated factors associated with each behavior using multivariable logistic regression analysis. The most common behavior of medication nonadherence was forgetting to take medication (28.6%), followed by discontinuing medication (9.2%) and reducing the medication dose (8.8%). Age ≥ 65 years (adjusted odds ratio [aOR] = 0.32, 95% confidence interval [CI] = 0.15–0.69) and male sex (aOR = 2.61, CI = 1.31–5.19) were associated with forgetting to take medication. The presence of comorbidities (diabetes, kidney disease, or both) and insomnia (aOR = 3.97, 95% CI = 1.30–12.1) was associated with reducing the medication dose. The use of diet supplements was associated with discontinuing the medication (aOR = 4.82, 95% CI = 1.50–15.5). Compliance with a low oil/sugar/sodium diet was a protective factor against discontinuing medication (aOR = 0.14; 95% CI = 0.03–0.75). The most pervasive behavior associated with medication nonadherence among hypertensive patients was forgetting to take medication. Age <65 years, male sex, comorbidities, insomnia, noncompliance with diet, and the use of dietary supplements were specifically associated with medication nonadherence.
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