Inverse Association Between Riboflavin Intake and New-Onset Hypertension

The prospective relation of dietary riboflavin intake with hypertension remains uncertain. We aimed to investigate the relationship of dietary riboflavin intake with new-onset hypertension and examine possible effect modifiers in general population. A total of 12 245 participants who were free of hypertension at baseline from China Health and Nutrition Survey were included. Dietary intake was measured by 3 consecutive 24-hour dietary recalls combined with a household food inventory. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or diagnosed by physician or under antihypertensive treatment during the follow-up. A total of 4303 (35.1%) subjects developed hypertension during 95 573 person-years of follow-up. Overall, there was a nonlinear, inverse association between total, plant-based, or animal-based riboflavin intake and new-onset hypertension (all P for nonlinearity, <0.001). The risk of new-onset hypertension was increased only in participants with relatively lower riboflavin intake. Accordingly, a significantly lower risk of new-onset hypertension was found in participants in quartiles 2 to 4 of total riboflavin intake (hazard ratio, 0.74 [95% CI, 0.68–0.80]), plant-derived riboflavin intake (hazard ratio, 0.77 [95% CI, 0.71–0.84]), or animal-derived riboflavin intake (hazard ratio, 0.70 [95% CI, 0.65–0.77]), compared with those in quartile 1. In addition, the association between total riboflavin intake and new-onset hypertension was particularly evident in those with lower dietary sodium/potassium intake ratio ( P interaction, <0.001). In summary, there was an inverse association between riboflavin intake and new-onset hypertension in general Chinese adults. Our results emphasized the importance of maintaining relatively higher riboflavin intake levels for the prevention of hypertension.

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U-shaped Association Between Dietary Zinc Intake and New-onset Diabetes: A Nationwide Cohort Study in China

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab636 ◽

2021 ◽

Author(s):

Panpan He ◽

Huan Li ◽

Mengyi Liu ◽

Zhuxian Zhang ◽

Yuanyuan Zhang ◽

...

Keyword(s):

Chinese Adults ◽

Dietary Zinc ◽

Nutrition Survey ◽

Zinc Intake ◽

Health And Nutrition ◽

Onset Diabetes ◽

Household Food Inventory ◽

Diagnosed Diabetes ◽

New Onset

Abstract Aims We aimed to investigate the relationship of dietary zinc intake with new-onset diabetes among Chinese adults. Materials and Methods A total of 16 257 participants who were free of diabetes at baseline from the China Health and Nutrition Survey were included. Dietary intake was measured by 3 consecutive 24-hour dietary recalls combined with a household food inventory. Participants with self-reported physician-diagnosed diabetes, or fasting glucose ≥ 7.0 mmol/L, or glycated hemoglobin ≥ 6.5% during the follow-up were defined as having new-onset diabetes. Results A total of 1097 participants developed new-onset diabetes during a median follow-up duration of 9.0 years. Overall, the association between dietary zinc intake and new-onset diabetes followed a U-shape (P for nonlinearity < 0.001). The risk of new-onset diabetes was significantly lower in participants with zinc intake < 9.1 mg/day (per mg/day: hazard ratio [HR], 0.73; 95% CI, 0.60-0.88), and higher in those with zinc intake ≥ 9.1 mg/day (per mg/day: HR, 1.10; 95% CI, 1.07-1.13). Consistently, when dietary zinc intake was assessed as deciles, compared with those in deciles 2-8 (8.9 -<12.2 mg/day), the risk of new-onset diabetes was higher for decile 1 (<8.9 mg/day: HR, 1.29; 95% CI, 1.04-1.62), and deciles 9 to 10 (≥12.2 mg/day: HR, 1.62; 95% CI, 1.38-1.90). Similar U-shaped relations were found for plant-derived or animal-derived zinc intake with new-onset diabetes (all P for nonlinearity < 0.001). Conclusions There was a U-shaped association between dietary zinc intake and new-onset diabetes in general Chinese adults, with an inflection point at about 9.1 mg/day.

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Occupational Physical Activity and New-Onset Hypertension: A Nationwide Cohort Study in China

Hypertension ◽

10.1161/hypertensionaha.121.17281 ◽

2021 ◽

Author(s):

Qinqin Li ◽

Rui Li ◽

Shaojie Zhang ◽

Yuanyuan Zhang ◽

Panpan He ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Occupational Physical Activity ◽

Nutrition Survey ◽

Metabolic Equivalent ◽

Health And Nutrition ◽

Increased Risk ◽

Males And Females ◽

New Onset

The association between occupational physical activity (OPA) and the risk of hypertension remains uncertain. We aimed to examine the prospective relations of OPA and new-onset hypertension among Chinese males and females. A total of 9350 adults who were free of hypertension at baseline were enrolled from the CHNS study (China Health and Nutrition Survey). Data on OPA were obtained by using self-reported questionnaires and calculated as metabolic equivalent task (MET)–hours per week. MET–hours per week may account for both intensity and time spent on activities. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or diagnosed by physician or under antihypertensive treatment during the follow-up. During a median of 6.1 years (82 410 person-years) of follow-up, a total of 2949 participants developed hypertension. Overall, there was a L-shaped association between the OPA and new-onset hypertension in males and a U-shaped association in females (all P values for nonlinearity <0.001). Accordingly, when OPA was categorized as four groups (<80, 80–<160, 160–<240, and ≥240 metabolic MET–hours per week), in males, the risk of new-onset hypertension was significantly increased only among participants with OPA <80 MET–hours per week; however, in females, the lowest risk of new-onset hypertension was found among those with OPA 80 to 240 MET–hours per week. In summary, moderate OPA, in terms of both duration and intensity, is associated with a lower risk of new-onset hypertension among both males and females, whereas heavy OPA was related to increased risk of new-onset hypertension in females.

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Dietary Carbohydrate Intake and New-Onset Hypertension

Hypertension ◽

10.1161/hypertensionaha.120.16751 ◽

2021 ◽

Author(s):

Qinqin Li ◽

Chengzhang Liu ◽

Shaojie Zhang ◽

Rui Li ◽

Yuanyuan Zhang ◽

...

Keyword(s):

Blood Pressure ◽

Carbohydrate Intake ◽

Minimal Risk ◽

Inverse Association ◽

Nutrition Survey ◽

High Quality ◽

Increased Risk ◽

Low Carbohydrate ◽

New Onset

The association between carbohydrate intake and the risk of hypertension remains uncertain. We aimed to evaluate the prospective relations of the amount and type of carbohydrate intake with new-onset hypertension. A total of 12 177 adults who were free of hypertension at baseline from the China Health and Nutrition Survey were included. Dietary intake was measured by 3 consecutive 24-hour dietary recalls combined with a household food inventory. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or diagnosed by physician or under antihypertensive treatment during the follow-up. A total of 4269 subjects developed hypertension during 95 157 person-years of follow-up. Overall, there was a U-shaped association between the percentage energy consumed from total carbohydrate (mean, 56.7%; SD, 10.7) and new-onset hypertension ( P for nonlinearity <0.001), with the lowest risk observed at 50% to 55% carbohydrate intake. The increased risks were mainly found in those with lower intake of high-quality carbohydrate (mean, 6.4%; SD, 5.6) or higher intake of low-quality carbohydrate (mean, 47.0%; SD, 13.0). Moreover, there was an inverse association between the plant-based low-carbohydrate scores for low-quality carbohydrate and new-onset hypertension. However, there was a U-shaped association between the animal-based low-carbohydrate scores for low-quality carbohydrate and new-onset hypertension ( P for nonlinearity <0.001). In summary, both high and low percentages of carbohydrate diets were associated with increased risk of new-onset hypertension, with minimal risk at 50% to 55% carbohydrate intake. Our findings support the intake of high-quality carbohydrate, and the substitution of plant-based products for low-quality carbohydrate for prevention of hypertension.

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Associations of Carbohydrate Intake With New-Onset Hypertension Subtypes: Results From the China Health and Nutrition Survey (2000–2011)

Frontiers in Nutrition ◽

10.3389/fnut.2021.728774 ◽

2022 ◽

Vol 8 ◽

Author(s):

Su-Fen Qi ◽

Ya-Jing Cao ◽

Hui-Jun Wang ◽

Bing Zhang ◽

Jing Yan ◽

...

Keyword(s):

Blood Pressure ◽

Energy Intake ◽

Carbohydrate Intake ◽

Nutrition Survey ◽

Health And Nutrition ◽

Hazard Ratios ◽

Lactating Mothers ◽

Diastolic Hypertension ◽

New Onset

Background: The effects of carbohydrate intake on hypertension (HTN) subtypes are scarce. We examined the association of carbohydrate intake with new-onset HTN subtypes in Chinese adults.Methods: Chinese Health and Nutrition Survey (CHNS) 2000–2011, 22,418 individuals were recorded using a 24-h recall method over three consecutive days. We excluded those who were pregnant women, lactating mothers, age <18 years, baseline age, blood pressure, and energy intake deficiency, extreme energy intake (male > 6,000 kcal or < 800 kcal; female > 4,000 kcal or < 600 kcal), and pulse pressure difference (Systolic Blood Pressure [SBP] - Diastolic Blood Pressure [DBP]) <10 mm Hg, HTN at baseline and data from only one survey. The total number of subjects who participated in at least two surveys was 7,930. The main outcome was new-onset HTN subtypes over 6.9 person years of follow-up.Results: 2,521 participants were found to be HTN, which included 1,318 males (52.3%), 1,203 females (47.7%), 721 had systolic-diastolic hypertension (SDH, 28.6%), 655 had isolated systolic hypertension (ISH, 26.0%), and 993 had isolated diastolic hypertension (IDH, 39.4%). Compared with extreme quintiles of carbohydrate, multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for new-onset HTN, SDH, ISH and IDH associated with carbohydrate intake were 1.12 (0.97–1.30), 1.54 (1.18–2.00), 0.89 (0.67–1.19) and 1.15 (0.91–1.45), respectively. The HR of SDH compared with extreme quintiles of carbohydrates was 1.56 (95% CI, 1.08–2.25; Ptrend = 0.04) in men and 1.52 (95% CI, 1.02–2.26; Ptrend = 0.02) in women.Conclusion: Carbohydrates were related to a higher risk of SDH, which were not observed with HTN, ISH, and IDH.

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Variety and quantity of dietary protein intake from different sources and risk of new-onset diabetes: a Nationwide Cohort Study in China

BMC Medicine ◽

10.1186/s12916-021-02199-8 ◽

2022 ◽

Vol 20 (1) ◽

Author(s):

Chun Zhou ◽

Chengzhang Liu ◽

Zhuxian Zhang ◽

Mengyi Liu ◽

Yuanyuan Zhang ◽

...

Keyword(s):

Food Sources ◽

Inverse Association ◽

Nutrition Survey ◽

Protein Sources ◽

Onset Diabetes ◽

Household Food Inventory ◽

Using Data ◽

Different Sources ◽

New Onset

Abstract Background The relation of the variety and quantity of different sources of dietary proteins intake and diabetes remains uncertain. We aimed to investigate the associations between the variety and quantity of proteins intake from eight major food sources and new-onset diabetes, using data from the China Health and Nutrition Survey (CHNS). Methods 16,260 participants without diabetes at baseline from CHNS were included. Dietary intake was measured by three consecutive 24-h dietary recalls combined with a household food inventory. The variety score of protein sources was defined as the number of protein sources consumed at the appropriate level, accounting for both types and quantity of proteins. New-onset diabetes was defined as self-reported physician-diagnosed diabetes or fasting glucose ≥7.0mmol/L or glycated hemoglobin ≥6.5% during the follow-up. Results During a median follow-up of 9.0 years, 1100 (6.8%) subjects developed diabetes. Overall, there were U-shaped associations of percentages energy from total protein, whole grain-derived and poultry-derived proteins with new-onset diabetes; J-shaped associations of unprocessed or processed red meat-derived proteins with new-onset diabetes; a reverse J-shaped association of the fish-derived protein with new-onset diabetes; L-shaped associations of egg-derived and legume-derived proteins with new-onset diabetes; and a reverse L-shaped association of the refined grain-derived protein with new-onset diabetes (all P values for nonlinearity<0.001). Moreover, a significantly lower risk of new-onset diabetes was found in those with a higher variety score of protein sources (per score increment; HR, 0.69; 95%CI, 0.65–0.72). Conclusions There was an inverse association between the variety of proteins with appropriate quantity from different food sources and new-onset diabetes.

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Legume consumption and risk of hypertension in a prospective cohort of Chinese men and women

British Journal Of Nutrition ◽

10.1017/s0007114519002812 ◽

2019 ◽

Vol 123 (5) ◽

pp. 564-573 ◽

Cited By ~ 1

Author(s):

Fang Guo ◽

Qiang Zhang ◽

Yue Yin ◽

Yan Liu ◽

Hong Jiang ◽

...

Keyword(s):

Significant Heterogeneity ◽

Inverse Association ◽

Nutrition Survey ◽

Hypertension Risk ◽

Health And Nutrition ◽

Hazard Ratios ◽

Drinking Status ◽

Household Food Inventory ◽

Food Recalls

AbstractPrior data on long-term association between legume consumption and hypertension risk are sparse. We aimed to evaluate whether total legume and subtype intakes prospectively associate with hypertension incidence among 8758 participants (≥30 years) from the China Health and Nutrition Survey 2004–2011. Diet was assessed by interviews combining 3-d 24-h food recalls and household food inventory weighing at each survey round. Incident hypertension was identified by self-reports or blood pressure measurements. We applied multivariable Cox regressions to estimate hazard ratios (HR) with corresponding 95 % CI for hypertension across increasing categories of cumulatively averaged legume intakes. For 35 990 person-years (median 6·0 years apiece), we documented 944 hypertension cases. After covariate adjustment, higher total legume intakes were significantly associated with lower hypertension risks, with HR comparing extreme categories being 0·56 (95 % CI 0·43, 0·71; Ptrend < 0·001). Then we found that intakes of dried legumes (HR 0·53 (95 % CI 0·43, 0·65); Ptrend < 0·001) and fresh legumes (HR 0·67 (95 % CI 0·55, 0·81); Ptrend < 0·001) were both related to decreased hypertension hazards. However, further dried legume classification revealed that negative association with hypertension substantially held for soyabean (HR 0·51 (95 % CI 0·41, 0·62); Ptrend < 0·001) but not non-soyabean intakes. In stratified analyses, the association of interest remained similar within strata by sex, BMI, physical activity, smoking and drinking status; rather, significant heterogeneity showed across age strata (Pinteraction = 0·02). Total legume consumption among the over-65s was related to a more markedly reduced hypertension risk (HR 0·47 (95 % CI 0·30, 0·73); Ptrend < 0·001). Our findings suggest an inverse association of all kinds of legume (except non-soyabean) intakes with hypertension risks.

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Dietary Carbohydrate Intake and New-onset Diabetes: A Nationwide Cohort Study in China

10.21203/rs.3.rs-551817/v1 ◽

2021 ◽

Author(s):

Chun Zhou ◽

Zhuxian Zhang ◽

Mengyi Liu ◽

Yuanyuan Zhang ◽

Huan Li ◽

...

Keyword(s):

Carbohydrate Intake ◽

Minimal Risk ◽

Inverse Association ◽

Nutrition Survey ◽

Total Carbohydrate ◽

High Quality ◽

Onset Diabetes ◽

Low Carbohydrate ◽

New Onset

Abstract Background: The association of carbohydrate intake with diabetes risk remains uncertain. We aimed to evaluate the prospective associations of the amount and types of carbohydrate intake with new-onset diabetes.Methods: A total of 16,260 non-diabetic participants from the China Health and Nutrition Survey (CHNS) were included. Dietary intake was collected by three consecutive 24-h dietary recalls combined with a household food inventory. Participants with self-reported diabetes, or fasting plasma glucose ≥7.0 mmol/L or glycated hemoglobin ≥6.5% during the follow-up were defined having new-onset diabetes. Results: During a median follow-up of 9 years (158,930 person-years), 1,100 participants developed diabetes. Overall, there was a U-shaped association between percent of energy from carbohydrate intake and new-onset diabetes, with minimal risk at 49-56% of energy from total carbohydrate intake (quartile 2) (P for nonlinearity <0.001). Moreover, there was an L-shaped association between high-quality carbohydrate intake and new-onset diabetes (P for nonlinearity <0.001), and a J-shaped association of low-quality carbohydrate intake with new-onset diabetes (P for nonlinearity <0.001). Furthermore, there was an inverse association between the plant-based low-carbohydrate scores for low-quality carbohydrate and new-onset diabetes. However, a reversed J-shaped association was found between the animal-based low-carbohydrate scores for low-quality carbohydrate and new-onset hypertension (P for nonlinearity <0.001). Conclusions: There was a U-shape association between percent of total carbohydrate intake and new-onset diabetes, with the lowest risk at 49-56% carbohydrate intake. Our findings provide some evidence for the intake of high-quality carbohydrate, and the substitution of plant-based products for low-quality carbohydrate for primary prevention of diabetes.

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Trajectories of mid-life to elderly adulthood BMI and incident hypertension: the China Health and Nutrition Survey

BMJ Open ◽

10.1136/bmjopen-2020-047920 ◽

2021 ◽

Vol 11 (7) ◽

pp. e047920

Author(s):

Qi Zeng ◽

Lin Sun ◽

Qing Zeng

Keyword(s):

Latent Class ◽

Mixed Model ◽

Longitudinal Design ◽

Nutrition Survey ◽

Incident Hypertension ◽

Health And Nutrition ◽

Stable Class ◽

Bmi Trajectories ◽

Distinct Individual ◽

Prevention Of Hypertension

ObjectivesThis study is designed to identify different body mass index (BMI) trajectories of individuals aged 40–70 years and test the effect of distinct BMI trajectories on incident hypertension.DesignThe accelerated longitudinal design was used for this study.MethodsThe study drew data from the third to ninth China Health and Nutrition Surveys (CHNS), and 4697 participants were included between 1991 and 2015. As analysed, three distinct individual BMI trajectories were identified by the latent class growth mixed model (LCGMM). Then, BMI values and BMI slopes were worked out through calculation with LCGMM trajectory parameters and their primary derivatives, respectively. Later, Cox proportional hazard models were applied to examine BMI values and slopes, and find out the relationship between the said predicted data and incident hypertension for different classes.ResultsThree different trajectory classes were identified, that is, low-stable class (n=3711), sharp-increasing class (n=282) and high-stable class (n=704). Compared with the low-stable class, the adjusted HRs (95% CI) were 1.321 (1.119 to 1.559) and 1.504 (1.322 to 1.711) for the sharp-increasing class and the high-stable class, respectively. The HR (95% CI) for BMI values rose from 1.081 (1.030 to 1.135) to 1.221 (1.171 to 1.273) while the HR (95% CI) for BMI slopes dropped from 1.154 (1.100 to 1.211) to 0.983 (0.943 to 1.025). That is, the HR for BMI slopes were higher than that for BMI values for the class aged 40–47 years.ConclusionThese findings suggest that the calibrated BMI trajectories for the period from mid-life to elderly adulthood have a significant effect on the risk of incident hypertension. The period from age 40 to 47 years is critical and has positive implications for the early prevention of hypertension.

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Association between selenium intake, diabetes, and mortality in adults: findings from National Health and Nutrition Examination Survey (NHANES) 2003-2014

British Journal Of Nutrition ◽

10.1017/s000711452100177x ◽

2021 ◽

pp. 1-24

Author(s):

Bushra Hoque ◽

Zumin Shi

Keyword(s):

National Health ◽

Cox Regression ◽

Inverse Association ◽

Nutrition Examination Survey ◽

Health And Nutrition ◽

Hazard Ratios ◽

The Us ◽

All Cause Mortality ◽

Cvd Mortality

Abstract Selenium (Se) is a trace mineral that has antioxidant and anti-inflammatory properties. This study aimed to investigate the association between Se intake, diabetes, all-cause and cause-specific mortality in a representative sample of US adults. Data from 18,932 adults who attended the 2003-2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Information on mortality was obtained from the US mortality registry updated to 2015. Multivariable logistic regression and Cox regression were used. Cross-sectionally, Se intake was positively associated with diabetes. Comparing extreme quartiles of Se intake, the odds ratio (OR) for diabetes was 1.44 (95% CI: 1.09–1.89). During a mean of 6.6 years follow-up, there were 1627 death (312 CVD, 386 cancer). High intake of Se was associated with a lower risk of all-cause mortality. When comparing the highest with the lowest quartiles of Se intake, the hazard ratios (HRs) for all-cause, CVD mortality, cancer mortality and other mortality were: 0.77 (95% CI 0.59-1.01), 0.62 (95% CI, 0.35-1.13), 1.42 (95% CI, 0.78-2.58) and 0.60 (95% CI,0.40-0.80), respectively. The inverse association between Se intake and all-cause mortality was only found among white participants. In conclusion, Se intake was positively associated with diabetes but inversely associated with all-cause mortality. There was no interaction between Se intake and diabetes in relation to all-cause mortality.

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Association between physical activity, occupational sitting time and mortality in a general population: An 18-year prospective survey in Tanushimaru, Japan

European Journal of Preventive Cardiology ◽

10.1177/2047487318810020 ◽

2018 ◽

Vol 27 (7) ◽

pp. 758-766 ◽

Cited By ~ 6

Author(s):

Akiko Sakaue ◽

Hisashi Adachi ◽

Mika Enomoto ◽

Ako Fukami ◽

Eita Kumagai ◽

...

Keyword(s):

Physical Activity ◽

General Population ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Sitting Time ◽

Inverse Association ◽

Physical Activity Questionnaire ◽

Occupational Sitting ◽

Activity Questionnaire

Aims It is well known that a decline in physical activity is associated with an increase of all-cause death including cardiovascular events and cancer. Few studies have examined the association between occupational sitting time and mortality. Therefore, we investigated this issue in a general population. Methods Physical activity and occupational sitting time were measured using the Baecke physical activity questionnaire in 1999. The questionnaire generated indices in three physical activity categories: work, sport and leisure-time. A total physical activity index was calculated by adding these three indices. The Baecke physical activity questionnaire was able to evaluate occupational sitting time. Hazard ratios and 95% confidence intervals (CIs) were calculated using Cox's proportional hazard regression models. Results We enrolled a total of 1680 participants, who were followed up for 15.9 ± 3.8 years. The final follow-up rate was 93%. During the follow-up period, 397 subjects died. A significant inverse association ( p < 0.0001) was found between physical activity and mortality after adjustment for age and sex. Compared with lower levels of physical activity, the adjusted hazard ratio for mortality at higher levels of physical activity was 0.85 (95% CI: 0.78–0.92). Longer occupational sitting time was also significantly associated with higher mortality ( p < 0.01). The adjusted hazard ratio for mortality at longer occupational sitting time was 1.16 (95% CI: 1.05–1.27). These findings were observed in males, but not in females. Conclusions Our data demonstrated that higher levels of physical activity are associated with a reduced risk of cancer and cardiovascular death. Further, longer occupational sitting time is associated with increased mortality.

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