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Background: The prevalence of obesity is increasing rapidly in low- and middle-income countries (LMICs) as their populations become exposed to obesogenic environments. The transition from an agrarian to an industrial and service-based economy results in important lifestyle changes. Yet different socioeconomic groups may experience and respond to these changes differently. Investigating the socioeconomic distribution of obesity in LMICs is key to understanding the causes of obesity but the field is limited by the scarcity of data and a uni-dimensional approach to socioeconomic status (SES). This study splits socioeconomic status into two dimensions to investigate how educated women may have lower levels of obesity in a context where labour market opportunities have shifted away from agriculture to other forms of employment. Methods: The Four Provinces Study in China 2008/09 is a household-based community survey of 4,314 people aged ⩾60 years (2,465 women). It was used to investigate an interaction between education (none/any) and occupation (agricultural/non-agricultural) on high-risk central obesity defined as a waist circumference ⩾80 cm. An interaction term between education and occupation was incorporated in a multivariate logistic regression model, and the estimates adjusted for age, parity, urban/rural residence and health behaviours (smoking, alcohol, meat and fruit & vegetable consumption). Complete case analyses were undertaken and results confirmed using multiple imputation to impute missing data. Results: An interaction between occupation and education was present (P = 0.02). In the group with no education, the odds of central obesity in the sedentary occupation group were more than double those of the agricultural occupation group even after taking age group and parity into account (OR; 95%CI: 2.21; 1.52, 3.21), while in the group with any education there was no evidence of such a relationship (OR; 95%CI: 1.25; 0.92, 1.70). Health behaviours appeared to account for some of the association. Conclusion: These findings suggest that education may have a protective role in women against the higher odds of obesity associated with occupational shifts in middle-income countries, and that investment in women's education may present an important long term investment in obesity prevention. Further research could elucidate the mechanisms behind this association. [ABSTRACT FROM AUTHOR]

Discusses trends that have emerged in Sino-American trade as of May 1983. Stories told by American businessmen who have traded with China; Institutional arrangements that U.S. firms have been willing to make in trading with China; Flexibility in the use of shorter contracts; Establishment of special affiliates.

It remains unclear whether a total exposure to air pollution (AP) is associated with an increased risk of dementia. Little is known on the association in low- and middle-income countries. Two cohort studies in China (in Anhui cohort 1402 older adults aged ≥ 60 followed up for 10 years; in Zhejiang cohort 6115 older adults followed up for 5 years) were conducted to examine particulate matter - PM 2.5 associated with all dementia and air quality index (AQI) with Alzheimer's disease, respectively. A systematic literature review and meta-analysis was performed following worldwide literature searched until May 20, 2020 to identify 15 population-based cohort studies examining the association of AP with dementia (or any specific type of dementia) through PubMed, MEDLINE, PsycINFO, SocINDEX, CINHAL, and CNKI. The cohort studies in China showed a significantly increased relative risk (RR) of dementia in relation to AP exposure; in Anhui cohort the adjusted RR was 2.14 (95% CI 1.00–4.56) in people with PM 2.5 exposure at ≥ 64.5 μg/m3 versus <63.5 μg/m3 and in Zhejiang cohort the adjusted RR was 2.28 (1.07–4.87) in AQI>90 versus ≤ 80. The systematic review revealed that all 15 studies were undertaken in high income countries/regions, with inconsistent findings. While they had reasonably good overall quality of studies, seven studies did not adjust smoking in analysis and 13 did not account for depression. Pooling all eligible data demonstrated that dementia risk increased with the total AP exposure (1.13, 1.08–1.19). Data analysis of air pollutants showed that the RR significantly increased with PM 2.5 (1.06, 1.03–1.10 in 2nd tertile exposure; 1.13, 1.07–1.19 in 3rd tertile versus 1st tertile), PM 10 (1.05, 0.86–1.29; 1.62, 0.60–4.36), carbon monoxide (1.69, 0.72–3.93; 1.52, 1.35–1.71), nitrogen dioxide (1.06, 1.03–1.09; 1.18, 1.10–1.28) and nitrogen oxides (1.09, 1.04–1.15; 1.26, 1.13–1.41), but not ozone. Controlling air pollution and targeting on specific pollutants would reduce dementia globally. • Two cohort studies were conducted in China to investigate the high PM 2.5 and poor air quality index associated with dementia risk, revealing significant association. • Pooling data from all eligible studies published and new cohorts in China showed dementia risk increased with overall AP exposure, PM 2.5 , PM 10 , CO, NO 2 , NOx, but not O 3. • Controlling air pollution and targeting on specific pollutants would reduce dementia globally. [ABSTRACT FROM AUTHOR]