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Background The decline of human sperm quality has caused great concern. Whether exposure to parabens and the intestinal endotoxin (IE) they induce are related to sperm quality is a challenging scientific question. Results We measured seminal methyl-(MeP), ethyl-(EtP), propyl-(PrP), and butyl-(BuP) parabens, their metabolites PHBA and 3,4-DHB, semen parameters, and blood IE (lipopolysaccharide, LPS) of 315 healthy men. Bivariate correlation and multiple linear regression were used to evaluate their interrelationships. For the first time, we found that MeP, EtP, PrP, BuP, PHBA, and 3,4-DHB in semen were negatively correlated with sperm parameters (r = − 0.184 to − 0.438), with EtP showing the strongest correlation. LPS was detected in all plasma samples (0.021–0.195 EU/mL) and negatively correlated with sperm concentration and total sperm count with R2 = 0.295 and R2 = 0.236, respectively, when LPS was higher than 0.104 EU/mL. LPS was positively correlated with EtP and BuP. Conclusion We concluded that seminal parabens affected sperm quality possibly due to estrogenic activity. Parabens likely promote intestinal endotoxemia and affect sperm quality in healthy people by altering the composition of gut microbiota through antimicrobial activity. The finding that parabens exert dual toxicological effects on sperm quality provides novel insights for future research.

What is already known about this topic? The prevalence of underweight malnutrition largely decreased in Chinese adults in recent thirty years while obesity became increasingly concerning. However, underweight malnutrition still affected elderly populations and increased risk of anemia, infection diseases, some non-communicable chronic diseases and disability. What is added by this report? In this study, data from 4 national surveys from 1992 to 2015 were analyzed to study underweight malnutrition. There was an 80.5% reduction for underweight malnutrition nationally, including a 67.5% reduction in rural areas and 67.4% in urban areas, and 76.2% in males and 79.4% in females. What are the implications for public health practice? Underweight malnutrition seriously affects the health and quality of life for older people and will lead to heavy burdens for families and society overall. Therefore, efforts should be maintained to screen, treat, and safeguard elderly populations with underweight malnutrition using nutritional improvement strategies, especially for the oldest elderly individuals in rural areas.

What is already known about this topic? Elderly persons are vulnerable to infectious diseases, and nutritional status and health conditions were important to evaluate for disease prevention and ability to recover for the elderly during the coronavirus disease 2019 (COVID-19) pandemic. What is added by this report? In our study, a rapid assessment questionnaire was used to investigate the change of household life and dietary intake of the elderly (aged 60 years or more) during community closure. Food consumption frequency of aquatic food products, soybeans, and fresh fruits declined dramatically with reductions of 70.9%, 70.9%, and 53.0%, respectively, and 49.6% of the elderly lived with chronic non-communicable diseases but had little knowledge of nutrition and health. What are the implications for public health practice? Community closure measures in Wuhan City have played a key role in cutting off the transmission route of COVID-19 and protecting vulnerable groups. As a high-risk population, the elderly should be advised to maintain and strengthen a balanced diet with proper nutrition through increasing intake of aquatic food products, soybeans, fruits, and vegetables, reducing total caloric intake, and decreasing oil and salt consumption. These measures will be significant for the elderly to reduce the risk of chronic disease complications and COVID-19 infection and to decrease the chance of critical illness.

Background A growing number of researches supported that dietary fructose was associated with most of the key features of metabolic syndrome (MetS). However, there was no related epidemiological studies among Chinese population, despite the sharp increase in MetS cases. This study explores the relationship between dietary fructose and MetS among Chinese residents aged 45 and above. Methods A total of 25,528 participants (11,574 males and 13,954 females) were included in this nationwide representative cross-sectional study of China National Nutrition and Health Survey. Dietary fructose intake was assessed by 3-day 24-h dietary records. MetS was defined by the International Diabetes Federation and Chinese Diabetes Society criteria. Results The consumption of dietary fructose was 11.6 g/day for urban residents and 7.6 g/day for rural residents. Fruits and vegetables as well as their products were the main sources of fructose intake. There was no association between dietary fructose intake and the odds of having MetS in both urban (P = 0.315) and rural residents (P = 0.230) after adjustment for confounding factors. Moreover, for urban residents participating physical activities, the odds of having MetS in the fourth quartiles (OR: 0.67; 95%CI: 0.52-0.87) was lower than that in the first quartile. In the sensitivity analysis, a significant reduction in the odds of having MetS was also found in the fourth quartiles (OR, 95%CI: 0.68, 0.51-0.90; 0.67, 0.49-0.91; 0.74, 0.56-0.99) compared with the first quartile when excluding smokers, alcohol users, and underweight/obesity, respectively. And there was no association between dietary fructose intake and the odds of having MetS after multivariate adjustment stratified by gender, smoking and alcohol use. Conclusions Under the current dietary fructose intake status, there was no association between dietary fructose intake and the odds of having MetS among Chinese residents aged 45 and above. Physical activity and relatively low fructose intake may have a beneficial synergistic effect on MetS.

We aimed to investigate the association between dietary patterns and low HDL-C among the elderly population living in North China. The data were from a national cross-sectional survey conducted in 2015. General information in terms of living habits, health status, and food intake using 24 h dietary recall for three consecutive days was procured, and the weight of edible oil and condiments recorded. Anthropometric index, blood pressure, and fasting serum lipids were measured using standard methods. Dietary patterns were derived from food categories by exploratory factor analysis, and multivariate logistic regression was used to estimate the odds ratios of low HDL-C across quartiles of dietary patterns. Among 3387 elderly participants, 21.9% had low HDL-C levels. After adjusting for potential confounding factors, participants with highest score versus lowest score in the balanced dietary pattern had a decreased risk of low HDL-C (OR = 0.38, 95% CI: 0.16–0.88, p for trend = 0.013) in the group with a BMI of 27.1 kg/m2 and above. Compared to the lowest quartile, there was a statistically significant negative association between the highest scores of the Western dietary pattern and low HDL-C (OR = 0.37, 95% CI: 0.17–0.82, p for trend = 0.018) in the group with a BMI of 21.6–24.8 kg/m2. However, greater adherence to a thrifty dietary pattern (highest quartiles vs. lowest quartiles) was associated with increased risk of low HDL-C (OR = 3.31, 95% CI: 1.05–10.40, p for trend = 0.044), especially in the subgroup with a BMI of 21.6 kg/m2 and below. The study revealed that it is urgent to develop district-specific dietary improvement plans for dyslipidemia based on the nutritional status of the elderly population in North China.

Background: Magnesium and calcium play a variety of biological roles in body functions. Reference values of these elements have not yet been systematically determined in China, especially in childbearing women. We proposed to establish the reference range of Mg, Ca, and Ca/Mg ratio in plasma and whole blood for 18–44 years healthy childbearing women in China. Method: A total of 1921 women of childbearing age (18–44 years) were randomly selected from the 2015 China National Nutrition and Health Survey by taking into account the regional types and monitoring points. Among them, 182 healthy women were screened out with a series strict inclusion criteria to study the reference ranges of elements. Fundamental indicators (weight, height, waist, blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein, fast glucose, HbA1c, blood pressure, uric acid) and elements concentrations in plasma and whole blood were collected. The 2.5th to 97.5th was used to represent the reference range of Mg, Ca, and Ca/Mg ratio. Results: The reference range of Mg, Ca, and Ca/Mg ratio in plasma were 0.75–1.13 mmol/L, 2.27–3.43 mmol/L, and 2.41–3.44, respectively. Additionally, the reference range of Mg, Ca, and Ca/Mg ratio in whole blood were 1.28–1.83 mmol/L, 1.39–2.26 mmol/L, and 0.90–1.66, respectively. According to the established reference range, the prevalence of magnesium deficiency was 4.79% in 1921 childbearing women, 21.05% in type 2 diabetes, and 5.63% in prediabetes. Conclusion: The reference values of Mg, Ca and Ca/Mg proportion in plasma and entire blood of healthy childbearing women can be utilized as a pointer to assess the status of component lack and over-burden. The lower limit of plasma Mg is in good agreement with the recommended criteria for the determination of hypomagnesemia.

The aim of this cross-sectional study was to investigate the association of serum 25-hydroxyvitamin D (25[OH]D) levels and vitamin D receptor (VDR) genotypes with skeletal muscle mass and function in elderly subjects in northern China.A total of 275 men and 510 women, ages 63.1 to 72.5 y, in two randomly selected communities in Beijing were investigated. The investigation included a questionnaire, physical measurements, muscle mass and function measurements, serum 25(OH)D levels, and VDR gene polymorphisms analysis.In the group with 25(OH)D levels10.0 ng/mL, the proportion with low handgrip strength was 3.04 times higher than that in the group with 25(OH)D levels20.0 ng/mL for men (odds ratio: 3.04; 95% confidence interval, 1.13-8.20) but not for women. The general linear model showed that higher 25(OH)D levels and having T allele of Fok1 and the bb genotype of Bsm1 were significantly associated with more handgrip strength. The regression coefficients (β) were 1.80 (P0.01), 1.26 (P0.01), and 2.90 (P0.01), respectively. There was a significant interaction between 25(OH)D and VDR gene polymorphisms for handgrip strength for both Fok1 (β = 2.86; P0.01) and Bsm1 (β = 3.14; P = 0.02) after adjustment for potential confounders (sex, age, body mass index, fat mass, physical activity, sun exposure, energy, and protein intake).25(OH)D levels are associated with handgrip strength for men and this relationship could be modified with the interaction between 25(OH)D and VDR gene polymorphisms (Fok1 and Bsm1).

Selenium (Se) is a “dual-surface” element. Both Se-deficiency and Se-overload have bad effects on humans. The amount of Se in the blood is a good indicator of Se intake, and there are considerable differences in the reference ranges among different regions and populations. The purpose of this study was to establish the age-specific reference interval of blood Se in healthy child-bearing-aged women in China. A total of 187 healthy women aged 18–45 years old were enrolled with strict inclusion criteria from the China Adult Chronic Disease and Nutrition Surveillance (2015 CACDNS) database to establish the reference interval of Se. Plasma and whole-blood Se were detected by inductively coupled plasma mass spectrometry (ICP-MS). The reference range (RR) estimated as P2.5–P97.5 percentiles (geometric mean) was 73.81–140.75 (100.94) μg/L and P2.5–P97.5 percentiles (median) 81.06–164.75 (121.05) μg/L for plasma and whole-blood Se, respectively. The proposed RR of plasma Se in this study was used to evaluate the Se nutritional status of a representative sample of 1950 women of child-bearing age who were randomly selected from 2015 CACDNS. The proportion of Se level lower than P2.5 cut-off value was 24.05%, and there were 5.08% child-bearing-aged women with plasma Se higher than the upper limit of RR. Women in the western and rural areas tend to have lower Se levels.

Associations between dietary patterns (DPs) and sarcopenia remain controversial, and fewer studies have mentioned the relationship between dietary energy composition and sarcopenia. The present cross-sectional study was conducted in three regions of China, to detect the associations between DPs and sarcopenia, and to identify the influencing nutrients. Exploratory factor analysis was conducted for DP identification. Logistic regressions were performed to explore the associations between DPs and sarcopenia. Dietary nutrients and dietary energy composition were calculated and compared among different DPs. Three DPs were identified from 861 community-dwelling older people. The &ldquo, mushrooms&ndash, fruits&ndash, milk&rdquo, pattern was negatively associated with sarcopenia (OR = 0.33, 95% CI = 0.14~0.77, p-trend = 0.009). Subjects in the highest quartile of the &ldquo, pattern showed more abundant intake (1.7 g/kg/d) of dietary protein, and lower percentage (31%) of energy from fat (PEF) than the other two DPs. Further analyses indicated that lower PEF (&lt, 30%) was negatively associated with sarcopenia. In conclusion, the &ldquo, pattern was negatively associated with sarcopenia in community-dwelling older Chinese people. This pattern showed abundant protein intake and low PEF, which may partially contribute to its protective effect on sarcopenia. Therefore, besides protein, dietary fat and PEF may also be considered in the prevention and management of sarcopenia.

The association between obesity and sarcopenia remains controversial. The present study was conducted to explore the associations among body mass index (BMI), visceral fat area (VFA), and sarcopenia in older people and analyze their potential mechanisms. This cross-sectional study included 861 community-dwelling older Chinese people from three regions of China. BMI, VFA, muscle mass, muscle strength, physical performance, body composition, and metabolic markers were measured. Muscle mass and muscle strength were positively correlated with BMI, but were negatively correlated with VFA. Simple overweight/obesity was negatively associated with sarcopenia (OR = 0.07, 95% CI = 0.03~0.18), and the OR value was lower than combined obesity (OR = 0.16, 95% CI = 0.09~0.28). Fat free mass and total body protein were positively associated with high BMI but negatively associated with high VFA. Furthermore, high VFA was adversely associated with some metabolic risk factors of sarcopenia. Combination of BMI and VFA increased diagnostic efficiency of low muscle mass and sarcopenia. In conclusion, high BMI was negatively associated with sarcopenia, while high VFA attenuated the negative association between high BMI and sarcopenia. The opposite association may partially be attributed to their different associations with body composition and metabolic risk factors of sarcopenia. Therefore, bedsides BMI, VFA and its interaction with BMI should be considered in sarcopenia prevention.

Background: Copper (Cu), magnesium (Mg) and zinc (Zn) are essential elements that participate in a series of oxidative stress and inflammation pathways related to metabolic reactions. Many studies have analyzed the relationship between Cu, Mg and Zn and metabolic syndrome (MetS) in adolescents and adults, but there have been few studies of children. We aimed to investigate the association of whole blood Cu, Mg and Zn with MetS components in 6–12-year-old rural Chinese children. Methods: A total of 911 children (51.2% male, 48.7% female) aged 6–12 years were enrolled from the 2010–2012 China National Nutrition and Health Survey. Basic characteristics, metals and MetS component parameters were collected. Multivariate logistic regression analysis was performed to examine the independent relationship between metals and the incidence of MetS components.Results: Copper was positively associated with elevated waist circumference when analyzed alone (OR=2.00, 1.18–3.28). Combined with Zn, this association approached zero. For elevated triglyceride levels, the combination of low Cu and high Zn showed the opposite association with triglyceride relative to Cu alone (OR=2.21, 1.18–4.13 versus OR=0.33, 0.16–0.65, respectively), but was similar to the analysis of Zn alone (OR=2.12, 1.10–4.10). There was no association between whole blood Mg and waist circumference. However, the presence of both high Cu and high Mg levels significantly increased the risk of waist circumference exceeding the standard value (OR=2.03, 1.26–3.27). In addition, separate analysis of the distribution of Mg and Zn found no association with the risk of reduced high density lipoprotein-cholesterol (HDL-C); but high Zn combined with low Mg negatively associated with the risk of reduced HDL-C levels (OR=0.47, 0.28–0.77). Conclusions: Both the single and combined effects of Cu, Mg and Zn were associated with components of MetS. These results indicate the importance of combined analysis of multiple elements, and also provide new avenues for the early screening of MetS. The current results need to be further investigated in future work and other populations.

Background: A growing number of researches supported that dietary fructose was associated with all the key features of metabolic syndrome (MetS). However, there was no related epidemiological studies among Chinese population despite that cases of MetS increased sharply. This study explores the relationship between dietary fructose and MetS among Chinese residents aged 45 and above. Methods: A total of 25528 participants (11574 males and 13954 females) were included in this nationwide representative cross-sectional study of China National Nutrition and Health Survey. Dietary fructose intake was assessed by 3-day 24-h dietary records. MetS was defined by the International Diabetes Federation and Chinese Diabetes Society criteria. Results: The consumption of dietary fructose was 11.6g/day for urban residents and 7.6g/day for rural residents. Fruits and vegetables as well as their products were the main food sources. There was no association between dietary fructose intake and the risk of MetS in both urban (P = 0.315) and rural residents (P = 0.230) after adjustment for confounding factors. Moreover, for urban residents participating physical activities, the risk of MetS in the fourth quartiles (OR: 0.67; 95%CI: 0.52-0.86) was reduced compared with the first quartile. In the sensitivity analysis, a significant reduction in the risk of MetS was also found in the fourth quartiles (OR, 95%CI: 0.67, 0.51-0.89; 0.63, 0.46-0.85; 0.74, 0.56-0.98) compared with the first quartile when excluding smokers, alcohol users, and underweight/obesity, respectively. And there was no association between dietary fructose intake and the risk of MetS after multivariate adjustment stratified by gender, smoking and alcohol use. Conclusions: Under the current dietary fructose intake status, there was no association between dietary fructose intake and the risk of MetS among Chinese residents aged 45 and above. Physical activity and relatively low fructose intake may have a beneficial synergistic effect on MetS.

To analyze dietary energy and macronutrients intake among Chinese older adults from 2010 to 2012.Data was from Chinese Nutrition and Health Surveillance in 2010-2012. Dietary intake information was collected by three days food recall and weighed record of edible oil and condiments among 16 612 older adults. Daily energy and three macronutrients intake were calculated according to Chinese Food Composition 2004 and 2009 edition, and then evaluated by 2013 Chinese dietary reference intake.The daily average energy, carbohydrate, protein and fat intake of Chinese older adults was(1840. 9 ± 636. 7) kcal/d, (255. 9 ± 106. 8) g/d, (55. 6±22. 7) g/d and(66. 8±35. 0) g/d, respectively. The mean proportion of energy supplied from carbohydrate, protein and fat was(55. 7% ± 12. 1%), (12. 3% ± 3. 4%)and(32. 5% ± 11. 7%), respectively. Total energy intake, carbohydrate intake and proportion of energy from carbohydrate among urban elderly were lower than that in rural, whereas protein and fat intake as well as their contribute rate for energy were higher in urban than those in rural. Regardless of urban and rural areas, four regions and genders, there was a decreasing trend of energy and macronutrient intake with the increase of age(P0. 01). There 57. 0% of male and 53. 8% of female had lower protein intake than the recommended value, while 56. 7% of male and 56. 8% of female had higher fat contribution for energy upper than 30%. The rate of protein intake deficiency among participants aged 60-69 years old, 70-79 years old, 80 years old and above was 51. 0%, 61. 2% and 68. 6% respectively, and the proportion of energy from fat that exceeded 30%was 56. 9%, 56. 3% and 57. 1%, respectively.The daily average macronutrients intake model was unreasonable with higher fat but lower protein among Chinese older adults.

To analyze salt intake among Chinese aged 60 and above in2010- 2012.Data was from 2010- 2012 Chinese Nutrition and Health Surveillance. Salt and condiment intake information of Chinese elderly was collected by the 3-condecutive days-24-hour dietary recall and food weighting method, the average salt intake was calculated based on energy percentage of family members.The daily average salt intake of Chinese elderly was( 8. 8 ± 6. 8) g / d, the level was( 9. 5 ± 7. 2) g / d for male and( 8. 2 ± 6. 3) g / d for female, ( 7. 9 ± 6. 2) g / d for urban areas and( 9. 9 ±7. 2) g / d for rural areas. Salt intake among the elderly in big cities, medium-sized and small cities, general rural and poor rural was( 7. 3 ± 5. 8) g / d, ( 8. 6 ± 6. 6) g / d, ( 9. 9 ±6. 9) g / d and( 10. 1 ± 7. 9) g / d, respectively. The average daily salt intake decreased with increasing age and also declined with the increase of per capita annual income, while the average daily intake of salt increased from illiteracy to primary school and thendecreased in junior middle-school or above. Compared with the salt recommendation( less than 6g / d) from Chinese residents dietary guidelines 2016 edition, there were only37. 7% of elderly meet with salt recommendation, 41. 0% of participants were in the level between 6 g to 11 g, and 21. 4% were higher than 12 g. Urban participants whose salt intake were less than 6 g, 6 g to 11 g and higher than 12 g accounted for 43. 4%, 40. 3%and 16. 3%, while in rural areas these percentage were 30. 7%, 41. 7% and 27. 6%, respectively.The daily average salt intake among Chinese elderly was still in high level, and the elderly should reduce salt consumption gradually.

Introduction. To study the influence of different glycemic statuses on the relationship of insulin action to age, gender, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) among Chinese population. Methods. A total of 35,327 participants (17,456 males and 17,871 females) were included in this nationally representative cross-sectional study. Glycemic status was defined according to the 2010 American Diabetes Association criteria. Fasting insulin was measured by the chemiluminescence method. Results. Insulin and HOMA-IR levels were the highest in newly diagnosed diabetes and were lowest in normal fasting glucose (NFG) (P<0.001). Insulin and HOMA-IR levels were higher in females (P<0.001) than in males with previously diagnosed diabetes and impaired fasting glucose (IFG) and NFG, meanwhile decreased with age (P<0.001) among IFG and NFG participants. As compared with participants with a BMI from 18.5 to 19.9, those in the lowest BMI category (P<0.001 for linear trend) for the participants with NFG but not in those with IFG. Conclusions. Different glycemic statuses significantly affect the relationships of insulin action to age, gender, BMI, WC, and WHtR among Chinese population.

Background: China has been undergoing tremendous demographic transitions towards an aging society. Although suboptimal diets and malnutrition are the leading risk factors for disease burden, capturing nutrition challenges faced by the aging population is challenging due to the limited national representative information available. This study aimed to provide a comprehensive picture of the nutrition status of mid-aged and elderly Chinese and its relation to geographical and socioeconomic factors. Methods: A total of 75,758 non-institutionalized adults aged 45-80 years from the 2010-2013 Chinese National Nutrition and Health Survey were included in this study to evaluate their nutritional status and prevalence of malnutrition problems including anemia, underweight, overweight and obesity. Dietary data from 33,418 participants in this sample were obtained through 24 hour-recall over three consecutive days combined with weighted food inventory. Nutrient intakes were estimated based on dietary records and comparison with Chinese Dietary Reference Intakes 2013 (DRIs). Malnutrition problems were reported with stratification for demographic, geographic, and socioeconomic variables. Odd ratios of risks factors for malnutrition were estimated through multilevel multiple logistic regression analysis. Findings: Chinese population mean intakes of nutrient-dense food groups including fruits, dairy, soy and nuts, eggs, fish and seafood, as well as vegetables were lower than recommendations. Conversely, consumption of fat- and sodium- contributing groups such as meat and poultry, cooking oil, salt and condiments were higher than recommendations.The low adherence to dietary recommendations led to inadequate micronutrient intakes compared to DRIs, especially for eight micronutrients (calcium, folate, magnesium, selenium, vitamin A, vitamin B1, vitamin B2, and vitamin C), with more than 50% of participants have intakes lower than Estimated Average Requirements (EAR). Older age groups showed lower percentages of nutrient adequacy. The overall prevalences of anemia, underweight, overweight and obesity were 10.9%, 3.7%, 36% and 14%, respectively. The combined prevalence of overweight and obesity was 51.3% for the middle-aged group (45-59 years) and 45.2% for the elderly group (60-80 years). After adjusting for confounders at both individual and province levels, being older, female, a rural resident and having lower education were factors associated with higher risk for anemia and underweight, while younger age, female, urban residency and higher income were factors associated with greater risk for being overweight and obese. Interpretation: The results provide reference data for the development of policy and interventions to substantiate the China National Nutrition Plan 2017-2030. Within Chinese adults, older people have the highest prevalence of malnutrition. We suggest three priorities which require attention and solution: addressing anemia and underweight in high risk groups, curbing overweight and obesity, and supporting healthy eating and balanced diets. Funding Statement: The China National Nutrition and Healthy Survey (CNNHS), the Chinese Center for Disease Control and Prevention (CDC). This secondary data analysis received financial support from the Nestle Research Center. Declaration of Interests: This secondary data analysis received financial support from Nestle Research Center. Co-author Kai Yu, Jing Yin, and Fabrizio Arigoni are employed by Nestle Research Center. These authors contributed to the development of the manuscript, with no roles in the survey design and data analysis. Ethics Approval Statement: The study protocol was approved by the ethical review committee of the Chinese CDC. Written informed consent was obtained from all participants.

To investigate the association of serum 25-hydroxyvitamin D (25(OH)D) with skeletal muscle mass (SMM) and function among the elderly in an urban area in northern China.A total of 912 participants (316 men, 596 women) aged more than 60 years from 4 communities in Beijing were enrolled. Serum concentrations of 25(OH)D were measured through radioimmunoassay. SMM was assessed through bioelectrical impendence analysis, whereas skeletal muscle function was assessed through grip strength and 4-m regular gait speed measurements. On the basis of expert consensus of the Asian Working Group for Sarcopenia, low muscle mass was defined as relative skeletal mass index (RSMI)7.0 kg/m2 for men and5.7 kg/m2 for women. A noncondition logistical regression model was employed to explore the association between vitamin D and both muscle mass and function.Serum 25(OH)D was positively associated with grip strength (β=0.16, SE=0.05). The upper quartile of 25(OH)D was negatively associated with loss of grip strength (OR=0.05, 95% CI: 0.01-0.48) in men but not in women. No significant associations were noted between 25(OH)D and appendicular skeletal muscle mass, RSMI, and gait speed.The present study demonstrated a positive association between vitamin D and skeletal muscle strength in elderly Chinese men but not women.

Genetically modified animals rich in omega-3 unsaturated fatty acid offer a new strategy to improve the human health, but at the same time present a challenge in terms of food safety assessment. In this study, we evaluated the function and safety of sFat-1 transgenic pork rich in omega-3 fatty acids in mice by feeding basic diet and diets that contain wild type pork and sFat-1 transgenic pork. Blood biochemistry, haematology, peripheral T cell distributions, bacterial counts, gross necropsy, histopathology and organ weights were performed in mice fed with different doses of wild type and transgenic pork. Results indicated that both low and high dose of wild type and transgenic pork had no significant effect on blood biochemistry, T cell distribution, immunoglobulins and bacterial counts in intestine and feces. However, it was noted that both low and high dose of transgenic pork improved the liver immune system in mice, which is probably due to the beneficial contribution of high level of the "good" fatty acids in transgenic pork. There is no significant effect of transgenic pork on all other organs in mice. In summary, our study clearly demonstrated that feeding transgenic pork rich in omega-3 fatty acids did not cause any harm to mice, and in fact, improved the liver immune system.

Hypercholesterolemia is a known risk factor for cardiovascular diseases and affects a high proportion of the population. This study aimed to assess and compare the determinants of hypercholesterolemia among Chinese adults aged 18 years and above, from 2002 to 2012. The study used a stratified multistage cluster sampling method to select participants. Sociodemographic and lifestyle information was collected during face-to-face interviews. Dietary intake was calculated by 3-day, 24-h dietary records in combination with weighted edible oil and condiments. Hypercholesterolemia was defined as total cholesterol above 6.22 mmol/L (240 mg/dL) from fasting blood samples. The study included 47,701 (mean age 43.0 years) and 39,870 (mean age 51.0 years) participants in 2002 and 2010–2012 surveys respectively. The weighted prevalence of hypercholesterolemia increased from 1.6% (2.1% urban, 1.0% rural) in 2002 to 6.0% (6.4% urban, 5.1% rural) in 2012. The intake of plant-based food decreased but the intake of pork increased over the 10 years. A high intake of protein and pork, alcohol drinking and overweight/obesity were positively associated with hypercholesterolemia. Neither education nor fruit and vegetable intake were associated with hypercholesterolemia. In conclusion, the burden of hypercholesterolemia increased substantially between 2002 and 2012 in China. Unhealthy lifestyle factors and change in traditional dietary pattern were positively associated with hypercholesterolemia. Further research on the role of diet in the development and prevention of hypercholesterolemia is needed.

There is limited information regarding the intake and status of polyunsaturated fatty acids (PUFA) in Chinese pregnant women with different dietary patterns. We hypothesize that there will be significant differences in long chain n-3 and n-6 PUFA status in pregnant women from 3 regions of China (river/lake, coastal and inland). Dietary fatty acid intakes and fatty acid profiles in maternal and umbilical erythrocyte phosphatidylcholine (PC) were analyzed. The median daily intakes (mg) of eicosapentanoic acid and docosahexaenoic acid (DHA) in the coastal group (64.6 and 93.9, n = 42) were significantly higher than those in the river/lake group (27.9 and 41.8, n = 41) and the inland group (12.1 and 41.1, n = 40). Daily intake of arachidonic acid (AA) was highest (170.2 mg) in the inland group. The median DHA level (%) of maternal erythrocyte PC was comparable between river/lake and inland groups (5.7 vs. 5.6) while both were significantly lower than in coastal group (8.4). The median AA level (%) of maternal erythrocyte PC tended to be lower in the coastal group than in the inland group but the difference was not significant. The AA and DHA levels in umbilical erythrocyte PC were comparable among the 3 groups. In conclusion, differences in long chain n-3 PUFA intake between geographic regions, in particular in DHA, were reflected in differences in maternal erythrocyte PC DHA status but did not result in differences in umbilical erythrocyte PC.

To analyze the dietary factors on sarcopenia in elderly in Beijing and provide nutritional recommendations for the sarcopenia.A total of 830 participants aged 60 and above and without serious diseases were selected from two representative communities in Beijing. A cross-sectional research design was used, including inquiry investigation, dietary surveys (food frequency questionnaire) anthropometry, muscle mass and functional assessment.The prevalence of sarcopenia was 20.1% in this area, the men was 17.1%, while the women was 21.6% (P0.05). The prevalence of sarcopenia in the five age groups has significant statistically difference (chi2 = 19.03, P = 0.0008) and increased with age rising (Z = -4.18, P0.0001). The prevalence of sarcopenia would be downward if the time of exercise prolonged and body mass index (BMI) increased (P0.05). The prevalence of sarcopenia in the group of meat consumption35, 35-70,70 g/d was 24.5%,19.9% and 15. 3% (chi2 = 6.02, P = 0.0492), respectively (trend test for groups comparison, Z = 2.45, P =0.0141). The prevalence of sarcopenia in the group of egg consumption35, 35-60,60 g/d was 25.8%, 18.7% and 11.3% (chi2 = 6.50, P = 0.0388), respectively ( trend test for groups comparison, Z =2. 55, P = 0.0109). The prevalence of sarcopenia in the group of energy consumption1612, 1612-2109,2109 kcal/d was 25.8%,19.5% and 15. 0% (x2 = 8. 19 , P = 0. 0158), respectively (trend test for groups comparison, Z = 2.87, P = 0.0042). The prevalence of sarcopenia in the group of protein consumption58.2, 58.2 - 78.4,78.4 g/d was 25.3%, 18.2% and 16.7% (chi2 = 5.97, P = 0. 0505 ) , respectively (Z = 2.28, P = 0.0227). After controlling the influence of age, BMI, exercise and education, meat consumption (beta = -0.1703, P = 0.0119), egg consumption (beta = -0.1545, P = 0.0302) and the high quality protein consumption (beta = -0.1805, P = 0.0302) were negatively related with sarcopenia.Animal food, such as meet and egg, is an important protective factor for sarcopenia. Therefore, it is the first important thing for the elderly to ensure adequate energy intake, then you should increase the animal food intake which contains high quality protein to prevent sarcopenia.

To analyze the serum total cholesterol level and the prevalence of hypercholesterolemia and borderline high cholesterolemia among urban-resident adults in China from 2010 to 2012.Data were from Chinese Nutrition and Health Surveillance in 2010-2012. Multi-stage stratified proportion to the population cluster random sampling method was conducted to determine 54 042 adult residents in 34 big cities and 41 small and medium-sized cities. Serum total cholesterol was measured by cholesterol oxidase method. Hypercholesterolemia and borderline high cholesterolemia were evaluated by Guidelines on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults 2007 edition. Standardized cholesterol level (x ± Sx) and prevalence of hypercholesterolemia and borderline high cholesterolemia were calculated through weighted complex sampling processing by population data released by the National Bureau of Statistics in 2009.The mean level of urban-resident adults's erum total cholesterol was (4.58 ± 0.05)mmol/L, (4.58 ± 0.05)mmol/L for both male and female. The cholesterol concentration level in big cities and small and medium-sized cities were (4.66 ± 0.04)mmol/L and (4.57 ± 0.06) mmol/L, respectively. It increased with age gradually from the minimum level, which was (4.18 ± 0.05)mmol/L in aged 18 to 29 group, till reached the maximum, which was (4.94 ± 0.05)mmol/L in aged 60 to 69 group, and then it declined to (4.92 ± 0.06)mmol/L in aged 70 group. The prevalence of hypercholesterolemia and borderline high cholesterolemia were 5.6%(95%CI:4.5%-6.6%) and 24.7%(95%CI:21.6%-27.9%) totally; 5.1% (95%CI:4.1%-6.1%) and 24.4% (95%CI:21.0%-27.6%) for male, 6.0% (95%CI:4.7%-7.3%) and 25.1%(95%CI:21.8%-28.4%) for female; 6.0%(95%CI: 5.0%-7.0%) and 27.7%(95%CI:24.9%-30.6%) in big cities, while 5.5%(95%CI: 4.2%-6.7%) and 24.2%(95%CI:20.5%-27.9%) in small and medium-sized cities. The minimum prevalence of hypercholesterolemia was in aged 18 to 29 group and maximum in aged 70 group, which were 2.2%(95%CI: 1.4%-3.0%) and 10.3%(95%CI: 7.1%-13.4%), respectively; while the lowest borderline high cholesterolemia prevalence was in aged 18 to 29 group and the highest in aged 60 to 69 year group, which were 12.9%(95%CI: 10.4%-15.4%) and 37.6% (95%CI: 33.6%-41.6%), respectively.The serum total cholesterol level and the prevalence of hypercholesterolemia and borderline high cholesterolemia were high among urban adults in China from 2010 to 2012, and more attention should be paid for high serum total cholesterol level among older adults.

A variety of conditions lead to anemia, which affects one-quarter of the world's population. Previous genome-wide association studies revealed a number of genetic polymorphisms significantly associated with plasma iron status. To evaluate the association of genetic variants in genes involved in iron delivery and hepcidin regulation pathways with the risk of iron-deficiency anemia (IDA), the following single nucleotide polymorphisms were genotyped in 2139 unrelated elderly Chinese women: rs3811647 (TF), rs7385804 (TFR2), rs235756 (BMP2), and rs855791(V736A) and rs4820268 (TMPRSS6, encoding matriptase-2). We identified common variants in TMPRSS6 as being genetic risk factors for both iron deficiency (OR(rs855791) = 1.55, P = 4.96 × 10(-8)) and IDA (OR(rs855791) = 1.78, P = 8.43 × 10(-9)). TMPRSS6 polymorphisms were also associated with lower serum iron (SI) and hemoglobin levels, consistent with their associations to increased iron deficiency and anemia risk. Variants rs3811647 in TF and rs7385804 in TFR2 were associated with reduced SI, serum transferrin and transferrin saturation levels; however, these variants were not associated with iron deficiency or anemia risk. Our findings suggest that TF, TFR2 and TMPRSS6 polymorphisms are significantly associated with decreased iron status, but only variants in TMPRSS6 are genetic risk factors for iron deficiency and IDA.

Dietary intervention studies to assess the cardioprotective effects of oily fish are scarce in China. The present study aimed to examine the effects of the oily fish, Norwegian salmon, herring and local farmed pompano (Trachinotus ovatus) on CVD risk markers when included in the Chinese diet. In this 8-week, parallel-arm, randomised intervention study, 126 Chinese women with hypertriacylglycerolaemia, aged 35–70 years, were assigned to four groups to consume an experimental lunch containing 80 g fillets of either one of three oily fish or a mix of commonly eaten meats (pork/chicken/beef/lean fish) for 5 d/week. The results showed that inclusion of the three oily fish significantly increased the intake ofn-3 long-chain PUFA (LC-PUFA) while decreasing the dietaryn-6:n-3 PUFA ratio. Compared to the control group, significant increases of DHA, EPA+DHA and totaln-3 PUFA in plasma choline phosphoglyceride were observed in the three oily fish groups. Plasma TAG levels were significantly reduced only in the salmon and herring groups. When compared to the baseline level, the three oily fish diets significantly decreased serum concentrations of TAG, apoB, apoCII and apoCIII, but only the salmon and herring diets significantly lowered TNF-α and raised adiponectin levels in serum. The salmon diet additionally decreased the serum concentration of IL-6. To conclude, dietary inclusion of salmon, herring and pompano as oily fish can effectively increase serumn-3 LC-PUFA content and are associated with favourable biochemical changes in dyslipidaemic middle-aged and elderly Chinese women, and these beneficial effects are mainly associated withn-3 LC-PUFA contents.

Although the beneficial effects of n-3 fatty acids on several physiologic functions have been widely reported, information about the effects of oily fish in the Asian diet on cardiovascular disease (CVD) risk is diminutive. We hypothesize that daily inclusion of oily fish for 8 weeks in the Chinese diet will elevate serum eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels and reduce CVD risk markers in dyslipidemic adult men, comparable with the effects generally observed by inclusion of oily fish in the Western diet. In this 8-week randomized, parallel-arm, food-based intervention study, lunches were prepared with 500 g pork/chicken/beef, typically consumed fish (hairtail and freshwater carp), or oily fish (salmon). Male subjects aged between 35 and 70 years with hyperlipidemia were randomly assigned to eat lunches with pork/chicken/beef (n = 30 subjects at 8 weeks), freshwater fish (n = 30), or oily fish (n = 32). Circulating markers were measured at baseline and at 8 weeks. In the oily fish diet, dietary EPA and DHA levels were significantly increased as compared with other diets; and the n-6:n-3 polyunsaturated fatty acid ratio was decreased (P < .05). Thus, the oily fish diet significantly elevated serum EPA and DHA concentrations (P < .01) and lowered serum n-6:n-3 ratio at 8 weeks (P < .05). Furthermore, oily fish intake significantly reduced serum levels of triglycerides (P < .05) and interleukin-6 (P < .01) and increased levels of high-density lipoprotein cholesterol (P < .01). In conclusion, daily inclusion of oily fish as part of the Chinese diet for 8 weeks is sufficient to significantly increase the serum content of long-chain n-3 polyunsaturated fatty acids and reduce levels of CVD risk markers in dyslipidemic adult men.

Although dietary patterns are crucial to cognitive function, associations of dietary patterns with cognitive function have not yet been fully understood. This cross-sectional study explored dietary patterns associated with cognitive function among the older adults in underdeveloped regions, using 1504 community-dwelling older adults aged 60 and over. Diet was assessed using a food frequency questionnaire and 24-h dietary recall. Factor analysis was used to extract dietary patterns. Global cognitive function was assessed using the Mini-Mental State Examination (MMSE). Two dietary patterns, a “mushroom, vegetable, and fruits” (MVF) pattern and a “meat and soybean products” (MS) pattern, were identified. The MVF pattern, characterized by high consumption of mushrooms, vegetables, and fruits was significantly positively associated with cognitive function (p < 0.05), with an odds ratio of (95% CIs) 0.60 (0.38, 0.94) for cognitive impairment and β (95% CIs) 0.15 (0.02, 0.29) for –log (31-MMSE score). The MS pattern, characterized by high consumption of soybean products and meat, was also associated with better cognitive function, with an odds ratio of 0.47 (95% CIs 0.30, 0.74) for cognitive impairment and β (95% CIs) 0.34 (0.21, 0.47) for –log (31-MMSE score). Our results suggested that both the MVF and MS patterns were positively associated with better cognitive function among older adults in underdeveloped regions.

To investigate dietary pattern during late pregnancy and fatty acid composition of transitional milk in inland regions of China.Eighty Chinese women were recruited from two different geographical inland regions (Jurong, an inland region close to freshwater. Xushui, an inland region with limited access to freshwater, forty women from each region) during late pregnancy. Their dietary status during late pregnancy was recorded and fatty acid composition in transitional milk was quantified.Both marine fish consumption frequencies during late pregnancy were less than one time/week. The consumption of rapeseed oil in Jurong was significantly higher than in Xushui (P0.05). The total lipids contents of Jurong and Xushui were (4.39 ± 1.18) g/100g and (3.92 ± 1.47) g/100g, respectively (P = 0.11), and DHA composition were (0.46 ± 0.20 )% and (0.29 ± 0.09 )%, respectively (P0.05). There was positive relationship between rapeseed oil consumption and DHA in transitional milk (r = 0.362, P0.05).Fatty acid composition in transitional milk differed between these two inland regions of China, which may be caused by difference of maternal dietary pattern during late pregnancy. The intake of precursor of n-3 long chain polyunsaturated fatty acid could compensate its dietary deficiency to some extent.

Dietary cholesterol intake increased dramatically over the past two decades in the elderly Chinese population. However, the nationwide dietary cholesterol intake and its related factors seldom been investigated. Based on data from 16,594 participants aged 60 years or older (49.0% male, 54.8% urban residents) from the China National Nutrition and Health Survey (CNHS) 2010–2012, we aimed to describe the intake of cholesterol and major food contributions, as well as its association with serum cholesterol level and relationship with protein intake. Mean daily cholesterol intake for all participants was 217.4 mg, the mean cholesterol intakes in urban and rural areas were 264.0 mg and 168.8 mg, respectively. Cholesterol intake levels varied by age, gender, BMI and region (p < 0.001). In addition, the proportion of all participants who consumed greater than 300 mg of cholesterol per day was 26.6%. Eggs, red meats, and seafood were the top three food sources and their contributions to total daily cholesterol intake were 57.7%, 24.0% and 10.9% respectively. Serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were related to dietary cholesterol intake, with each 100 mg increase in dietary cholesterol intake apparently leading to a 0.035 mmol/L (p = 0.001) increase in serum TC and a 0.038 mmol/L (p < 0.001) increase in LDL-C. The partial correlation coefficients between dietary cholesterol and total protein, high-quality protein, intake of protein per kilogram body weight (BW), and high-quality protein percentage were 0.538, 0.580, 0.426, and 0.548, respectively, after adjusting for age, gender, and energy, fat and carbohydrate intakes (p < 0.001). In conclusion, there was a substantial urban-rural difference in cholesterol intake. Eggs and red meat were the main sources of dietary cholesterol intake. Serum TC and LDL-C were associated with dietary cholesterol and the response was linear. Dietary cholesterol intake was closely related to the intake of high-quality protein.

Objectives To propose a feasible suggestion to reduce the high prevalence of anaemia in middle-aged and elderly women by investigating risk factors, particularly nutritional factors, and analysing the effect on anaemia in three different rural areas of China. Design A case–control study. Setting Three counties of China. Participants Women aged 50–75 years in the three counties. Main outcome measures Adjusted OR (95% CI) of anaemia associated with diet, lifestyle and blood biochemical indices. Results Compared with controls, women with anaemia had lower body mass index (22.1 (3.2) kg/m2 vs 23.2 (3.5) kg/m2; p

To compare the performance of glycated hemoglobin (HbA1c) and oral glucose tolerance test (OGTT) in diagnosing diabetes and pre-diabetes in the general population.A total of 1416 subjects from Nanchang, Jiangxi Province and Wuhan, Hubei Province who have participated the 2010 Chinese Nutrition and Health Survey were studied and their HbA1c were measured. The glycemic levels and distribution of the subjects diagnosed with diabetes and pre-diabetes by OGTT and HbA1c were compared. Receiver operating characteristic curves were constructed to determine the sensitivity and specificity of HbA1c in detecting diabetes as defined by OGTT.According to the 1999 WHO criteria, 86 subjects were diagnosed with diabetes and 262 were with pre-diabetes. Comparing with OGTT, the sensitivity and specificity of HbA1cor = 6.5% was 41.9% and 98.9%. Subjects with diabetes diagnosed by HbA1c and OGTT were not consistent, and they have different HbA1c level. The HbA1c level of 5.7% - 6.4% was associated with a sensitivity of 78.6% and a specificity of 55.1% in detecting impaired glucose regulation (IGR). Cases with pre-diabetes identified by HbA1c 5.7% - 6.4% were different from those with IGR. They had lower fasting glucose and 2-hour plasma glucose after glucose load than those with IGR.Among this studied population, HbA1cor = 6.5% showed high specificity but low sensitivity for detecting glucose-defined diabetes. The performance of HbA1c of 5.7% -6.4% in screening pre-diabetes is poor.

To describe the fatty acid composition of human colostrum in three different regions of China.Women were recruited from river/lake, coastal and inland regions of China during late pregnancy. Their diet frequency was assessed during the 34th week of pregnancy. Colostrum samples were collected between postpartum days 3 and 5. Thirty-one different fatty acids were separated and identified in colostrum.There were significant differences among the women in the three regions with respect to food and culinary oil consumption patterns. The mean±SD fat content (g/100 g) of colostrum from river/lake, coastal and inland regions was 2.17±1.26, 2.50±1.39 and 2.68±1.26, respectively (p=0.265, adjusted by pregnant women's age). The main saturated, monounsaturated, n-6 polyunsaturated and n-3 polyunsaturated fatty acids in colostrum were 16:0, 18:1n9, 18:2n6 and 18:3n3, respectively. Colostrum from river/lake region had the lowest composition of total SFA and of total n-6 PUFA and the highest composition of total MUFA and of total n-3 PUFA. The amount of DHA (22:6n3) in colostrum (mean±SD, % wt/wt) was 0.51±0.18, 0.52±0.20 and 0.35±0.13 in the river/lake, coastal and inland regions, respectively (p=0.0002, adjusted by pregnant women's age). Frequency of maternal marine fish intake during the late pregnancy was positively correlated with DHA in colostrum (r=0.203, p=0.040).The fatty acid composition of colostrum differs across geographical regions in China, which may be related to differences in maternal dietary pattern.

This study was carried out to investigate the nutritional status and feeding practices of young children in the worst-affected areas of China two years after the Wenchuan Earthquake. The sample consisted of 1,254 children 6-23 months of age living in four selected counties from the disaster-affected provinces of Sichuan, Shaanxi and Gansu. Length-for-age, weight-for-age, weight-for-length, and hemoglobin concentration were used to evaluate nutritional status. Interviews with selected children's caretakers collected basic demographic information, children's medical history, and child feeding practices. Stunting, underweight, and wasting prevalence rates in children 6-23 months of age were 10.8%, 4.9% and 2.8% respectively, and anemia prevalence was 52.2%. Only 12.3% of children had initiated breastfeeding within the first hour after birth. Overall, 90.9% of children had ever been breastfed, and 87% children 6-8 months of age had received solid, semi-solid or soft foods the day before the interview. The diets of 45% of children 6-23 months of age met the definition of minimum dietary diversity, and the diets of 39% of breastfed and 7.6% non- breastfed children 6-23 months of age met the criteria for minimum meal frequency. The results highlight that a substantial proportion of young children in the earthquake affected disaster areas continue to have various forms of malnutrition, with an especially high prevalence of anemia, and that most feeding practices are suboptimal. Further efforts should be made to enhance the nutritional status of these children. As part of this intervention, it may be necessary to improve child feeding practices.