Higher egg consumption associated with increased risk of diabetes in Chinese adults – China Health and Nutrition Survey

Abstract The association between egg consumption and diabetes is inconclusive. We aimed to examine the association between long-term egg consumption and its trajectory with diabetes in Chinese adults. A total of 8545 adults aged ≥18 years old who attended the China Health and Nutrition Survey from 1991 to 2009 were included in this analysis. Egg consumption at each survey was assessed by a 3-d 24-h recall and weighed food record methods. The consumption trajectories of eggs were modelled with the latent class group approach. Diabetes was diagnosed based on fasting blood glucose in 2009. Logistic regression was used to examine the association. The mean age of the study population was 50·9 (sd 15·1) years. About 11·1 % had diabetes in 2009. Egg consumption nearly doubled in 2009 from 16 g/d in 1991. Compared with the first quartile of egg consumption (0–9·0 g/d), the adjusted OR of diabetes for the second (9·1–20·6 g/d), third (20·7–37·5 g/d) and fourth (≥37·6 g/d) quartiles were 1·29 (95 % CI 1·03, 1·62), 1·37 (95 % CI 1·09, 1·72) and 1·25 (95 % CI 1·04, 1·64), respectively (Pfor trend = 0·029). Three trajectory groups of egg consumption were identified. Compared with group 1 (30·7 %, low baseline intake and slight increase), both group 2 (62·2 %, medium baseline intake and increase) and group 3 (7·1 %, high baseline intake and decrease) were associated with an increased OR for diabetes. The results suggested that higher egg consumption was positively associated with the risk of diabetes in Chinese adults.

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Long-term BMI change trajectories in Chinese adults and its association with the hazard of type 2 diabetes: evidence from a 20-year China Health and Nutrition Survey

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000879 ◽

2020 ◽

Vol 8 (1) ◽

pp. e000879

Author(s):

Baibing Mi ◽

Chenlu Wu ◽

Xiangyu Gao ◽

Wentao Wu ◽

Jiaoyang Du ◽

...

Keyword(s):

Type 2 Diabetes ◽

Latent Class ◽

Chinese Adults ◽

Change Trajectories ◽

Nutrition Survey ◽

Health And Nutrition ◽

Increased Risk

IntroductionTo investigate the relationship between long-term change trajectory in body mass index (BMI) and the hazard of type 2 diabetes among Chinese adults.Research design and methodsData were obtained from the China Health and Nutrition Survey (CHNS). Type 2 diabetes was reported by participants themselves in each survey wave. The duration of follow-up was defined as the period from the first visit to the first time self-reported type 2 diabetes, death, or other loss to follow-up from CHNS. The patterns of change trajectories in BMI were derived by latent class trajectory analysis method. The Fine and Gray regression model was used to estimate HRs with corresponding 95% CIs for type 2 diabetes.ResultsFour patterns of the trajectories of change in BMI were identified among Chinese adults, 42.7% of participants had stable BMI change, 40.8% for moderate BMI gain, 8.9% for substantial BMI gain and 7.7% for weight loss. During the follow-up with mean 11.2 years (158 637 person-years contributed by 14 185 participants), 498 people with type 2 diabetes (3.7%) occurred. Risk of type 2 diabetes was increased by 47% among people who gained BMI more substantially and rapidly (HR: 1.47, 95% CI 1.08 to 2.02, p=0.016) and increased by 20% among those in people with the moderate BMI gain (HR: 1.20, 95% CI 0.98 to 1.48, p=0.078), compared with those with stable BMI change.ConclusionsLong-term substantial gain of BMI was significantly associated with an increased risk of type 2 diabetes in the Chinese adults.

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Serum Uric Acid Might Be Positively Associated With Hypertension in Chinese Adults: An Analysis of the China Health and Nutrition Survey

Frontiers in Medicine ◽

10.3389/fmed.2021.755509 ◽

2022 ◽

Vol 8 ◽

Author(s):

Yingdong Han ◽

Kaidi Han ◽

Xinxin Han ◽

Yue Yin ◽

Hong Di ◽

...

Keyword(s):

Uric Acid ◽

Dose Response ◽

Response Relationship ◽

Chinese Adults ◽

Dose Response Relationship ◽

Nutrition Survey ◽

Health And Nutrition ◽

Increased Risk ◽

Stratified Analysis

Background: Previous studies have clarified the relationship between serum uric acid (SUA) and hypertension; most of previous studies suggest that elevated uric acid levels are associated with an increased risk of hypertension, while in China, there are relatively few studies to explore above association. The objective of this longitudinal study is to investigate the correlation of SUA and hypertension in Chinese adults with a nationwide large-scale sample.Methods: Data from the China Health and Nutrition Survey 2009, 2011, and 2016 were used; a total of 8,469 participants (3,973 men and 4,496 women) were involved. This study was conducted separately by gender. Clinical characteristics of the participants among different uric acid groups are compared. The binary logistic regression analysis was conducted to examine the association between SUA and hypertension. Restricted cubic spline analysis with three knots of the SUA concentration were used to characterize the dose-response relationship. Additionally, we compared the incidence of hypertension in the different baseline uric acid groups during follow-up in 2011 and 2015.Results: After the covariates were fully adjusted, we found that elevated uric acid levels were correlated with increased risk of hypertension in both males (p < 0.01) and females (p < 0.01). With 2-year or 6-year of follow-up, we found participants with higher baseline uric acid levels had a higher incidence of hypertension (p < 0.01). In stratified analysis by obesity, above relationship remained significant in nonobesity population (males: p < 0.05, females: p < 0.01) and became nonsignificant in obesity people. In stratified analysis by age, above positively correlation remained significant in middle-aged men (p < 0.05) and elderly women (p < 0.01). Restricted cubic spline revealed the dose-response relationship between SUA and hypertension; we also found that above relationship was much stronger in females.Conclusion: This study suggests that elevated SUA levels might be positively associated with an increased risk of hypertension in general Chinese adults.

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High Chili Intake and Cognitive Function among 4582 Adults: An Open Cohort Study over 15 Years

Nutrients ◽

10.3390/nu11051183 ◽

2019 ◽

Vol 11 (5) ◽

pp. 1183 ◽

Cited By ~ 8

Author(s):

Zumin Shi ◽

Tahra El-Obeid ◽

Malcolm Riley ◽

Ming Li ◽

Amanda Page ◽

...

Keyword(s):

Cognitive Function ◽

Cognitive Decline ◽

Positive Association ◽

Screening Tests ◽

Cognitive Screening ◽

Food Record ◽

Chinese Adults ◽

Nutrition Survey ◽

Memory Decline ◽

Health And Nutrition

We aimed to examine the association between chili intake and cognitive function in Chinese adults. This is a longitudinal study of 4852 adults (age 63.4 ± 7.7) attending the China Health and Nutrition Survey during 1991 and 2006. Cognitive function was assessed in 1997, 2000, 2004 and 2006. In total, 3302 completed cognitive screening tests in at least two surveys. Chili intake was assessed by a 3-day food record during home visits in each survey between 1991 and 2006. Multivariable mixed linear regression and logistic regression were used. Chili intake was inversely related to cognitive function. In fully adjusted models, including sociodemographic and lifestyle factors, compared with non-consumers, those whose cumulative average chili intake above 50 g/day had the regression coefficients (and 95% CI) for global cognitive function of −1.13 (−1.71–0.54). Compared with non-consumers, those with chili consumption above 50 g/day had the odds ratio (and 95% CI) of 2.12(1.63–2.77), 1.56(1.23–1.97) for self-reported poor memory and self-reported memory decline, respectively. The positive association between chili intake and cognitive decline was stronger among those with low BMI than those with high BMI. The longitudinal data indicate that higher chili intake is positively associated with cognitive decline in Chinese adults in both genders.

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Trajectories of Dietary Patterns and Their Associations with Overweight/Obesity among Chinese Adults: China Health and Nutrition Survey 1991–2018

Nutrients ◽

10.3390/nu13082835 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2835 ◽

Cited By ~ 1

Author(s):

Jiguo Zhang ◽

Huijun Wang ◽

Zhihong Wang ◽

Feifei Huang ◽

Xiaofan Zhang ◽

...

Keyword(s):

Dietary Patterns ◽

Dietary Pattern ◽

Chinese Adults ◽

Nutrition Survey ◽

Health And Nutrition ◽

Group 3 ◽

Group 2 ◽

Prospective Association ◽

Initial Score ◽

The Impact

It is essential to understand the impact of different dietary pattern trajectories on health over time. Therefore, we aimed to explore the long-term trajectories of dietary patterns among Chinese adults and examine the prospective association between different trajectory groups and the risk of overweight/obesity. The sample was 9299 adults aged 18 years or older from the China Health and Nutrition Survey (CHNS) between 1991 and 2018. We used factor analysis to identify dietary patterns and group-based trajectory modeling to identify dietary pattern trajectories. Three trajectories of a southern pattern and a modern pattern and four trajectories of a meat pattern were identified. Participants who followed the highest initial score and a slight decrease trajectory (OR = 1.63; 95% CI: 1.04, 2.54) of the meat dietary pattern were positively associated with risk of overweight/obesity when compared with the lowest initial score trajectory. The southern dietary pattern and the modern dietary pattern trajectories of participants in Group 2 (OR = 0.64; 95% CI: 0.51, 0.81; OR = 0.76; 95% CI: 0.63, 0.91) and Group 3 (OR = 0.71; 95% CI: 0.54, 0.91; OR = 0.64; 95% CI: 0.44, 0.90) were associated with lower risk of overweight/obesity when compared with Group 1. We observed that dietary pattern trajectories have different associations with overweight/obesity among Chinese adults.

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Hb level, iron intake and mortality in Chinese adults: a 10-year follow-up study

British Journal Of Nutrition ◽

10.1017/s000711451700040x ◽

2017 ◽

Vol 117 (4) ◽

pp. 572-581 ◽

Cited By ~ 8

Author(s):

Zumin Shi ◽

Shiqi Zhen ◽

Yonglin Zhou ◽

Anne W. Taylor

Keyword(s):

Iron Intake ◽

Food Record ◽

Chinese Adults ◽

Hazard Ratios ◽

Increased Risk ◽

All Cause Mortality ◽

Weighed Food Record ◽

Fourth Quartile ◽

Cvd Mortality

AbstractAnaemia is prevalent in developing countries and is commonly Fe deficiency related. We aimed to assess the association between Fe status, Fe intake and mortality among Chinese adults. We prospectively studied 8291 adults aged 20–98 years with a mean follow-up of 9·9 years. All participants were measured for Hb at baseline in 2002. Food intake, measured by 3-d weighed food record (n 2832), and fasting serum ferritin were measured. We documented 491 deaths (including 192 CVD and 165 cancer deaths) during 81 527 person-years of follow-up. There was a U-shaped association between Hb levels and all-cause mortality. Compared with the second quartile of Hb (121 g/l), the first (105) and fourth quartile (144) had hazard ratios (HR) of 2·29 (95 % CI 1·51, 3·48) and 2·31 (95 % CI 1·46, 3·64) for all-cause mortality in women. In men, compared with third quartile of Hb (143 g/l), first (122) and fourth quartiles (154) had 61 and 65 % increased risk of all-cause mortality. Anaemia was associated with an increased risk of all-cause and CVD mortality in men but not in women after adjusting for potential confounders. Low and high Fe intake as percentage of Chinese recommended nutrient intake (RNI) were positively associated with all-cause mortality in women but not in men. In women, across quartiles of relative Fe intake, HR for all-cause mortality were 2·55 (95 % CI 0·99, 6·57), 1·00, 3·12 (95 % CI 1·35, 7·18) and 2·78 (95 % CI 1·02, 7·58). Both low and high Hb levels are related to increased risk of all-cause mortality. Both low and high intake of Fe as percentage of RNI was positively associated with mortality in women.

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Ultra-Processed Food Consumption Associated with Overweight/Obesity among Chinese Adults—Results from China Health and Nutrition Survey 1997–2011

Nutrients ◽

10.3390/nu13082796 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2796

Author(s):

Ming Li ◽

Zumin Shi

Keyword(s):

Processed Food ◽

Chinese Adults ◽

Nutrition Survey ◽

Mixed Effect ◽

Dietary Recall ◽

Health And Nutrition ◽

Daily Diet ◽

Increased Risk ◽

Study Population ◽

D 20

The association between the consumption of ultra-processed food (UPF) with overweight/obesity in Chinese adults has not been investigated. This study included a cohort of 12,451 adults aged >20 years who participated at least twice in the China Nutrition and Health Survey (CNHS) during 1997–2011. Food intake at each survey was assessed using a 3-day 24-h dietary recall. Body weight (kg), height (m), and waist circumference (WC) were measured during the survey. UPF was defined by the NOVA classification. Mixed effect logistic regression analyses were used. The mean UPF consumption of the study population (baseline mean age 43.7 years) increased from 12.0 g in 1997 to 41.5 g in 2011 with the corresponding proportion of UPF in daily diet from 1.0% to 3.6%. The adjusted odds ratios (95% CI) for BMI ≥ 25 kg/m2 for those with mean UPF consumption of 1–19 g/d, 20–49 g/d, and ≥50 g/d were 1.45 (1.26–1.65), 1.34 (1.15–1.57), and 1.45 (1.21–1.74), respectively (p-trend = 0.015), compared with the non-consumers. Similarly, the corresponding adjusted ORs (95% CI) for central obesity were 1.54 (1.38–1.72), 1.35 (1.19–1.54), and 1.50 (1.29–1.74). Higher long-term UPF consumption was associated with increased risk of overweight/obesity among Chinese adults.

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Long-term body mass trajectories and hypertension by sex among Chinese adults: a 24-year open cohort study

Scientific Reports ◽

10.1038/s41598-021-92319-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ruru Liu ◽

Baibing Mi ◽

Yaling Zhao ◽

Shaonong Dang ◽

Hong Yan

Keyword(s):

Body Mass ◽

Latent Class ◽

Study Data ◽

Chinese Adults ◽

Nutrition Survey ◽

Health And Nutrition ◽

Hypertension Prevention ◽

Latent Class Trajectory Analysis

AbstractEvidence was limited on trajectory of body mass index (BMI) through adulthood and its association with hypertension. We aimed to evaluate their association by sex in large-scale study. Data were obtained from the China Health and Nutrition Survey (CHNS) from 1991 to 2015. Latent class trajectory analysis (LCTA) was used to capture BMI change trajectories. Hazard risks (HRs) were estimated from Cox proportion hazard regression. Among 14,262 participants (mean age, 38.8; 47.8% men), 5138 hypertension occurred (2687 men and 2451 women) occurred during a mean follow-up 9.6 years. Four body mass trajectory groups were identified as BMI loss, stable, moderate and substantial gain. Appropriately half of participants (48.0%) followed 1 of the 2 BMI gain trajectories, where BMI increased at least 3 kg/m2 overtime. Compared with participants with stable BMI, those gaining BMI substantially had higher risk of hypertension by 65% (HR 1.65, 95% CI 1.45–1.86) in male and 83% (HR 1.83, 95% CI 1.58–2.12) in female. The HRs in BMI loss patterns were 0.74 (0.62–0.89) in men and 0.87 (0.75–1.00) in women. Our findings imply that majority of Chinese adults transited up to a higher BMI level during follow-up. Avoiding excessive weight gain and maintaining stable weight might be important for hypertension prevention.

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Longitudinal Trajectories of Diet Quality and Subsequent Mortality Among Chinese Adults: Results from the China Health and Nutrition Survey 1997–2015

Current Developments in Nutrition ◽

10.1093/cdn/nzaa046_044 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 544-544

Author(s):

Ming-wei Liu ◽

Rebecca Leech ◽

Sarah McNaughton ◽

Qi-qiang He

Keyword(s):

Mortality Rate ◽

Diet Quality ◽

Dietary Guidelines ◽

Chinese Adults ◽

Nutrition Survey ◽

Risk Of Death ◽

Health And Nutrition ◽

Group 4 ◽

History Of ◽

Group 2

Abstract Objectives China has witnessed a significant nutritional transition. But there is a gap in the literature investigating the effect of change of diet on mortality among Chinese. Thus, we aimed to explore the longitudinal trajectories of diet quality over ten years (from 1997 to 2006) and the subsequent risk of death from 2009 through 2015 among Chinese adults. Methods Data from the China Health and Nutrition Survey were analyzed in 6398 adults. Dietary intake was assessed using three consecutive 24-h recalls. Diet quality was assessed by the Chinese Healthy Eating Index (CHEI), which includes 17 components and is based on the Dietary Guidelines for Chinese. The Latent Class Growth Analysis was conducted to derive trajectories of diet quality over ten years. And logistic models were used to calculate hazard ratios for total mortality. Models adjusted for age, sex, residence, education, household income, marital status, physical activity, smoke status, BMI, history of hypertension, and history of diabetes. Results Four distinct CHEI trajectories were identified: 1) persistently moderate; 2) acutely elevated from low to moderate and steady; 3) high and slightly elevated; 4) acutely descend and acutely elevated to moderate and steady. The “high and slightly elevated” group had the lowest mortality rate (6.0%) in the subsequent 6 years, while the two groups with a history of low diet quality had a higher mortality rate (8.8% for group 2 and 10.7% for group 4). The fully adjusted model showed that, as compared to the “persistently moderate” group, the mortality rates were higher among the two groups with a history of low diet quality. The relative risks and 95% confidence intervals were 1.58 (1.004, 2.47) for group 2 and 1.84 (1.20, 2.81) for group 4. Results for the “high and slightly elevated” group was not significant. Conclusions Long-term improved diet quality and adherence to the Dietary Guidelines for Chinese may decrease the risk of death in Chinese adults. Funding Sources None.

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Longitudinal trajectories of diet quality and subsequent mortality among Chinese adults: results from the China health and nutrition survey 1997–2015

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01118-7 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Ming-wei Liu ◽

Sarah A. McNaughton ◽

Qi-qiang He ◽

Rebecca Leech

Keyword(s):

Mortality Rate ◽

Diet Quality ◽

Dietary Guidelines ◽

Chinese Adults ◽

Nutrition Survey ◽

Risk Of Death ◽

Health And Nutrition ◽

Group 3 ◽

Group 2 ◽

Group 1

Abstract Background China has witnessed a significant nutritional transition. However, there is a gap in the literature investigating the association between change of diet and mortality among Chinese. Thus, we aimed to explore the longitudinal trajectories of diet quality over 10 years (from 1997 to 2006) and the subsequent risk of death till 2015 among Chinese adults. Methods Data from the China Health and Nutrition Survey were analyzed in 6398 adults. Dietary intake was assessed using three consecutive 24-h recalls. Diet quality was assessed by the Chinese Healthy Eating Index (CHEI), which includes 17 components and is based on the Dietary Guidelines for Chinese. Latent Class Growth Analysis was conducted to derive trajectories of diet quality over 10 years. Cox proportional hazard regression was used to calculate hazard ratios for total mortality. Results Four distinct CHEI trajectories were identified: 1) worsening; 2) low-moderate-low; 3) improving; 4) high-moderate-high. Group 3 had the lowest mortality rate (5.6%) in the subsequent 9 years, while the groups with worsening or low diet quality had a higher mortality rate (Group 1: 7.5%; Group 2: 10.8%). In the fully adjusted model, compared to group 2, mortality rates were lower for group 3 (RR = 0.73; 95% CI: 0.55, 0.97) and group 4 (RR = 0.76; 95% CI: 0.59, 0.98). No associations with mortality were found for the group 1, when compared to group 2. Conclusions Long-term improved diet quality and adherence to the Dietary Guidelines for Chinese may decrease the risk of death in Chinese adults.

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Association between risk of type 2 diabetes and changes in energy intake at breakfast and dinner over 14 years: a latent class trajectory analysis from the China health and nutrition Survey, 1997–2011

BMJ Open ◽

10.1136/bmjopen-2020-046183 ◽

2021 ◽

Vol 11 (7) ◽

pp. e046183

Author(s):

Xiyun Ren ◽

Jian Gao ◽

Tianshu Han ◽

Changhao Sun

Keyword(s):

Type 2 Diabetes ◽

Energy Consumption ◽

Energy Intake ◽

Latent Class ◽

Early Stage ◽

Harmful Effect ◽

Nutrition Survey ◽

Health And Nutrition ◽

Diabetes Status

ObjectiveThis study aimed to investigate the association between the trajectories of energy consumption at dinner versus breakfast and the risk of type 2 diabetes (T2D).DesignCohort study.SettingThe study was conducted in China.ParticipantsA total of 10 727 adults, including 5239 men and 5488 women, with a mean age of 42.7±11.2 years and a mean follow-up time of 9.1 years, met the study criteria and completed a questionnaire about energy intake and diabetes status from the China Health and Nutrition Survey in 1997–2011.Primary outcome measuresParticipants were divided into subgroups based on the trajectories of the ratio of energy consumption at dinner versus breakfast. Cox multivariate regression models were used to explore the associations between different trajectories and the risk of T2D after adjustment for confounders and their risk factors. Mediation analysis was performed to explore the intermediary effect of triacylglycerol (TG), total cholesterol (TC), uric acid (UA) and apolipoprotein B (ApoB) between the trajectories and the risk of T2D.ResultsFor energy consumption at dinner versus breakfast, compared with a low-stable trajectory, the adjusted HR of T2D in low-increasing from early-stage trajectory was 1.29 (95% CI 1.04 to 1.60). TG, TC, UA and ApoB were significantly higher in low-increasing from early-stage trajectory than other trajectories and play partial regulation roles between trajectories and T2D.ConclusionsThis study emphasised the harmful effect of a gradual increase in the ratio of energy consumption at dinner versus breakfast from early stage on the development of T2D and partially mediated by TG, TC, UA and ApoB, highlighting that it is necessary to intake more energy at breakfast compared with dinner to prevent T2D in adults.

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