Objective:To characterize long-term transition probabilities in waist circumference (WC) status from childhood into early adulthood and identify critical age windows for the development, persistence, and reversal of central obesity. Methods:Using the China Health and Nutrition Survey data (1993-2022), 7,007 WC measurements from 2,440 participants aged 6-17 years at baseline were analyzed. Participants were grouped by baseline age: 6-11, 12-14, and 15-17 years. Generalized linear mixed-effects models were used to estimate WC transition probabilities, adjusting for sociodemographic factors. Results:Central obesity prevalence increased from age 6, declined in early adulthood (approximately 22 years), and subsequently increased again. The 6-14-year age window exhibited dynamic, bidirectional transitions; specifically, the 10-year reversal probabilities from central obesity to normal WC were 44.19% (ages 6-11) and 41.39% (ages 12-14), decreasing to 26.93% for ages 15-17. Among those aged 15-17 years with central obesity, boys had a > 80% probability of maintaining increased WC for 20 years. Conclusion:Ages 6-14 years represent a critical "reversal period" for central obesity. Interventions should prioritize this window using age- and sex-specific strategies to maximize normalization and curb long-term obesity risk.

BACKGROUND AND OBJECTIVES:Diet is a modifiable factor influencing serum uric acid levels, but evidence on the associations between dietary fat composition and hyperuricemia (HUA) remains limited. This study examined the relationships between the proportion of energy from total fat and specific dietary fatty acids and the risk of HUA among Chinese adults. METHODS AND STUDY DESIGN:Data were obtained from adults who participated in at least two follow‑up waves of the China Health and Nutrition Survey (CHNS) in 2009, 2015, and 2018. Associations and dose-response relationships were assessed using multivariate Cox proportional hazards and restricted cubic spline (RCS) models. RESULTS:During a mean follow‑up of 6.05 years among 2,722 participants, the prevalence of HUA was 10.2% (men: 14.1%; women: 7.76%). In women, energy from saturated fatty acids (SFAs) in the fourth quintile (7.88%) and from monounsaturated fatty acids (MUFAs) in the third quintile (9.97%) was positively associated with HUA (HR = 2.19, 95% CI 1.19-4.05; HR = 2.14, 95% CI 1.21-3.79), whereas polyunsaturated fatty acids (PUFAs) in the third quintile (6.88%) were negatively associated (HR = 0.41, 95% CI 0.22-0.78). RCS analyses showed J‑shaped and U‑shaped as-sociations in men between total fat (37.9%, 95% CI 11.0-40.3) and PUFAs energy ratio (9.60%, 95% CI 2.25-10.7) with HUA, respectively, and an L‑shaped association in women for PUFAs energy ratio (6.25%, 95% CI 5.54-9.42). CONCLUSIONS:These findings suggest sex‑specific, non‑linear relationships be-tween total fat and different fatty acid intakes and HUA risk. Men should consider moderating total fat intake, while women should limit SFAs and moderately increase PUFAs to help reduce HUA risk.

This erratum corrects the academic qualifications of the authors of the article DOI: 10.6133/apjcn.202604_35(2).0007 The correct academic qualifications of the authors are: Pengfeng Qu MSc, Yingying Jiao MSc, Liusen Wang MSc, Weiyi Li MPH, Hongru Jiang MPH, Jiguo Zhang PhD, Huijun Wang MSc, Bing Zhang PhD, Junhua Han PhD, Aidong Liu PhD, Zhihong Wang PhD The authors regret this error. This correction does not affect the scientific content, results, or conclusions of the article.

OBJECTIVE:To analyze the relationship between dietary pattern and nonalcoholic fatty liver disease (NAFLD) among adults. METHODS:Individuals aged ≥18 years with completed data in China Health and Nutrition Survey 2015 were selected. Dietary survey was performed using three consecutive 24-hour dietary recalls combined with a weighing inventory at the household level. Dietary pattern was extracted using factor analysis, and scores were categorized into four groups by quartiles. NAFLD was screened using the fatty liver index (FLI) and NAFLD liver fat score (LFS). Association between dietary patterns and NAFLD was analyzed using multivariate logistic regression model. Subgroup analyses were conducted by age, gender and eating out. RESULTS:A total of 9147 participants were included, and four dietary patterns were identified, named as Rice-Veg-Pork dietary pattern, Egg-Fruit dietary pattern, Wheat-Mixed Grain dietary pattern, and Poultry-and-Other-Red-Meat dietary pattern. The prevalence of NAFLD screened by FLI and NAFLD-LFS were 15.0% and 11.1%, respectively. The result showed that Rice-Veg-Pork dietary pattern and Egg-Fruit dietary pattern were not associated with the prevalence of NAFLD. Compared with the lowest quartile group (Q1), adults in the highest quartile group (Q4) of Wheat-Mixed Grain dietary pattern score had a significantly reduced odds of developing NAFLD (FLI: OR=0.766, 95%CI 0.623-0.942, Ptrend=0.002; NAFLD-LFS: OR=0.656, 95%CI 0.536-0.803, Ptrend<0.001). Similar result were observed in subgroups aged 45-59 years, ≥60 years, females, and those eating out. Poultry-and-Other-Red-Meat dietary pattern score was positively associated with odds of NAFLD (NAFLD-LFS: OR=1.088, 95%CI 1.017-1.163), and this association was not influenced by dining out. CONCLUSION:Wheat-Mixed Grain dietary pattern could reduce the odds of NAFLD in adults, whereas Poultry-and-Other-Red-Meat dietary pattern is converse.

Objective:This study aimed to investigate the association between exposure to mixtures of environmental endocrine-disrupting chemicals (EDCs) and metabolic dysfunction-associated steatotic liver disease (MASLD) and to assess the potential mediating role of iron metabolism. Methods:A total of 6,989 adults from the China Health and Nutrition Survey (2015 cycle) were included. The serum concentrations of 22 EDCs were measured. Logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models were used to evaluate the association between EDC exposure and risk of MASLD. Mediation analyses were performed to assess the mediating role of serum ferritin (SF). Results:Eight EDCs were positively associated with MASLD. The WQS regression model identified six major contributors, including β-hexachlorocyclohexane, p,p'-DDT, monoethyl phthalate, acenaphthene, perfluorooctanoic acid, and perfluoro-n-pentanoic acid, in mixture effects. The BKMR model demonstrated that higher levels of EDC mixture were associated with an increased risk of MASLD. Subgroup analyses suggested stronger correlations in males and in individuals aged < 65 years. SF was estimated to mediate 11.2%-32.1% of the association between key EDCs and MASLD. Conclusion:Exposure to EDC mixtures was associated with an increased risk of MASLD, with iron metabolism playing a notable mediating role. Reducing the exposure to key EDCs may help alleviate the burden of MASLD.

Objective To investigate the associations of the energy-adjusted dietary inflammatory index(E-DII)with hyperglycemia risk and fasting plasma glucose(FPG)level among adults in China.Methods A total of 9 363 adults aged≥18 years who participated in at least two rounds of the China Health and Nutrition Survey(CHNS)in 2009,2015,and 2018,with complete dietary data and blood glucose measurements,were included.The E-DII was calculated based on a quantitative food frequency questionnaire(FFQ).Participants were assigned into quintiles(Q1-Q5)according to the E-DII distribution in each survey year.The associations of E-DII with hyperglycemia risk and FPG level were analyzed via a three-level logistic mixed-effects model and a three-level linear mixed-effects model,respectively,with inverse probability of treatment weighting(IPTW)for confounding adjustment.Results The baseline mean age of the 9 363 participants was(51.4±13.1)years,with an average follow-up of 5.6 years.The E-DII scores ranged from-4.5 to 5.2,with a mean of 0.6.The prevalence of hyperglycemia was 24.2%.After adjusting for confounders,compared with the Q5 group(highest pro-inflammatory diet),the Q2 group in the overall population had a decreased risk of hyperglycemia(OR=0.616,95%CI:0.470 to 0.807).Similar trends were observed in males,individuals aged 45-59 years at baseline,both rural and urban residents,and the overall population.In the overall population,the Q4 group exhibited a 0.046 mmol/L decrease in FPG(95%CI:-0.091 to-0.001).In females,the Q1 group showed a 0.120 mmol/L reduction in FPG(95%CI:-0.216 to-0.024).Among participants aged 18-44 years at baseline,the Q1 and Q4 groups had FPG reductions of 0.160 mmol/L(95%CI:-0.281 to-0.039)and 0.128 mmol/L(95%CI:-0.238 to-0.018),respectively.Urban residents in the Q3 and Q4 groups demonstrated FPG decreases of 0.195 mmol/L(95%CI:-0.349 to-0.041)and 0.180 mmol/L(95%CI:-0.330 to-0.029),respectively.Conclusions Reducing dietary inflammatory potential may aid in FBG control and hyperglycemia prevention among Chinese adults.

Accelerated economic development and innovative food industry trends have contributed to worsening dietary imbalanced among Chinese school-aged population. To investigate snack preferences among school-aged children, determine the relative importance of different snack attributes, and explore how these preferences vary by social-demographic characteristics to inform targeted nutritional interventions. A stratified cluster random sampling strategy was employed to recruit 854 school-aged children (grades 7 and 8) from Hubei and Anhui provinces. An evaluation framework comprising six attributes (taste, nutrient claims, purchase location, price, package size, and social influence) was constructed based on a Discrete Choice Experiment (DCE). A D-optimal design was implemented using SAS 9.4 software to generate 16 choice sets (divided into two versions), with two-stage questions incorporated to mitigate bias. A mixed logit model was applied to calculate preference coefficients (β), relative importance (RI), and willingness-to-pay (WTP) for different attributes. All six included attributes demonstrated statistically significant effects on local school-aged children’s snack choices (all P < 0.05). Specifically, school-aged children showed stronger preferences for snacks sold in supermarkets (β = 0.439), those rich in dietary fiber (β = 0.611), with sweet taste (β = 0.471), and commonly consumed by family members (β = 0.452). They were willing to pay an additional 46.49 CNY for snacks rich in dietary fiber. Large package size (β = -0.112) and price (β = -0.013) showed slight negative associations. Heterogeneity analysis revealed that boys preferred snacks rich in dietary fiber (β = 0.554) and were more price-sensitive (β = -0.026), while girls prioritized low-fat options (β = 0.738) and showed lower willingness to choose large packages (β = -0.259). School-aged children with less-educated parents placed greater emphasis on taste (RI = 25.33

OBJECTIVE:To analyze the trends and demographic characteristics of body mass index and waist circumference changes in children and adolescents aged 6-17 in China. METHODS:Using the survey data of 6-17 children and adolescents from five rounds of national nutrition surveys/surveillance from 1982 to 2016, excluding those with missing demographic information and key indicators such as body mass index and waist circumference. A total of 185 491 children and adolescents aged 6-17 were included. Complex weighting method were used to adjust body mass index, waist circumference, obesity rate, and high waist circumference rate. The distribution curves and percentile variation curves of body mass index and waist circumference for Chinese children and adolescents aged 6-17 in different years by gender were drawn. The trends of the prevalence of different types of obesity based on the occurrence of body mass index obesity and high waist circumference obesity were described. RESULTS:From 1982 to 2016, the overall distribution curves of body mass index and waist circumference for children and adolescents aged 6-17 in China showed a peak decrease, a trend of rightward shift, and an accelerating increase over time. The average body mass index of boys and girls increased by 1.80 and 1.23 respectively over the decades, and the average waist circumference increased by 1.40 cm and 1.05 cm respectively from 2012 to 2016. The body mass index and waist circumference levels of boys in all age groups were generally higher than those of girls. The higher increase of body mass index and waist circumference were both observed among boys and girls with higher values than those with lower values. The main type of obesity among children and adolescents in China was high waist circumference obesity, and there were population differences in the ratios of different types of obesity. The main type of obesity in boys and children aged 7-11 was a mixture of body mass index obesity and high waist circumference obesity. The main type of obesity among girls and adolescents aged 12-17 was high waist circumference obesity alone, but the proportion of mixed obesity increased year by year. Body mass index obesity alone had the lowest proportion among all populations. CONCLUSION:From 1982 to 2016, the body mass index and waist circumference of children and adolescents aged 6-17 in China showed a significant increase trend, with gender and age differences.

The effects of perfluoroalkyl and polyfluoroalkyl substances (PFAS) on kidney function across physiological conditions remain inconclusive, and previous research has not assessed the potential mediating effect of iron status. We aimed to examine the relationships between PFAS exposure and kidney function in various demographic groups, as well as to evaluate the potential mediating role of iron status. This study included 7369 Chinese adults aged 18 years or older from the China Health and Nutrition Survey (CHNS). Estimated glomerular filtration rate (eGFR) levels were used to reflect the efficiency of kidney function. Generalized linear models and weighted quantile sum regression models indicated negative associations between PFAS and eGFR levels, with PFNA and PFHxS emerging as the dominant contributors. Subgroup analysis revealed that the adverse effects of PFAS on eGFR levels were more pronounced in the males, young and middle age, non-hypertension, and non-diabetes subgroups. Further mediation analyses demonstrated that iron status (ferritin, transferrin, and hemoglobin) partially mediated these associations, with mediation proportions ranging from 8.89 % to 60.84 %. Our study established PFNA and PFHxS as critical nephrotoxic PFAS in China while pioneering the identification of iron status as a novel mechanistic mediator between PFAS exposure and kidney dysfunction, advancing mechanistic understanding of environmental nephrotoxicity.

OBJECTIVE:To investigate the relationship between nutrient patterns and serum uric acid levels in the elderly population. METHODS:A total of 6288 elderly individuals aged 65 and above were analyzed from the Community-based Cohort Study on Nervous System Diseases baseline survey conducted from 2018 to 2021. Food frequency questionnaires were used to estimate the average daily intake of various foods per person in the past year, based on the frequency and quantity of food consumed per occasion. The average daily consumption of cooking oil and condiments per person was estimated by considering the average monthly household usage of these items and the number of meals prepared at home. Based on the food weights in Dietary Guidelines: Scientific Evidence and Methodological Studies and Chinese Food Composition, daily energy and nutrients intakes were calculated. Nutrient patterns for 24 nutrients, including macronutrients, vitamins and minerals, were extracted using principal component analysis. Quartile regression models were used to analyze the relationship between nutrient patterns and fasting serum uric acid levels. RESULTS:Male elderly, individuals aged ≥75 years, living in rural areas, with junior high school education or above, high income, smokers, drinkers, elderly with low physical activity level, high body mass index(BMI) value or having chronic diseases had significantly higher serum uric acid levels(P&lt;0.05). Four nutrient patterns were extracted: the &apos;carbohydrate-vitamin B_1 pattern&apos;, the &apos;vitamin A-vitamin C pattern&apos;, the &apos;unsaturated fatty acid-vitamin E pattern&apos;, and the &apos;cholesterol pattern&apos;. Each nutrient pattern was divided into four quartiles, with Q1 as the reference. The &apos;unsaturated fatty acid-vitamin E pattern&apos; showed a negative correlation between Q4 and serum uric acid levels at the P10, P25, P50, and P75 quartiles(β-values and 95%CIs:-8.01(-15.55--0.48), -11.33(-17.77--4.89), -15.35(-18.39--5.35), -8.94(-17.46--0.41), P_(trend)&lt;0.05); At the P25 percentile of serum uric acid levels, Q2, Q3, and Q4 were negatively correlated with serum uric acid levels(β-values and 95%CIs:-6.28(-12.49--0.06), -6.86(-12.67--1.06), -11.33(-17.77--4.89), respectively, P_(trend)&lt;0.05). At the P50 percentile of serum uric acid levels, Q3 and Q4 were negatively correlated with blood uric acid levels(β-values and 95%CIs:-7.64(-14.39--0.89), -11.87(-18.39--5.35), respectively, P_(trend)&lt;0.05). CONCLUSION:The &apos;unsaturated fatty acid-vitamin E pattern&apos; model had a greater impact on intermediate and lower serum uric acid levels in the elderly population, suggesting that targeted dietary interventions may have a lowering effect on intermediate and lower serum uric acid levels.

OBJECTIVE:To investigate the molecular mechanisms underlying EA(elaidic acid)-induced lipid accumulation in VSMCs(vascular smooth muscle cells). METHODS:CCK-8 assay determined the effects of EA(0-2.8 mmol/L) on MOVAS(murine aortic vascular smooth muscle cells)to select experimental concentrations. Oil Red O staining combined with quantitative lipid droplet analysis was conducted to examine the effects of EA on intracellular lipid droplet accumulation. Intracellular total cholesterol(TC) and triglyceride(TG) levels were quantified spectrophotometrically to assess EA&apos;s effects on intracellular lipid levels. Western blot analyzed protein expression of PPARγ, LXRα, ABCA1, and ABCG1 to delineate EA&apos;s pro-foamogenic mechanism. RESULTS:EA dose-dependently suppressed MOVAS viability(P&lt;0.01). EA-treated groups exhibited significant increases in lipid droplet area/number and TC/TG content versus controls(P&lt;0.01). EA downregulated PPARγ and LXRα protein expression(P&lt;0.05), subsequently suppressing downstream targets ABCA1 and ABCG1(P&lt;0.05). CONCLUSION:EA disrupts lipid metabolism in VSMCs by inhibiting the PPARγ-LXRα-ABCA1/ABCG1 signaling pathway, thereby inducing lipid accumulation and promoting foam cell formation.

Background/Objectives: Alcohol consumption can increase the risk of dyslipidemia, thereby elevating the risk of cardiovascular diseases. However, the relationship between alcohol consumption patterns and dyslipidemia remains controversial. Based on large-scale cross-sectional data from the Chinese population, this study aims to investigate the correlations between various alcohol consumption behaviors and dyslipidemia among adult residents in China. Methods: Our analysis utilized data from the 2015–2017 China Nutrition and Health Surveillance project, which provides a large, nationally representative sample (N = 52,471). We employed a binary logistic regression model specifically designed for complex sampling frameworks. This model was utilized to assess the relationship between various alcohol consumption behaviors (including daily alcohol intake levels and drinking frequency) and the incidence of hypercholesterolemia, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol (low HDL-C), and elevated levels of low-density lipoprotein cholesterol (high LDL-C). Drinking behaviors were classified into three distinct categories for analysis: China classification (never, moderate, excessive), WHO classification (never, low-risk, medium-risk, high-risk), and drinking frequency (never, <1, 1–3, 4–6, ≥7 times/week). Results: Compared with never drinkers, the risk of hypercholesterolemia was significantly higher in men who were excessive drinkers (aOR = 1.39, 95%CI: 1.24–1.57), medium-risk drinkers (aOR = 1.24, 95%CI 1.01–1.53), high-risk drinkers (aOR = 1.67, 95%CI: 1.4–1.95), and those who drank more than once a week (aOR range: 1.27–1.65), and there was no such association in women (p > 0.05). Compared with never drinkers, the risk of hypertriglyceridemia was higher in male drinkers with excessive drinking (aOR = 1.35, 95%CI: 1.24–1.47), medium-risk drinking (aOR = 1.29, 95%: 1.11–1.50), high-risk drinking (aOR = 1.52, 95%CI: 1.3–1.71), and a drinking frequency more than 1 time/week (aOR range: 1.22–1.38), while in women, it was moderate drinking (aOR = 0.85, 95%CI 0.77–0.94), low-risk drinking (aOR = 0.86, 95%CI 0.78–0.94), and a drinking frequency of more than once a week (aOR = 0.74, 95%CI 0.63–0.87) that reduced the occurrence of hypertriglyceridemia. Compared with non-drinkers, men with any drinking status had a lower risk of low HDL-C (aOR range: 0.38–0.90) and a similar association was also observed in women (aOR range: 0.26–0.84). Compared with never drinkers, male excessive drinkers (aOR = 0.86, 95%CI: 0.77–0.97), medium-risk drinkers (aOR = 0.80, 95%CI:0.65–0.99), high-risk drinkers (aOR = 0.83, 95%CI: 0.70–0.97), and those with a drinking frequency of 1–3 times/week (aOR = 0.89, 95%: 0.79–0.99) had a lower risk of high LDL-C, and there was no such association in women (p > 0.05). Conclusions: Significant gender differences were observed in the effects of alcohol consumption on lipid profiles. Men who were excessive drinkers, medium-risk drinkers, high-risk drinkers, and those who drank more than once a week had a higher risk of hypercholesterolemia and hypertriglyceridemia, but a lower risk of low HDL-C and high LDL-C. In women, moderate drinking was associated with a reduced risk of hypertriglyceridemia. Any alcohol consumption and drinking frequency more than 1 time/week were associated with a lower risk of low HDL-C in women. No significant association was found between alcohol consumption and hypercholesterolemia or high LDL-C in women.

The persistence and biotoxicity of perfluoroalkyl and polyfluoroalkyl substances (PFASs) have raised concerns about cardiometabolic diseases (CMDs). Inflammation is thought to underlie the pathology of various CMDs. We aimed to comprehensively assess the risk of CMDs associated with PFASs and quantify the mediating effects of two kinds of inflammatory markers. Nine PFASs, a direct marker (high-sensitivity C-reactive protein [hs-CRP]), and an indirect marker (serum ferritin [SF]) were analyzed. A total of 12 CMDs of five types were defined based on 15 cardiometabolic biomarkers. The PFAS mixture had significant adverse effects on hypercholesterolemia (HC; OR = 1.20, 95% CI: 1.03-1.39), high low-density lipoprotein cholesterol (high LDL-C; OR = 1.13, 95% CI: 1.01-1.30), hypertension (OR = 1.10, 95% CI: 1.03-1.19), and hyperuricemia (OR = 1.31, 95% CI: 1.16-1.48) in the quantile-based g-computation (QGC) model, with PFNA and PFTrDA contributing the most. PFHxS was found to significantly impact all five types of CMDs simultaneously. The exposure-response analysis exhibited complex nonlinear patterns, with significant heterogeneity across diseases. Both inflammatory markers significantly mediated the effects of multiple PFASs on CMDs, with SF contributing a higher proportion of the mediating effects for obesity, dyslipidemia, and hyperuricemia. The highest mediation proportion reached 85.78% for abdominal obesity (FDR = 0.024). These results suggest that inflammation may serve as a key pathological mechanism linking PFAS exposure to CMDs, highlighting the potential value of SF as an iron status and indirect inflammatory marker in assessing PFAS-related cardiometabolic health risks.

ObjectiveElevated sodium consumption is associated with increased risk for chronic kidney disease (CKD) and data for this disease burden attributable to high sodium intake in China from 1990 to 2019 are scarce in China. Our study aims to estimate and present the national burden of CKD attributable to high sodium intake, as well as its profile.MethodsThe regional disease burden data from the China Center for Food Safety Risk Assessment (CFSA) from 1990 to 2019 were compiled based on the methodology of GBD 2019. CKD burden [deaths and disability-adjusted life years (DALYs)] was quantified according to population group (age, gender) and regions categories (province, SDI). The estimated annual percentage change (EAPC) in age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) were calculated to describe long-term trends.ResultsTotally, the number of deaths of CKD attributable to high sodium intake reached 95,000, with DALYs amounting to 2.59 million person-years in 2019, while the trends of ASMR (EAPC: -0.31, 95%CI: −0.46, −0.17%) and ASDR (−0.33, 95%CI: −0.48, −0.18%) were down during the observation period. The age-specific numbers and rates of deaths, as well as DALYs increase with age are higher in males than in females. Significant disparities in CKD burden attributable to high sodium intake were observed across provinces and SDI regions. In both 1990 and 2019, the number of deaths and DALYs were higher in middle SDI regions, while low-middle SDI regions had highest ASMR and ASDR. The EAPC of ASDR was found to be significantly negatively correlated with the 1990 ASDR (ρ = −0.393, p = 0.024), and the EAPC of ASMR and ASDR were also significantly negatively correlated with the 2019 SDI (ASMR:ρ = −0.571, p < 0.001; ASDR:ρ = −0.368, p = 0.035).ConclusionHigh sodium intake accounted for a sizeable burden of disease from 1990 to 2019 in China, also presents sexual and geographic variations. Despite a slight decreasing trend exists, the absolute number increased as much as twofold, particularly among males and seniors. Targeting to reduce sodium intake remains a priority, and progress requires systematic monitoring and evaluation, particularly in middle SDI regions that are experiencing rising trends and low-middle SDI regions being susceptible to approaches.

What is already known about this topic? Childhood overweight and obesity pose significant risks to physical and mental health. The Nutrition Improvement Programme for Rural Compulsory Education Students (NIPRCES) has demonstrated effectiveness in reducing malnutrition. What is added by this report? From 2012 to 2023, obesity prevalence increased more rapidly (AAPC=10.6%) than overweight prevalence (AAPC=2.0%) among children aged 6-15 years in central and western rural China. A quicker increase in the trends of overweight and obesity was observed in rural western China (AAPC for overweight=3.0%, AAPC for obesity=11.8%), among males (AAPC for overweight=2.1%, AAPC for obesity=10.8%). Additionally, while the prevalence of overweight/ obesity was lower in older age groups of children, these cohorts showed more rapid increases. What are the implications for public health practice? Continuous monitoring of prevalence and implementation of targeted interventions are essential to prevent and control the expansion of overweight and obesity.

OBJECTIVE:To understand the current situation and changing trends of eating away from home in adult residents aged 18-49 years old. METHODS:Data was collected from 2002 Chinese Nutrition and Health Survey, 2010-2012 Chinese Nutrition and Health Surveillance and 2015 Chinese Adult Chronic Disease and Nutrition Surveillance. The multi-stage stratified cluster random sampling method was used in all the surveys(surveillance). The sample sizes for 2002, 2010-2012 and 2015 were 24 709, 15 701and 32 337, respectively. The basic information, height, weight and eating out index of the subjects were collected through inquiry survey, physical measurement and dietary survey. RESULTS:From 2002 to 2015, the proportion of Chinese adults aged 18 to 49 years old who eat away from home showed an overall rising trend. From the perspective of gender, from 2002 to 2015, the proportion of Chinese adult men aged 18 to 49 years old eating away from home increased from 37.6% in 2002 to 46.8% in 2015, and the proportion of adult women eating away from home increased from 29.9% in 2002 to 35.0% in 2015, showing an increasing trend. From the perspective of age group, from 2002 to 2015, the proportion of adults aged 18 to 49 years old who eat away from home showed a downward trend as the age increased. From the perspective of geographical region and urban and rural areas, the proportion of adults aged 18-49 years old eating away from home in seven categories of regions in China from 2002 to 2015 showed an increasing trend, among which, the proportion of adults in South China and East China was higher, with more than half of adults eating away from home every week. The urban growth rate was higher than that in rural areas. CONCLUSION:From 2002 to 2015, the proportion of Chinese adults aged 18 to 49 years old who eat away from home shows an overall rising trend. With the increase of age, the proportion of adults eating away from home shows a declining trend, which is higher in urban areas than in rural areas, and higher in South and East China than in other geographical regions.

Objective:Burning solid cooking fuel contributes to household air pollution and is associated with frailty. However, how solid cooking fuel use contributes to the development of frailty has not been well illustrated. Methods:This study recruited 8,947 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study, 2011-2018. Group-based trajectory modeling was employed to identify frailty trajectories. Multinomial logistic regression was used to assess the association between solid cooking fuel use and frailty trajectories. Population-attributable fractions were used to estimate the frailty burden from solid fuel use. Results:We identified three frailty trajectories: low-stable ( n = 5,789), moderate-increasing ( n = 2,603), and fast-increasing ( n = 555). Solid fuel use was associated with higher odds of being in the moderate-increasing ( OR: 1.24, 95% CI: 1.08-1.42) and fast-increasing ( OR: 1.48, 95% CI: 1.14-1.92) trajectories. These associations were strengthened by longer solid fuel use ( P for trend < 0.001). Switching to clean fuel significantly reduced the risk of being in these trajectories compared with persistent solid fuel users. Without solid fuel, 8% of moderate- and 19% of fast-increasing trajectories demonstrated frailty development like the low-stable group. Conclusion:Solid cooking fuel use is associated with frailty trajectories in middle-aged and older Chinese populations.

Five groups of douchi were obtained from various origins and species and subjected to high-throughput sequencing and gas chromatography-mass spectrometry to analyse the composition of microorganisms, douchi flavourings and the correlation between them. Experimental results indicated that the predominant genera would have a significant impact on the flavour substances of douchi. Bacillus, Tetragenococcus, Lactobacillus and Romboutsia dominated the fermentation process in all five groups. Cysteine, arabinose and 2,4-dimethyl-3-pentanol were the main volatile flavour substances. Notable regional and climatic variances and peculiarities were observed, and the micro-biological composition of douchi was found to be rich and diversified. The findings of this study may serve as a theoretical foundation for the commercial manufacture of traditional Chinese douchi.

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