Xiaoqun Pan

Association between serum ferritin, hemoglobin, iron intake, and diabetes in adults in Jiangsu, China

OBJECTIVE—To investigate the association between iron status, iron intake, and diabetes among Chinese adults. RESEARCH DESIGN AND METHODS—This cross-sectional household survey was carried out in 2002 in Jiangsu Province, China. The sample contained 2,849 men and women aged ≥20 years with a response rate of 89.0%. Iron intake was assessed by food weighing plus consecutive individual 3-day food records. Fasting plasma glucose (FPG), serum ferritin, and hemoglobin were measured. RESULTS—The prevalence of anemia was 18.3% in men and 31.5% in women. Mean hemoglobin and serum ferritin increased across groups with increasing FPG. The prevalence of anemia among women was 15.0% in individuals with FPG >7.0 mmol/l compared with 32.6% in individuals with FPG <5.6 mmol/l. There was a similar, however not significant, trend among men. In women, after adjusting for known risk factors, the odds ratio (OR) of diabetes was 2.15 (95% CI 1.03–4.51) for subjects in the upper quartile of hemoglobin compared with the rest, and the corresponding OR for the upper quartile of serum ferritin was 3.79 (1.72–8.36). Iron intake was positively associated with diabetes in women; fourth quartile intake of iron yielded an OR of 5.53 (1.47–20.44) compared with the first quartile in the multivariate analyses. In men, similar trends were suggested, although they were not statistically significant. CONCLUSIONS—Iron status and iron intake was independently associated with risk of diabetes in Chinese women but not in men.

Vegetable-rich food pattern is related to obesity in China

Objective:To investigate the association between a vegetable-rich food pattern and obesity among Chinese adults.Design:A food pattern rich in vegetables is associated with lower risk of obesity and non-communicable chronic disease in Western countries. A similar food pattern is found in the Chinese population but the cooking method is different. A cross-sectional household survey of 2849 men and women aged 20 years and over was undertaken in 2002 in Jiangsu Province (response rate, 89.0%). Food intake was assessed by food frequency questionnaire. Factor analysis was used to identify food patterns. Nutrient intake was measured by food weighing plus consecutive individual 3-day food records. Height, weight and waist circumference were measured.Results:The prevalence of general obesity (BMI ⩾28 kg m−2) was 8.0% in men and 12.7% in women, central obesity was 19.5% (⩾90 cm) and 38.2% (⩾80 cm), respectively. A four-factor solution explained 28.5% of the total variance in food frequency intake. The vegetable-rich food pattern (whole grains, fruits and vegetables) was positively associated with vegetable oil and energy intake. Prevalence of obesity/central obesity increased across the quartiles of vegetable-rich food pattern. After adjusting for sociodemographic factors and four distinct food patterns, the vegetable-rich pattern was independently associated with obesity. Compared with the lowest quartile of vegetable-rich pattern, the highest quartile had higher risk of general obesity (men, prevalence ratio (PR): 1.82, 95% confidence interval (CI): 1.05–3.14; women, PR: 2.25, 95% CI: 1.45–3.49).Conclusion:The vegetable-rich food pattern was associated with higher risk of obesity/central obesity in Chinese adults in both genders. This association can be linked to the high intake of energy due to generous use of oil for stir-frying the vegetables.

Monosodium glutamate is not associated with obesity or a greater prevalence of weight gain over 5 years: findings from the Jiangsu Nutrition Study of Chinese adults

Animal studies and one large cross-sectional study of 752 healthy Chinese men and women suggest that monosodium glutamate (MSG) may be associated with overweight/obesity, and these findings raise public concern over the use of MSG as a flavour enhancer in many commercial foods. The aim of this analysis was to investigate a possible association between MSG intake and obesity, and determine whether a greater MSG intake is associated with a clinically significant weight gain over 5 years. Data from 1282 Chinese men and women who participated in the Jiangsu Nutrition Study were analysed. In the present study, MSG intake and body weight were quantitatively assessed in 2002 and followed up in 2007. MSG intake was not associated with significant weight gain after adjusting for age, sex, multiple lifestyle factors and energy intake. When total glutamate intake was added to the model, an inverse association between MSG intake and 5 % weight gain was found (P = 0.028), but when the model was adjusted for either rice intake or food patterns, this association was abolished. These findings indicate that when other food items or dietary patterns are accounted for, no association exists between MSG intake and weight gain.

Anemia in relation to body mass index and waist circumference among Chinese women

BackgroundThis study aimed to investigate the relationship of anemia and body mass index among adult women in Jiangsu Province, China. Data were collected in a sub-national cross-sectional survey, and 1,537 women aged 20 years and above were included in the analyses. Subjects were classified by body mass index (BMI) categories as underweight, normal weight, overweight and obese according to the Chinese standard. Central obesity was defined as a waist circumference ≥ 80 cm. Anemia was defined as hemoglobin concentration < 12 g/dl. Prevalence ratios (PRs) of the relationship between anemia and BMI or waist circumference were calculated using Poisson regression.FindingsOverall, 31.1% of the Chinese women were anemic. The prevalence of overweight, obesity and central obesity was 34.2%, 5.8% and 36.2%, respectively. The obese group had the highest concentrations of hemoglobin compared with other BMI groups. After adjustment for confounders, overweight and obese women had a lower PR for anemia (PR: 0.72, 95% CI: 0.62-0.89; PR: 0.59, 95% CI: 0.43-0.79). Central obesity was inversely associated with anemia.ConclusionIn this Chinese population, women with overweight/obesity or central obesity were less likely to be anemic as compared to normal weight women. No measures are required currently to target anemia specifically for overweight and obese people in China.

Monosodium glutamate is related to a higher increase in blood pressure over 5 years: findings from the Jiangsu Nutrition Study of Chinese adults

Objective One large cross-sectional study across four countries suggests that glutamate intake may be inversely associated with blood pressure (BP). The aim of this analysis was to investigate a possible association between monosodium glutamate (MSG) intake and change in blood pressure over 5 years. Methods Data from 1227 Chinese men and women who participated in the Jiangsu Nutrition Study (JIN) were analyzed. In this study, MSG intake and blood pressure were quantitatively assessed in 2002, and followed-up in 2007. Results MSG intake was associated with a significant increase in SBP and DBP. A strong sex interaction was observed in relation to SBP change. Women with high MSG intake were more likely to have increased SBP and DBP. Total glutamate intake was also positively associated with an increase in SBP. In those chronically taking antihypertensive medications, there was a strong association between MSG intake and an increase in DBP. Conclusion MSG intake may have independent BP-increasing effects, especially among women and those taking hypertension medications at baseline and follow-up.

Reactions of Chinese adults to warning labels on cigarette packages: A survey in Jiangsu Province

BackgroundTo compare reactions to warning labels presented on cigarette packages with a specific focus on whether the new Chinese warning labels are better than the old labels and international labels.MethodsParticipants aged 18 and over were recruited in two cities of Jiangsu Province in 2008, and 876 face-to-face interviews were completed. Participants were shown six types of warning labels found on cigarette packages. They comprised one old Chinese label, one new label used within the Chinese market, and one Chinese overseas label and three foreign brand labels. Participants were asked about the impact of the warning labels on: their knowledge of harm from smoking, giving cigarettes as a gift, and quitting smoking.ResultsCompared with the old Chinese label, a higher proportion of participants said the new label provided clear information on harm caused by smoking (31.2% vs 18.3%). Participants were less likely to give cigarettes with the new label on the package compared with the old label (25.2% vs 20.8%). These proportions were higher when compared to the international labels. Overall, 26.8% of participants would quit smoking based on information from the old label and 31.5% from the new label. When comparing the Chinese overseas label and other foreign labels to the new Chinese label with regard to providing knowledge of harm warning, impact of quitting smoking and giving cigarettes as a gift, the overseas labels were more effective.ConclusionBoth the old and the new Chinese warning label are not effective in this target population.

Soft drink and sweet food consumption and suicidal behaviours among Chinese adolescents

Aim:  Greater soft drink consumption was associated with increased risk of mental health problems in Western countries. The objective of the study was to examine the association between soft drink and sweet food consumption and suicidal behaviours among adolescents in China.

Zinc Biofortification of Rice in China: A Simulation of Zinc Intake with Different Dietary Patterns

A cross-sectional survey of 2819 adults aged 20 years and above was undertaken in 2002 in Jiangsu Province. Zinc intake was assessed using a consecutive 3-day 24-h dietary recall method. Insufficient and excess intake was determined according to the Chinese Dietary Recommended Intakes. Four distinct dietary patterns were identified namely “traditional”, “macho”, “sweet tooth”, and “healthy”. Intake of zinc from biofortified rice was simulated at an intermediate zinc concentration (2.7 mg/100 g) and a high zinc concentration (3.8 mg/100 g) in rice. Average total zinc intake was 12.0 ± 3.7 mg/day, and insufficiency of zinc intake was present in 15.4%. Simulated zinc intake from biofortified rice with intermediate and high zinc concentration decreased the prevalence of low zinc intake to 6.5% and 4.4%, respectively. The effect was most pronounced in the “traditional” pattern, with only 0.7% of insufficiency of zinc intake remaining in the highest quartile of the pattern. Zinc intake was inversely associated with the “sweet tooth” pattern. Zinc biofortifed rice improves dietary zinc intake and lowers risk for insufficient zinc intake, especially for subjects with a more “traditional” food pattern, but less for subjects with a “sweet tooth” food pattern.

Strong Negative Association between Intake of Tofu and Anemia among Chinese Adults in Jiangsu, China

BACKGROUND Anemia is prevalent in China. Tofu made from soybean is a popular food. Soybean is shown to have an affect on iron status. No study has examined the relation between tofu and iron status. OBJECTIVE To investigate the association between tofu intake and anemia among Chinese adults. DESIGN A cross-sectional household survey of 2,849 men and women aged 20 years and older (mean age 47.0+/-14.5 years), from a nationally representative random sample in Jiangsu province undertaken in 2002 (response rate 89%). Tofu intake was assessed by food frequency questionnaire. Nutrient intake was measured by 3-day weighed food records. Serum ferritin and hemoglobin were measured. RESULTS The prevalence of anemia was 18.3% in men and 31.5% in women. Mean hemoglobin values increased by quartiles of tofu intake (men: 14.1, 14.0, 14.5, and 14.8 mg/dL [141, 140, 145, and 148 g/L]; women: 12.4, 12.5, 12.6 and 13.3 g/dL [124, 125,126, and 133 g/L]), and the prevalence of anemia decreased concomitantly. Comparing first and fourth quartiles of tofu intake, the prevalence of anemia was 23.9% vs 10.7% in men, and 38.1% vs 16.8% in women. Tofu intake was inversely associated with serum ferritin levels in women. In multivariate analyses, the odds ratio of anemia for men in fourth compared to first quartile of tofu intake was 0.30 (95% confidence interval 0.17 to 0.50), and the corresponding odds ratio for women was 0.31 (95% confidence interval 0.20 to 0.47). The association between tofu intake and anemia was independent of iron intake. CONCLUSIONS Tofu intake was associated with lower risk of anemia among Chinese adults in both sexes.

Monosodium Glutamate Intake, Dietary Patterns and Asthma in Chinese Adults

Objectives Emerging evidence shows that diet is related to asthma. The aim of this analysis was to investigate the association between monosodium glutamate (MSG) intake, overall dietary patterns and asthma. Methods Data from 1486 Chinese men and women who participated in the Jiangsu Nutrition Study (JIN) were analyzed. In this study, MSG intake and dietary patterns were quantitatively assessed in 2002. Information on asthma history was collected during followed-up in 2007. Results Of the sample, 1.4% reported ever having asthma. MSG intake was not positively associated with asthma. There was a significant positive association between ‘traditional’ (high loadings on rice, wheat flour, and vegetable) food pattern and asthma. No association between ’macho’ (rich in meat and alcohol), ‘sweet tooth’ (high loadings on cake, milk, and yoghurt) ‘vegetable rich’ (high loadings on whole grain, fruit, and vegetable) food patterns and asthma was found. Smoking and overweight were not associated with asthma in the sample. Conclusion While a ‘Traditional’ food pattern was positively associated with asthma among Chinese adults, there was no significant association between MSG intake and asthma.