Objective To evaluate the dietary quality of residents aged 18 to 80 years in Shandong Province to guide the implementation of targeted dietary intervention in the future using the China Dietary Balance Index（DBI＿16）. Methods In total 3 275 residents aged 18 to 80 years old were selected from the 2015 adult chronic disease and nutrition surveillance project in China, and the diet quality was evaluated using DBI＿16 scoring method. Results The seriously insufficient intake of food among adult residents in Shandong Province were vegetables, fruits, milk, legumes, fish and shrimp, eggs, and excessive intake of food were edible oil and seasoning salt. Overall, the dietary quality of residents were at the level of moderate dietary imbalance（DBI＿DQD=37.9）, moderate dietary deficiency（DBI＿LBS= 27.0）, and low dietary over-ingestion（DBI＿HBS =10.9）, while excessive dietary intake and dietary imbalance were more serious in rural areas, men, northwest Shandong, those over 60 years old, and those with lower education level. Dietary patterns were concentrated in D, E, G, and H, mainly in H pattern. Conclusion Dietary intake of adults aged 18 to 80 years in Shandong Province needs to be improved,and there are problems of insufficient intake as well as excessive intake. Therefore, we should continue to strengthen the popularization of nutrition knowledge related to balanced diet to improve the nutrition and health of residents.

ObjectiveTo investigate mediating role of blood pressure on the association of body mass index (BMI) with cardiovascular disease (CVD) risk and to provide evidence for control of CVD risk. MethodsUsing stratified multistage random sampling and a self-designed questionnaire, a baseline survey including face-to-face interview, physical examination and laboratory tests were conducted among 15 600 permanent urban/rural residents aged 18 – 69 years during June – September, 2021 in Shandong province; then the residents were followed up to October 11, 2021 through the Cardiovascular Diseases and Mortality Surveillance System to collect the information on the prevalence of CVD. Univariate and multivariate Cox proportional risk regression model was used to analyze the association of body mass index (BMI) with the risk of CVD. The dose-response relationship between BMI and CVD risk was described with restricted cubic splines (RCS). The mediating role of blood pressure on the association of BMI with CVD risk was assessed with sequential test. ResultsOf all the residents at the baseline survey, 89.17% (13 688) were followed up; after excluding those with previous history of coronary heart disease (n = 254) and stroke (n = 115) and those without valid outcome information, 13 268 participants were finally included in the analysis, with a total follow-up of 133 733.79 person-years and a median follow-up period of 10.25 years. By the end of the follow-up among the participants, totally 492 CVD incidences were identified and the CVD incidence density was 367.90/100 000 person-years. The number of CVD incidence was 22，173，183, and 114 among the participants with low-weight, normal-weight, overweight, and obesity, with the corresponding CVD incidence densities (1/100 000 person-years) of 380.08, 285.84, 410.42, and 499.25, respectively. After adjusting for age, gender, education, marital status, annual household income, living area (urban/rural), geographical region of residence (central/southeast/northwest), smoking, alcohol drinking, physical activity, daily salt intake, daily oil intake, and disease history of hypertension, diabetes or dyslipidemia, multivariate Cox proportional risk regression model analysis showed that the participants with overweight were at an increased risk of CVD incidence (hazard risk [HR] = 1.253, 95% confidence interval [95% CI]: 1.014 – 1.548) compared to those with normal weight. Dose-response analysis revealed a J-shaped relationship between BMI and the risk of CVD (χ2overall = 29.87, P overall = 0.004; χ2nonlinear = 7.08, Pnonlinear = 0.069). Mediating effect analysis demonstrated that the direct effect of BMI on CVD incidence risk was 0.038 (Z = 11.644, P < 0.001) and the mediating effect of systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension was 0.022 (Z = 12.354, P < 0.001), 0.041 (Z = 10.589, P < 0.001) and 0.133 (Z = 11.506, P < 0.001). The mediating effect percentages of SBP, DBP pressure and hypertension were 36.67%, 51.90% and 77.78%, respectively. ConclusionBlood pressure has a strong mediating effect on the association of BMI with CVD risk. The results suggested that more attention and intervention on the changes of blood pressure need to be promoted among overweight and obesity populations.

Objective To evaluate the impact of short-term walking intervention project on the health indicators of occupational population with higher blood pressure in the comprehensive prevention and control of chronic disease demonstration area of Shandong Province,and provide the experience for the prevention and control of chronic disease in occupational population.Methods A total of 1 292 residents with higher blood pressure who have complete health data and 100 day walking records in the Shandong Division of the "10,000 Steps to Make an Appointment" Chinese Professional People Walking Incentive Intervention Project in 2019 were selected as the objects,and a WeChat management group was created to conduct walking intervention,the systolic blood pressure,diastolic blood pressure,waist circumference,hip circumference,body weight,body mass index（BMI）,body fat percentage（BFP）,and visceral fat index（VAI） were measured before and after walking. Paired t test,analysis of variance,linear regression model test and multivariate ordinal logistic regression model test were performed using SPSS 24.0 software.Results After walking for 100 days,the diastolic blood pressure,systolic blood pressure,body weight,waist circumference,hip circumference,BMI,BFP,and VAI decreased significantly（P＜0.01）.There were significant differences in the decrease values of hip circumference,systolic and diastolic blood pressure among residents with different blood pressure levels（P ＜0.05）.Waist circumference,hip circumference,systolic blood pressure,diastolic blood pressure,body weight,VAI,BMI,and BFP decreased with the increase of average steps and average effective steps.The decrease values in systolic blood pressure,diastolic blood pressure,VAI,BMI,and BFP increased with the level of concentration walking rate and group activity level. After 100 days of walking intervention,the every increased 1 000 steps of the average step number resulted in the decrease 0.075 cm of waist circumference,the decrease 0.087 cm of hip circumference,the decrease 0.346 mmHg of systolic blood pressure,the decrease0.213 mmHg of diastolic blood pressure,the decrease 0.231 kg of body weight,the decrease 0.045 of VAI,the decrease 0.052 kg/m~2 of BMI,and the decrease 0.095% of BFP（P＜0.05）. Every 1 000 steps increase in the average effective steps resulted in the decrease0.106 cm of waist circumference,the decrease 0.120 cm of hip circumference,the decrease 0.522 mmHg of systolic blood pressure,the decrease 0.289 mmHg of diastolic blood pressure,the decrease 0.236 kg of body weigh,the decreased 0.036 kg/m~2of BMI,and the decreased 0.062% of BFP,respectively（P＜0.05）. Compared with the low level concentration walking group,the systolic blood pressure of the high level group decreased by 18.064 mmHg,the diastolic blood pressure decreased by 9.116 mmHg,the body weight decreased by 3.929 kg,and the VAI decreased by 0.530. Compared with the WeChat group activity level 1 group,the VAI of the group activity level 4 group decreased by 0.426,the BMI decreased by 0.602 kg/m~2,and the BFP decreased by0.608%. Conclusion Strengthening walking exercise in a short period can improve the various health indicators of occupational groups with higher blood pressure. It is suggested that in walking exercise,the decrease values of health indicators can be increased by the elevating the number of average step and average effective step and adopting concentration walking. The health intervention management of occupational groups should be carried out by WeChat intervention.