National Nutrition Survey Data Research Articles

The relationship between nocturia and suicidal ideation: A study on The National Health and Nutrition Survey data.

The focus of this research was to explore any potential link between nocturia and the risk of suicidal ideation. Drawing from the National Health and Nutrition Survey, data relating to 25 241 participants was scrutinized. This included 13 421 individuals identifying as male and 11 820 individuals identifying as female. Participants provided information on nocturia and suicidal ideation via self-completed questionnaires. To determine if nocturia was independently related to suicidal ideation, a multivariable logistic regression analysis was employed. Analyses were also undertaken separately for adult males and females. It was found that around 3.5% of participants had experienced suicidal ideation. The results indicated that nocturia increased the risk for suicidal ideation in all adult groups (odds ratio [OR] = 1.67, 95% confidence interval[CI]: 1.37-2.03, p < 0.0001), including both males (OR = 1.91, 95% CI: 1.38-2.65, p < 0.001) and females (OR = 1.48, 95% CI: 1.158-1.90, p = 0.002). The risk for suicidal ideation increased with the severity of nocturia, with significant trends observed in adult males (p for trend = 0.04) and adult females (p for trend = 0.01). Additionally, subgroup examination showed a significant interaction between nocturia and educational level in adult males (p for interaction = 0.03). Among adult females, a noteworthy interaction was observed between nocturia and body mass index (p for interaction = 0.02). The research uncovered a connection between nocturia and an elevated risk of suicidal ideation.

Association between biological aging and diabetic retinopathy

The impact of aging on diabetic retinopathy (DR) remains underestimated. The current study aimed to investigate the association between biological aging and DR, in contrast to chronological age (CA). Using the National Health and Nutrition Survey data from 2005 to 2008. Biological aging was evaluated through the biological age (BA) and phenotypic age (PA), which were calculated from clinical markers. DR was identified in participants with diabetes mellitus (DM) when they exhibited one or more retinal microaneurysms or retinal blot hemorrhages under retinal imaging, with or without the presence of more severe lesions. Survey-weighted multivariable logistic regression was performed, and the regression model was further fitted using restricted cubic splines. The discriminatory capability and clinical utility of the model were evaluated using receiver operating characteristic (ROC) curves and decision curve analysis (DCA). Based on weighted analyses, of the 3100 participants included in this study, of which 162 had DR. In the adjusted model, BA (odds ratio [OR] = 1.12, 95% CI, 1.06–1.18) and PA (OR = 1.11, 95% CI, 1.07–1.14) were associated with DR, while CA was not significantly (OR = 1.01, 95% CI, 0.99–1.03). Narrowing the analysis to DM participants and adjusting for factors like insulin showed similar results. ROC and DCA analyses indicate that BA/PA predicted DR better than CA and offer greater clinical utility. The positive association between BA/PA and DR was consistent across subgroups despite potential interactions. Biological aging heightens DR risk, with BA/PA showing a stronger association than CA. Our findings underscored the importance of timely anti-aging interventions for preventing DR.

Determinants of overweight and obesity among children between 5 to 11 years in Ecuador: A secondary analysis from the National Health Survey 2018.

During the 1990s, global eating habits changed, affecting poorer and middle-income nations, as well as richer countries. This shift, known as the "obesity transition," led to more people becoming overweight or obese worldwide. In Ecuador, this change is happening, and now, one in three children is affected by overweight or obesity (OW/OB). This study explores the links between social, economic, and demographic factors and childhood obesity in Ecuador, seeking to provide insights for shaping future health policies in response to this intricate shift. A cross-sectional study using 2018 National Health and Nutrition Survey data from Ecuador. Weighted percentages were computed, and odds ratios for OW/OB unadjusted and adjusted for each category of explanatory variables were estimated using multilevel multivariate logistic regression models. Among 10,807 Ecuadorian school children aged 5 to 11, the prevalence of OW/OB was 36.0%. Males exhibited 1.26 times higher odds than females (95% CI: 1.20 to 1.33), and each additional year of age increased the odds by 1.10 times (95% CI: 1.09 to 1.10). Economic quintiles indicated increased odds (1.17 to 1.39) from the 2nd to 5th quintile (the richest) compared with the first quintile (the poorest). Larger household size slightly reduced odds of OW/OB (adjusted odds ratio [aOR] = 0.93, 95% CI: 0.91 to 0.95), while regular physical activity decreased odds ([aOR] = 0.79, 95% CI: 0.75 to 0.82). The consumption of school-provided meals showed a non-significant reduction (aOR: 0.93, 95% CI: 0.82 to 1.06). Children from families recognizing and using processed food labels had a higher likelihood of being overweight or obese (aOR = 1.14, 95% CI: 1.02 to 1.26). Age, male gender, and higher economic quintile increase OW/OB in Ecuadorian school children. Larger households and physical activity slightly decrease risks. Ecuador needs policies for healthy schools and homes, focusing on health, protection, and good eating habits.

Changes in UK price disparities between healthy and less healthy foods over 10 years: An updated analysis with insights in the context of inflationary increases in the cost-of-living from 2021

Food prices and affordability play an important role in influencing dietary choices, which in turn have implications for public health. With inflationary increases in the cost-of-living in the UK since 2021, understanding the dynamics of food prices becomes increasingly important. In this longitudinal study, we aimed to examine changes in food prices from 2013 to 2023 by food group and by food healthiness. We established a dataset spanning the years 2013–2023 by combining price data from the UK Consumer Price Index for food and beverage items with nutrient and food data from the UK nutrient databank and UK Department of Health & Social Care's National Diet and Nutrition Survey data. We calculated the price (£/100 kcal) for each food item by year as well as before and during the period of inflationary pressure, and classified items into food groups according to the UK Eatwell Guide and as either “more healthy" or “less healthy" using the UK nutrient profiling score model. In 2023, bread, rice, potatoes and pasta was cheapest (£0.12/100 kcal) and fruit and vegetables most expensive (£1.01/100 kcal). Less healthy food was cheaper than more healthy food (£0.33/100 kcal versus £0.81/100 kcal). Before the inflationary pressure period (from 2013 to late 2021), the price of foods decreased by 3%. After this period, the price of food increased by 22%: relative increases were highest in the food group milk and dairy food (31%) and less healthy category (26%). While healthier foods saw smaller relative price increases since 2021, they remain more expensive, potentially exacerbating dietary inequalities. Policy responses should ensure food affordability and mitigate price disparities via, for example, healthy food subsidies.

Faktor- Faktor Yang Mempengaruhi Kejadian Stunting Pada Balita Di Indonesia Tahun 2024

Stunting caused by malnutrition during the growth and development process has a higher risk of illness and death in adulthood, so it can hamper motor skills and reduce the level of productivity and competitiveness of a nation (Rahmadhita, 2020). National nutritional status survey data (SSGI) in 2022, the prevalence of stunting was 21.6%. The target stunting rate in Indonesia is 14% in 2024 and the WHO standard target is below 20%, therefore how important it is to handle stunting in Indonesia. The aim of this research is to determine the factors that influence the incidence of stunting in toddlers. The method in this research is a full text critical review in Indonesian. Articles were selected in stages using the appraisal tool preferred reporting items for systematic reviews and meta analyzes (PRISMA), then duplicate filtering was carried out, screening was carried out based on title and abstract, full text, feasibility studies and until the final stage 11 articles were found that met the inclusion and study criteria. appropriateness. The results of this research show that the factors that influence the incidence of stunting in toddlers are exclusive breastfeeding, low birth weight, infectious diseases, mother's height, mother's education, family income, and nutritional status of pregnant women.

The moderated mediating effect of physical activity restriction in the relationship between chronic disease, depression, and quality of life in middle age: – 2020 National Health and Nutrition Survey Data -

BackgroundSince middle-aged adults comprise the largest portion of the Korean population, improving their quality of life can be related to the quality of life of the entire population. This study aimed to investigate the moderated mediating effect of physical activity restrictions on the relationship between chronic disease, depression, and quality of life in middle-aged Koreans. MethodsSecondary data analysis was conducted on the dataset of the 2020 National Health and Nutrition Survey. Data from 1,487 of the original 7,359 participating middle-aged Koreans aged between 40 and 59 years were included. Descriptive statistical analysis, correlation analysis, and mediating, moderating, and moderated mediating effect analyses were performed. ResultsDepression had a mediating effect on the relationship between chronic disease and quality of life in middle-aged Koreans. Physical activity restrictions had a moderating effect on the relationship between chronic disease and depression. Finally, a moderated mediating effect of physical activity restrictions on the mediating effect of depression was observed. LimitationsThe study did not control demographic variables such as gender, age, income level, marital status, education level, and occupation. Response bias may have influenced the questionnaire data. The variables were only measured using a cross-sectional survey design. ConclusionsThis study is the first to use large-scale research data to identify a specific path to the quality of life in middle-aged Koreans. The findings provide a basis for implementing the necessary intervention measures to support middle-aged Koreans’ quality of life.

National Diet and Nutrition Survey data reveal a decline in folate status in the United Kingdom population between 2008 and 2019

BackgroundFolate is essential for healthy growth and development. Fortification of foods with folic acid can improve folate status and reduce risk of neural tube defects (NTD). Following concern around folate status in the United Kingdom, the United Kingdom government announced in 2021 the intention to introduce mandatory folic acid fortification. ObjectiveThis study aimed to describe folate status in the United Kingdom population prior to the implementation of mandatory folic acid fortification of non-whole wheat (non-wholemeal) flour and to assess trends in folate status, including in females of reproductive age (FRA). MethodsData were from the United Kingdom National Diet and Nutrition Survey Rolling Program (2008–2019), a cross-sectional, nationally representative survey of children and adults aged 1.5+ (n = 5792 with folate result). Serum folate concentration was measured by liquid chromatography tandem mass spectrometry (LC-MS/MS) and red blood cell (RBC) folate concentration by microbiological assay. Concentration data were compared against method-specific cut-offs and thresholds, and relationships were explored against demographic and lifestyle characteristics. ResultsRBC and serum folate concentration significantly decreased by ∼3 percentage points per year between 2008 and 2019 in all age/sex groups. Prevalence of deficiency (RBC folate < 305 nmol/L) was highest in children aged 11 to 18 y (17% in 2016–2019). The proportion of FRA below the cut-off for increased risk of NTD (RBC folate < 748 nmol/L) increased from 69% to 89% between 2008 and 2019. Ethnicity, smoking status, and income were significant determinants of RBC and serum folate concentrations. ConclusionsThese data reveal a decline in population folate status in the United Kingdom between 2008 and 2019 and a high prevalence of folate deficiency. A high proportion of FRA had RBC folate concentrations below the cut-off for increased risk of NTD. These data provide information on folate status in a population not currently exposed to mandatory folic acid fortification and are essential to model and assess its impact.

Composite dietary antioxidant index and the risk of heart failure: A cross-sectional study from NHANES.

Previous studies show that oxidative stress is important in heart failure (HF) pathogenesis. The composite dietary antioxidant index (CDAI), which reflects the antioxidant profile of nutrient supplements, is associated with cardiovascular mortality risk. However, the association between CDAI and the risk of HF remains unknown. In this study, we investigated the relationship between CDAI and HF risk using National Health and Nutritional Examination Survey (NHANES) data. The data of participants aged >40 years old from the NHNANES between 2001 and 2018 were obtained and used to assess the relationship between CDAI and the risk of HF. Logistic regression was used to calculate the odds ratio (OR) of CDAI for the risk of HF. A total of 29 101 participants were divided into the HF (n = 1419; 4.88%) and non-HF groups (n = 27 682; 95.12%), HF group participants had lower CDAI than the non-HF group (-0.32 ± 0.14 vs. 0.67 ± 0.05, p < .0001). Compared with the lowest CDAI quartile (Q1), the OR for HF risk was 0.88 (0.68-1.13) for Q2 (p = .30), 0.77 (0.61-0.99) for Q3 (p = .04), and 0.68 (0.52-0.89) for Q4 (p = .01). CDAI was negatively associated with the risk of HF. Our findings show that the intake of an antioxidant-rich dietary is a potential method to reduce the risk of HF.

Racial and ethnic differences in physical activity among mothers of young children: 2011–2018 NHANES

BackgroundAmerican women tend to reduce physical activity (PA) during the transition to motherhood. Their main barrier to participation in PA is lack of time due to new/increased parenting and housework responsibilities. Because there are known racial/ethnic variations in time spent on housework among American women, their PA changes during the transition to motherhood might also differ by racial/ ethnic background. This study aimed to compare PA between American mothers of young child(ren) under age 5 years (YC) and American women without children by their racial/ethnic background.MethodsSecondary data analyses were conducted using 2011–2018 US National Health and Nutrition Survey data. The study sample included 4,892 women aged 20–45 years (Asian n = 760; Black n = 1,162; Hispanic n = 1,324; White n = 1,646). Participants completed a Physical Activity Questionnaire that asked about participation in transportation and leisure-time moderate- and vigorous-intensity PA (MVPA; minutes/week). Multivariable regression analyses were conducted to compare MVPA among women living without children and with YC (no older children) in each of the racial/ethnic groups.ResultsOverall, the prevalence of physical inactivity, defined as zero minutes of MVPA in a typical week, was 43% (95% CI = 38–49%) vs. 32% (95% CI = 29–35%) among women living with YC vs. without children. The adjusted odds of physical inactivity for women living with YC, compared to women living without children, was significantly higher among Asian (OR = 2.08 [95% CI = 1.37–3.17]) and White women (OR = 1.63 [95% CI = 1.11–2.38]), while it was statistically insignificant among Hispanic and Black women. Among women who reported participating in MVPA, Asian women living with YC had 35 fewer minutes/week of MVPA than their counterparts living without children (p = 0.06), while other racial and ethnic groups showed no significant differences.ConclusionsAmerican mothers of YC were less likely to engage in transportation or leisure-time MVPA, compared to those living without children. This association was particularly strong among Asian women. The study results suggest that a PA reduction in the transition to motherhood may be particularly large among Asian American women, calling for targeted efforts for PA promotion among Asian American mothers of YC; e.g., culturally-tailored community-based physical activity programs for Asian American mothers.

Life’s Essential 8 and Mortality in US Adults with Chronic Kidney Disease

Introduction: The current prevalence of chronic kidney disease (CKD) is substantial, and CKD individuals face a heightened risk of mortality, encompassing both all-cause and cause-specific outcomes. The current study aims to investigate the potential impact of adhering to Life’s Essential 8 (LE8) on reducing mortality among CKD individuals. Methods: Using the National Health and Nutrition Survey (NHANES) data from 2005 to 2018, we analyzed 22,420 US adults (≥20 years old). CKD is defined by urinary albumin-to-creatinine ratio (≥30 mg/g or 3 mg/mmol) and estimated glomerular filtration rate (<60 mL/min/1.73 m²). The components of LE8, including diet, physical activity (PA), nicotine exposure, sleep, body mass index, blood lipids, blood glucose, and blood pressure (BP), were measured and given a score of 0–100. The total LE8 score was the unweighted average of all components and was divided into low cardiovascular health (CVH) (0–49), moderate CVH (50–79), and high CVH (80–100). A Cox proportional hazards regression model was used to explore the associations of LE8 with all-cause, cardiovascular disease (CVD), and cancer mortality, which were followed prospectively by the National Center for Health Statistics until December 31, 2019. Results: In the overall population, individuals with moderate CVH had a 47% lower risk of CKD, while high CVH was linked to a 55% lower risk compared to low CVH. During a median follow-up of 7.58 years, CKD individuals had a 93% higher all-cause mortality rate and a 149% higher CVD mortality rate compared to those without CKD. Among the CKD individuals, every 10-point increase in the LE8 score was associated with reduced risks of 17% for all-cause mortality (especially PA, nicotine exposure, blood glucose, and BP), 18% for CVD mortality (especially PA), and 12% for cancer mortality (especially PA and sleep health). In additional and sensitivity analysis, the results remained significant after further consideration of potential confounding of renal function. Additionally, LE8 demonstrated superior risk stratification for CVD mortality among CKD patients compared with LS7. Interaction was observed between LE8 and age, education level, marital status, and drinking status. Conclusion: The current study demonstrates that adherence to higher LE8 levels within CKD individuals is associated with a reduced risk of both all-cause and cause-specific mortality.

Association between creatine phosphokinase level within normal range and bone mineral density in adolescents.

Currently, it is unclear whether creatine phosphokinase (CPK) affects bone mineral density (BMD) in adolescents. We sought to clarify the relationship between CPK and total BMD in adolescents aged 12 to 19 years within normal values by conducting this study. A cross-sectional study was conducted using the 2011 to 2018 National Health and Nutrition Survey data to examine 1188 males (average age, 15.2 years) and 1629 females (average age, 15.4 years). In this study, CPK was the independent variable and total BMD was the outcome variable. In addition to using multivariate linear regression models, subgroup analyses were also conducted in order to examine the relationship between CPK levels and total BMD within normal ranges. Significant positive association was observed between the CPK levels and total BMD in adolescents (model 1: 0.0003 [0.0002, 0.0004], model 2: 0.0004 [0.0003, 0.0005] and model 3: 0.0004 [0.0003, 0.0004]). After adjusting for age, gender, race/ethnicity, body mass index, dietary protein intake, dietary protein intake, dietary fiber intake, poverty to income ratio, physical activities, total cholesterol, total protein, blood urea nitrogen, phosphorus, and serum calcium, CPK levels remained significantly associated with BMD (regression coefficients for quartiles 2 to 4 vs quartile1 were 0.0002, 0.0072, and 0.0154, respectively; P for trend <.001). The association was positive even when stratified by age, gender, and race. Further, adolescents aged 16 to 19 years were more likely to report positive relationships than adolescents aged 12 to 15 years. And the phase relationship between total BMD and CPK was further enhanced in boys. The results of our study show that CPK levels within the normal range are positively associated with total BMD in adolescents aged 12 to 19 years. Additionally, CPK may be a potential biomarker of bone health among adolescents.

Exploring the double burden of malnutrition at the household level in the Philippines: Analysis of National Nutrition Survey data.

In the Philippines, the rising prevalence of obesity and related chronic diseases alongside persistent undernutrition presents a complex public health challenge. Understanding the patterns and dynamics of this 'double burden of malnutrition' (DBM) is crucial for developing effective intervention strategies. However, evidence of the occurrence of undernutrition and overnutrition within the same household is currently lacking. Using cross-sectional data from the 2013 Philippines National Nutrition Survey this study examined the prevalence of different typologies of household-level DBM from an analytical sample of 5,837 households and 25,417 individuals. Multivariable logistic regression was performed to identify factors associated with overall occurrence of intrahousehold DBM. The overall prevalence of double burden households was 56% based on a comprehensive definition. The most common typology of intrahousehold DBM characterized in this study (% of all households) comprised households with at least one adult with overnutrition and at least one separate adult with undernutrition. Household size, wealth quintile, food insecurity, and household dietary diversity were all associated with household-level DBM. Double burden households were also influenced by head of household characteristics, including sex, level of education, employment status, and age. The findings from this study reveal that the coexistence of overnutrition and undernutrition at the household level is a major public health concern in the Philippines. Further comprehensive assessments of household-level manifestations of the DBM are needed to improve our understanding of the trends and drivers of this phenomenon in order to develop better targeted interventions.

Lower human papillomavirus vaccine initiation and completion among Asian American adolescents compared to their peers: National Health and Nutritional Examination Survey 2011-2018.

To compare human papillomavirus (HPV) vaccination initiation and completion between Asian American adolescents and their peers. HPV vaccine initiation and completion of adolescents aged 9-17years old were analyzed using the National Health and Nutritional Examination Survey data from 2011 to 2018. The outcomes were HPV vaccine initiation percentage among all adolescents and completion percentage among initiators. Odds ratios for initiation or completion among Hispanics, Blacks, and Asians (referred to as racial/ethnic minorities) versus Whites were compared using logistic regression, adjusted for adolescent's age, annual family income, parent education, and insurance coverage. From 2011 to 2018, overall initiation was less than 40% among U.S. adolescents. The initiation increased among boys (from 10% in 2011-12 to over 30% in 2017-2018) but not among girls. Compared to White girls, Black and Hispanic girls were more likely, while Asian girls were less likely to initiate vaccination. Although not statistically significant, Asian girls had ORs ranging from 0.65 to 0.99 for initiation compared to White girls in each of the four survey cycles. Black and Hispanic boys were more likely to initiate vaccination compared to White boys. Initiation among Asian boys increased to 39% in the 2017-2018 survey cycle. Racial/ethnic minority girls were less likely to complete the series compared to White girls, while the opposite was seen in Black boys. HPV vaccination status varies among racial/ethnic groups. Future efforts should be made to achieve the Healthy People 2020 goal of 80% vaccination among U.S. adolescents and address the gap among Asian American girls.

"Profiling Obese Subgroups in National Health and Nutritional Status Survey Data using Machine Learning Techniques – A Case Study from Brunei Darussalam"

"Profiling Obese Subgroups in National Health and Nutritional Status Survey Data using Machine Learning Techniques – A Case Study from Brunei Darussalam"

Sleep Deficit as a Risk Factor for Hypertension in Korean Adults

This study aims to evaluate the association between sleep duration and hypertension in Korean adults aged 30 and older. This is a population-based cross-sectional study using the 2020 Korean National Health and Nutritional Examination Survey data. Study subjects numbered 3984 after excluding people with missing data for key exposures and outcome variables. Of the study subjects, 18.8% (n = 748) sleep for less than 6 h a day. Increased risk for hypertension was associated with being male, of old age, unemployed, of low educational achievement, and overweight, as well as drinking, smoking, stress, and short sleep duration. The prevalence of sleep deficit was associated with sex, age, education level, income, and health insurance type. Logistic regression analyses were performed to identify whether sleep duration affects the risk of hypertension. In the unadjusted model, the odds ratio (OR) of having hypertension was lower among people sleeping for 7.0–7.9 h (OR = 0.52, 95% confidence interval (95% CI) = 0.42–0.64) than those sleeping for fewer than 6 h per day. After adjusting for sociodemographic factors (sex, age, education level, occupation, and health insurance), the OR for 7.0–7.9 h remained significant (OR = 0.74, 95% CI = 0.59–0.92). This association was not significant when the model was further adjusted for health-related factors (smoking, drinking, physical activity, BMI level, and stress). Measures to promote adequate sleep duration should be included in programs to prevent and manage hypertension.

Dietary Choices as Prevention Measure: Assessment of Societal Effects Related to Life Expectancy in Germany

Public health determines economic stability and growth. Inappropriate dietary behaviour induces a huge health burden across all age groups and geographical regions every year. Nutrition is one major driver to overcome non-communicable diseases and related costs. According to the World Health Organization, there is a gap in research considering the cost-effectiveness of policy nutrition interventions. The present modelling study is the first attempt to evaluate a potential nationwide shift towards healthy nutrition from a societal perspective. The scenario modelling builds on most recent findings from the research field and status quo food consumption according to national nutrition survey data. Potential age- and gender-specific gains in life expectancy due to diet improvement are evaluated for the 2019 population in Germany addressing different scenarios (optimal diet and feasible diet). Drawing on a human capital approach, the resulting health gains are translated into a societal value building on related gains in unpaid work productivity. The monetary evaluation of productivity increase is implemented according to the specialist’s approach. The potential gain in unpaid work activities related to improved nutrition, is estimated at € 5,046bn for the 2019 German population assuming an optimal diet scenario. In case of the more feasible diet scenario, additional life expectancy is lower but still valuable. Health gains are less for women as compared to men, but the societal value is higher for females due to higher societal contribution in terms of unpaid activities across all age groups. The potential health gains are highest for young age groups, but the monetary societal value for these individuals is lower due to discounting of future benefits. The study illustrates the societal value of nutrition as one dimension of preventing non-communicable diseases. Thereby, it provides valuable insights for policy decision makers to develop interventions on the population level that support transformation of the health care systems and economic structures towards a sustainable direction.

Prevalence and patterns of anthropometric failure among under-five children in Nigeria: Evidence from the National nutrition and health survey, 2018.

Globally, malnutrition among under-five children remains a public health concern. There is increasing concern at research and policy levels about anthropometric failure and the double burden of child malnutrition across different groups of children. The objective of this study was to describe the magnitude and distribution of various forms of anthropometric failure (AF) among children under age five in Nigeria. We used the 2018 National Nutrition and Health Survey data collected among 19,471 under-five children in Nigeria. The most prevalent AF was stunting only (17.7%) followed by stunting and underweight (13.9%). Wasting, stunting and underweight was found among 3.5% of the sample. Wasting, stunting and underweight was most common in age 6-11 months (7.0%) and 12-23 months (6.9%). Overall, about 1 out of 5 under-five children has multiple anthropometric failure. The peak age group for multiple AFs was between six months and 35 months. Multiple AF was less likely among females compared to males (RR=0.74, CI: 0.69, 0.80). The risk of multiple AF was higher in both North East (RR=2.15, CI: 1.78, 2.59) and North West (RR=2.98, CI: 2.51, 3.55) relative to the North Central. In contrast, the risk was lesser in the South East (RR=0.75, CI: 0.59, 0.95) and other southern regions. The study showed that multiple anthropometric failure is a common problem among children in Nigeria. Programmes that will support prevention and early identification of different types of malnutrition among under-five children across States in Nigeria are recommended.

Association between Lower-to-Upper Ratio of Appendicular Skeletal Muscle and Metabolic Syndrome.

(1) Background: Metabolic syndrome (MetS) is a cluster-based disorder comprising several pre-disease or pre-clinical statuses for diabetes, hypertension, dyslipidemia, cardiovascular risk, and mortality. Appendicular skeletal muscle (ASM), or lean mass, is considered the main site of insulin-mediated glucose utilization. Therefore, we aimed to reveal the association between lower appendicular skeletal muscle mass to upper appendicular skeletal muscle mass ratio (LUR) and risk for MetS. (2) Methods: We analyzed the 2008-2011 Korean National Health Examination and Nutrition Survey (KNHANES) data. Quintiles of lower ASM to upper ASM ratio (LUR) were categorized as follows: Q1: ≤2.65, Q2: 2.66-2.80, Q3: 2.81-2.94, Q4: 2.95-3.11, and Q5: ≥3.12 in men and Q1: ≤3.00, Q2: 3.01-3.18, Q3: 3.19-3.36, Q4: 3.37-3.60, and Q5: ≥3.61 in women. Multivariate logistic regression models were used after setting MetS and the LUR quintiles as the independent and dependent variables and adjusting for covariates. (3) Result: In men, MetS in accordance with the LUR quintiles exhibits a reverse J-curve. All groups from Q2 to Q5 had a lower odds ratio (OR) (95% CI) for MetS compared to the Q1 group. The lowest OR (95% CI) of 0.85 (0.80-0.91) was observed in Q4. However, in women, the figure shows a sine curve. Compared to the Q1 group, the Q2 and Q3 groups had a higher OR, while the Q4 and Q5 groups presented a lower OR. Among them, the OR (95% CI) in the Q4 group was lowest, at 0.83 (0.76-0.91). (4) Conclusions: While total appendicular skeletal muscle mass is important to prevent MetS, it is necessary to maintain an optimal ratio of muscle mass between the upper and lower appendicular skeletal muscle mass.

Association of medical uninsurance with sociodemographic attributes in US cancer population: A cross-sectional study of NHANES data 2013 to 2018.

Medical uninsurance (MU) is associated with cancer disparities, particularly among underprivileged and minority sections of the United States. In this cross-sectional study of National Health and Nutritional Examination Survey (NHANES) data from 2013 to 2018, we evaluated sociodemographic attributes of MU disparity in the US cancer population. Those aged ≥20 years with a history of cancer and disclosed MU status were included. We calculated the descriptive statistics of the population stratified by insurance type and performed bivariate and multivariate logistic regression models to assess the association of sociodemographic attributes and MU and reported unadjusted (UOR) and adjusted odds ratios (AOR). Among the 1681 participants (US estimated, 25,982,352), 4.3% ± 0.62 were uninsured. Uninsured individuals were 13.5-year younger, largely female, less educated, and non-US born compared to insured individuals. Age (UOR: 0.94, 95% CI: 0.93–0.96), female sex (UOR: 3.53, 95% CI: 1.73–7.19), Hispanics (UOR: 4.30, 95% CI: 2.45–7.54), <high school education (UOR: 7.41, 95% CI: 2.51–21.86), and non-US born with <20-years-stay in US (UOR: 7.69, 95% CI: 3.32–17.82) were associated with MU. In the multivariate model, age (AOR: 0.95, 95% CI: 0.93–0.96), female sex (AOR: 2.88, 95% CI: 1.25–6.62), <high school education (AOR: 4.02, 95% CI: 1.24–13.00), and non-US-born status with <20-years stay (AOR: 3.42, 95% CI: 1.44–8.11) were independent predictors of MU. Income was not a predictor of MU. The US cancer population has unique determinants of MU. Ethnicity alone is not a predictor of MU, whereas income is not correlated with MU. Public health interventions focusing on the attributes of MU are needed.

The Ecuadorian School Food Environment: Association With Healthy and Unhealthy Food and Beverage Consumption and BMI.

Schools can play an important role in promoting healthy child diet and body weight. However, this issue is understudied in Latin American and other populations undergoing nutrition and epidemiologic transition. 2018 Ecuadorian National Health and Nutrition Survey data were used to examine the association of school food sources with healthy and unhealthy food intake and body mass index (BMI) in primary (n = 12632) and secondary students (n = 6617). Data on school food environment characteristics were collected by questionnaire, intakes of fruits, vegetables, plain water, sweetened beverages, processed snacks, and fast foods by food frequency questionnaire, and BMI using measured weight and height. Data were analyzed using multivariable methods. The major school food sources were competitive foods sold by commercial outlets (73%), School Breakfast Program (SBP; 52%), and home-packed items (37%). Most (69%) competitive food outlets sold fruits and vegetables but only 44% offered free clean drinking water and 60% sold prohibited "red traffic light" foods. Primary and secondary students who bought competitive foods consumed sweetened beverages, processed snacks, and fast food more frequently than nonpurchasers (P = .0001). Those who packed home foods had higher fruit and vegetable intakes (P = .0001). Plain water intakes were reduced among all SBP participants (P = .0001). However, primary students in the SBP consumed fast foods less frequently (P = .0001) and had lower average BMI and odds for being obese compared to nonparticipants (P = .0001). The findings from this nationally representative study underscore the important contribution of the school food environment to child nutrition.