Yingdong Zheng

Nutrient Intakes of Pregnant Women and their Associated Factors in Eight Cities of China: A Cross-sectional Study.

Background: During the last 3 decades, China has dramatic changes of the dietary pattern among its citizens, particularly in urban cities. This study aimed to determine the nutrient intake status and factors associated with nutrient intakes of urban Chinese pregnant women now-a-day. Methods: The multistage stratified random sampling method was applied in the cross-sectional study. 479 women in three trimesters of pregnancy from eight cities of China were recruited. Nutrient intakes were evaluated with one 24 h dietary recall, and compared with the Chinese Dietary Reference Intakes (DRIs) 2013 for available nutrients. Results: Most pregnant women had imbalanced macronutrient distribution with excessive energy derived from fat. Intakes of Vitamin A, B6, calcium, magnesium, and selenium were below Chinese Recommended Nutrient Intake (RNI) and Estimated Average Requirements (EARs) in all trimesters. Most pregnant women took more folic acid in the first trimester with a significant decrease in the second and third trimester (P < 0.05). Shortfall in iron intake was found in the third trimester whereas some women may be at the risk of excessive iron intake. Intakes of thiamin met RNI in the first trimester but were below EAR in all trimesters. Trimester phasing was positively associated with most nutrients (P < 0.05). Prepregnancy body mass index was inversely associated with energy, fat, Vitamin C, and calcium intake (P < 0.05). Educational level and household income were positively associated with folic acid intake (P < 0.05). Conclusions: Current prenatal dietary choices of urban pregnant women in China are imbalanced in the nutrient intake when compared with national DRIs 2013, particularly in intakes of energy derived from fat and micronutrients. Appropriate dietary advice to pregnant women should promote a balanced diet with emphasis on avoidance of foods of high fat content and incorporation of foods that are good sources of the key micronutrients that are usually lacking in a regular pregnancy diet. Further research is needed to understand the eating habits and food patterns that contribute to this imbalanced diet in order to be able to effectively improve prenatal womens nutrient intake status.

Association between gestational weight gain according to prepregnancy body mass index and short postpartum weight retention in postpartum women

BACKGROUND & AIMS This study aims to assess the relationship among prepregnancy body mass index, gestational weight gain, and postpartum weight retention, and to clarify the predictors of the amount of weight retained by Chinese women after pregnancy. METHODS The multistage stratified random sampling was used in the cross-sectional study. RESULTS The subjects included 1643 women. Mean gestational weight gain was 15.9 kg and mean postpartum weight retention was 5.1 kg. 43.2% of women gained excessive gestational weight gain and 53.3% of women gained 5 kg or more postpartum weight retention. In addition, the proportions of underweight women with inadequate weight gain and overweight women with excessive weight gain were 24.2% and 52.3%, respectively. Logistic regression analysis showed that the adjusted OR of excessive gestational weight gain was 1.74 (95% CI: 1.09-2.79) in overweight women compared with normal weight women. The postpartum weight retention and the proportion of women with postpartum weight retention of 5 kg or more were significantly higher in the excessive gestational weight gain women than in the adequate gestational weight gain women in all three body mass index groups. The adjusted OR of a weight increase of 5 kg or more was at least 1.90 for underweight, normal weight, and overweight women with a gestational weight gain above the recommended amount compared with those with a gestational weight gain within the recommended amount. CONCLUSIONS Gestational weight gain above the recommended amount increases the risk of postpartum weight retention in all body mass index groups.

Consumption of sugar-sweetened beverages and its association with overweight among young children from China

OBJECTIVE To fully understand the sugar-sweetened beverage (SSB) consumption status among Chinese young children and to explore its association with weight gain. DESIGN In this cross-sectional study, data on sociodemographic characteristics, SSB intake and weight/height were collected by means of face-to-face interviews. The intake of SSB among young Chinese children in relation to their age, different characteristics and types of SSB consumed is described, and the association between SSB intake and BMI-for-age Z-score and overweight is explored. SETTING Seven large cities and two villages in China. SUBJECTS Nine hundred and forty-six healthy children, aged 3-7 years. RESULTS The proportion of SSB intake among Chinese young children was 80·5 %; 3·4 % were daily consumers, 34·0 % (31·4 %) consumed at least once per week (month). The per capita and per consumer SSB intake was 63·1 9 (sd 100·8) and 78·4 (sd 106·9) ml/d. Children from rural areas consumed twice, or even triple, the amount of SSB as those from urban areas (P<0·001) and great disparities existed between the types of SSB consumed by urban and rural children. An association was found between increased SSB intake and higher BMI-for-age Z-score (P<0·05) after adjusting for potential confounders; there was also an association between SSB intake and increased risk of being overweight or obese. CONCLUSIONS The consumption status of SSB in Chinese young children is of concern. There was a positive association between SSB intake and weight gain. Measures should be taken to improve the present situation of SSB consumption among Chinese young children.

Food groups consumed by infants and toddlers in urban areas of China

Background Food consumption patterns of young children in China are not well known. Objective Characterised food groups consumed by infants and young children in urban China using data from the Maternal Infant Nutrition Growth (MING) study. Design One 24-h dietary recall was completed for 1,350 infants and young children (436 infants aged 6–11 months and 914 young children aged 12–35 months), who were recruited from maternal and child care centres in eight cities via face-to-face interviews with the primary caregiver. All foods, beverages and supplements reported were assigned to one of 64 food groups categorised into the following: milk and milk products, grains, vegetables, fruits, protein foods and desserts/sweets. The percentage of infants and young children consuming foods from specific food groups was calculated, regardless of the amount consumed. Results Less than half of infants consumed breast milk (47%), whereas 59% of infants consumed infant formula and 53–75% of young children consumed growing-up (fortified) milk. Rice was the number one grain food consumed after 6 months (up to 88%) and the consumption of infant cereal was low. About 50% of infants did not consume any fruits or vegetables, and 38% of young children did not consume any fruits on the day of the recall. Only 40% of all children consumed dark green leafy vegetables and even fewer consumed deep yellow vegetables. Eggs and pork were the most commonly consumed protein foods. Conclusions The data provide important insight for developing detailed food consumption guidelines for this population group. Mothers of infants should be encouraged to continue breastfeeding after the first 6 months. Parents should be advised to offer a wide variety of vegetables and fruits daily, particularly dark green leafy and deep yellow vegetables and colourful fruits. The consumption of fortified infant cereal should be advocated to improve the iron intake of Chinese infants.

Dietary diversity scores: an indicator of micronutrient inadequacy instead of obesity for Chinese children

BackgroundMicronutrient malnutrition affects the well-being of both adults and children. Dietary diversity score (DDS) is a useful evaluation index with a relatively well-developed guideline by FAO. It’s meaningful to assess and predict inadequate micronutrient intakes using DDS in Chinese children, after ruling out the risk of obesity coming with more dietary diversity.MethodsData for evaluation were extracted from the Nutrition Study of Preschool Children and School Children, which is a cross-sectional study covering 8 cities of China, including 1694 children in kindergartens and primary schools. This study applied DDS to Chinese children to test the validity for micronutrient inadequacy, and then explored the relationship between dietary diversity and obesity.ResultsIt reveals that dietary diversity varied with age and place of residence; the older ones and the ones living in rural areas tend to have poorer dietary diversity. Another discovery is that DDS is positively correlated with indicators of micronutrient adequacy, with a score of 6–8 indicating the lowest risk of micronutrient inadequacy in different groups of children. In our study population, dietary diversity is not related with obesity.ConclusionsDietary diversity score is a valid indicator to evaluate micronutrient inadequacy in Chinese children, though there is still room for improvement of the method. Besides, the relationship between increase of dietary diversity and risk of obesity should be treated circumspectly.

Nutritional Status of Breast-Fed and Non-Exclusively Breast-Fed Infants from Birth to Age 5 Months in 8 Chinese Cities

This study aimed to assess the nutritional status of infants aged 0 to 5 months by different feeding approaches. A cross-sectional study on infant nutrition was performed in eight cities in China. A total of 622 infants from birth to 2 months of age and 456 infants from 3 months to 5 months of age were included in this study. Mix-fed infants received breast milk and complementary foods from birth to 2 months of age. Approximately 38.2% of mix-fed infants received excessive vitamin A, and 15.6% of infants exceeded the tolerable upper intake levels (ULs) of zinc. For artificially fed infants who received only complementary foods, approximately 20% and 12.5% infants received inadequate dietary vitamin A and zinc intakes, respectively. The vitamin A and zinc intakes of half of the infants exceeded the ULs. Results showed that the usual intake distribution of the infants from 3 months to 5 months of age were similar to that of the infants from birth to 2 months of age. The common vitamin A and zinc intakes were also severely imbalanced. In addition, higher disease prevalence and lower Z scores of length-forage, weight-for-age, and weight-for-length were found in artificially fed infants and mix-fed infants compared with those in breast-fed infants. In conclusion, the usual nutrient intakes were adequate for the majority of Chinese infants, except for an important number of infants at risk for imbalance of vitamin A and zinc intakes.

The Effect of Vitamin D Supplementation on Glycemic Control in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis

Observational studies have indicated an inverse association between vitamin D levels and the risk of diabetes, yet evidence from population interventions remains inconsistent. PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov were searched up to September 2017. Data from studies regarding serum 25(OH)D, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were pooled. Twenty studies (n = 2703) were included in the meta-analysis. Vitamin D supplementation resulted in a significant improvement in serum 25(OH)D levels (weighted mean difference (WMD) = 33.98; 95%CI: 24.60–43.37) and HOMA-IR (standardized mean difference (SMD) = −0.57; 95%CI: −1.09~−0.04), but not in other outcomes. However, preferred changes were observed in subgroups as follows: short-term (WMDFBG = −8.44; 95%CI: −12.72~−4.15), high dose (WMDFBG = −8.70; 95%CI: −12.96~−4.44), non-obese (SMDFasting insulin = −1.80; 95%CI: −2.66~−0.95), Middle Easterners (WMDFBG = −10.43; 95%CI: −14.80~−6.06), baseline vitamin D deficient individuals (WMDFBG = −5.77; 95%CI: −10.48~−1.05) and well-controlled HbA1c individuals (WMDFBG = −4.09; 95%CI: −15.44~7.27). Vitamin D supplementation was shown to increase serum 25(OH)D and reduce insulin resistance effectively. This effect was especially prominent when vitamin D was given in large doses and for a short period of time, and to patients who were non-obese, Middle Eastern, vitamin D deficient, or with optimal glycemic control at baseline.