BACKGROUND AND OBJECTIVES:The dietary inflammatory potential, assessed by the Dietary Inflammatory Index (DII), may influence ischemic stroke (IS) risk, but evidence from high-incidence regions in China remains limited. This study aimed to investigate the associations among dietary patterns, the DII, and IS in Eastern China. METHODS AND STUDY DESIGN:In a hospital-based case-control study in Zhejiang, China, 223 IS patients and 510 age- and sex-matched controls completed a validated food frequency questionnaire. DII scores were calculated, and dietary patterns were derived using factor analysis. Multivariate logistic regression models were used to calculate odds ratios and 95% confidence intervals (CIs). RESULTS:A "Jiangnan red-sauce and heavy oil" pattern, characterized by high intake of refined grains, salted vegetables, processed meats, and fats, was associated with higher DII scores and an increased IS risk (OR = 1.85; 95% CI: 1.74-2.51; top versus bottom tertile). Conversely, a "Traditional Chinese" pattern, rich in whole grains, vegetables, fruits, and legumes, was correlated with lower DII scores and a potentially reduced IS risk (OR = 0.85; 95% CI: 0.76-0.94). CONCLUSIONS:The findings suggest that pro-inflammatory diets were associated with a high likelihood of IS, while anti-inflammatory patterns, such as the Traditional Chinese diet, may be protective. The findings may also provide insights for dietary prevention strategies in the high-risk populations, pending confirmation from prospective studies.

The double burden of malnutrition (DBM)—the coexistence of micronutrient deficiencies and overweight/obesity—poses a growing challenge in pediatric populations. This cross-sectional study examined divergent associations of vitamin D, vitamin A, zinc, and iron deficiencies with cardiometabolic risk factors in Chinese children and adolescents (Causality cannot be inferred from these observational data). This cross-sectional study analyzed data from 9,585 children and adolescents aged 6–17 years from the Nutrition and Health Survey in Zhejiang Province (2022–2024). Micronutrient status was assessed using established cut-offs. Cardiometabolic outcomes included seven binary risk factors and the continuous metabolic syndrome score (cMetS). Modified Poisson regression with robust standard errors and multiple linear regression were used, adjusted for age, sex, residence, and energy intake. Vitamin D deficiency was associated with higher risk of hypertriglyceridemia (RR = 1.13, p = 0.005) and low HDL-C (RR = 1.45, p < 0.001), yet lower risk of hypercholesterolemia (RR = 0.85, p = 0.007) and hypertension (RR = 0.88, p = 0.022). Vitamin A deficiency was inversely associated with overweight/obesity (RR = 0.68, p < 0.001), hypertriglyceridemia (RR = 0.35, p < 0.001), and hypertension (RR = 0.68, p = 0.032). Zinc deficiency risk showed divergent associations: lower risk of overweight/obesity (RR = 0.85, p = 0.033) and hypertension (RR = 0.66, p < 0.001), yet higher risk of impaired fasting glucose (RR = 2.27, p < 0.001) and low HDL-C (RR = 1.62, p < 0.001). Iron deficiency was inversely associated with overweight/obesity (RR = 0.74, p = 0.002), hypertriglyceridemia (RR = 0.75, p = 0.005), and low HDL-C (RR = 0.38, p < 0.001). In the blood pressure subsample (n = 3,492), cMetS was higher with vitamin D deficiency and zinc deficiency risk (β = 0.356 and 0.515) but lower with vitamin A and iron deficiencies (β = − 0.700 and − 0.374; all p ≤ 0.013). The inverse associations for vitamin A and iron were attenuated after additional adjustment for BMI z-score, whereas the adverse associations for vitamin D and zinc remained robust. Micronutrient deficiencies showed nutrient-specific, bidirectional associations with cardiometabolic risk in this cross-sectional study. Vitamin D and zinc deficiencies were consistently associated with adverse profiles, whereas the inverse associations for vitamin A and iron should not be interpreted as evidence of protective effects of deficiency; they likely reflect adiposity-driven metabolic and inflammatory alterations. Precision nutrition approaches that account for metabolic context warrant evaluation for micronutrient screening and supplementation in youth with obesity.

OBJECTIVES:To explore the association between parent-child lifestyle synergy and overweight/obesity, and to assess actor and partner effects of healthy lifestyles on weight status among parent-child dyads. STUDY DESIGN:Cross-sectional study. METHODS:Data from 2538 Chinese parent-child dyads were analyzed. Children's healthy lifestyle scores (0-4) included dietary diversity, moderate-to-vigorous physical activity (MVPA) ≥60 min/day, screen time <2 h/day, and sufficient sleep. Parental scores (0-5) comprised dietary diversity, no tobacco or alcohol use, MVPA ≥150 min/week, and sufficient sleep. Lifestyle synergy was defined based on tertiles of lifestyle scores: synergistic ideal (both in the highest tertile), synergistic non-ideal (neither in the highest tertile), and non-synergistic (only one in the highest tertile). Overweight/obesity was defined by body mass index (BMI) percentile for children and BMI ≥24.0 kg/m2 (Chinese criteria) for parents. Multivariable logistic regression assessed associations between synergy status and overweight/obesity. Actor-Partner Interdependence Model (APIM) evaluated actor and partner effects. RESULTS:Among 2538 dyads, 34.24% of children and 30.69% of parents had overweight/obesity. Compared to the synergistic non-ideal group, both the non-synergistic and synergistic ideal groups had lower odds of overweight/obesity in children (OR = 0.79, 95%CI: 0.67-0.95; 0.70, 0.52-0.95) and parents (0.80, 0.67-0.97; 0.71, 0.51-0.98). APIM analyses showed significant actor effects and partner effects, with healthier lifestyles associated with lower odds of overweight/obesity in both individuals and their counterparts. CONCLUSIONS:Healthy lifestyles within parent-child dyads are associated with both individual and cross-partner weight status. Family-based interventions targeting both parents and children may be more effective than individual-focused approaches for preventing overweight and obesity.

Background/Objectives: Precise prevention strategies for mild cognitive impairment (MCI) are an urgent public health priority. This study aimed to investigate the association of the Composite Dietary Antioxidant Index and alcohol consumption, as well as their interaction, with the risk of MCI. Methods: A multicenter cross-sectional study was conducted in 2020, involving 1084 individuals aged ≥55 years, in Zhejiang Province, China. Data were collected on demographics, cognitive function, alcohol consumption, depression scale, dietary intake and physical examinations. The Composite Dietary Antioxidant Index (CDAI) was calculated based on the converted Food Frequency Questionnaire (FFQ) Food Composition Tables and the data of the FFQ. CDAI values were divided into four groups by interquartile ranges: Quartile-1 (Q1), Quartile-2 (Q2), Quartile-3 (Q3) and Quartile-4 (Q4). Multivariate logistic regression models were used to evaluate the association of CDAI and alcohol consumption with MCI risk and their interaction. Results: The prevalence of MCI was 24.6%. After adjusting for gender, age, educational level, job, marriage, Body Mass Index (BMI), central obesity, frequency of social activities, depression, sleep disturbances, smoking, diabetes, and energy intake, the Q2 (OR = 0.63, 95% CI: 0.42~0.95), Q3 (OR = 0.52, 95% CI: 0.34~0.81) and Q4 (OR = 0.25, 95% CI: 0.14~0.48) of CDAI were significantly associated a reduced risk of MCI. In contrast, alcohol consumption 1~2 times per week (OR = 2.38, 95% CI: 1.02~5.59) and at least 3 times a month (OR = 2.04, 95% CI: 1.19~3.50) was significantly associated with an increased risk of MCI. Interaction analysis indicated a negative additive interaction between alcohol consumption and CDAI on MCI risk, with the detrimental effects of alcohol predominating. Conclusions: A higher CDAI is associated with a reduced risk of MCI, while alcohol consumption is associated with an increased risk. There may be a negative additive interaction between CDAI and alcohol intake in relation to MCI. Targeted strategies that reduce alcohol consumption and improve dietary antioxidant intake are essential for MCI prevention.

Background: This study investigates the associations between lipid profiles, including triglycerides (TGs), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), and vitamin A (VA) and vitamin D (VD) deficiencies among children and adolescents in Zhejiang Province, China. Methods: This cross-sectional study was conducted from 2022 to 2024 and included 9039 children and adolescents aged 6–17 years who participated in the provincial nutrition surveillance in Zhejiang Province. Blood samples were collected to measure the concentrations of TG, TC, HDL-C, LDL-C, VA and VD. Results: The prevalence of elevated TG, elevated TC, low HDL-C, and elevated LDL-C was 21.0%, 11.6%, 4.7% and 5.1% among children and adolescents aged 6–17 years, respectively. There were significant differences with respect to elevated TG and low HDL-C prevalence between sex (χ2 = 10.303 and 7.27, p = 0.006 and 0.026). There were significant differences with respect to elevated TC and low HDL-C prevalence between urban areas and rural areas (χ2 = 13.289 and 10.195, p = 0.001 and 0.006). There were significant differences with respect to elevated TG, elevated TC, low HDL-C, and elevated LDL-C prevalence among children with or without obesity/overweight (χ2 = 209.828, 58.54, 171.972, and 146.256, p < 0.001). There were significant differences with respect to elevated TC and low HDL-C prevalence among children with or without vitamin D deficiency/vitamin D insufficiency (χ2 = 33.37 and 56.848, p < 0.001). Ordinal regression analysis revealed that sex and obesity/overweight were associated with critical/abnormal TG (χ2 = 340.03, p < 0.001), sex, age group, location and obesity/overweight were associated with critical/abnormal TC (χ2 = 255.125, p < 0.001), age group, location, obesity/overweight and vitamin D deficiency/vitamin D insufficiency were associated with critical/abnormal HDL-C (χ2 = 458.527, p < 0.001), and age group, obesity/overweight were associated with critical/abnormal LDL-C (χ2 = 164.380, p < 0.001). Conclusions: Elevated TG, elevated TC, low HDL-C, and elevated LDL-C are prevalent in this population, with notable differences based on sex, urban vs. rural residence, and obesity/overweight status. Furthermore, vitamin D deficiency was linked to elevated TC and low HDL-C prevalence. Future interventions should focus on targeted public health strategies to mitigate these disparities and promote healthier lipid profiles in children and adolescents.

Objective:To assess the nutritional status of vitamin D and to analyze the influencing factors of vitamin D deficiency among children and adolescents. Methods:Data from 1,827 children and adolescents aged 6-17 years from the nutrition and health surveillance of Zhejiang province, China, were analyzed. The serum concentration of 25-(OH)D were measured using High-Performance Liquid Chromatography-Tandem Mass Spectrometry. The prevalence of vitamin D deficiency and insufficiency were calculated. Ordinal regression were used to identify the influencing factors of vitamin D deficiency and insufficiency. Results:The mean 25-(OH)D concentration was 20.84 ± 6.34 μg/L. Among the participants, 37.4% had vitamin D insufficiency (25-(OH)D <20 μg/L) and 7.8% had vitamin D deficiency (25-(OH)D <12 μg/L). Age group (Wald c 2 = 5.921, p = 0.015), sex (Wald c 2 = 6.206, p = 0.013), overweight/obesity (Wald c 2 = 3.894, p = 0.048), and outdoor activity time (Wald c 2 = 4.113, p = 0.043) were the influencing factors of children and adolescents with insufficiency/deficiency vitamin D status. Conclusions:Our study assessed the nutritional status of vitamin D and analyzed the influencing factors of vitamin D deficiency among children and adolescents in the eastern coastal areas of China. The results indicated a significant prevalence of vitamin D insufficiency and deficiency. Key influencing factors included age group, sex, overweight/obesity, and outdoor activity time. These findings highlight the need for targeted interventions to improve vitamin D levels in children and adolescents. Specifically, promoting adequate outdoor activity and addressing overweight/obesity could be effective strategies to enhance vitamin D status in this population.

Hyperuricemia (HUA) is a metabolic disorder syndrome caused by purine metabolism dysregulation, and its prevalence increases year by year. The development and progression of HUA are accompanied by significant alterations in the composition of intestinal microbiota, making probiotics a potential and safe method to reduce serum uric acid. Probiotics ameliorate HUA through three pathways: competing with intestinal epithelial cells for purine absorption to decrease uric acid synthesis, inhibiting xanthine oxidase activity through modulation of inflammatory cytokines to reduce the conversion of purine to uric acid, as well as restoring and maintaining an orderly state of the gut microbiota to facilitate normal uric acid excretion. This article reviews the role of probiotics in ameliorating HUA, so as to provide the reference for the application of probiotics in the prevention and intervention of HUA.

OBJECTIVE:Exploring the cost-effectiveness of community-based nutrition interventions in urbanizing areas. METHODS:In January, 2022, 2 communities with typical urbanization process in Hangzhou, Zhejiang Province were selected, and adults aged 18 years or older from each community were recruited as study subjects. Whole venous blood sample was collected. The fully automatic biochemical analyzer was used to detect the hemoglobin in whole blood and the four serum lipids(total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein). The level of serum vitamin D was detected by ultra-high-performance liquid chromatography-tandem mass spectrometry. Meanwhile, the questionnaire survey and health examination at baseline were conducted to acquire the dietary quality score, body mass index(BMI) and waist. According to the inclusion and exclusion criteria, 100 participants were included for each community and divided into four groups, including abnormal fat distribution group, the improper diet group, the vitamin D malnutrition group, and the anemia group. Participant were randomly divided into nutritional intervention and control arms at the match ratio of 1∶1 by age and sex. Continuous nutritional interventions were offered for 3 months for intervention arm, and no intervention was offered for control arm. Repeat survey and health examinations were conducted after 3 months for all participants. The improvements of health indicators related to the four nutritional problems(including BMI, waist, serum lipids, hemoglobin and serum vitamin D) and the relative risk(RR) were calculated. The cost-effectiveness ratios were calculated by integrating the cost. RESULTS:The improvement rate in the intervention group in abnormal fat distribution group was higher than that of the control group(50% vs.18.8%, RR=2.66). The improvement rate in the intervention group in improper diet group was higher than that of the control group(64.5% vs.43.9%, RR=1.47). The improvement rate in the intervention group in vitamin D malnutrition group was higher than that in the control group(62.5% vs.46.7%, RR=1.34). The improvement rate of anemia intervention group was lower than that of control group(40% vs.60%, RR=0.67). The result of the cost-effectiveness analysis showed that the costs for improving each subject with abnormal fat distribution, improper diet, vitamin D malnutrition and anemia were Chinese Yuan(CNY) 390, CNY 302.3, CNY 408 and CNY 487.5 respectively. CONCLUSION:The implementation of community-based nutrition interventions in rapidly urbanizing areas is effective in improving the health status and is in line with the cost-effectiveness principle.

Background/Objectives: Plant-based diets are associated with reduced chronic disease risk, though regional variations persist. In Zhejiang, China, where plant-based food intake is high, this study aimed to explore the association between plant-based diets and metabolic syndrome (MetS) in adults aged 35-75. Methods: This cross-sectional study utilized data from the 2024 Zhejiang Nutrition and Health Survey (ZJNHS). Three plant-based diet indices were calculated: the overall plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Multivariate logistic regression models evaluated associations between diet index quintiles and MetS and its components. Results: Among the 4695 participants included in the study, 23.9% (n = 1122) had MetS. After adjusting for demographic and lifestyle factors, individuals in the highest uPDI quintile showed a significantly higher MetS risk compared to the lowest quintile (OR = 1.37, 95% CI: 1.08-1.73, p-trend = 0.013). Subgroup analyses revealed significant gender interaction (p for interaction < 0.001), with women exhibiting elevated MetS risk (OR = 1.03, 95% CI: 1.01-1.04, p < 0.001). For MetS components, the highest uPDI quintile was associated with increased risks of abdominal obesity (OR = 1.32, 95% CI: 1.05-1.66; p-trend = 0.032), elevated blood pressure (OR = 1.41, 95% CI: 1.12-1.78; p-trend = 0.003), and elevated fasting glucose (OR = 1.27, 95% CI: 1.01-1.59; p-trend = 0.037). Conclusions: Unhealthy plant-based foods are associated with increased MetS risk, particularly in women. Reducing intake of such foods, considering sex differences, and implementing precision nutrition interventions are essential.

Background/Objectives: The Jiangnan diet—a traditional dietary pattern prevalent in Eastern China—is a newly proposed dietary pattern. This study provides additional epidemiological evidence for the promotion of the Jiangnan diet through examining the association between the Jiangnan diet and mild cognitive impairment (MCI). Methods: A multicenter cross-sectional study was carried out during 2020 among 1084 community-dwelling adults aged 55 years and above across multiple sites in Zhejiang Province, China. Data collection encompassed basic information of the population, cognition (using the Montreal Cognitive Assessment), dietary intake information (using the Food Frequency Questionnaire, FFQ), life pattern, depressive symptoms (using the Mental Health Assessment Scale for the Elderly), and physical examinations (e.g., height, weight). The dietary patterns were assessed using a validated semi-quantitative FFQ. Factor analysis was used to analyze the 16 categories of food intake of the participants, and dietary patterns and the “Jiangnan diet” were extracted. The Jiangnan diet scores were categorized into quartiles: Q1 (lowest) to Q4 (highest). Multivariate logistic regression was employed to examine the association between adherence to the Jiangnan diet and the prevalence of MCI, with results expressed as odds ratios (OR) and 95% confidence intervals (CI). Results: The estimated prevalence of MCI in the study population was 24.6%. The dietary pattern characterized by whole grains, low salt, and low oil was identified as the “Jiangnan diet”. Participants with the highest adherence to the “Jiangnan diet” pattern had 79.2% lower odds of MCI than those with the lowest adherence (odds ratio = 0.208, 95% CI = 0.120~0.362, p < 0.0001) after adjusting for age, frequency of social activities, depression, hypertension, alcohol consumption, and energy intake. Conclusions: High adherence to the Jiangnan diet was associated with lower odds of MCI. To further verify the relationship between the Jiangnan diet and MCI, future studies will focus on longitudinal research exploring different dietary patterns and disease outcomes across various regions.

Background/Objectives: Sex differences in nutrition-related determinants of mild cognitive impairment (MCI) exist among the elderly. This study aimed to explore sex-specific influencing factors of MCI. Methods: A case–control study was conducted in 2020 involving 1086 elderly people aged 55 years and above from four sites in Zhejiang Province, China. Data on demographics, cognitive assessment, depression scale, daily food intake, and physical examinations were collected. The assessment of plant-based diet patterns depended on an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). Multivariate logistic regression models were employed to assess the determinants of MCI in females and males. Results: Among 571 females, 141 (24.7%) had MCI, and 126 (24.5%) had MCI among 514 male participants. In females, the multivariate analysis revealed that being unmarried/divorced/widowed (OR = 1.95, 95% CI: 1.10–3.45), having depression (OR = 6.06, 95% CI: 1.87–19.66), and having a uPDI score ≥ 55 (OR = 2.41, 95% CI: 1.50–3.89) were associated with a significantly elevated risk of MCI. Conversely, a cereal consumption of ≥300 g/d (OR = 0.32, 95% CI: 0.19–0.53) was linked to a significantly reduced risk. In males, vegetable consumption ≥ 150 g/d (OR = 0.39, 95% CI: 0.23–0.66), vegetable oil consumption ≥ 22 g/d (OR = 0.502, 95% CI: 0.307–0.820), and cereal consumption ≥ 300 g/d (OR = 0.44, 95% CI: 0.27–0.71) were associated with a lower MCI risk. Meanwhile, rural residence (OR = 1.90, 95% CI: 1.12–3.25) and advanced age, especially 75 years old and above (OR = 4.71, 95% CI: 2.44–9.12), were also risk factors in males. Notably, the Restricted Cubic Spline (RCS) model showed that females with a uPDI score < 55 had a lower prevalence of MCI, while those with a score ≥ 55 faced a higher risk. Conclusions: This study indicates potential sex disparities in the risk factors for MCI. Future research should prospectively establish causal relationships. Additionally, precise intervention strategies are urgently needed.

BACKGROUND:The relationship between serum vitamin D levels and metabolic syndrome (MetS) has been controversial. This study focused on the relationship between the prevalence of MetS and serum vitamin D levels in middle-aged and elderly people. METHODS:This study included middle-aged and older adults who participated in the 2023 Zhejiang Provincial Nutrition and Health Survey, which was conducted in 90 districts and counties in Zhejiang Province, China. RESULTS:A total of 11,305 participants were included in this study. MetS was prevalent in 31.7% of participants. Vitamin D and vitamin D3 concentrations were inversely associated with MetS prevalence (Ptrend<0.05), but not with vitamin D2, regardless of whether logistic regression models were adjusted for confounding factors. After adjusting for age, sex, physical activity level, smoking status, education level, annual per capita household income, and body mass index residuals, the highest tertile (Q3) of vitamin D (odds ratio [OR], 0.779; 95% confidence interval [CI], 0.702-0.865) and vitamin D3 (OR, 0.787; 95% CI, 0.709-0.875) concentrations had a lower risk of MetS than the lowest tertile (Q1). We found that vitamin D and D3 levels were correlated with age (Pinteraction<0.05). When age-stratified analyses were performed, vitamin D and vitamin D3 levels were significantly negatively associated with MetS in older adults but not in middle-aged adults. CONCLUSIONS:Low total serum vitamin D and vitamin D3 levels were associated with a higher risk of MetS in adults aged 60 years and older.

ObjectivesThe aim of this study was to explore the factors influencing type 2 diabetes mellitus (T2DM) among adults in Zhejiang Province.MethodsA stratified cluster sampling technique was employed, and adults without known diabetes were included in the analysis. Food consumption was assessed using three consecutive days of 24-h dietary recall. Blood samples were collected to measure fasting blood glucose (FBG), blood lipids [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), 25-(OH)D vitamin D (VD), and vitamin A (VA). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were also measured. Ordinal regression was used to explore factors influencing T2DM.ResultsThe analysis included a total of 5,804 adults. The prevalence rates of T2DM and prediabetes were 5.5 and 5.8%, respectively. Significant differences were observed in age, sex, nutritional status, hypertension, and blood lipid levels among adults with normal fasting blood glucose, prediabetes, and T2DM (p < 0.05). Adults aged 55 years and above, those who were overweight or obese, those with hypertension, and those with higher TG levels had a greater risk of developing diabetes (p < 0.05).ConclusionThis study revealed that adults aged 55 years and above, those who are overweight or obese, those with hypertension, and those with higher TG levels have a greater risk of developing diabetes. These findings underscore the need for targeted interventions to manage these risk factors in the prevention and management of T2DM.

BackgroundInformation on the prevalence of postpartum women anemia is scarce in China, as well as its impact on their offspring. This study aimed to explore the influencing factors of anemia and the impact on the offspring.MethodsA cross-sectional study was conducted among 977 women within 2 years postpartum in 10 sites from 2016 to 2017 in Zhejiang Province, China. Information on demographics, nutrient supplementation and diet was collected. Whole blood hemoglobin, serum ferritin and transferrin receptor were assessed for all women and whole blood hemoglobin was assessed in offspring. The multivariate logistic regression was used to assess the determinants of anemia and the impact on the offspring by calculating odds ratio (OR) and its 95% confidence interval (95%CI).ResultsAmong 977 participants, 144 (14.74%) had anemia. Regression analysis showed that women intaking iron supplements during pregnancy (0.549, 0.350 ~ 0.860), and intaking sufficient red meat (0.647, 0.437 ~ 0.958) had lower rates of anemia, while women wo had anemia during pregnancy (2.754, 1.844 ~ 4.113 for mild anemia, and 3.815, 1.564 ~ 9.309 for moderate or severe anemia), had postpartum over 7 months (1.717, 1.112 ~ 2.650), with abnormal serum ferritin (11.931, 4.846 ~ 29.379) and excessive transferrin receptor levels (1.817, 1.050 ~ 3.145) had higher rates of anemia. Moreover, maternal anemia significantly increases the rate of anemia in offsprings, with ORs being 1.456 (0.994 ~ 2.133) for mild anemia, and 2.961 (1.242 ~ 7.058) for moderate or severe anemia, respectively.ConclusionThe status of anemia in postpartum women was severe and its impact on the anemia of their offspring should be noted. It is highly necessary to strengthen the regular monitoring of hemoglobin levels in pregnant and postpartum women, as well as implement targeted dietary interventions and suggest to intake dietary supplements if necessary.

IntroductionIncreasing research has focused on the influence of diet on mental health and well-being. This study aimed to investigate dietary habits status and their associations with emotional and behavioral problems (EBPs) in pre-teen children, as well as explore the mediating effect of child self-concept in the associations between healthy dietary habits and EBPs.MethodsA cross-sectional survey using stratified random sampling was conducted to recruit third-grade children and their caregivers. Dietary habits and self-concept were assessed with self-administrated questionnaires in children. Information on children’s EBPs was collected through questionnaires completed by their caregivers. Multilevel logistic regression models were used to estimate the associations between dietary habits and self-concept and EBPs, respectively. The mediation analysis was employed to test the mediating role of self-concept in the association between dietary habits and EBPs.ResultsOf 1,126 caregiver-child dyads (Mean age of children: 9.53, 52.8% boys) included, only 37.4 and 54.2% of children met the healthy standard of milk/soy milk and fruit, respectively. Healthy fresh fruit (odds ratio [OR] = 0.57, 95% confidence intervals [CI] 0.40–0.78) and vegetables intake (OR = 0.54, 95% CI 0.38–0.76) were associated with a higher self-concept while frequent consumption of sweet foods (OR = 1.58, 95% CI 1.05–2.36) and street foods (OR = 1.61, 95% CI 1.14–2.28) were associated with a lower self-concept. Children who had unhealthy sugar-sweetened beverages intake were at an elevated risk of EBPs (OR = 1.41, 95% CI 1.03–1.95). Moreover, the relationship between healthy dietary habits and EBPs was mediated by self-concept (indirect effect β = −0.09, p < 0.001, total effect β = −0.13, p < 0.001), the proportion of mediation was 29%.ConclusionThis study revealed that the dietary habits of pre-adolescents need improvement, and dietary habits of certain foods, such as fresh fruits and sugar-sweetened beverages, were significantly associated with child mental health. Furthermore, dietary practices were related to the reduced EBPs through an enhanced self-concept. The findings provide an evidence base for developing dietary improvement strategies for pre-adolescent children in families, schools, and other health service settings, thereby contributing to the United Nations’ Sustainable Development Goals related to zero hunger and good health and well-being.

OBJECTIVE:To explore the relationship between dietary quality and metabolic syndrome(MS) in the population aged 45 to 59 in Zhejiang Province. METHODS:Selecting the 45-59 year old population as the research object from the 2022 nutrition and health monitoring data of residents in Zhejiang Province. Dietary data was obtained by the 24-hour dietary review method on 3 consecutive days and the weighing method of household cooking oil and condiments, and dietary quality was evaluated using the China health diet index(CHDI), which was categorized into four groups according to quartiles of CHDI scores. Multivariate logistic regression model was used to analyze the relationship between different CHDI score groups and MS and its components. RESULTS:A total of 1421 study participants were included, with a mean CHDI score of(56.83±11.80) and a prevalence of MS of 24.5%. After adjusting for gender, age, smoking, and physical activity, the Q4 group with the highest CHDI score had a decreased risk of developing MS(OR=0.57, 95%CI 0.40-0.82), hypertension(OR=0.60, 95% CI 0.44-0.81), and elevated fasting blood glucose(OR=0.41, 95%CI 0.26-0.65) compared to the Q1 group with the lowest CHDI score. After conducting gender subgroup analysis, it was found that: the risk of developing MS, hypertension and high triglycerides was decreased in the Q4 group of CHDI scores in females compared with the Q1 group(P&lt;0.05), whereas in males only high CHDI scores were found to be a protective factor for elevated fasting blood glucose(P&lt;0.05). CONCLUSION:The quality of diet is negatively associated with the risk of MS, hypertension and hyperglycemia in people aged 45-59 years in Zhejiang Province, and there are gender differences in the relationship between CHDI and MS and its components.

We aim to analyze the changes in dietary iodine intake and the contribution rates of various foods to it after the reduction in salt iodine concentration in Zhejiang. We used data from two cross-sectional nutrition surveillance surveys conducted by the Zhejiang Provincial Center for Disease Control and Prevention in 2010 (9798 residents) and 2022 (5980 residents). In both surveys, multi-stage stratified and systematic sampling were adopted, and uniformly trained investigators conducted the dietary surveys using a 24 h dietary review and weighing record methods for 3 consecutive days. From 2010 to 2022, the median salt iodine concentration and the consumption rate of qualified iodized salt in Zhejiang households dropped from 28.80 to 22.08 mg/kg and from 76.65% to 64.20%, respectively. Moreover, the residents’ median dietary iodine intake decreased from 277.48 to 142.05 μg/d. Significant interregional differences in dietary iodine intake were found in 2010 and 2022 (H = 639.175, p < 0.001; H = 588.592, p < 0.001, respectively); however, no significant differences existed between urban and rural areas (p > 0.05). From 2010 to 2022, the proportion of residents with dietary iodine intake below the estimated average requirement increased from 15.10% to 34.80%, while that of residents with intake above the tolerable upper limit decreased from 15.00% to 2.90%. The contribution rate of salt to dietary iodine intake among residents in Zhejiang decreased from 74.92% to 48.54%, showing an apparent overall downward trend despite the dietary intake being generally adequate (markedly inadequate in coastal regions). The salt iodine concentration and the consumption rate of qualified iodized salt in households in Zhejiang showed downward trends. Salt remained the main source of dietary iodine; however, its contribution decreased significantly. Zhejiang may need to reverse the trend of the continuous decline in the consumption rate of qualified iodized salt to protect the health of its residents.

Abstract Background Children with dyslipidemia may lead to early onset atherosclerotic cardiovascular disease and even life-threatening. However, few studies have determined the characteristics of dyslipidemia among children and adolescents in Zhejiang Province, and few studies have investigated the correlations of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) and diet as well as sleep time. Methods This study included children and adolescents aged 6–17 years who participated in provincial nutrition surveillance, which was including 90 counties (cities and districts) in Zhejiang Province with provincial representative. Food consumption was assessed using three consecutive days of 24-h dietary recall. Blood sample were collected to detect the concentration of TG, TC, HDL-C, and LDL-C. Results The prevalence of elevated TG, elevated TC, low HDL-C, elevated LDL-C and dyslipidemia was 17.1%, 10.1%, 5.5%, 4.0% and 23% among children and adolescents aged 6–17 years, respectively. TG was negatively correlated with egg intake and sleep time of study days(Spearman’s rho=-0.125, -0.057, P < 0.001). TC was positively correlated with livestock and poultry meat intake and egg intake, but negaviley correlated to legume intake (Spearman’s rho = 0.077, 0.093 and − 0.162, P < 0.001). HDL-C was positively correlated with egg intake, sleep time of study days, and sleep time of rest days, but negaviley correlated to legume intake (Spearman’s rho = 0.108, 0.065, 0.082 and − 0.119, P < 0.001). LDL-C was positively correlated with livestock and poultry meat intake and dairy intake, but negatively correlated to legume intake (Spearman’s rho = 0.131, 0.11, and − 0.118, P < 0.001). There were significant difference of TG, TC, HDL-C, LDL-C and dyslipidemia prevalence among children with or without obesity/overweight(chiquare = 46.309, 9.836, 54.99, 30.436, and 56.631, P < 0.001). Ordinal regression shows that the gender, agegroup, Obesity/Overweight, Sleep time of study days(h) > = 8 were associated with critical /abnormal TG(χ2 = 541.619, p < 0.001). Conclusions The prevalence of dyslipidemia was high among children and adolescents. Children and adolescents with obesity/overweight and with short sleep time were associated with dyslipidemia .

Background Low 25-hydroxyvitamin D (25-(OH)D) serum levels, and a nutritional calcium deficit are widely encountered in China. However, few studies have determined the the calcium dietary intake and the corresponding food sources, and few studies have investigated investigated the influencing factors of serum 25-(OH)D. Objective This study was conducted to explore the vitamin D and calcium nutritional status among children and adolescents. Methods This study included children and adolescents aged 6–17 years who participated in provincial nutrition surveillance, which was including 90 counties (cities and districts) in Zhejiang Province with provincial representative. Food consumption was assessed using three consecutive days of 24-h dietary recall, and nutrient intake were calculated using dietary recall in conjunction with the China Food Composition Table. Blood sample were collected to detect the concentration of 25-hydroxyvitamin D by enzyme linked immunosorbent assay. Results The analysis included a total of 1827 children and adolescents. The prevalence of vitamin D deficiency in 6–8, 9–11, 12–14 and 15–17 age groups were 2.3%, 4.75%, 8.33% and 16.98% respectively. The prevalence of vitamin D inadequacy in 6–8, 9–11, 12–14 and 15–17 age groups were 24.33%, 34.50%, 45.5% and 43.24% respectively. The medians of dietary calcium intake in 6–8, 9–11, 12–14 and 15–17 age groups were 336.5, 359.4, 323.4 and 320.47 milligrams per day (mg/d), respectively. The main food sources of dietary calcium were dairy and vegetables. The Spearman's rho of dietary calcium and dairy in 6–8, 9–11, 12–14 and 15–17 age groups were 0.627, 0.660, 0.637, and 0.479, respectively(P < 0.001) and the Spearman's rho of dietary calcium and vegetables in 6–8, 9–11, 12–14 and 15–17 age groups were 0.424, 0.410, 0.447, and 0.440, respectively(P < 0.001). The concentration of serum 25-(OH)D were correlated with sleep time of study days in 6–8 and 9–11 age groups (Spearman’s rho = 0.09, 0.095, p < 0.05). The dietary calcium intake of children and adolescents of 15–17 age groups were positively related to outdoor activities (Spearman’s rho = 0.207, p < 0.05). Dairy intake were negatively related to the sleep time of rest days and outdoor activity time among children and adolescents of 9–11 age group (Spearman’s rho=-0.219, -0.199, p < 0.05). Conclusions There was a high prevalence of inadequacy and deficiency of vitamin D in children and adolescents and their dietary calcium intake were severely insufficient. Dairy are the most effective food sources for improving dietary calcium intake. Nutrition education to increase dairy products intake should be conducted and more opportunities should be provided children and adolescents to receive sunlight exposure to improve the vitamin D nutritional status.

We aimed to assess dietary iodine intake and sources in Zhejiang Province a decade after a reduction in iodine concentration in iodized salt. Three-day 24 h dietary recall and household weighing were used, complemented by “Chinese Food Composition” data. Household water and salt samples were collected from 5890 residents and analyzed. Differences in iodized salt consumption rates were observed across the following regions: inland (84.20%), subcoastal (67.80%), and coastal (37.00%) areas. The median (P25, P75) iodine concentration in water and diet were 2.2 (0.9, 4.0) μg/L and 142.05 (58.94, 237.11) μg/d, respectively, with significant regional differences in dietary concentration (inland [185.61 μg/d], subcoastal [153.42 μg/d], and coastal [75.66 μg/d]). Males (149.99 μg/d) and iodized salt consumers (191.98 μg/d) had a significantly higher dietary iodine intake than their counterparts. Regions were ranked as follows based on the proportions of individuals meeting the recommended dietary iodine intake: inland (69.40%), subcoastal (56.50%), and coastal (34.10%) areas. Dietary sources included salt (48.54%), other foods (32.06%), drinking water (8.84%), laver (4.82%), kelp (3.02%), and other seafood (2.32%). The qualified iodized salt consumption rate was significantly lower than the national standard. Zhejiang Province should continue implementing measures to control iodine deficiency through salt iodization, education efforts, and increasing the qualified iodized salt consumption rate.