Objective: To analyze probability of prodromal Parkinson's disease (pPD) and assess the association between global cognitive function and cognitive domain function and probability of pPD in ≥55 years old middle-aged and elderly people in Hebei, Zhejiang, Shaanxi and Hunan Provinces in China. Methods: Data were collected from dataset of the Community-based Cohort Study on Nervous System Disease 2020. We selected 4 634 Alzheimer disease and Parkinson's disease free persons aged ≥55 years with completed information on demographics, disease history, cognitive test, and risk factors of Parkinson's disease for this study. Cognitive function was assessed using Montreal Cognitive Assessment Scale (Chinese version). Calculation of probability of pPD and assessment of possible/probable pPD were performed according to the criteria published by the International Parkinson and Movement Disorder Society. Multivariate linear regression model was used to analyze the association between cognitive function and probability of pPD. Results: The M (Q1,Q3) of global cognitive function and cognitive domains in terms of memory, execution, visuospatial function, language, attention and orientation were 25 (20, 30), 13 (11, 15), 10 (7, 12), 6 (4, 7), 5 (4, 6), 15 (12, 18) and 6 (6, 6) points, respectively. The M(Q1,Q3) of probability of pPD was 0.42% (0.80%, 1.73%), and the proportion of the study subjects with possible/probable pPD was 0.4%. Differences in the distribution of probability of pPD were significant among groups by total cognitive score quartiles (P<0.001), and the difference in proportions of study subjects with possible/probable pPD was significant and showed decline trend (P=0.001). After adjusted for confounders, the results of multivariate linear regression analyses showed that probability of pPD in the Q2, Q3 and Q4 group decreased by 23.4%, 31.2% and 20.1% compared with Q1 group, and corresponding β values were 0.766 (95%CI: 0.702-0.836), 0.688 (95%CI: 0.631-0.751) and 0.799 (95%CI: 0.730-0.875), respectively, the trend was significant (P<0.001). Higher index scores of execution, visuospatial function, language, attention and orientation were highly related to lower probability of pPD (P<0.001). Conclusion: Declines in global cognitive function and cognitive domains of execution, visuospatial function, language, attention and orientation might increase the probability of pPD in middle-aged and elderly people, suggesting the importance of cognitive intervention in early stage for pPD prevention.

Objective:To analyze the association of fasting plasma glucose (FPG) with mild cognitive impairment (MCI) in the Chinese middle-aged and elderly population from four provinces.Methods:Data were drawn from the baseline data of the Community-based Cohort Study on Nervous System Disease 2018-2019. We selected 3 272 subjects aged 55 and above with completed information on demographics, lifestyle, disease history, cognitive test, psychological assessment, and bio-chemistries measurement, and who were capable of performing basic activities of daily living but without Alzheimer's disease during recruitment. A multivariate logistic regression model was employed to analyze the association between FPG and MCI.Results:Median level of FPG in the study population was 5.5 mmol/L. The prevalence of MCI was 24.8%, and those in groups of the FPG quintile were 19.4%, 22.2%, 29.2%, 26.6%, and 26.1%, respectively, which significantly increased the trend ( P=0.002). After adjustment of confounders, multivariate logistic regression analysis found that the MCI risk of subjects in the Q3, Q4 and Q5 groups was 1.641 (95% CI: 1.226-2.131), 1.373 (95% CI: 1.036-1.825), 1.402 (95% CI: 1.054-1.871) times as high as that in the Q1 group, respectively. Conclusion:High FPG level might serve as a risk factor for MCI in the middle-aged and elderly population, suggesting the importance of monitoring and controlling plasma glucose even without diabetes.

Objective: To assess the relationship between smoking status and sleep duration in male adults in urban-rural areas of 15 provinces (municipalities, autonomous regions) in China in 2015. Methods: Data were derived from the China Nutritional Transition Cohort Study 2015, a total of 4 419 participants aged 18-64 years, including 1 713 urban males (38.8%) and 2 706 rural males (61.2%), with complete information about smoking status and sleep duration were included in the final analysis. Based on the number of cigarettes consumed daily, the current smokers were classified to be heavy (25 cigarettes/d and above), moderate (15-24 cigarettes/d), and light (1-14 cigarettes/d). Sleep duration was classified to be insufficient (<7 h/d), sufficient (7-9 h/d), and excessive (9 h/d and above). Two-level mixed-effects linear and logistic regression models were used for association analysis. Results: The smoking rates in male adults in urban and rural areas were 45.7% and 53.8%, respectively. In male heavy smokers in urban and rural areas, the proportions of sufficient sleep were the lowest (66.7% and 68.1%). However, the proportions of sleep deprivation were highest (15.3% and 20.3%). After controlling for confounding factors, the net effect on male heavy smokers was a significant decrease of 0.21 h/d (β=-0.21, 95%CI: -0.44 - -0.01) in sleep duration. Moreover, the odds ratio for insufficient sleep were 1.83 (95%CI: 1.03-3.23) in male heavy smokers in rural area compared with nonsmokers. Conclusion: Heavy smoking is associated with decreased sleep duration and increased risk of sleep deprivation in male adults in rural China.

Objective: To investigate longitudinal association between smoking behavior and obesity risk in male adults in China from 1991 to 2015. Methods: A total of 32 169 male adults aged 18-64 years who participated in two or more rounds of China Health and Nutrition Survey (CHNS, 1991-2015) and had complete information of demographic characteristics, smoking status and physical measurements were selected as the study subjects. According to whether the subjects smoked or not and the number of cigarettes smoked per day, the subjects were divided into four groups: nonsmoker, light smoker (1-14 cigarettes/d), moderate smoker (15-24 cigarettes/d) and heavy smoker (≥25 cigarettes/d). The distribution of body mass index (BMI), waist circumference (WC), general obesity and central obesity of subjects with different smoking status were observed. Two-level mixed effect linear regression model and logistic regression model were used to analyze the relationship between smoking status and obesity risk. Results: Compared with nonsmokers, the BMI decreased by 0.19 kg/m2 in light smokers (95%CI:-0.27--0.10), 0.40 kg/m2 in moderate smokers (95%CI:-0.49--0.31), and 0.36 kg/m2 in heavy smokers (95%CI:-0.53--0.19), respectively, and the WC decreased by 0.49 cm in light smokers (95%CI:-0.76--0.21), 0.80 cm in moderate smokers (95%CI:-1.08--0.51) and 0.79 cm in heavy smokers (95%CI:-1.38--0.36) in, respectively. Compared with nonsmokers, the odds ratio of the risk for general and abdominal obesity were 0.70 (95%CI:0.62-0.79) and 0.78 (95%CI:0.73-0.84) in light smokers, 0.61 (95%CI:0.55-0.69) and 0.74 (95%CI:0.70-0.79) in moderate smokers and 0.78 (95%CI:0.65-0.96) and 0.84 (95%CI:0.76-0.95) in heavy smokers, respectively. Conclusions: From 1991 to 2015, the BMI, WC, prevalence of general and abdominal obesity in male adults showed a significant upward trends in both nonsmokers and smokers (light, moderate and heavy) in China, suggesting that smoking is negatively associated with the risk for obesity in male adults.

Objective: To investigate the level of serum uric acid and the prevalence of hyperuricemia among adult residents in China. Methods: Data were derived from the China Nutritional Transition Cohort Study (CNTCS) in 2015. A total of 8 217 adult residents, aged 18-59 years old, who had completed survey data were selected as the subjects of the study. The demographic data was collected by questionnaire, and the fasting serum uric acid was detected by enzymatic method on the automatic biochemical analyzer (German Roche C701/702) by using German Roche uric acid reagent test kit. The levels of serum uric acid and the prevalence of hyperuricemia were analyzed under different demographic characteristics. Results: The results showed that, in 2015, the average level of serum uric acid in Chinese adults aged 18-59 years old was 288.0 μmol/L, and the prevalence rate of hyperuricemia was 9.8% (weighted value). Among them, the average level of serum uric acid and weighted prevalence of hyperuricemia was 329.7 μmol/L and 15.1% in men and 254.3 μmol/L and 5.8% in women. The average level of serum uric acid and weighted prevalence of hyperuricemia was 298.5 μmol/L and 10.9% in urban residents and 281.9 μmol/L and 9.1% in rural residents. The level of serum uric acid and the prevalence rate of hyperuricemia decreased when age increased in men, but increased with age increased in women. Conclusions: There are some differences in the level of serum uric acid and the prevalence rate of hyperuricemia among adult residents of different regions, gender, ages, household income and educational level. It is suggested that accurate prevention and control measures should be taken according to different demographic characteristics.

Objective: To analyze the changes on the rates of prevalence, awareness and treatment of hypertension as well as the differences of the disease by demographic and economic factors, among adult farmers in nine provinces of China. Methods: Adult farmers, (including fishermen and hunters) with completed data on demographics, socio-economic characteristics, disease histories and physical measurements were selected from the 1991-2015 China Health and Nutrition Survey. Hypertension was defined based on the Chinese guidelines. Multivariate logistic regression was used to analyze the influence of demographic and economic factors on the rates of prevalence, awareness and treatment of hypertension among those adult farmers in 2015. Results: A total of 18 236 participants were included. From 1991 to 2015, rates of prevalence, awareness and treatment of hypertension among the adult farmers in nine provinces all significantly increased (P<0.05). Results from the multivariate analysis showed that farmers aged ≥45 years were 98% more likely to suffer from hypertension than those aged 18-44 years. Farmers who were overweight or obese were 1.58 times and 5.21 times more likely to suffer from hypertension than those in the control group (BMI<24.0 kg/m(2)), respectively. The rates on awareness of hypertension among farmers with junior high school education (OR=0.23) or above (OR=0.12) or with junior high school education (OR=0.30) were both lower than those with primary school education or below. Rates on the awareness and treatment of hypertension in obese farmers were 5.77 times and 7.52 times of those in the control group. Conclusions: The rates of prevalence of hypertension showed increasing trends during 1991-2015, with a slower increase in the rates of awareness and treatment in the farmers. Age ≥45 year-olds, and being obese were the risk factors for farmers to have hypertension, which suggested the above population should be focused on hypertension prevention strategy and practice.

Objective To analyze the status of dietary sodium intake of Chinese adult residents in fifteen provinces in 2015. Methods Data were collected from 2015 China Nutrition Transition Cohort Study. This cohort study used a three consecutive 24?h retrospective method to record food intake and weighing method to record household condiment consumption. In this study, 14 847 residents aged 18 years and over with complete data from 15 provinces in 2015 were selected for the comparison of dietary sodium intake (median) with different characteristics. Results Among the 14 847 residents, 47.1% were males, and the rural and northern residents accounted for 60.1% and 37.7%, respectively. Median sodium intake was 3 960.0 mg/d among residents in 2015. The sodium intake of males (4 272.1 mg/d) was higher than that of females (3 716.6 mg/d). Across age subgroups, sodium intake was highest among residents aged 45-59 years (4 257.0 mg/d; 18-44 years old, 3 867.1 mg/d; ≥60 years old, 3 799.0 mg/d). Sodium intake was higher in rural area (4 042.9 mg/d) than in urban area (3 866.8 mg/d), higher in north (4 229.2 mg/d) than in south (3 806.8 mg/d) (all P values<0.05). 11.8% of residents with dietary sodium intake were below 2 000 mg/d. The main sources of dietary sodium were condiments (79.4%), regular cooking foods (11.9%) and processed foods (8.7%). Among the condiments, the salt and soy sauce accounted for 63.6% and 10.4%, respectively. Conclusion In 2015, Chinese adult residents had higher dietary sodium intake with gender and regional differences. Condiments were the main source of dietary sodium.

Recent years,national laws and government policies were published as series to encourage the development of group standardizations.The updated Standardization Law of the People's Republic of China,implemented on January 1st,2018,stipulates that group standard is a part of the Chinese standard system.Under the current supportive circumstances,more institutes and organizations have joined in the writing and releasing procedures of group standards'.Despite the rapid development of group standardization to publish,we are still at the phase of exploring and regulating group standardizations.This review summarizes the development and practice on the development group standardization in the Chinese Preventive Medicine Association and analyzes current condition and deficiency of the work in China,in order to develop suggestions and strategies to improve and regulate group standardization.

Background/Objectives: Present study aims to longitudinally explore independent association of physical activity and sedentary behaviors with body weight. Subjects/Methods: This study included 15050 adults who have complete demographic and dietary data, leisure time physical activity (LTPA) and sedentary behavior evaluations, anthropometric measurements from longitudinal data of China Health and Nutrition Survey 2004–2011. Three-level mixed-effects linear and logistic regression models were performed for association analysis. Results: Overweight and obesity prevalence in men and women progressively increased from 2004 to 2011. MET-h/week from LTPA declined, whereas time (h/day) spent in sedentary behaviors increased in men and women over 7 years. After adjustment for confounders, LTPA (MET-h/week) was linked with weight gain for moderate ( β =0.43, 95% confidence interval (CI): 0.16–0.60, P <0.01) and low ( β =0.52, 95% CI: 0.23–0.81, P <0.01) versus high LTPA in men; weight was increased by 0.7 kg (95% CI: 0.44–0.93, P <0.001) and 0.4 kg (95% CI: 0.12–0.68, P <0.01) among men and women without LTPA, respectively, compared with those with high LTPA. Sedentary behavior was associated with weight gain in men ( β =0.45, 95% CI: 0.14–0.76, P <0.01) and in women ( β =0.29, 95% CI: 0.11–0.49, P <0.05) for high versus low level. Moreover, overweight and obesity risk in men with low LTPA or without LTPA was 1.88 (95% CI: 1.15–2.51, P <0.05) and 2.01 (95% CI: 1.41–3.03, P <0.001) times higher than those with high LTPA, respectively. Odds of overweight and obesity were increased to 1.63 (95% CI: 1.29–2.21, P <0.01) times in women with low LTPA and 1.69 (95% CI: 1.37–2.27, P <0.001) times in women without LTPA compared with those with high LTPA. High level sedentary behavior was associated with 19% (OR=1.19, 95% CI: 1.04–1.35, P <0.05) greater odds of overweight and obesity against low level in men. Conclusions: LTPA and sedentary behaviors are independently and longitudinally associated with overweight and obesity, especially in men.

Dietary patterns represent the combined effects of foods and efficaciously illustrate the impact of diet on health outcomes. This study identified the dietary patterns and determined their relationships with obesity among young Chinese women. In 2011, the China Health and Nutrition Survey included 2363 young women aged 18–44 years. Factor analysis of data from three consecutive 24-h dietary recalls identified the dietary patterns. Weight, height and waist circumstance (WC) were measured, and body mass index (BMI) was calculated. General obesity was defined as BMI ⩾28 kg/m2 and abdominal obesity as WC ⩾85 cm. Four dietary patterns were identified: traditional south; traditional north; snack; and high protein. After adjusting for confounders and energy intake, women in the highest-score quintiles of the traditional south pattern were less likely to have general obesity (odds ratio (OR)=0.48; 95% confidence interval (CI) 0.29–0.78) and abdominal obesity (OR=0.64; 95% CI 0.46–0.90). Subjects in the highest-score quintiles of the traditional north pattern had significantly greater risk of general obesity (OR=2.28; 95% CI 1.38–3.74) and of abdominal obesity (OR=2.32; 95% CI 1.66–3.24). The traditional south pattern of rice as the major staple food with pork and vegetable dishes is associated with lower risk of general and abdominal obesity. The traditional north pattern of high intake of wheat, other cereals and tubers is positively associated with general and abdominal obesity. This provides important information for interventions and policies addressing obesity prevention among young Chinese women.

Background/Objectives: To analyze the time trends in total dietary fiber (DF) intake, DF food sources and total DF intake per 1000 kcal (DF density) in Chinese adults aged 45 years and above in the past 20 years. Subjects/Methods: We used the data from the China Health and Nutrition Survey (CHNS) collected in 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011. Adults who were aged 45 years and above were included in each round. Water-insoluble DF intake was calculated by substituting the water-insoluble DF content of each food in the Chinese Food Composition Table (FCT) for food intake. Total DF was calculated according to the convert index, which indicates the ratio between total DF and water-insoluble DF for each food group. Results: The mean daily total DF intake in males was 19.5 g/day in 1991 and 19.4 g/day in 2011. In females, it was 17.5 g/day in 1991 and 17.6 g/day in 2011. DF density increased in both males and females from 2004 to 2011. It was 9.0 g/1000 kcal in males and 9.5 g/1000 kcal in females in 2011. The major food sources of water-insoluble DF were cereals and vegetables. Communities with different levels of urbanization showed different trends in total DF intake: decreased consumption (2.9 g) in residents of low-urbanization communites and increased consumption (3.1 g) in those of high-urbanization communities. Conclusion: The average total DF intake in Chinese adults aged 45 years and above remained at a stable level. DF density increased because of slight decrease in energy intake. More public health messages should be disseminated, especially to the residents of low-urbanization communities, so as to increase their daily DF intake to a level close to the recommended DF intake.

Several studies have suggested differential health effects in relation to different meat composition in Western population. The purpose of the study was to examine secular trends in meat and seafood consumption patterns among Chinese adults between 1991 and 2011. Our longitudinal data are from 21 144 adults aged 18–75 in the China Health and Nutrition Survey, prospective cohort study. We assessed the intakes of meat and subtypes with three 24-h dietary recalls. We conducted multilevel mixed-effect logistic and linear regression models to examine meat consumption dynamics. The proportions of Chinese adults who consumed red meat, poultry and seafood increased from 65.7% in 1991 to 86.1% in 2011, from 7.5 to 20.9% and from 27.4 to 37.8%, respectively. With rapid decrease in meat intakes since 2009, the intakes of total meat, red meat, poultry and seafood among their consumers were 86.7 g/day, 86.4 g/day, 71.0 g/day and 70.3 g/day in 2011, respectively, which were just slightly higher compared with those in 1991. Fatty fresh pork has been predominantly component of total meat overtime, which consituted 54.0% of total meat intake, 80.0% of fresh red meat intake and 98.7% of fatty fresh red meat intake in 2011. Over the past two decades, meat consumption patterns of Chinese adults have been characterized by having a predominant intake of fatty fresh pork, suboptimal intakes of seafood and increased proportion of adults having excessive intakes of red meat and poultry overtime.