Nutrition Surveillance Program Research Articles

A cross-sectional study of prevalence of chronic kidney disease and related factors in adults in Anhui province

Objective: To understand the prevalence of chronic kidney disease (CKD) and related factors in adults in Anhui province based on the data of Chinese Chronic Diseases and Nutrition Surveillance program (2018) in Anhui. Methods: Multi-stage stratified cluster random sampling was used to select participants aged ≥18 years. Moreover, questionnaire survey, body measurements and laboratory tests were conducted. The complex weighting method was used to estimate the prevalence of CKD in residents with different characteristics, and complex sampling data logistic regression model was used for multivariate analysis to identify related risk factors. Results: A total of 7 181 participants were included. The overall prevalence of CKD was 11.06% in adults in Anhui, and the prevalence was 12.49% in women and 9.59% in men (P<0.05). The moderate, high and very high risk for CKD progression were 8.66%, 2.02% and 0.38%, respectively. Multivariate analysis showed that age (OR=1.03, 95%CI: 1.00-1.05), BMI (OR=1.05, 95%CI: 1.01-1.09), being woman (OR=1.38,95%CI: 1.22-1.55), hypertension (OR=2.50, 95%CI: 1.76-3.56), diabetes (OR=2.28, 95%CI: 1.51-3.43), dyslipidemia (OR=1.26, 95%CI: 1.11-1.43) and hyperuricemia (OR=2.16, 95%CI: 1.68-2.78) were risk factors for CKD. Conclusion: The prevalence of CKD in adults in Anhui was relatively high and age, gender, BMI, hypertension, diabetes, dyslipidemia and hyperuricemia were found to be associated with the prevalence of CKD. To prevent CKD and its complications, attention should be paid to the management of related risk factors, including overweight and obesity, hypertension, diabetes, dyslipidemia and hyperuricemia.

The Relationship between Dietary Patterns and High Blood Glucose among Adults Based on Structural Equation Modelling.

: AimsThe aim of this study was to examine the association between dietary patterns and high blood glucose in Jiangsu province of China by using structural equation modelling (SEqM). Methods: Participants in this cross-sectional study were recruited through the 2015 Chinese Adult Chronic Disease and Nutrition Surveillance Program in Jiangsu province using a multistage stratified cluster random sampling method. Dietary patterns were defined by exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) was used to test the fitness of EFA. SEqM was used to investigate the association between dietary patterns and high blood glucose. Results: After exclusion, 3137 participants with complete information were analysed for this study. The prevalence of high blood glucose was 9.3% and 8.1% in males and females, respectively. Two dietary patterns: the modern dietary pattern (i.e., high in red meats and its products, vegetables, seafood, condiments, fungi and algae, main grains and poultry; low in other grains, tubers and preserves), and the fruit–milk dietary pattern (i.e., high in milk and its products, fruits, eggs, nuts and seeds and pastry snacks, but low in vegetable oils) were established. Modern dietary pattern was found to be positively associated with high blood glucose in adults in Jiangsu province (multivariate logistic regression: OR = 1.561, 95% CI: 1.025~2.379; SEqM: β = 0.127, p < 0.05). Conclusion: The modern dietary pattern—high intake of red meats—was significantly associated with high blood glucose among adults in Jiangsu province of China, while the fruit–milk dietary pattern was not significantly associated with high blood glucose.

Association between Early Life Famine Exposure and Metabolic Syndrome in Adulthood.

To analyze the relationship between famine exposure at different stages of early life and the risk of developing metabolic syndrome (MetS) in adulthood, 11,865 study participants from the 2015 Chinese Adult Chronic Disease and Nutrition Surveillance Program were enrolled and then divided into a non-exposed group, fetal exposure group, early childhood exposure group, middle childhood exposure group and late childhood exposure group according to their birth time and famine exposure. MetS was defined by the NCEP ATP III criteria. Using logistic regression to explore the association between famine exposure at different stages of early life and the increased risk of developing MetS in adulthood. After adjusting other factors, compared with the non-exposure group, famine exposure during the fetal period (OR = 1.23, 95% CI = 1.00–1.51), early childhood (OR = 1.44, 95% CI = 1.11–1.87), middle childhood (OR = 1.50, 95% CI = 1.13–1.99) and late childhood (OR = 1.67, 95% CI = 1.21–2.30) had a higher risk of developing MetS in adulthood. Stratified analysis found an association between early life famine exposure and the increased risk of MetS in adulthood in females, overweight or obese participants and those who lived in areas of severe famine, in city areas and in southern China. Compared with the non-exposed group, the fetal, early childhood, middle childhood and late childhood famine-exposed groups are more likely to suffer from MetS in adulthood, especially the subjects who are females, overweight or obese and had lived in severe famine areas, city areas and southern China.

Association of Salt-Reduction Knowledge and Behaviors and Salt Intake in Chinese Population.

ObjectiveExcessive salt intake is causally associated with an increased risk of cardiovascular disease. Salt-reduction strategies have been rapidly deployed across China since 2017. This study aimed to investigate the association of salt-reduction knowledge and behaviors and salt intake in Chinese population.Study DesignThis study was a national cross-sectional study in China.MethodsThis cross-sectional study was based on data collected during a Chinese adult chronic disease and nutrition surveillance program in 2018 with 7,665 study participants. Salt intake was assessed by calculating 24 h urine sodium from morning urine samples. Logistic regression and mean impact value (MIV) based on the back propagation (BP) artificial neural network were used to screen the potential influencing factors.ResultsA total of 7,665 participants were included in the analysis, with an average age of 54.64 ± 13.26 years, and with men accounting for 42.6%. Only 19.3% of the participants were aware of the Chinese Dietary Guidelines, and only 7.3% of them could accurately identify the level of salt intake recommended in the Chinese Dietary Guidelines. Approximately 41% of the participants adopted salt-reduction behaviors, among whom the number of participants who used less salt when cooking was the highest, and the number of participants who used low sodium salt was the lowest. In the logistic regression, only “No extra salt was added at the table” group showed the effect of salt-reduction, the odds ratio (OR) being 0.78 (95% confidence interval [CI]: 0.64–0.95). The MIV result based on the BP neural network showed that the most important salt-reduction behavior was using less salt when cooking, while reducing eating-out behavior and using salt-limiting tools were the least important.ConclusionThe research shows that the popularization of salt-reduction knowledge and behaviors can reduce the population's salt intake. However, there is still considerable scope for promoting salt-reduction knowledge and behaviors, while the promotion of salt-reduction tools and low-sodium salt still needs to be strengthened.

Unhealthy Food Consumption Pattern and Nutritional Status among Adolescents: A Cross-sectional Study

Introduction: Nutritional balance is needed during adolescence for health and optimal growth. The aim of the study is to analyse the nutritional status and food consumption patterns of adolescents in Luwuk.&#x0D; Methods: This study was conducted with a cross-sectional design involving 385 adolescents at four high schools (grade 10-12). The sample was divided into four schools and selected by the accidental sampling method. Food consumption patterns were assessed using a World Health Organization-designed Global School-based Student Health Survey questionnaire (modified for Indonesia). Nutritional status is based on the results of anthropometric. Data were analysed using frequency distribution and inferential analysis.&#x0D; Results: Of the total 385 adolescents studied, there were 4.7% adolescents overweight and 2.3% were obese. On the other hand, there are also 10.6% thin adolescents and 4.4% with very thinness. 49.9% of adolescents do not consume fruit, 22.3% do not eat vegetables, 23.5% drink soft drinks with carbonated &gt;=1 time per day, 54.8% eat fast food &gt;=1 day a week, 66 .5% rarely or never breakfast, 58.2% never bring lunch and 18.7% usually eat street snacks.&#x0D; Conclusion: Some adolescents in Luwuk City had nutritional problems and unhealthy food consumption patterns. A nutritional surveillance program is needed for adolescents which includes monitoring nutritional status, consumption patterns, and risk factors related to nutrition.

Study of influence of birth weight on risk of chronic diseases and blood uric acid in adulthood

Objective: To understand the influence of birth weight on the risk of chronic diseases, such as hypertension and diabetes, and the relationship between birth weight and serum uric acid in adulthood. Methods: According to the Chinese Adult Chronic Disease and Nutrition Surveillance Program, a total of 1 131 residents aged 18 years and above were enrolled from Hexi, Nankai, Hongqiao, Wuqing, Jinnan, Baodi and Jizhou districts of Tianjin. The data of birth weight and blood pressure of the residents were collected, and fasting venous blood samples were collected from them to detect uric acid, blood glucose and blood lipids levels. The distribution of birth weight of the surveyed population was described, and the relationship between birth weight and chronic diseases, such as hypertension and diabetes, and the blood uric acid level in adulthood were analyzed. Results: The average birth weight of the surveyed population in Tianjin was 3.37 kg, which was higher in males than in females. No matter overweight/obesity, hypertension or diabetes, the prevalence rate of normal birth weight was the lowest in adulthood. After univariate logistic regression analysis and adjusting for age, sex, smoking and drinking status, it was found that compared with normal birth weight, low birth weight had a stronger correlation with diabetes (OR=2.91,95%CI:1.46-5.76) and dyslipidemia (OR=1.79,95%CI:1.01-3.19) in adulthood. Macrosomia was strongly associated with overweight/obesity in adulthood (OR=1.47, 95%CI:1.08-2.01). There was no significant difference in serum uric acid level among the residents with different birth weights. Conclusions: The low birth weight of the surveyed population in Tianjin was closely related to the risk of diabetes and dyslipidemia in adulthood, and the macrosomia was closely related to the risk of overweight/obesity in adulthood.

Modulating effect of vitamin D status on serum anti-adenovirus 36 antibody amount in children with obesity: National Food and Nutrition Surveillance

BackgroundThe association of ADV-36 infection and obesity has been reported in children.The objective of this study was to examine the hypothesis that the association between ADV-36 infection and adiposity may be mediated by sub-optimal vitamin D status of the host.MethodsNinety one apparently healthy children in different weight categories (normal weight: 33, overweight: 33, obesity: 25) aged 5–18 years were randomly selected from the registered population at National Food and Nutrition Surveillance Program (NFNS). The groups were matched based on age and sex. Anthropometric, biochemical and serological assessments were performed.ResultsThe amount of anti-ADV36-Ab increased whereas circulating concentrations of 25(OH) D decreased across BMI categories with higher amounts in children with normal weight than in children with overweight and obesity (31.0 ± 16.4, 22.5 ± 10.5 and 21.9 ± 9.8 nmol/L, respectively, p = 0.004). Logistic regression analysis revealed that for each unit increment of anti-ADV36-Ab, the chance of increase in weight was 8.5 times (OR: 8.5, p = 0.029). Interestingly, when 25(OH) D was introduced into the model, anti-ADV36-Ab was no longer the predictor of weight increment and the chance of increase in weight reduced 5% for each unit increase in 25(OH) D concentration (OR: 0.95, p = 0.012).ConclusionIt is suggested that ADV36-induced lipogenesis may be mediated by vitamin D deficiency in children with obesity.

An Overview on Acute Malnutrition and Food Insecurity among Children during the Conflict in Yemen.

Background: This study aims to describe malnutrition among children under five and to describe the food insecurity status during the current conflict in Yemen. Methods: Data were obtained from a Yemeni nutrition surveillance program (pilot phase) targeting 4142 households with 5276 children under five from two governorates (Ibb and Sana’a). Results: Global acute malnutrition was found in 13.3% of overall screened children, while 4.9% had severe acute malnutrition (SAM) and 8.4% had moderate acute malnutrition. One-fifth of the children under six months of age were acutely malnourished, followed by children under two years at 18.5% based on weight-for-height z scores. Significant associations between malnutrition and other diseases included suspected measles at three times higher rates (4.5%, p < 0.00) among SAM cases than other children. Diarrhea, fever, and cough were significantly higher among the SAM group (p < 0.05). Most households depended on market food purchases in the month preceding this survey (84.7%). Household coping mechanisms to secure daily meals included borrowing food to survive, changing types and quality of food, and decreasing the number of meals per day; some families sent their children to live with relatives. Conclusion: Malnutrition is a serious public health problem. The humanitarian community needs to adopt alternative strategies to improve food security and the nutrition status in Yemen.

Epidemiological characteristics of waist circumference and abdominal obesity among Chinese children and adolescents aged 6-17 years

Objective: To analyze the epidemiological characteristics of waist circumference and abdominal obesity among Chinese children and adolescents aged 6-17 years. Methods: Data was from the samples of aged 6-17 years in the China National Nutrition and Health Surveillance program in 2010-2012. P(90) (the same age, the same sex) was used as the diagnostic value for abdominal obesity. Results: The overall waist circumference of children and adolescents in all the age groups appeared higher in males than that in females (P<0.000 1), higher in cities than that in the rural areas (P<0.05), and higher in children with high family income than those with middle or low family incomes (P=0.000 3). The rate of abdominal obesity in children and adolescents aged 6-17 years appeared as 11.2% on average and 10.7% and 11.8% for boys and girls, respectively but with no significant difference (P>0.05). Rates on abdominal obesity appeared as 13.2% and 8.5% for boys while as 12.3% and 11.2% for girls respectively, in urban or rural areas. As for the levels of family income, the abdominal obesity rates appeared as 15.8%, 11.5% and 8.8% respectively for boys while 13.5%, 11.9% and 11.6% respectively for girls, under high, middle and low levels of family income. Conclusion: The rate of abdominal obesity in boys seemed more responsive to the impact of income in urban or rural areas.

Vitamin D Status, Latitude and their Associations with Some Health Parameters in Children: National Food and Nutrition Surveillance.

Recent data indicate a role for vitamin D in many health aspects including anthropometric measures and blood lipid profiles. Dermal vitamin D synthesis may be influenced by latitude. However, the contribution of latitude in vitamin D status and its association with anthropometric and blood lipid measures in Iranian children have not been studied to date. We used data from the National Food and Nutritional Surveillance Program. In total, 667 apparently healthy children aged 5-18 years were randomly selected from six provinces of Iran with different latitudes, from 29 to 37°. Weight, height, circulating 25-hydroxycalciferol; calcidiol [25(OH)D] and blood lipids were measured. In total, 16.7 and 4.1% of children were overweight or obese, respectively. The mean 25(OH)D concentration was 27.3 ± 17.6 nmol/l (95% confidence interval: 26.0-28.7 nmol/l). Over 93% of all children had suboptimal circulating calcidiol concentrations. Undesirable status of vitamin D, serum triglyceride and low-density lipoprotein were all more prevalent in children living in regions >33° latitude than those in <33°, significantly. There was no significant difference in duration of sun exposure between children living in latitudes below and above 33° (p = 0.093). In multivariate regression model, sex, latitude, body mass index for age z-score and sun exposure duration were independently related to 25(OH)D concentrations, but age was not. Despite significant association of latitude and vitamin D status, hypovitaminosis D is prevalent across latitude gradient in Iranian children. Our findings warrant immediate sustainable nutritional intervention, including supplementation, to protect children from hypovitaminosis D irrespective of the latitude of their residence.

Prevalence of Obesity and Overweight and Its Associated Factors in Urban Adults from West Azerbaijan, Iran: The National Food and Nutritional Surveillance Program (NFNSP)

Globally, the prevalence of overweight/obesity is increasing at an alarming rate. According to the World Health Organization (WHO), about 1.9 billion adults worldwide are overweight, and of these, over 600 million are obese. The purpose of this study was to determine the prevalence of overweight and obesity in West Azerbaijan, Iran, in 2014. Materials and Methods: Data were collected as part of the National Food and Nutritional Surveillance Program (NFNSP). A total of 249 men and women aged 20–60 from West Azerbaijan were included in the survey conducted in 2014. Body height and weight were measured with light clothing and no footwear after overnight fasting. Results: Mean age of the participants was 38.5 ±7.8 yrs. Mean BMI was 28.0±4.9 kg/m2 (men: 26.8±4.2 vs. women: 29.0±5.3, p<0.001). The prevalence of overweight and obesity was 36.5% (men: 38.6 % vs. women: 34.8%, p: 0.439) and 33.3% (men: 25.4 vs. women: 40.0 %, p: 0.016), respectively. Women were more likely to be overweight or obese than males (P=0.038). Multiple logistic regression revealed that gender (women vs. men) (OR, 2.05; CI, 1.15-3.65; p,0.014) and age (OR, 1.06; CI, 1.01-1.1; p,0.004) increased the risk of becoming overweight or obese. Women who were housewives were five times more at risk of becoming overweight or obese (OR: 4.93; CI: 1.9-12.3; p<0.001) even after adjusting for age and educational level. Conclusions: The high prevalence of weight problems in West Azerbaijan is a serious health concern, especially in women. The lifestyle of housewives is a potential risk factor for weight gain in women.

Dietary behavior and nutritional status among Chinese female college students residing in Korea

The purpose of this study was to analyze the nutritional status of Chinese female college students in Korea, and to investigate changes in their dietary behavior after residing in Korea. The subjects included 114 Chinese female college students currently studying in Korea. General characteristics and dietary behaviors before and after residing in Korea were investigated. Daily nutrients and food intake were assessed using a one-day 24-hour recall. Consumption of most nutrients, namely calcium, iron, zinc, vitamin B 2 , vitamin C, and folate was estimated to fall below the EAR for the Korean population. The proportions of subjects whose intake were estimated below the EAR for folate, calcium, vitamin B 2 , iron, zinc, and vitamin C were 93.0%, 71.9%, 66.7%, 65.8%, 65.8%, and 63.2%, respectively. In the current study, the dietary behavior scores fell significantly after Chinese students immigrated to Korea (p ＜ 0.001); increased frequency of meal skipping, less consumption of fruits and vegetables, irregular meal pattern, and imbalanced diet were some of the significant changes among Chinese students before and after residing in Korea. In addition, consumption of most nutrients, including dietary fiber, vitamin A, vitamin B group, vitamin C, and folate in the Worsened Group was significantly lower, compared with the No Change Group (p ＜ 0.05). According to the changes in dietary behaviors, consumption of most nutrients, including dietary fiber, vitamin A, vitamin B group, vitamin C, and folate in the Worsened Group was significantly lower than in the No Change Group (p ＜ 0.05). In conclusion, these results indicated that Chinese students practiced more unhealthy dietary behaviors after residing in Korea and Chinese students residing in Korea showed poor nutrient-based diet quality. Conduct of a follow-up study using blood profile tests is needed in order to assess the nutritional status of Chinese students. These results would be used in planning of a nutritional surveillance program for Chinese students. (Korean J Nutr 2013; 46(2): 177 ~ 185)

Age- and Gender-Specific Smoothed Waist Circumference Percentiles for Kuwaiti Adolescents

Objective: To ascertain abdominal obesity prevalence (waist circumference, WC) in adolescents and to develop smoothed WC percentile charts for Kuwaiti adolescents for public health use. Subjects and Methods: A cross-sectional study of 4,219 healthy Kuwaiti male and female secondary school students between the ages of 11–19 years was examined. Adolescents were drawn from all geographical regions of the country, as part of the Kuwait Nutrition Surveillance Program (KNSP). The KNSP consists of yearly data collections of variables, including weights, heights, and WCs and several sociodemographic variables. LMS regression was used to develop smoothed WC percentile curves. The final percentile curves presented are the result of smoothing three age-specific curves, termed lambda (L), mu (M), and sigma (S) for each gender. Results: Between 5.9 and 12.8% of females and 8.0–30.3% males had WC values ≧90th percentile. Moreover, the mean WC of males was consistently higher than those of females at each age and the percent of adolescents who exceed the 90th percentile increased with age in males, but not in females. Conclusion: Mean WC was higher in males than in females at every age. In most cases, two to three times greater percentages of males, compared to females, equaled or exceeded the 90th percentile, a value frequently associated with higher cardiovascular risk. These results indicate the urgent need to reduce abdominal obesity, an important indicator of the metabolic syndrome, in Kuwaiti adolescents.

The nursing work process in care for healthy children at a social security institution in Mexico

We aimed to analyze the nursing work process directed at care in the Nutrition, Growth and Development Surveillance and Control Program (VNCD) for children under five years at a social security institution in Mexico. The study adopted a qualitative approach and was based on the work category, on conceptions of the work process in health and on institutional analysis. We carried out direct systematic observations and interviews with a group of nurses and their assistants and with mothers who attended nursing appointments with their children. The care process was identified as procedure-centered and based on care protocols, with rapid appointments and little room for interaction between nurses and mothers. However, on some occasions, nurses were capable of producing live work as a result of their self-government, which allowed them to establish a mother/child-centered care nucleus.

Vigilância do estado nutricional das crianças de um distrito de saúde no Sul do Brasil

To investigate the nutritional status of children referred by a primary care center to the Nutritional Surveillance Program (Prá-Crescer), and to follow up children at risk in a health district of Porto Alegre. A retrospective cohort study was conducted with 674 children, aged between 6 and 59 months, referred to the Prá-Crescer Program. Height-for-age, weight-for-height and weight-for-age indices were used to evaluate nutritional status. The cutoff points were the 3rd and 10th percentiles of the NCHS standards. The nutritional status of 391 children at nutritional risk was followed up for 12 months. The chi-square test was used to analyze associations between variables. Fifty-eight percent of the children had nutritional deficit. Of these, 38.1% were undernourished (< P3), and 61.9% were at nutritional risk (between P3 and P10). Height-for-age deficit was the most frequent, and the age group mostly affected was 12 to 24 months. Among those at nutritional risk, 50.1% completed the follow-up, 33.5% did not start follow-up, and 16.4% were lost to follow-up. 41.3 % recovered nutritional health, 10.2% showed some improvement, without correcting their anthropometric deficits. 39.8% did not show any improvement, and 8.7% had worsening of their deficits. Recovery of nutritional health occurred, on average, within 7.5 months. This study showed the importance of following up children at nutritional risk and indicates that some aspects should be improved in surveillance programs. Such improvements may reduce the number of children lost to follow-up.

GENDER AND AGE DIFFERENCES IN ANEMIA PREVALENCE DURING THE LIFECYCLE IN KUWAIT

Anemia remains a significant worldwide public health problem. Most studies of anemia and iron deficiency, the major cause of anemia, have targeted small children and reproductive age women. Much less is known about anemia in other lifecycle groups, especially preschool age children, prepubertal boys and girls, or in older adults. Yet recent studies indicate that anemia may increase the risk for chronic diseases and accelerate declining function in older adults. We examined anemia throughout the lifecycle in Kuwait by analyzing data from the 2002 Kuwait Nutrition Surveillance Program. Over 13,000 individuals of both sexes representing all ages were studied. The prevalence of anemia was higher in females than males between 6 months and 3 years. From age 4 to 14 years, there was a reversal with males having a higher rate of anemia. Older females had a lower prevalence of anemia than younger females. These results imply certain policy options.

Home-delivered meals benefit the diabetic elderly

he importance of a regular meal pattern is commonly stressed to elderly diabetic persons and to their caretakers. This recommendation takes forgranted that there are no physical or financial barriers to buying or preparing food. The diabetic elderly who fail to comply with their diets are assumed to lack motivation, intelligence, or both (1-3). By removing these barriers, home-delivered meals (HDMs) may improve the eating patterns of the diabetic elderly and in turn improve control of their diabetes. Because of the increasing incidence of diabetes in the aging population, the number of people who could be helped by HDMs is considerable. For example, in a recent study of HDMs in New York State, 20% of recipients reported that they had diabetes (4). The study reported here, undertaken by the New York State Nutritional Surveillance program, examined the effects of an HDM program on food insecurity, dietary practices, and control of diabetes in an elderly diabetic population.

Within month variability in use of soup kitchens in New York State. p4.

This paper describes the variation in use of soup kitchens throughout the month using data from the New York State Nutritional Surveillance Program. Excluding November, December, and May, when holiday meals created a different pattern of use, number of meals served in soup kitchens generally increased toward the end of the month, averaging 43 per cent higher for Upstate and 14 per cent higher for New York City in the last week as compared to the first week of the month. The overall increase throughout the month and difference in the magnitude of increase between Upstate and New York City corresponds to the timing of income maintenance benefits distribution. Distribution of most public assistance benefits occurs at the beginning of each month in Upstate, whereas it is staggered in New York City throughout the month.