Nutrition Survey 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.

Malnutrition: A Longstanding Challenge in India

Abstract: According to the World Health Organization, “malnutrition is the “deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients”. Indian population has the highest rate of adolescent malnutrition. Deficiency, Illness, Small level of education, and a range of other factors contribute to India's malnutrition crisis. Undernutrition, micronutrient deficiency conditions, and overnutrition are all forms of malnutrition. A malnourished always lags in every aspect of life which will eventually affect the productivity of the country. In the 2023 Global Hunger Index, India is positioned at 111th among 125 countries, reflecting a serious level of hunger with a score of 28.7. India is grappling with a substantial population affected by anemia, malnutrition, and obesity. Other than this Indian population is also affected by several other micronutrient deficiencies. The present article provides an overview of the triple burden of malnutrition in India by applying the literature review method and the data were collected from online sources such as government survey reports, articles, and publications related to nutrition, healthcare status, healthcare indicators, nutritional indicators, and healthcare survey reports, etc. A brief introduction of the strategies followed by the Government as well as global health organisations to combat the issue is also discussed.

Ochratoxin a levels in Turkish coffee: a probabilistic health risk assessment via Monte Carlo simulation.

Throughout history, Turkish coffee has been the most widely consumed type of coffee in Turkey. Therefore, the goal of this study was to determine the amount of ochratoxin A (OTA) present in Turkish coffee and to analyze any potential health hazards. A total of 41 Turkish coffees were collected and analyzed for OTA activity using a competitive enzyme immunoassay (ELISA). Furthermore, dietary exposure and health risk assessments for the Turkish population were calculated based on analytical results and coffee consumption data from the Turkish Nutrition and Health Survey 2019 (TNHS-2019) in three age categories (15-18, 19-64, and 65 + years). Nine of the samples contained more than 2.5μg/kg OTA, with an average of 5.24μg/kg. The OTA concentration in 3 samples exceeded the permissible maximum limit (5μg/kg) established by Turkish legislation, and the mean concentration was 8.41μg/kg. A margin of exposure (MOE) approach was used for risk characterization, considering both non-neoplastic and neoplastic consequences. There were no concerns about health risks because MOEs were more than 10,000 for all categories. Although the levels of OTA analyzed in Turkish coffee did not pose a risk to individuals in the three age categories, emphasis should be placed on minimizing and controlling OTA concentrations in Turkish coffee. Additionally, it is also necessary to consider other food sources that could contribute to OTA exposure.

Changes in Health Spending During the COVID-19 Pandemic by Expenditure Type and Household Profiles in Mexican Households

ObjectiveThis study aimed to analyze the changes in the health expenditure of households in Mexico during the COVID-19 pandemic to approximate changes in healthcare that can lead to difficulties in detecting noncommunicable diseases, among others. MethodsWe compare health spending before and after the pandemic through various estimators using multivariate linear regression models at the household level. We also explore heterogeneous effects by zone, sex, and household composition by age. We explore potential mechanisms of change estimating probit models of healthcare. We use microdata from the National Health and Nutrition Survey 2018 and COVID-19. ResultsThe results suggest a significant reduction in health spending, mainly referring to oral health, clinical analysis, and medical studies. Moreover, differences arise by type of area and household age profile. Changes are more significant among families with children younger than 12 years and households situated in urban areas. Regarding the mechanisms, the results suggest that the lower spending is not due to fewer health needs but rather due to less healthcare attention. ConclusionThe COVID-19 pandemic had a significant and heterogeneous impact on household health spending. This lower spending could lead to less detection of noncommunicable diseases, translating into more pressure on the health system in the medium and long term.

A study of oral health and quality of life in patients with dyslipidemia

Objectives: This study analyzed factors influencing oral health and quality of life in patients with dyslipidemia using raw data from the first year (2019) and third year (2021), where the quality of life was assessed using the HINT-8 tool from the 8th National Health and Nutrition Survey data. Methods: Frequency analysis, descriptive statistics, general linear model analysis, and linear regression analysis were performed on the collected data using SPSS program 26.0, and the data of 1,926 participants were analyzed. Results: The mean quality of life (HINT-8) score was 0.78 out of 1.00. Quality of life according to general characteristics, showed significant differences according to gender, age, household income, education level, lifetime smoking status, and lifetime alcohol consumption. In terms of oral health, it significantly differed according to chewing discomfort, speaking discomfort, oral examination history, toothbrushing frequency, toothache history, untreated dental care needs, subjective oral health status and use of oral care products. The predictors of quality of life were gender, household income, education level, lifetime alcohol consumption, chewing discomfort, speaking discomfort, toothache history, and untreated dental care needs. Conclusions: These results confirm that oral health influences the quality of life of patients with dyslipidemia and are expected to provide basic data for research on improving oral health and quality of life in these patients.

Consumption of low-calorie sweetened products and intakes of free sugar and energy among UK adults

Abstract Background Policies to reduce free sugar intake in the population often suggest alternative low or no sugar products that may contain low-calorie sweeteners (LCS). However, the health effects of LCS are controversial and little is known about whether free sugar and energy intake differ between people with varying levels of LCS product consumption. This study examines the associations between LCS product consumption and free sugar and energy intake in UK adults from 2008 to 2019. Methods Repeat cross-sectional data from the UK’s National Diet and Nutrition Survey (2008/09 to 2018/19) involve 8304 adults aged ≥18 years (mean 48.7, SD 18.3) with 58.4% being women. Consumption of LCS products (grams/day) were obtained from 4-day diet diaries and participants were categorized into four groups (No-LCS, Low-LCS, Mid-LCS, High-LCS) based on LCS consumption tertiles in 2008/09. Linear regression analysed associations with LCS group, year, their interaction, and adjusted for sociodemographic factors. Results All four groups consumed free sugar (relative to total energy intake) above recommended levels (5% kcal/day) throughout the study period. In 2008/09, the mean free sugar intake for the No-LCS group was 58.1 grams/day, and the mean total energy intake was 1855.7 kcal/day, which were not significantly different from the High-LCS group. Over time, free sugar intake declined by -1.0 g/year (95%CI: -1.4, -0.6) whereas total energy intake declined by -6.0 kcal/year (95%CI: -11.4, -2.1) in the No-LCS group. The High-LCS group showed similar declines leading to no significant difference in mean free sugar and total energy intake between the No-LCS and High-LCS groups in 2018/19. Conclusions In this representative study of UK adults, similar levels of free sugars and total energy intake were observed among those with no LCS and those with the highest LCS product consumption from 2008 to 2019. Absence of LCS product consumption in diets were not associated with higher free sugar intake. Key messages • The high level of LCS product consumption was not associated with lower free sugar intake among UK adults. These finding challenges policies promoting LCS to reduce UK adults’ free sugar intake. • The finding that UK adults consistently consumed free sugar above recommended levels highlights the ongoing need for policy interventions.

Association between normal range UACR and insulin resistance and prediabetes among US adults:

Abstract Background Recent studies have shown that urine albumin-to-creatinine ratio (UACR) within the normal range is associated with increased risk of hypertension, diabetes, cardiovascular death and all-cause death. However, the relationship between normal range UACR and the prevalence of insulin resistance (IR) and prediabetes has not been explored. Methods The study included 14,208 US adults with normal range UACR values and without diabetes from the National Health and Nutrition Survey (1999-2018). The outcome variables included IR and prediabetes, as defined by the 2013 American Diabetes Association guidelines. The weighted multivariate linear regression, weighted multivariate logistic regression, restricted cubic spline (RCS) regression, and subgroup analysis were conducted to examine the relationship of UACR with IR and prediabetes. Results The weighted multivariate linear regression analysis showed that a 1-standard deviation (SD) increment in ln (UACR) was positively associated with fasting plasma glucose (FPG) (β = 0.02, 95% CI: 0.01, 0.04), glycosylated hemoglobin (β = 0.01, 95% CI: 0.00, 0.02), fasting serum insulin (FSI) (β = 0.50, 95% CI: 0.31, 0.68), and homeostasis model assessment of insulin resistance (HOMA-IR) (β = 0.14, 95% CI: 0.09, 0.19). The weighted multivariate logistic regression analysis revealed that a 1-SD increment in ln (UACR) was significantly associated with an increased prevalence of prediabetes (OR = 1.10, 95% CI: 1.04-1.15), but not with IR (OR = 1.05, 95% CI: 0.99-1.12). With the lowest quartile of UACR as a reference, ORs (95% CIs) for IR in the second, third, and fourth quartiles were 1.10 (0.86, 1.15), 1.15 (0.98, 1.33), and 1.12 (0.95, 1.32), respectively, and ORs (95% CIs) for prediabetes were 1.35 (1.19, 1.52), 1.32 (1.14, 1.53), and 1.44 (1.24, 1.66), respectively. Subgroup analysis indicated that smoking had a significant impact on the association between UACR and prediabetes. The association between UACR and prediabetes was more significant in smokers than in non-smokers (P for interaction = 0.03). RCS regression analysis revealed a non-linear positive dose-response association between UACR and indicators of diabetes. Conclusion Elevated UACR, even within the normal range, was positively associated with indicators of diabetes and increased prevalence of prediabetes among US adults. Smoking had a significant impact on the association between UACR and prediabetes, with a more pronounced association observed among smokers.uacr with diabetes markersUacr with ir and prediabetes

Accuracy of body weight perception: The Case of Türkiye

Abstract Background Accuracy of body weight perception is defined as the extent to which an individual’s self-assessment of their body weight aligns with their actual body weight. Our study evaluates the accuracy of body weight perception, an important factor in preventing and managing obesity and overweight, according to sociodemographic factors. Methods This study utilizes data from the nationwide cross-sectional ‘Nutrition and Health Survey 2017’. The survey includes 12,266 participants who were interviewed face-to-face. Factors influencing the accuracy of body weight perception were evaluated using the chi-square test. Subsequently, the logistic regression models were constructed to assess factors that were statistically significant (p &amp;lt; 0.05). Results The prevalence of obesity and overweight was found to be 36.3% and 71.5%, respectively. The accuracy of body weight perception was 39.2%, underestimation was 57.0%, and overestimation was 3.8%. There was no significant difference in accuracy of body weight perception between sexes (p = 0.94). According to logistic regression analysis (n = 12.168), accuracy of body weight perception was higher among individuals who were not overweight compared to those who were overweight (p &amp;lt; 0.001, OR: 4.56, CI: 4.16-4.98), among those aged 15-44 compared to those aged 45 and over (p &amp;lt; 0.001, OR: 1.47, CI: 1.35-1.60), among those with high school and higher education compared to those with middle school education or less (p &amp;lt; 0.001, OR: 1.43, CI: 1.31-1.56), among unmarried individuals compared to married ones (p = 0.011, OR: 1.12, CI: 1.03-1.23), and in individuals with poor income status compared to good (p = 0.005, OR: 1.13, CI: 1.04-1.22). Conclusions In health promotion programs aiming to perceive body weight accurately, priority should be given to people with overweight, those with low education levels, married individuals, people aged 45 and over, and individuals with low income. Key messages • Accuracy of body weight perception is important in fighting obesity. • Individuals with overweight, have a low level of education, are married, aged 45 and over, and have low income are misperceive their body weight to a greater extent.

Addressing deficits in malnutrition care in northern Sierra Leone; an educational intervention

Abstract The 2017 Sierra Leone National Nutrition Survey reported poor practice regarding the medical management of severe acute malnutrition and the provision of emergency food to patients, particularly in the northern city of Makeni. We developed a training package for paediatric nurses, aiming to design an easily reproducible format which could be utilised nationally. Our aims were to empower and educate staff to provide more consistent care by challenging the negative cultural perception of malnourished patients and increasing knowledge of key guidelines. A two-day course based around UNICEF guidance on malnutrition was developed with the financial support of the Sierra Leonean office of the World Health Organisation. We sought the advice of local staff on issues impacting the quality of malnutrition care, including cultural barriers, educational limitations and supply issues. Lectures and practical sessions were devised covering recognition, assessment and management. Communication skills were taught using role play, focussing on the key role of nurses in parental education, and nursing skills were reinforced using practical tasks. Local staff identified for their strong teaching and leadership were recruited as instructors and to provide feedback on session design and content. 21 candidates attended from across the region, with the majority based in inpatient feeding units. Candidates completed a pre- and post-course written examination and a qualitative feedback form. Pre-course exam results ranged from 35%-85% with an average of 65%; post-course results showed improvement with a range of 55%-100% and an average of 88%. Candidates rated the course on average 9.7 out of 10 and the written feedback was positive. We subsequently observed positive changes in clinical practice in the inpatient feeding units across the region. Based on these assessments the course achieved its aims. Further study is needed to know if noted clinical improvements were sustained. Key messages • Challenging local cultural perceptions of malnourished patients is crucial to establishing improvement in medical care for this group. • Sustainable educational intervention requires local instructors who can independently deliver teaching, and establishing this cohort at the course inception is critical to its ongoing success.

An increasing trend of overweight and obesity in the Japanese incident end-stage kidney disease population.

The global prevalence of overweight/obesity has been rising, and this trend is apparent in US and European incident end-stage kidney disease (ESKD) populations. We aimed to examine temporal trends in the prevalence of overweight/obesity and underweight among adult incident ESKD patients in Japan by year of dialysis initiation between 2006 and 2019 in comparison with those observed in the Japanese adult population during the same period. Using data from the Japanese Society of Dialysis Therapy Renal Data Registry and the National Health and Nutrition Survey, the sex-specific prevalence of overweight/obesity and that of underweight (BMI ≥ 25 kg/m2 and <18.5 kg/m2, respectively) were calculated, adjusted for age according to the 2019 Population Census via the direct method. Average annual percentage changes (AAPCs) and corresponding 95% confidence intervals (CIs) were calculated to examine trends. From 2006 to 2019, the age-adjusted prevalence of overweight/obesity in the incident ESKD population increased for males (AAPC 3.36 [95% CI, 2.70 to 4.09]) and females (AAPC 2.86 [95% CI, 1.65 to 4.19]). The age-adjusted prevalence of overweight/obesity in the general population increased for males (AAPC 0.87 [95% CI, 0.26 to 1.42]) but not for females (AAPC 0.01 [95% CI, -0.55 to 0.57]). The age-adjusted prevalence of underweight in the incident ESKD population significantly decreased but was higher than that in the general population for both sexes. An increasing trend of overweight/obesity was observed in the incident ESKD population in Japan. There is a pressing need to address both underweight and overweight/obesity in the incident ESKD population.

Dose–Response Relationship Between Serum 25(OH)D and the Risk of Abnormal Glycemic Status in Chinese Older Adults

Background/Objectives: The relationship between serum 25-hydroxyvitaminD (25(OH)D) concentration and the risk of abnormal glycemic status remains contradictory. Whether sufficient 25(OH)D plays a role in reducing the risk of diabetes and prediabetes is debatable. Its dose–response relationship and the optimal 25(OH)D threshold are not clear. This study investigated the relationship between serum 25(OH)D and the risk of abnormal glycemic status to explore the optimal cut-off value. Methods: This study included 5856 Chinese older adults aged 60 years and above from the China Adult Chronic Disease and Nutrition Survey (CACDNS 2015–2017). Serum 25(OH)D concentration was measured via an enzyme-linked immuosorbent assay. Abnormal glycemic status in the present study includes diabetes and prediabetes. Statistical methods such as a locally weighted regression and smoothing scatterplot (LOESS), restricted cubic spline regression (RCS) and binary and trend logistic regression were used to explore the dose–response relationship and the optimal 25(OH)D threshold. Results: The concentration of 25(OH)D was nonlinearly related to the levels of FPG and HbA1C in the LOESS curves. The nonlinear relation between 25(OH)D and the risk of diabetes and prediabetes was illustrated in the RCS curves and the optimal 25(OH)D threshold beneficial for diabetes was preliminarily explored to be 29.06 ng/mL, but no threshold for prediabetes was found. The dose–response results showed that for each 1 ng/mL increase in 25(OH)D, the risk of the fasting glucose type of diabetes reduced by 2.1%, the risk of the abnormal HbA1C type of diabetes reduced by 2.2% and the risk of the mixed type of diabetes reduced by 1.7%, whereas a dose–response relationship was not found for prediabetes. Conclusions: Higher serum 25(OH)D concentrations in Chinese older adults were associated with a reduced risk of glycemic abnormalities. The optimal 25(OH)D cut-off value was sufficiently beneficial if the diseased diabetes risk was 29.06 ng/mL, but no threshold was found for prediabetes.

Mediterranean diet lowers risk of new-onset diabetes: a nationwide cohort study in China

BackgroundThe Mediterranean diet (MD) has shown promising results in preventing type 2 diabetes, particularly in Mediterranean and European populations. However, the applicability of these benefits to non-Mediterranean populations is unclear, with contradictory findings in the literature.MethodsIn this study, we included 12,575 participants without diabetes at baseline from the China Health and Nutrition Survey (CHNS). Dietary intake was measured by three consecutive 24-h dietary recalls. The Mediterranean diet adherence (MDA) was measured by a score scale that included nine components of vegetables, legumes, fruits, nuts, cereals, fish, red meat, dairy products, and alcohol. New-onset diabetes was defined as self-reported physician-diagnosed diabetes during the follow-up.ResultsDuring a median follow-up of 9.0 years, 445 (3.5%) subjects developed diabetes. Overall, there was an inverse association between the MDA score and new-onset diabetes (per score increment, HR 0.83, 95% CI 0.76–0.90). Moreover, age, sex, BMI, and energy intake significantly modified the association between the MDA score and the risk of new-onset diabetes (all P interactions < 0.05). Greater fruit, fish, and nut intake was significantly associated with a lower risk of new-onset diabetes.ConclusionThere was an inverse association between Mediterranean diet adherence and new-onset diabetes in the Chinese population.

Methodology for developing and validating Bangladesh healthy eating index: A study protocol.

One of the widely used methods for evaluating the overall quality of a diet is the Healthy Eating Index. In the present study protocol, we lay out the methodological approach to the development and validation of a healthy eating index specific for the Bangladeshi population (hereinafter referred to as Bangladesh Healthy Eating Index (BD-HEI)). Bangladesh Healthy Eating Index will be developed based on the Food-based dietary guidelines (FBDG) of Bangladesh. Using a scoring system that aligns with the eleven food groups outlined in the FBDG, the index will consist of eleven eating components. A cross-sectional community nutrition survey will be carried out among 1080 reproductive-aged women. Through this survey, quantitative dietary data will be collected following multiple pass 24h dietary recall method. Repeated 24-hour dietary data (of two consecutive days) will be collected from one-third of the respondents. Evaluating usual food and nutrient intake as well as the probability of nutrient intake adequacy, the study will examine the validity of the BD-HEI. Following a suitable statistical procedure, the reliability and construct validity of BD-HEI will be evaluated. Country-specific HEI can be used to assess the dietary quality of the people of that country. The findings from this research can inform policy decisions and strategies to promote healthier eating habits and combat the rising burden of diet-related diseases in the country.

Leisure sedentary time and elevated blood pressure: evidence from the statutory retirement policy

ObjectivesThe relationship between sedentary behaviors and elevated blood pressure remains inconclusive, and the socioeconomic mechanisms underlying the linkage are rarely discussed. Since retirement is often associated with behavioral changes that impact health, this study aims to provide evidence on changes in leisure sedentary time after the statutory retirement age on elevated blood pressure, along with the socioeconomic mechanisms.MethodsWe utilized data from five waves (2004–2015) of the China Health and Nutrition Survey (CHNS), focusing on males aged 55–65 employed in the formal sector. Leisure sedentary time, the independent variable, was measured based on self-reported data, while diastolic (DBP) and systolic (SBP) blood pressure were the dependent variables. Using statutory retirement policy as an exogenous variation, we employed a continuous difference-in-differences (DID) framework and a propensity score matching difference-in-differences (PSM-DID) approach to examine the relationship between changes in leisure sedentary time after the statutory retirement age and elevated blood pressure. The analysis was conducted using ordinary least squares (OLS). To address potential endogeneity, we applied the instrumental variable (IV) method via two-stage least squares (2SLS).ResultsOur findings indicate an increase in diastolic blood pressure after statutory retirement, attributed to increased leisure sedentary time. However, there was no significant increase in systolic blood pressure. Moreover, physical activity did not appear to offset this rise in blood pressure, while higher educational attainment and having family members employed in the medical field helped mitigate its negative effects.ConclusionThis study highlights the potential adverse impact of increased leisure sedentary time on diastolic blood pressure among middle-aged men in the formal sector, while also exploring the socioeconomic factors that may alleviate these effects. These results provide a foundation for public health initiatives aimed at addressing the rising prevalence of sedentary behavior and its association with blood pressure issues.

Development of Phil-HEI and its evaluation of the Filipino diet: 2018 expanded national nutrition survey

Development of Phil-HEI and its evaluation of the Filipino diet: 2018 expanded national nutrition survey

Sex-specific associations between body mass index trajectories and risk of hypertension

BackgroundAlthough it is well established that obesity is a risk factor for hypertension, the effect of distinct long-term patterns of body mass index (BMI) on blood pressure (BP) in later life is poorly understood.MethodsBased on the China Health and Nutrition Survey, we analyzed 2920 participants aged 3–17 years with initial normal BP at baseline (1991–2011), who were followed up for the development of hypertension (1993–2015). The group-based trajectory model was applied to identify BMI trajectories, and Cox regression was used to assess their associations with hypertension risk. Stratified analyses were conducted to explore differences across subgroups.ResultsDuring an average follow-up time of 11.20 (7.69) years for males and 7.20 (5.21) years for females, 339 males and 212 females were identified with hypertension, respectively. Three BMI trajectories were identified: low-increasing (60.58% of males and 73.03% of females), moderate-increasing (33.08% of males and 24.22% of females), and high-increasing (6.34% of males and 2.76% of females). Our study found a significant positive association between a higher BMI trajectory and hypertension risk in males (all P for trend < 0.05). Specifically, males in the high-increasing BMI group had a higher risk of hypertension compared with those in the low-increasing group (HR = 1.76, 95% CI: 1.04–2.97). Stratified analyses revealed stronger associations among smokers, drinkers, and inactive individuals.ConclusionOur findings suggest that maintaining a normal BMI and healthy lifestyle from childhood may lower subsequent risk of hypertension.

Improving case-detection of severe wasting among under-five-year-old children in Timor Leste: A secondary analysis of data from the 2020 national cross-sectional food and nutrition survey.

The World Health Organization recommends using weight-for-height Z-score (WHZ) <-3 or Mid-Upper Arm Circumference (MUAC) <115 mm as independent criteria for diagnosing severe wasting. However, there are several challenges in using the WHZ criterion. As a result, the MUAC (and edema)-only approach for identifying children needing treatment for severe wasting has been developed and is being rapidly scaled-up globally, including in Timor-Leste. But previous studies reported that MUAC<115 mm has poor diagnostic accuracy for detecting children with WHZ<-3. The two options being explored globally for improving the identification of these children in MUAC (and edema)-only programming contexts include expanding MUAC cut-off and the combination of the indicators MUAC and Weight-for-Age Z-score (WAZ). This study explored the accuracy for diagnosing severe wasting (WHZ<-3) of these two options in Timor-Leste. We conducted a secondary analysis of data from the 2020 national Timor-Leste Food and Nutrition Survey. We tested the accuracy of various MUAC cut-offs, and predefined case definitions in five age groups (0-5 months, 6-23 months, 24-59 months, 6-59 months, and 0-59 months). We calculated the standard diagnostic test parameters (sensitivity, specificity, Youden Index, and others) and used the Youden Index as the principal criterion for rating the overall level of accuracy. The sample analyzed comprised 11,056 children with complete information on our key variables (anthropometric data, age, and sex), of whom 52.2% were boys. The age groups 0 to 5 months, 6 to 23 months, and 24 to 59 months represented 9.0%, 33.7%, and 57.3% of the sample, respectively. We found that the optimal diagnostic MUAC cut-off varied across the age groups between 117 mm and 142 mm, with the Youden Index remaining < 55% in all the age groups considered. The use of case definitions combing MUAC and WAZ optimized the identification of children with WHZ<-3. The case definition MUAC<130 mm or WAZ<-3 Z-score had the best diagnostic accuracy in all the age groups except for the 0 to 5 months age group for which the case definition MUAC<110 mm or WAZ<-2 Z-score had the highest Youden Index. Our findings show that it is challenging to significantly improve diagnostic accuracy for identifying children with WHZ<-3 by only expanding the MUAC cut-off in under five Timorese children. However, In settings facing challenges in using WHZ, the combination of MUAC and WAZ indicators offers a promising approach. Further research is needed to confirm the effectiveness of the proposed combination of MUAC and WAZ indicators case definitions in a programmatic context in Timor-Leste, and other similar contexts.

Associations between cooking methods and socio-demographic, dietary and anthropometric factors: results from the Swiss National Nutrition Survey.

Appropriate cooking methods can improve food safety, decrease contaminants and increase nutrient bioavailability. Few studies assessed the sociodemographic characterization of their use in European populations. We aimed to characterize the socio-demographic, lifestyle, and anthropometric predictors of cooking methods in the Swiss population. adults aged 18-75 years (n=2,050) participating in the cross-sectional national nutrition survey in Switzerland (menuCH) (2014-2015), representing the 7 main regions in the country. We used logistic regressions to assess the probability of presence or absence of boiled, roasted, microwaved, oven-cooked, gratinated, fried, steamed, and grilled foods by sociodemographic variables. Among all participants, the most frequently used cooking methods were boiling (46%), stove-cooking (19%), and steaming (8%). Single participants had a higher probability of consuming grilled or fried foods (68%) than their married counterparts and participants with obesity had a higher probability of consuming grilled or fried foods (67% or 135%) compared to those with normal weight. Divorced or separated participants had a 55% lower probability of consuming roasted foods than married participants. Those following a diet had a 57% lower probability of consuming grilled foods compared to those not on a diet. We found differences in the distribution cooking methods of the Swiss population by sociodemographic variables. Further studies should examine the link between cooking methods and disease risk.

Intraindividual Discordance Between Remnant Cholesterol and Low-Density Lipoprotein Cholesterol Associated With Incident Stroke: Results From 2 National Cohorts.

The atherogenic effect of remnant cholesterol is being increasingly acknowledged. This study aimed to explore the association of discordance between remnant cholesterol and low-density lipoprotein cholesterol with stroke onset using 2 Chinese national cohorts. We studied 11 139 participants from CHARLS (China Health and Retirement Longitudinal Study) and 5993 participants from CHNS (China Health and Nutrition Survey) aged 45 years or older. The discordance between remnant cholesterol and low-density lipoprotein cholesterol was defined using the difference in percentile units (>15 units). There were 988 (8.9%) and 128 (2.1%) stroke events reported during follow-up in the 2 cohorts. Elevated remnant cholesterol was significantly associated with a higher risk of total stroke in 2 cohorts. After adjusting for remnant cholesterol level, the discordantly high remnant cholesterol group was significantly associated with an increased stroke risk (CHARLS: subdistribution hazard ratio [sHR], 1.31 [95 CI, 1.10-1.55]; CHNS: sHR, 1.84 [95 CI, 1.15-3.08]) compared with the discordantly low group. Consistent results were shown even among those with optimal low-density lipoprotein cholesterol level. The discordance between remnant cholesterol and low-density lipoprotein cholesterol, representing the intraindividual discrepancy, is significantly associated with stroke onset among Chinese adults.

Association of dietary patterns with serum uric acid and hyperuricemia in Chinese adults

Objective: To analyze the dietary patterns of Chinese adults and explore the relationship with serum uric acid (SUA) and hyperuricemia (HUA). Methods: A total of 9 358 adults were selected in the 2018 China Health and Nutrition Survey. Dietary intake data were collected by three consecutive 24-hour dietary recalls and weighing method. The social demographic information of the survey subjects was obtained through questionnaire surveys. The dietary patterns were extracted using factor analysis, and the relationship between dietary patterns and SUA was analyzed using multiple linear regression analysis. The correlation between HUA and dietary patterns was analyzed using logistic regression analysis models. Results: Four dietary patterns were identified: northern (high intakes of wheat, other cereals,and tubers); modern (high intakes of fruit, dairy, eggs, and nuts); southern (high intakes of rice and vegetables);animal food-wine (high intake of organ meats, seafood, and wine). The multiple linear regression analysis results showed that the northern pattern was negatively correlated with SUA (β=-0.438, 95%CI: -0.500--0.376); the modern pattern was negatively correlated with SUA (β=-0.134, 95%CI: -0.219--0.049); the southern model was significantly correlated with higher SUA (β=0.146, 95%CI: 0.079-0.214); the animal food-wine pattern was positively correlated with SUA (β=0.188, 95%CI: 0.123-0.252). Logistic regression analysis showed that compared with the northern model score Q1 group, the risk of developing HUA was reduced in Q3 and Q4 groups, with ORs values of 0.777 (95%CI: 0.650-0.929) and 0.509 (95%CI: 0.423-0.613), respectively; and compared with the modern model score Q1 group, the higher the scores in Q3 and Q4 groups, the HUA was lower, with ORs of 0.793 (95%CI: 0.660-0.953) and 0.768 (95%CI: 0.631-0.934), respectively. Compared with the animal food-wine pattern score Q1 group, the risk of developing HUA was increased in both Q3 and Q4 groups (Q3 group: OR=1.224, 95%CI: 1.012-1.480; Q4 group: OR=1.312, 95%CI: 1.086-1.584). Conclusions: Dietary patterns are associated with HUA. The northern and modern patterns are related to lower SUA levels and reduced risk of HUA, while the animal food-wine pattern increases the risk of HUA.