Nutrition Literacy Measurement Tool With Multiple Features for Chinese Adults

Background: Nutrition literacy is an emerging term which is increasingly used in policy and research. Progression is limited by the lack of an accepted method to measure nutrition literacy in Chinese adult, even research in this area is growing. Objective: The objective of this study is to develop a valid instrument to assess nutrition literacy in Chinese adults. Methods: The process involved 2 steps: constructed nutrition literacy conceptual framework, and developed potential items of scale based on literature review; and conducted 2 rounds of Delphi consultation to select items of the preliminary questionnaire. Results: In Delphi survey, the content validity index for each domain, level, and dimension of nutrition literacy was 1.0, coefficient of variation was less than 0.10, and Kendall’s coefficient of concordance was greater than 0.83. All of the 2 domains, 3 levels, and 6 dimensions initially formulated by our research team were reserved in the conceptual framework of nutrition literacy. Furthermore, a 43-item nutrition literacy measurement scale was established. Each item kept in the final scale reaches a high degree of concentration and a high degree of coordination, with the mean of importance ranging from 4.38 to 5.00. Conclusions: A nutrition literacy measurement scale with multiple features was established for Chinese adults, providing an operationalized tool to assess comprehensively nutrition literacy for research and practice in the field of nutrition, diet, and health.

Influence of calcineurin inhibitors and genetic polymorphism of transporters on enterohepatic circulation and exposure of mycophenolic acid in Chinese adult renal allograft recipients

Aim: Study the influence of calcineurin inhibitors (CNI) and genetic polymorphisms of transporters on enterohepatic circulation (EHC) of mycophenolic acid (MPA) in Chinese adult renal allograft recipients and estimate the effect of various covariates on prediction performance of MPA AUC0-12h. Method: MPA concentrations of 125 Chinese patients were collected 0-12 hours after administration. Genotypes of transporters were determined in 64 patients. The influence of type of CNI and genetic polymorphisms on MPA exposure was studied. Shapley additive explanations method was used to study the impact of sampling times and covariates related to EHC on AUC0-12h. Extreme gradient boosting (XGboost) machine learning-based model was established to predict AUC0-12h. Results: Dn-AUC6-12h was significantly lower in patients co-administered with CsA (P<0.05). When co-administered with TAC, for SLCO1B1 T521C or ABCC C-24T, patients with wild-type genotype had significantly higher dn-AUC6-12h (P <0.05). Patients with SLCO1B3 334T/699G alleles had significantly lower dn-AUC6-12h than homozygotes (P=0.004). No significant difference was found in CsA subgroup. For estimating AUC0-12h, C0h, C2h, C8h, type of CNI, transporters genotypes and the difference between C0h and C2h were retained in the final model, which had good prediction performance (r2=0.9739). Conclusion: Patients co-administered with CsA had lower MPA EHC than those who received TAC. MPA EHC is affected by ABCC2 C-24T, SLCO1B3 T334G/G699A, and SLCO1B1 T521C genotypes in patients treated with TAC. Type of CNI and genetic polymorphisms of transporters can improve prediction performance of MPA AUC0-12h estimating model, developed using XGboost machine learning method.

Inverse Association of Plasma Molybdenum with Metabolic Syndrome in a Chinese Adult Population: A Case-Control Study

Molybdenum has been found to be associated with metabolic disorders. However, the relationship between molybdenum and metabolic syndrome (MetS) is still unclear. A large case-control study was conducted in a Chinese population from the baseline of Ezhou-Shenzhen cohort. A total of 5356 subjects were included with 2678 MetS and 2678 controls matched by sex and age (±2 years). Medians (IQRs) of plasma molybdenum concentrations were 1.24 μg/L for MetS cases and 1.46 μg/L for controls. After adjustment for multiple covariates, the odds ratio (OR) and 95% confidence intervals (CIs) for MetS were 1.00 (reference), 0.71 (0.59–0.84), 0.56 (0.46–0.68), and 0.47 (0.39–0.58) across quartiles of plasma molybdenum, and per SD increment of log-transformed molybdenum was associated with a 23% lower risk of MetS. In the spline analysis, the risk of MetS and its components decreased steeply with increasing molybdenum and followed by a plateau when the cutoff point was observed around 2.0 μg/L. The dose-dependent relationship of molybdenum with MetS remained consistent when considering other essential elements in the Bayesian kernel machine regression (BKMR) model. In our study, higher plasma molybdenum was significantly associated with a lower risk of MetS, as well as its components, in a dose-response manner.

Dietary Inflammatory Index and the Risk of Hyperuricemia: A Cross-Sectional Study in Chinese Adult Residents

Background: Dietary Inflammatory Index (DII) scores have been consistently associated with several chronic diseases. This study explored the correlation between the DII and hyperuricemia in Chinese adult residents. Methods: The study included 7880 participants from the China Health and Nutrition Survey (CHNS), which was taken in in 2009. A 3-day 24 h meal review method was used to collect diet data and to calculate the DII score. Serum uric acid was obtained to determine hyperuricemia levels. Subjects were divided into a hyperuricemia group and a non-hyperuricemia group, according to their serum uric acid level. Multilevel logistic regression models were used to examine the association between DII scores and hyperuricemia. Results: After adjusting for covariates, a higher DII score was determined to be associated with a higher risk of hyperuricemia. Compared to those in the highest DII score group, the lower DII score group had an inverse association with hyperuricemia risk (Q2: 0.83, 95% CI: 0.70–0.99; Q3: 0.72, 95% CI: 0.60–0.86; Q4: 0.73, 95% CI: 0.61–0.88). The intake of energy-adjusted protein, total fat, MUFAs, PUFAs and saturated fatty acid was higher in the hyperuricemia group. Conclusions: A higher DII score is significantly associated with a higher risk of hyperuricemia. Controlling the intake of pro-inflammatory food may be beneficial to reduce the risk of hyperuricemia.

Neuro-Cognitive Differences in Semantic Processing Between Native Speakers and Proficient Learners of Mandarin Chinese

The present study aimed to investigate the neural mechanism underlying semantic processing in Mandarin Chinese adult learners, focusing on the learners who were Indo-European language speakers with advanced levels of proficiency in Mandarin Chinese. We used functional magnetic resonance imaging technique and a semantic judgment task to test 24 Mandarin Chinese adult learners (L2 group) and 26 Mandarin Chinese adult native speakers (L1 group) as a control group. In the task, participants were asked to indicate whether two-character pairs were related in meaning. Compared to the L1 group, the L2 group had greater activation in the bilateral occipital regions, including the fusiform gyrus and middle occipital gyrus, as well as the right superior parietal lobule. On the other hand, less activation in the bilateral temporal regions was found in the L2 group relative to the L1 group. Correlation analysis further revealed that, within the L2 group, increased activation in the left middle temporal gyrus/superior temporal gyrus (M/STG, BA 21) was correlated with higher accuracy in the semantic judgment task as well as better scores in the two vocabulary tests, the Assessment of Chinese character list for grade 3 to grade 9 (A39) and the Peabody Picture Vocabulary Test-Revised. In addition, functional connectivity analysis showed that connectivity strength between the left fusiform gyrus and left ventral inferior frontal gyrus (IFG, BA 47) was modulated by the accuracy in the semantic judgment task in the L1 group. By contrast, this modulation effect was weaker in the L2 group. Taken together, our study suggests that Mandarin Chinese adult learners rely on greater recruitment of the bilateral occipital regions to process orthographic information to access the meaning of Chinese characters. Also, our correlation results provide convergent evidence that the left M/STG (BA 21) plays a crucial role in the storage of semantic knowledge for readers to access to conceptual information. Moreover, the connectivity results indicate that the left ventral pathway (left fusiform gyrus-left ventral IFG) is associated with orthographic-semantic processing in Mandarin Chinese. However, this semantic-related ventral pathway might require more time and language experience to be developed, especially for the late adult learners of Mandarin Chinese.

Association between relative handgrip strength and hypertension in Chinese adults: An analysis of four successive national surveys with 712,442 individuals (2000-2014)

Objectives This study aimed to identify the 15-year trends of handgrip strength-to-weight (relative HS) and assess the association between relative HS and hypertension among Chinese adults aged 20–69. Methods Using a complex, stratified, multistage probability cluster sampling, we analyzed data collected from 712,442 adults aged 20–69 years in four successive national surveys (2000–2014). We used a handheld dynamometer to measure strength and divided by body weight to calculate the relative HS. Blood pressure was recorded with a sphygmomanometer and hypertension was defined as resting systolic blood pressure at least 140 mmHg or diastolic at least 90 mmHg. The Mann-Kendall trend test examined trends in relative HS over time. We also computed odd ratios (OR) and 95% confidence intervals (95% CI) by tertile of relative HS and examined the association between relative HS and hypertension. Results The relative HS level decreased with the increase of age in both male and females (p trend <0.001). In each of four surveys, one interquartile decrease in relative HS was associated with an increased risk of hypertension by 44% (OR = 1.44, 95%CI: 1.40–1.47), 58% (OR = 1.58, 95%CI: 1.54–1.62), 48% (OR = 1.48, 95%CI: 1.45–1.52), 43% (OR = 1.43, 95%CI: 1.40–1.47), respectively. Conclusion In the Chinese adult population, the relative HS level decreased from 2000 to 2014 across all ages in both males and females. A lower relative HS was associated with a higher risk of hypertension. The findings provided evidence for the association between muscle strength and hypertension in large-scaled population.

Sex-Specific Differences in the Associations Between Omega-6 Polyunsaturated Fatty Acids and Type 2 Diabetes in Chinese People

Background: Some evidence indicates a potential beneficial effect of omega-6 polyunsaturated fatty acids (n-6 PUFAs) on type 2 diabetes mellitus (T2DM); however, the findings to date remains inconclusive and little is known about whether sex modifies these associations. Therefore, this study aimed to investigate potential sex-specific differences in this associations among Chinese adults.Methods: We conducted a cross-sectional study in an area of Dalian city, China; Chinese men and women who attended the Department of Clinical Nutrition and Metabolism between January and December 2020 were invited to participate in this study. All participants were assessed for basic demographic characteristics, fasting blood glucose, HbA1c, and other serum biomarkers and serum phospholipid FAs.Results: In total, 575 Chinese adult participants (270 men and 305 women) were included in the analysis. Hypertension and dyslipidaemia were more common among men than women, but there were no significant differences between the sexes in fatty acid composition, except for eicosadienoic acid (EA; 20:2n-6) and total monounsaturated fatty acids (MUFA). The age-adjusted OR for having T2DM in the highest quartile of arachidonic acid (20:4n-6) level was 0.47 (95% CI, 0.22, 0.98) in men, and this association remained consistently significant in the fully adjusted multivariate models. In contrast, no significant associations between n-6 PUFAs and T2DM risk were observed in women, regardless of model adjustment.Conclusions: In conclusion, these results demonstrate a notable sex-specific differences in the associations between n-6 PUFAs and T2DM. Higher n-6 PUFA status may be protective against the risk of T2DM in men.