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Temporal trends and geographical variations in cardiovascular disease attributable to high systolic blood pressure in China are not yet fully understood. The aim of this study was to quantify the cardiovascular disease burden attributable to high systolic blood pressure at national and provincial levels in China.In this population-based study, we evaluated systolic blood pressure and estimated the number of deaths, age-standardised mortality rates, and years of life lost (YLLs) due to cardiovascular disease and its subcategories (including ischaemic heart disease, ischaemic stroke, haemorrhagic stroke, and other cardiovascular diseases) attributable to high systolic blood pressure, at the national level and by 31 provincial levels, in China, from 2005 to 2018. We pooled blood pressure data of 1·30 million adults aged 25 years and older from the China Chronic Disease and Risk Factor Surveillance project, the China National Nutrition Survey, and the China Hypertension Survey. We applied a temporal-spatial Bayesian hierarchical model to estimate age-specific, sex-specific, province-specific, and year-specific average systolic blood pressure, and a comparative risk assessment method to compute the cardiovascular disease burden attributable to high systolic blood pressure by age, sex, year, and province.Nationally, age-standardised mean systolic blood pressure was 132·5 mm Hg (95% uncertainty interval [UI] 124·6-140·3) in men and 129·4 mm Hg (121·7 to 137·2) in women. 2·67 million (95% UI 2·61 to 2·72) cardiovascular disease deaths in China were attributable to high systolic blood pressure, including 1·12 million deaths (1·07 to 1·16) due to ischaemic heart disease, 0·63 million deaths (0·60 to 0·65) due to ischaemic stroke, 0·58 million deaths (0·57 to 0·60) due to haemorrhagic stroke, and 0·34 million deaths (0·32 to 0·36) due to other cardiovascular disease. The age-standardised cardiovascular disease mortality rates associated with high systolic blood pressure were 268·99 per 100 000 people (95% UI 264·11 to 273·51) in 2005 and 220·84 per 100 000 people (216·30 to 224·76) in 2018, a percentage change of -17·90%; the rate changed by an average of -1·50% (95% UI -1·55% to -1·45%) per year from 2005 to 2018 nationally. YLL rates for total cardiovascular disease caused by high systolic blood pressure varied substantially across provinces, ranging from 3078·33 (95% UI 2807·40 to 3303·57) per 100 000 people in Beijing to 7189·98 (95% UI 6817·18 to 7507·99) per 100 000 people in Heilongjiang in 2018. Age-standardised YLL rates for ischaemic heart disease and ischaemic stroke attributable to high systolic blood pressure were particularly high in northeastern provinces, including Heilongjiang, Liaoning, and Jilin.The deaths and YLLs for cardiovascular disease attributable to high systolic blood pressure in China increased between 2005 and 2018, and age-standardised cardiovascular disease mortality rates decreased in the same timeframe. Our findings could help policy makers in promoting blood pressure control measures and implementing effective and locally adapted preventive interventions to reduce the prevalence of high systolic blood pressure and reduce the burden of systolic blood pressure-related cardiovascular disease in China.China National Key Research and Development Program, China National ScienceTechnology Pillar Program, and National Health Commission of the People's Republic of China.For the Chinese translation of the abstract see Supplementary Materials section.

Hydrolyzed formulas (HFs) have been increasingly used in early enteral feeding in preterm infants. The current study aimed to compare the effect of HFs with standard preterm formula (SPF) on gastrointestinal tolerance in preterm infants by systematically reviewing the randomized controlled trials (RCTs) related.Relevant studies published until August 2021 were searched in English and Chinese databases, including PubMed, Embase, Cochrane Library, CNKI, WanFang Data, and VIP. Three outcomes, including the incidence of feed intolerance (FI), necrotizing enterocolitis (NEC), and the time to full enteral feeding, were chosen to evaluate the effect on gastrointestinal tolerance comprehensively.Ten eligible studies with 886 participants were included in the final analysis. Infants who received HFs showed a lower risk of FI (RR = 0.61, 95% CI = 0.42-0.90;The results showed that HFs may have benefits in improving gastrointestinal tolerance in preterm infants, including reducing the risk of FI and shortening the time to full enteral feeding.

Background The double burdens of under- and overnutrition are changing the health of individuals and the economic and disease burdens in China. Poor diet plays an important role; however, a valid and easily operationalized metric that could capture the full range of characteristics of the diet that are relevant to both under- and overnutrition is lacking in China. Objectives We aimed to examine the application of the Global Diet Quality Score (GDQS) to evaluate nutrient inadequacy and metabolic syndrome in different demographic groups of Chinese adults. Methods A total of 35,146 individuals (men 14,978, women 20,168) aged >18 y from the 2010–2012 China National Nutrition and Health Survey were included. We scored the GDQS using average intakes of 25 food groups from 3 d of 24-h dietary recalls. Double burden was defined as coexisting metabolic syndrome and nutrient inadequacy. Results Diet quality assessed by GDQS was significantly higher in urban than in rural residents (20.8 compared with 18.7), and increased with both educational level and household income (P-trends < 0.0001). A higher GDQS score was inversely associated with metabolic syndrome and nutrient inadequacy, or both (P-trends < 0.0001): multivariate adjusted ORs comparing extreme quintiles of GDQS were 0.79 (95% CI: 0.69, 0.91) for metabolic syndrome, 0.17 (95% CI: 0.14, 0.20) for nutrient inadequacy, and 0.59 (95% CI: 0.50, 0.69) for the double burden. These associations were consistent across different household income levels (P-interaction = 0.26), suggestively stronger in younger (

Background Poor diet quality is a major driver of both classical malnutrition and noncommunicable disease (NCD) and was responsible for 22% of adult deaths in 2017. Most countries face dual burdens of undernutrition and NCDs, yet no simple global standard metric exists for monitoring diet quality in populations and population subgroups. Objectives We aimed to develop an easy-to-use metric for nutrient adequacy and diet related NCD risk in diverse settings. Methods Using cross-sectional and cohort data from nonpregnant, nonlactating women of reproductive age in 10 African countries as well as China, India, Mexico, and the United States, we undertook secondary analyses to develop novel metrics of diet quality and to evaluate associations between metrics and nutrient intakes and adequacy, anthropometry, biomarkers, type 2 diabetes, and iteratively modified metric design to improve performance and to compare novel metric performance to that of existing metrics. Results We developed the Global Diet Quality Score (GDQS), a food-based metric incorporating a more comprehensive list of food groups than most existing diet metrics, and a simple means of scoring consumed amounts. In secondary analyses, the GDQS performed comparably with the Minimum Dietary Diversity - Women indicator in predicting an energy-adjusted aggregate measure of dietary protein, fiber, calcium, iron, zinc, vitamin A, folate, and vitamin B12 adequacy and with anthropometric and biochemical indicators of undernutrition (including underweight, anemia, and serum folate deficiency), and the GDQS also performed comparably or better than the Alternative Healthy Eating Index - 2010 in capturing NCD-related outcomes (including metabolic syndrome, change in weight and waist circumference, and incident type 2 diabetes). Conclusions The simplicity of the GDQS and its ability to capture both nutrient adequacy and diet-related NCD risk render it a promising candidate for global monitoring platforms. Research is warranted to validate methods to operationalize GDQS assessment in population surveys, including a novel application–based 24-h recall system developed as part of this project.

To predict the main food intake trend of the Chinaapos;s urban and rural residents from 2022 to 2030.Data was collected from the China Health and Nutrition Survey(CHNS), which was carried out on a stratified, multistage, clustered, and random sampling method. And the average daily food intake in the survey was continuously collected by a 24-hour dietary review method for 3 consecutive days. The sample sizes aged 20 years or older of seven rounds survey were 9794, 9425, 9313, 9726, 12 760, 15 446 and 15 051, respectively. Based on the seven rounds of average food intake, the main food intake of urban and rural residents in China from 2022 to 2030 was predicted by the Grey model.(1)The mean absolute percentage error of average food intake prediction in urban and rural ranged from 1.6% to 38.4%. (2)In terms of the trends of food intake from 2022 to 2030, the grain and vegetable average intake of plant food in urban and rural residents showed a decreasing trend, while the average intake of fruits showed an increasing trend. The average intake of animal food, such as poultry and aquatic products in urban, livestock, poultry, eggs in rural areas showed an upward trend. Meanwhile, the average intake of animal food, such as livestock and eggs in urban and aquatic products in rural showed a downward trend. (3)Compared with the 2018, the fruits, poultry and aquatic product intake of urban and rural residents in 2030 will increase by 60.7%, 29.4% and 6.6%, the intake of grain, vegetables, livestock and eggs in urban areas will decrease by 36.9%, 19.4%, 8.7% and 12.4%, respectively. In 2030, the intake of fruits, livestock, poultry and eggs of rural residents will increase by 88.9%, 31.8%, 71.9% and 9.2%, respectively. While the intake of grain, vegetables and aquatic products of rural residents will decrease by 32.5%, 24.8% and 2.2%, respectively. (4)By 2030, the average intake of poultry in urban and rural areas will be within the recommended range of dietary guidelines. But the average intake of grain, vegetables, fruits, eggs and aquatic products in urban and rural areas will remain below dietary recommendations. While the livestock average intake will be far higher than the recommendations.The model accuracy is different when applied to different kinds of food. According to the prediction result of the grey model, residents should be guided to maintain the current grain intake level and increase the intake of vegetables, fruits, poultry, eggs and aquatic products in order to get balanced diet, while reducing the intake of livestock.

Breastmilk is the optimal food for infants. Feeding pattern is closely related to physical development and health during infancy. Understanding the associations between feeding patterns and health status can inform related policy interventions and advocacy in China. This study aimed to investigate the relationship between infant feeding patterns and health status in China infants. The China National Nutrition and Health Surveillance 2013 was a national-representative cross-sectional study performed particularly for children aged 0–5 years. A total of 3974 infants aged under 1 year were included in the analysis, of whom 1082 (27.2%) made up the formula feeding group, and 2892 (72.8%) made up the breastfeeding group. The associations between feeding patterns and physical development and health were investigated using propensity score matching and multivariable logistic regression models. Among breastfeeding and formula feeding infants aged 9–11 months old, weight-for-age z score was 1.1 ± 1.1 and 0.9 ± 1.3, respectively, and weight-for-length z score was 1.0 ± 1.3 and 0.7 ± 1.4, respectively. Hemoglobin in 0–2, 3–5, 6–8, and 9–11 months old breastfeeding infants was 121.4 ± 15.2 g/L, 117.1 ± 13.0 g/L, 113. 9 ± 11.9 g/L, and 114.4 ± 14.0 g/L, while in 0–2, 3–5, 6–8, and 9–11 months formula feeding infants was 116.3 ± 14.8 g/L, 120.4 ± 11.3 g/L, 119.8 ± 11.2 g/L, and 120.0 ± 11.5 g/L, respectively. Breastfeeding was associated with lower risk of respiratory disease (OR: 0.79; 95% CI: 0.64, 0.99) and diarrhea (OR: 0.75; 95% CI: 0.57, 0.98). Breastfeeding could slightly improve infant physical development, and had a protective effect on the diarrheal and respiratory diseases. Infants aged 3–11 months who were breastfeeding showed lower hemoglobin than that of formula-fed infants and thus should increase intake of iron rich complementary foods.

To Develop the China Prime Diet Quality Score(CPDQS) and evaluate the relationship between dietary quality and health-related outcomes in Chinese adults.CPDQS was conducted by 22 components, including dark green vegetables, dark red/orange vegetables, other vegetables, dark yellow fruits, citrus fruits, other fruits, whole grains/legumes, sweet potato, other potatoes, soybean, nuts, poultry, fish and shrimp, milk, eggs, red meat, fried food, refined grains, sugar sweetered beverages, salt, cooking oil, and alcohol. CPDQS components were selected based on Chinese Dietary Guidelines, and the values of each CPDQS components were set according to the dietary recommendations of foods and nutrients. According to the recommended amount of all kinds of foods under energy requirements of 2000 kcal in the Balanced Diet Pagoda, the basic score for each kind of food was 0-4, and the total score of the 22 components ranges from 0 to 100. Dietary quality of Chinese residents was evaluated according to CPDQS by analyzing data of adults aged 20-80 from Chinese Nutrition and Health Surveillance in 2010-2012.Mean of CPDQS for Chinese residents aged 20 and above was 40. 28±0. 08. CPDQS was higher in urban areas than in rural areas with median 48 and 39 respectively. CPDQS of female was slightly higher than that of male with median 44 and 43 respectively. CPDQS showed significantly correlation with all kinds of nutrients, in which correlation coefficient with carbohydrate and MPA was-0. 18 and 0. 35. With the increase of CPDQS score, the risk of overweight and obesity, abdominal obesity, hypertension, low high-density lipoprotein cholesterol-emia and metabolic syndrome decreased. After multi-factor adjustment, ORs of the highest quantile-group were 0. 73(95%CI 0. 63-0. 84), 0. 72(95%CI 0. 63-0. 83), 0. 67(95%CI 0. 57-0. 78), 0. 85(95%CI 0. 73-0. 99) and 0. 72(95%CI 0. 61-0. 85), respectively compared with the lowest quantile-group.CPDQS is a simplified index for comprehensive evaluation of dietary quality and it can reflect differences in diet quality among people in different regions and different health conditions. CPDQS could be used as an effective tool for evaluation of dietary quality.

This study aims to examine association between sodium intake and overweight/obesity among Chinese children and adolescents. Data were obtained from China National Nutrition and Health Surveillance (CNNHS), 2010–2012. All participants recruited in this study aged 7–18 years old and provided complete dietary data on three-day consecutive 24 h dietary recalls combining with the household weighing method. Body Mass Index (BMI) was used to define overweight/obesity, and waist-to-height ratio (WHtR) was used to define abdominal obesity. Sodium intake showed association with risk of overweight/obesity assessed by BMI in the highest tertile group with OR of 1.48 (95%CI 1.13–1.94) and 1.89 (95%CI 1.33–2.67) for WHtR. After adjusted for gender, age, household income, area, energy, carbohydrates, protein, fat, saturated fatty acids, and fiber intake, the relationship between sodium intake and overweight/obesity and abdominal obesity are not changed. The same results were founded in subjects aged 10–18 years old. Our results reveal a positive association between sodium intake and overweight/obesity in Chinese children and adolescents, independent of energy consumption.

Background: China&rsquo, s diet transition might offer guidance to undeveloped countries on the way to prosperity. This report describes the trends and disparities in energy and macronutrient composition among Chinese adults, and between subpopulations. Methods: Data for the current study were obtained from the 1982, 1992, 2002, and 2010&ndash, 2012 China National Nutrition Survey (CNNS) rounds, which were nationally representative cross-sectional surveys. We applied 24-h dietary recall and food weighing to assess dietary intake. Results: There were 204,877 participants aged 20 years or older included in the current analysis. From 1982 to 2012, the estimated energy intake declined from 2614.7 kcal to 2063.9 kcal. The trend in the estimated percentage of energy intake from fat showed a spike. It increased from 16.3% to 33.1% (1992 vs. 1982 difference, 7.6%, 95% CI 7.4% to 7.7%, 2002 vs. 1992 difference, 7.7%, 95% CI 7.6% to 7.9%, 2012 vs. 2002 difference, 1.6%, 95% CI 1.4% to 1.7%, p &lt, 0.01 for trend). The trends coincided in all the subgroups (all p &lt, 0.01 for trend) except for the subgroup of those educated over 15 years, whose percentage of energy intake from fat declined from 37.4% to 36.6% (2012 vs. 2002 difference, &minus, 0.8%, 95% CI &minus, 1.6% to 0.0%). The estimated percentage of energy intake from carbohydrates declined from 74.0% to 55.0%. The ranges of the estimated percentage of energy intake from fat, within population subgroups stratified by education level, area and Gross national product (GNP) level, were narrowed. Conclusions: Quick improvements in society and the economy effectively curbed undernutrition, but easily triggered overnutrition. Disparities persistently existed between different subpopulations, while the gaps would narrow if comprehensive efforts were made. Education might be a promising way to prevent overnutrition during prosperous progress. The low-social profile populations require specific interventions so as to avoid further disease burdens.

OBJECTIVES: To obtain information on drinking patterns and its changing trends, and to reveal drinking pattern and risky drinking in relation to socioeconomic development in China. METHODS: Data from the 2002 China National Nutrition and Health Survey and the 2010–2012 Chinese Nutrition and Health Surveillance were used to describe the drinking patterns of Chinese aged 15 years and above. Stratified multistage cluster sampling methods were used to select nationally representative sample in the two surveys. Weighted analyses included 194,339 participants estimate 10 billion Chinese. Current drinkers defined as respondents who had consumed alcoholic beverages in the previous 12-month period. Drinking ≥5 times per week was considered as frequent drinking. Excessive drinking was defined as consumption of ≥25 g/d alcohol for men and ≥15 g/d alcohol for women. RESULTS: In 10-year period, the prevalence of current drinking increased from 44.0% (95%CI: 43.3–44.6) to 55.8% (95%CI: 51.6–58.5) for male, from 9.7% (95%CI: 9.3–10.1) to 13.5% (95%CI: 11.3–15.7) for female. Among current drinkers, prevalence of frequent drinking increased from 33.3% (95%CI: 32.4–34.3) to 35.5% (95%CI: 31.6–39.5) for male, from 13.4% (95%CI: 12.1–14.8) to 14.0% (95%CI: 11.3–16.6) for female. Median daily alcohol intake decreased from 14.8 g (95%CI: 14.2–15.4) to 11.4 g (95%CI: 8.9–13.9) for male and from 1.6 g (95%CI: 1.3–1.8) to 0.9 g (95%CI: 0.6–1.2) for female. Prevalence of excessive drinking among current drinkers decreased from 33.2% (95%CI: 32.3–34.0) to 30.4 (95%CI: 26.5–34.3). Education level showed significantly negative effect on the prevalence of excessive drinking. Female, drinkers with drinking frequency less than 1 time per week, and drinkers with high education or income level were more likely to choose wine. In contrast, male, frequent drinkers, and drinkers with low education or income level had higher proportion consume spirits. CONCLUSIONS: Increasing prevalence of current and frequent drinking, and high excessive drinking rate showed that culturally appropriate effort to reduce alcohol use in China is still necessary. FUNDING SOURCES: National Health and Family Planning Commission (former Ministry of Health of the People's Republic of China) Medical Reform Major Program: China Nutrition and Health Surveillance 2010–2012.

To understand the status of preschool children's feeding behavior, to analyse the feeding behavior of parents and its main influencing factors of children aged 3-5 years old.From August to December 2018, 10 kindergartens in Liaoning Province, Shanghai City, Inner Mongolia Autonomous Region, Guangdong Province and Sichuan Province were selected by means of convenient sampling. A survey of 1057 preschool children's caregivers was conducted using the caregiver feeding style questionnaire. Chi-square test and binary Logistic regression were used to analyze the demographic characteristics of families with different feeding behaviors.It was found that among the four feeding style, the authoritative type accounted for only 10. 3%, and the authoritarian type accounted for 36. 1%, followed by the indulgent type(35. 8%) and the uninvolved type(17. 8%). Parents of 5-year-old were more likely to adopt indulgent type(OR=2. 60, 95%CI 1. 60-4. 22);fathers with a college degree or above were more likely to adopt authoritarian type(OR=2. 77, 95%CI 1. 39-5. 52) and indulgent type(OR=3. 79, 95%CI 1. 86-7. 72); mothers as primary caregivers were more likely to adopt authoritarian feeding method(OR=2. 48, 95%CI 1. 06-5. 83) and grandparents as primary caregivers were more likely to adopt indulgent feeding method(OR=3. 49, 95%CI 1. 54-7. 91).The proportion of children aged 3-5 whose parents adopt authoritarian, indulgent feeding method is higher. Among them, mothers are more likely to adopt authoritarian feeding behaviors, grandparents are more likely to adopt permissive feeding behaviors, and fathers with higher education are more likely to adopt authoritarian and permissive feeding behaviors.

The present study was done to examine the status of dietary sodium intake and dietary sources of sodium among Chinese adults. Data were obtained from China National Nutrition and Health Surveillance (CNNHS) 2010&ndash, 2012. All adults recruited in this study provided complete dietary data on three-day consecutive 24-h dietary recalls combining with the household weighing method. Sodium intake was adjusted for energy to 2000 kcal/day using the residual method. Average sodium intake was 5013 (95% Confidence Interval, CI: 4858, 5168) mg/day, and 92.6% of adults&rsquo, sodium intake exceeded the standard in the Chinese proposed intake for preventing non-communicable chronic diseases (PI-NCD). The salt added to food was the main contributor to daily sodium intake, representing 69.2% of the total sodium consumption. The proportion of sodium from salt was different in some subgroups. The contribution ranged from 64.8% for those who came from urban areas aged 18&ndash, 49 years old to 74.7% for those who came from rural areas with education levels of primary school or less, and sodium from soy sauce was the next highest contributor (8.2%). The proportion of the subjects with sodium intake contributed by flour products was higher in the north with 7.1% than the south with 1.4%. The average consumption of sodium among Chinese was more than the recommended amount, and salt was the main source of sodium.

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.

The purpose of our study was to estimate the national prevalence of metabolic syndrome, its individual components and its changes in the past decade.Two national-representative cross-sectional surveys: the China National Nutrition and Health Survey 2002 (CNNHS 2002) and the Chinese National Nutrition and Health Surveillance 2010-2012 (CNNHS 2010-2012). A total of 48,235 and 104,098 participants aged 18 years or older who had completed data on physical examination, blood lipids, and fasting glucose tests from CNNHS 2002 and CNNHS 2010-2012, respectively, were included in current study.The prevalence of metabolic syndrome in Chinese adults increased from 9.5% (95% confident interval [CI]: 9.2%-9.7%) in 2002 to 18.7% (18.3%-19.1%) in 2010-2012, corresponding to an estimated 83.6 million adults in 2002 and 189 million adults in 2010-2012 living with metabolic syndrome in China. The increment was more than doubled among young, rural residents and those from poor households. Abdominal obesity, hyperglycemia, high triglycerides, low HDL-C, and elevated blood pressure were found in 18.9% (18.5%-19.3%), 6.4% (6.2%-6.7%), 13.8% (13.5%-14.2%), 19.3% (18.9%-19.7%), and 34.0% (33.5%-34.5%) of adults in 2002, respectively, which was 25.8% (25.3%-26.2%), 16.2% (15.8%-16.5%), 23.7% (23.3%-24.2%), 32.6% (32.0%-33.1%), and 34.4% (33.9%-34.9%), respectively, in 2010-2012.Based on two nationally representative surveys, our results indicated that the prevalence of metabolic syndrome is widespread and increasing in China.

Summary Background Few studies have used nationally representative data to describe dietary trends and the related cardiometabolic mortality burden in China. Thus, we aimed to characterise the trends in disease-related dietary factors as well as their associated disease burden among Chinese adults from 1982 to 2012. Methods For this cross-sectional population-based study, we analysed a nationally representative sample of 204 802 adults aged 20 years or older, using data from the 1982, 1992, 2002, and 2010–12 China National Nutrition Surveys (CNNS). We did a comparative risk assessment, in which the effects of suboptimal intakes of 12 dietary factors, individually and collectively, on cardiometabolic mortality were estimated by calculating the population attributable fraction (PAF) to estimate the proportional reduction in cardiometabolic deaths that would occur if exposure to each dietary risk factor was reduced to an alternative optimal level. Findings The overall PAF of mortality from cardiovascular disease and type 2 diabetes that was associated with suboptimal dietary quality was 62·2% in 1982, 57·9% in 1992, 56·2% in 2002, and 51·0% in 2010–12, which accounted for 21·6% of total mortality in China in 1982, 16·6% in 1992, 17·6% in 2002, and 20·8% in 2010–12. The estimated number of cardiometabolic deaths associated with suboptimal dietary intakes was 1·07 million in 1982, 0·93 million in 1992, 1·18 million in 2002, and 1·51 million in 2010–12. Of all 12 dietary factors examined, high sodium intake (17·3%), low fruit consumption (11·5%), and low marine omega-3 fatty acids (9·7%) were associated with the largest numbers of estimated cardiometabolic deaths in 2010–12. Interpretation We observed an improvement in several dietary factors in China in the past few decades. However, current intakes of these dietary factors remain suboptimal. Poor diet quality is estimated to be associated with a substantial proportion of deaths from heart disease, stroke, and type 2 diabetes in China. Funding Ministry of Health, China, and Ministry of Science and Technology, China.

To analyze the trends of food consumption among Chinese population from 1992 to 2012.Based on the results of 1992, 2002 and 2010-2012, data of average food consumption per reference man per day was compared. The 3-consecutive day-24-hour dietary recall was used to collect information on food intake, but the condiment intake was collected by weighting method.The intake of cereals decreased during 1992-2012 from 439. 9 g to 337. 3 g, tubers decreased 50. 8 g during20 years. The intake of fresh vegetables was decreased from 310. 3 g to 269. 4 g from 1992 to 2012, with rural area decreased more than urban area. Fruit intake in urban area decreased from 80. 1 g to 28. 8 g, whereas rural area had minor variation. The intake ofmeats increased from 58. 9 g to 89. 7 g. There were little change on the intake of legume, dairy, fishery and their products. Intake of edible oil was increased during 1992-2002but kept stable during 2002-2012. Salt intake was 3. 4 g less in 2010-2012 than 1992 and 1. 5 g less in 2010-2012 than 2002.There had been noticeable changes in dietarypattern among Chinese population in the past 20 years. Even though Chinese dietary pattern had kept stable since 2002 and had much improved, improper food consumption still existed. Double burdens should be considered as problems which asked for attention by the government and researchers.

To analyze the drinking practice of people in China. The purpose is to provide the evidence to alcohol drinking control in China.The data of 2010- 2012 China National Nutrition and Health Survey was used for this study. 145263 subjects aged 15 years and over were involved.The overall current drinking rate of people in China was 34. 3%, male( 54. 6%) was higher than female( 13. 3%), The 45 ~ 59 years age group ranked the highest( 38. 6%). Beer( 64. 6%)was the most, high degree wine( 38. 7%) and low degree wine( 29. 7%) were next in china drinkers. The daily alcohol consumption for drinkers was 28. 1g, 32. 8g for males and 8. 0 g for females. Daily alcohol intake( 38. 5 g) of 45 ~ 59 years were the highest. Of those who drank, 30. 4% were heavy drinkers, male( 34. 8%) was higher than female( 11. 7%). Of those who drank, 13. 9% were hazardous drinkers, male( 16. 0%) was higher than female( 4. 7%).Alcohol drinking has become a public health problem in China, and the drinking behaviors varied between differentgenders and ages. Health education program should be developed and conducted, especially for males of 45 ~ 59 years old.

To analyze the status of consumption of potato and its related products in Chinese residents from 2010 to 2012.Data was from China Nutrition and Health Surveillance 2010-2012. Information on the consumption of potato and its related products was collected using the 24 h recall method for three consecutive days.The average consumption of potatoes for Chinese residents was 29. 2 g / d, 20. 1 g for urban residents, 37. 7 g for rural residents. The consumption rate of potato was40. 1%, which were 35. 7% and 44. 2% in urban and rural areas. The average consumption of potato eaters was 72. 8 g, 56. 2 g and 85. 3 g for urban and rural areas respectively. The average consumptions of potato powder and chips were 0. 2 g and 0. 04 g, and the edible rate were 0. 4% and 0. 2% respectively.At present, the edible rate and the consumption of potato were lower in Chinese residents. To promote potato staple strategy should actively promote potato food products and industrial development, guide the dietary structure of Chinese residents, and improve the residents' understanding of the nutritional value of potato.

To describe the energy and dietary nutrients intake trends among Chinese population from 2002 to 2012.Data of energy, macronutrient, and micronutrient intake were collected from 2002 Chinese Nutrition and Health Survey, 2010-2012 Chinese Nutrition and Health Surveillance, and energy and dietary nutrients intake were analyzed. The 3-consecutive days-24-hour dietary recall and food weighting method were used to collect food, edible oil and condiment intake information. The dietary nutrients intake was calculated based on the energy percentage in one family and the China Food Composition.Compared with 2002, the average energy intake per reference man per day of Chinese people declined to 2172. 1 kcal from 2250. 5 kcal in 2010-2012. Dietary protein intake was basically flat. Dietary fat intake in 2010-2012 was 79. 9 g, with urban level higher than rural level. Compared with that in 2002, fat intake increased by 4 g, and urban residents' intake fell slightly, making urban / rural gap narrower. Theintake of micronutrient such as vitamin A, vitamin C, calcium, iron, zinc was still lower than Chinese Dietary Reference Intakes and falling continually.In the last decade, Chinese urban / rural residents' dietary energy supply was sufficient, and the dietary nutrients intake had improved. However, there were excessive intake of fat and low intake of micronutrient was still a problem among Chinese population. There was significant difference between the urban and rural area, and the dietary quality among Chinese population especially rural residents should be improved.

To examine the trend of stunting and wasting among children age between 6 and 17 in China.A multistage cluster random sampling process was used to investigate 36 058 children aged 6-17 years in 2010-2012 in 31 provinces( municipalities, autonomous region) in China. Their height and weight were measured, prevalence of stunting and wasting were calculated according to national standard of malnutrition screening among school children and adolescents( WS/T 456-2014) to compare children malnutrition status in children and adolescents in four classified areas. Data was weighted by post stratification adjustment, according to standard population data in 2009 from State Statistical Bureau.The prevalence of stunting among childrenand adolescents aged 6 to 17 in China in 2010-2012 were 3. 2%( 95% CI 2. 6%-3. 8%), among boys were 3. 6%( 95% CI 2. 9%-4. 3%) and girls were 2. 8%( 95%CI 2. 2%-3. 3%). Stunting rate among children and adolescents aged 6-17 in urban area were 1. 5%( 95% CI 1. 0%-2. 1%), and rural area were 4. 7%( 95% CI 3. 8%-5. 6%). Prevalence of stunting showed rising trend with the decline of economic level. Total prevalence of wasting among children and adolescents aged 6 to 17 years in China in2010-2012 were 9. 0%( 95% CI 8. 0%-9. 9%), 10. 4%( 95% CI 9. 3%-11. 6%)for boys and 7. 3%( 95% CI 6. 5%-8. 1%) for girls, 7. 8%( 95% CI 6. 6%-9. 0%)for urban area and 10. 0%( 95% CI 8. 6%-11. 4%) for rural area. Prevalence of wasting also showed rising trend with the decline of economic level.The overall prevalence of stunting and wasting among Chinese children and adolescents in 31 provinces( municipalities, autonomous region) was relatively low, however, stunting and wasting in poor areas should still be concerned.

Osteoporosis is a chronic disease affecting millions of people worldwide. It is generally accepted that acquisition of a high peak bone mass (PBM) early in life can reduce the risk of osteoporosis later in life. The aims of this study were to investigate the effects of Fructus Ligustri Lucidi (FLL) ethanol extract on bone mineral density and its mechanical properties in growing female rats and to explore the underlying mechanisms. The rats were given different doses of FLL extract mixed with AIN-93G formula (0.40, 0.65 and 0.90 %), and a group given AIN-93G diet treatment only was used as control. The intervention lasted for 16 weeks until the animals were about 5 months old, the time when the animals almost reach their PBM. Our results showed that FLL treatment increased bone mineral density and improved bone mechanical properties in the growing female rats in a dose-dependent manner. In addition, FLL treatment significantly decreased the serum bone-resorbing marker, CTX-I, while significantly increasing serum 25(OH)D3 and thereby increasing Ca absorption and Ca retention. Intriguingly, both in vivo and in vitro results demonstrated that FLL treatment could reduce the RANKL/OPG ratio. In conclusion, FLL ethanol extract exerted beneficial effects on peak bone mass acquisition and the improvement of bone mechanical properties by favoring Ca metabolism and decreasing the RANKL/OPG ratio.

Optimizing peak bone mass in early life is one of key preventive strategies against osteoporosis. Fructus ligustri lucidi (FLL), the fruit of Ligustrum lucidum Ait., is a commonly prescribed herb in many kidney-tonifying traditional Chinese medicinal formulas to alleviate osteoporosis. Previously, FLL extracts have been shown to have osteoprotective effect in aged or ovariectomized rats. In the present study, we investigated the effects of FLL ethanol extract on bone mineral density (BMD) and mechanical properties in growing male rats and explored the underlying mechanisms. Male weaning Sprague-Dawley rats were randomized into four groups and orally administrated for 4 months an AIN-93G formula-based diet supplementing with different doses of FLL ethanol extract (0.40, 0.65, and 0.90 %) or vehicle control, respectively. Then calcium balance, serum level of Ca, P, 25(OH)2D3, 1,25(OH)2D3, osteocalcin (OCN), C-terminal telopeptide of type I collagen (CTX-I), and parathyroid hormone, bone microarchitecture, and calcium absorption-related genes expression in duodenum and kidney were analyzed. The results demonstrated that FLL ethanol extract increased BMD of growing rats and improved their bone microarchitecture and mechanical properties. FLL ethanol extract altered bone turnover, as evidenced by increasing a bone formation maker, OCN, and decreasing a bone resorption maker, CTX-I. Intriguingly, both Ca absorption and Ca retention rate were elevated by FLL ethanol extract treatment, possibly through the mechanisms of up-regulating the transcriptions of calcitropic genes in kidney (1α-hydroxylase) and duodenum (vitamin D receptor, calcium transporter calbindin-D9k, and transient receptor potential vanilloid 6). In conclusion, FLL ethanol extract increased bone mass gain and improved bone properties via modulating bone turnover and up-regulating calcium absorption-related gene expression in kidney and duodenum, which could then activate 1,25(OH)2D3-dependent calcium transport in male growing rats.

Maternal ethanol consumption during pregnancy can induce learning deficits in the offspring. The objective of this study was to assess whether supplementation of exogenous nucleotides during pregnancy and lactation would ameliorate prenatal ethanol-induced learning and memory deficits in the offspring of mice, and to explore the possible mechanisms. In the present study, pregnant C57BL/6J mice were exposed to ethanol (5 g/kg body weight) intragastrically from gestational day (GD) 6 to GD15. The dams in exogenous nucleotide intervention groups were fed with feed containing 0.01 %, 0.04 %, or 0.16 % nucleotide powder, with control and ethanol groups receiving normal feed. The dams were allowed to deliver naturally and to breast feed their offspring. After weaning, behavioral tests were carried out in the offspring of each group. Serum oxidation indexes were analyzed, and the hippocampus of each offspring was collected and detected for acetyl cholinesterase (AChE) activity and the expression of p-CREB, CREB, and BDNF. The results showed that maternal supplementation with exogenous nucleotides during pregnancy could ameliorate prenatal ethanol-induced learning and memory deficits in the offspring of mice, through improving their antioxidant capacity, reversing hippocampus AChE levels, and allowing the expression of some proteins related to learning and memory. However, different sensitivities were found between the two sexes.

Maternal obesity is a risk factor for metabolic diseases in offspring. The aim of this study was to investigate whether quercetin administration during gestation and lactation could have any protective effect against the impact of maternal obesity on increased sensitivity to obesity and metabolic disorders in offspring. Female Sprague–Dawley rats were fed a high-fat diet to induce obesity. Obese dams were administered 0, 50, 100 or 200 mg/kg body weight (BW) quercetin intragastrically during gestation and lactation. Normal weight dams were used as controls. The F1 generation was fed with a standard diet after weaning, and blood glucose, lipids and inflammatory factors were assessed. Expression of biomarkers involved endoplasmic reticulum (ER) stress, and related inflammatory pathways in liver and adipose tissues were analyzed at postnatal day 100. Maternal obesity resulted in increased birth weight, postnatal BW gain, hyperglycemia, hyperlipemia, hyperinsulinemia, increased serum levels of inflammatory factors, and up-regulated biomarkers involved in ER stress and related inflammatory pathways in the offspring. Maternal quercetin intervention (QI) had significant ameliorating effects on maternal blood lipids, especially cholesterol, which resulted in improved glucose metabolism and insulin sensitivity and alleviated ER stress and related inflammation in the grown offspring of obese dams. Maternal QI in obese dams during gestation and lactation reduced birth weight and postnatal BW gain in the offspring, and helped to improve insulin sensitivity and lipid metabolism of the mature offspring via reducing ER stress and related inflammation in the liver and adipose tissue.

To study the effects of bisphenol A (BPA) on reproductive functions and oxidative stress in adolescent male mice, and to explore the effect of high dose vitamin E on reproductive functions and oxidative stress induced by BPA.Thirty-two kunming male mice aged 4 -5 weeks were randomly divided into 3 groups: control group (gavaged with corn oil 0.2 ml/d, n = 10), BPA group (gavaged with BPA 0.5 mg/kg BW, n = 11), and vitamin E intervention group (gavaged with BPA 0.5 mg/kg BW and vitamin E 150mg/kg BW, n = 11). All animals were sacrificed 3 weeks later and blood and tissue samples were collected.The wet weight of testis in BPA group, the wet weight and organ coefficient of spermatophore, and counts of sperm in BPA and vitamin E intervention groups were significantly lower than those in the control group (P0.05 or P0.01), and the organ coefficient of spermatophore in vitamin E intervention group was significantly higher than BPA group (P0.05). The rates of teratosperm in BPA and vitamin E intervention groups were significant higher than the control group (P0.05), and the activity ratio of sperm in BPA group was significantly lower than those in the control and vitamin E intervention groups (P0.05). The SOD activities of liver tissue in both BPA and vitamin E intervention groups and CAT activity in BPA group were significantly higher than the control group (P0.05). The serum testosterone level in BPA group was lower than the control and vitamin E intervention group without significant difference.Short-term BPA exposure may partly inhibit the reproductive function in adolescent male mice with certain stimulating effect on antioxidant ability, and supplementation of vitamin E during BPA exposure may have certain protective effect on reproductive inhibition caused by BPA exposure.