Background The decline of physical activity in the elderly due to aging may increase the risk of sarcopenia. Currently, there is a lack of evidence from large natural populations on the relationship between PA and sarcopenia. Objective To explore the relationship between PA and sarcopenia in the elderly aged 60 years and above in 10 provinces (autonomous regions) of China. Methods Data were retrieved from the 2022—2023 round of the China Development and Nutrition Health Impact Cohort. Personal basic information and PA data were collected by questionnaire survey. Skeletal muscle mass was measured by bio-electrical impedance analysis, muscle strength was measured using a grip dynamometer, and physical performance was reflected by 6-meter walk speed. The Asian Working Group for Sarcopenia (AWGS) 2019 criteria were used to diagnose sarcopenia. Light physical activity (LPA) duration, moderate-to-vigorous physical activity (MVPA) duration, and total physical activity volume were calculated. A total of 3326 residents aged ≥60 years with complete data were selected as the survey participants. Multiple logistic regression models and restricted cubic splines (RCS) were used to assess the association between PA duration/volume and sarcopenia. Results In 10 provinces (autonomous regions) of China, the prevalence of sarcopenia in the elderly aged 60 years and above was 5.5% (95%CI: 4.7%, 6.2%). The logistic regression analysis showed that compared with the elderly reporting 0-7.0 h·week⁻¹ in LPA duration, the risk of sarcopenia in the elderly with LPA duration of >14.0-21.0 h·week⁻¹ was reduced by 51% (OR=0.49, 95%CI: 0.26, 0.96). Compared with the elderly with total physical activity ≥15.0 metabolic equivalent of task (MET)-h·week⁻¹, those with <7.5 MET-h·week⁻¹ had a 2.24-fold increased risk of sarcopenia (OR=2.24, 95%CI: 1.17, 4.29). The RCS results found that LPA duration and total physical activity volume each showed a nonlinear dose-response relationship with the risk of sarcopenia (P_overall<0.05, P_non-linear<0.05). Compared with the elderly with an LPA duration of 0 h· week⁻¹, the risk of sarcopenia in the elderly with an LPA duration of 12.6 h· week⁻¹ was the lowest (OR=0.42, 95%CI: 0.21, 0.83). Compared with the elderly with a total physical activity volume of 15.0 MET-h· week⁻¹, the elderly with a total physical activity volume of 46.0 MET-h· week⁻¹ had the lowest risk of sarcopenia (OR=0.57, 95%CI: 0.38, 0.84). There was no statistically significant association between weekly MVPA duration and the risk of sarcopenia (P>0.05). Conclusion Increasing weekly LPA duration and total physical activity volume would help to reduce the risk of sarcopenia.

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.

Objective: To understand the malnutrition status and trends among children and adolescents, and to provide evidence for improving the nutritional status of children and adolescents in 9 provinces of China. Methods: A total of 5 746 children and adolescents aged 7-17 years old from the "China Health and Nutrition Survey" in 2000, 2006, 2011, 2015 and 2018 were selected as the subjects. Variance analysis and Chi square test were used to analyze the BMI of children and adolescents with different characteristics and different types of malnutrition. Linear regression model was used to analyze the trends of BMI, stunting and wasting, and overweight and obesity in children and adolescents with different characteristics. Results: From 2000 to 2018, the BMI of children and adolescents aged 7-17 increased from 17.66 kg/m 2 to 19.08 kg/m 2 ( F =22.88, P <0.05). The prevalence of overweight and obesity increased in both males and females( t =16.65,11.01, P <0.05). Comparison of the rates of wasting and Growth Retardation and overweight and obesity among children and adolescents aged 7-17 years in nine provinces in 2000, 2006,2 011, 2015 and 2018, the difference was statistically significant ( χ 2 wasting and grouth retardation =85.46, 29.55, 41.09, 29.86, 45.29; χ 2 overweight and obesity = 109.12 , 52.21, 98.23, 68.27, 52.49, P <0.05). Conclusion The prevalence of stunting and wasting of children and adolescents aged 7-17 in 9 provinces of China decreased. The prevalence of overweight and obesity showed an upward trend in 9 provinces of China. There were regional differences among the prevalence of stunting and wasting, as well as overweight and obesity. Active intervention strategies and measures should be taken to improve malnutrition and focus on the prevention of obesity in children and adolescents in China.

Objective:To investigate the predictive value of abnormal heart rate circadian rhythm for all-cause mortality in stage 5 chronic kidney disease (CKD 5) patients.Methods:The retrospective study was performed in CKD 5 patients enrolled from the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital) and the Affiliated BenQ Hospital of Nanjing Medical University from February, 2011 to December, 2019. A total of 159 healthy volunteers were enrolled as the healthy control group during the same period. The circadian rhythm of heart rate was monitored by 24-hour Holter. Related indices (including 24-hour, daytime and nighttime mean heart rate, night/day heart rate ratio, 24-hour maximum heart rate, 24-hour minimum heart rate and difference between maximum and minimum of 24-hour heart rate) were calculated. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Cox regression model was used to analyze the risk factors of all-cause mortality in CKD 5 patients. Kaplan-Meier survival curve and Log-rank test were used to compare the differences of cumulative mortality between high ratio group (night/day heart rate ratio>0.91) and low ratio group (night/day heart rate ratio≤0.91). The nonlinear relationship between night/day heart rate ratio and all-cause mortality was analyzed by restricted cubic spline plot. Time-dependent receiver operating characteristic (ROC) curve was used to analyze the predictive value of night/day heart rate ratio for all-cause mortality in CKD 5 patients.Results:A total of 159 healthy volunteers and 221 CKD 5 patients were included in this study. There were 123 males (55.66%) and the age was (52.72±13.13) years old in CKD 5 patients. The total median follow-up time was 50.0 months. Compared with controls, 24-hour, nighttime mean heart rate, 24-hour minimum heart rate in CKD 5 patients were increased (all P<0.05), furthermore, the night/day heart rate ratio was higher [(0.91±0.09) vs (0.81±0.08), P<0.001], showing "non-dipping heart rate". However, the 24-hour maximum heart rate and the difference between maximum and minimum of 24-hour heart rate in CKD 5 patients were lower than controls (both P<0.05). Multivariate Cox regression analysis showed that the increased night/day heart rate ratio (per 0.1 increase, HR=1.557, 95% CI 1.073-2.258, P=0.020) was an independent influencing factor for all-cause mortality in CKD 5 patients. Kaplan-Meier survival curve analysis showed that the cumulative mortality of the high ratio group was significantly increased than that of the low ratio group (Log-rank test χ 2=7.232, P=0.007). From the restricted cubic spline plot, there was a linear effect between night/day heart rate ratio and all-cause mortality ( P=0.141), and when night/day heart rate ratio was above 0.91, the risk of all-cause mortality was significantly increased in CKD 5 patients. According to time-dependent ROC curve, the accuracy of night/day heart rate ratio in predicting all-cause mortality was 70.90% even when the survival time was up to 70.0 months. Conclusions:The circadian rhythm of heart rate in CKD 5 patients displays "non-dipping" state. High night/day heart rate ratio is an independent influencing factor for all-cause mortality in CKD 5 patients.

Objective:To investigate the influence of environmental factors on body mass index of children and adolescents in China.Methods:Using data from the China Health and Nutrition Survey, the research object to 7 - 17 years old children and adolescents who participated in 2000, 2006, 2011, and 2015 round of survey with complete data, a total of 6 626 children and adolescents (male 3 473, female 3 153) were investigated under univariate analysis for each environmental factor variable before using Partial Least Square Regression fitting a linear model for further screening. Finally, we fitted a three-level linear mixed-effects model distinct by urban and rural area for analysis.Results:The three-level null model, log likelihood=-17 034.68, χ 2=483.06, P<0.001. Intern-class correlation coefficient ( ICC) showed that community-level was 9.97%, and both community and individual were 39.38%. The three-level model also showed that urban model's urbanization index ( β=-0.05, 95% CI: -0.09--0.01, P<0.05), the park location ( β=-0.88, 95% CI: -1.72 - -0.04, P<0.05), 15 - 17 age group ( β=-1.04, 95% CI:-1.78 - -0.30, P<0.05) were negatively correlated with BMI. The distance to the gym ( β=0.12, 95% CI: 0.02 - 0.22, P<0.05), the number of home TV sets ( β=0.50, 95% CI: 0.08 - 0.92, P<0.05) and the frequency of parents' alarm of fiction TV program contents ( β=1.85, 95% CI: 0.70 - 3.00, P<0.05) were correlated with BMI. Rural urbanization index ( β=-0.04, 95% CI:-0.07 - -0.01, P<0.05). Rural per capita income ( β=-7.29e -4, 95% CI:-1.00e -3 - -6.77e -5, P<0.05), parents' restricted frequency of watching TV ( β=-1.29, 95% CI:-2.36 - -0.21, P<0.05), adipo-energy ratio ( β=-0.03, 95% CI:-0.06 - -1.00e -3, P<0.05) were negatively correlated with the BMI. Factors as the frequency of parents' alarm of fiction TV program contents ( β=3.01, 95% CI: 0.03 - 6.00, P<0.05), the survey time was 2015 ( β=4.83, 95% CI: 1.96 - 7.69, P<0.05) were correlated with BMI. Conclusions:Environmental factors could indirectly influence the change of BMI of children and adolescents to different degrees and various aspects. Urbanization index and rural per capita income had a slight protective effect on increasing BMI of children and adolescents. At the community level, attention should be paid to the setting of activity places around the living environment of children and adolescents. Family members should also guide their children and adolescents to develop nice behavior in watching TV.

Objective: To analyze the status of dietary sodium intake of Chinese adult residents in fifteen provinces in 2015. Methods: Data were collected from 2015 China Nutrition Transition Cohort Study. This cohort study used a three consecutive 24-h retrospective method to record food intake and weighing method to record household condiment consumption. In this study, 14 847 residents aged 18 years and over with complete data from 15 provinces in 2015 were selected for the comparison of dietary sodium intake (median) with different characteristics. Results: Among the 14 847 residents, 47.1% were males, and the rural and northern residents accounted for 60.1% and 37.7%, respectively. Median sodium intake was 3 960.0 mg/d among residents in 2015. The sodium intake of males (4 272.1 mg/d) was higher than that of females (3 716.6 mg/d). Across age subgroups, sodium intake was highest among residents aged 45-59 years (4 257.0 mg/d; 18-44 years old, 3 867.1 mg/d; ≥60 years old, 3 799.0 mg/d). Sodium intake was higher in rural area (4 042.9 mg/d) than in urban area (3 866.8 mg/d), higher in north (4 229.2 mg/d) than in south (3 806.8 mg/d) (all P values <0.05). 11.8% of residents with dietary sodium intake were below 2 000 mg/d. The main sources of dietary sodium were condiments (79.4%), regular cooking foods (11.9%) and processed foods (8.7%). Among the condiments, the salt and soy sauce accounted for 63.6% and 10.4%, respectively. Conclusion In 2015, Chinese adult residents had higher dietary sodium intake with gender and regional differences. Condiments were the main source of dietary sodium.

Objective To analyze the status of dietary sodium intake of Chinese adult residents in fifteen provinces in 2015. Methods Data were collected from 2015 China Nutrition Transition Cohort Study. This cohort study used a three consecutive 24?h retrospective method to record food intake and weighing method to record household condiment consumption. In this study, 14 847 residents aged 18 years and over with complete data from 15 provinces in 2015 were selected for the comparison of dietary sodium intake (median) with different characteristics. Results Among the 14 847 residents, 47.1% were males, and the rural and northern residents accounted for 60.1% and 37.7%, respectively. Median sodium intake was 3 960.0 mg/d among residents in 2015. The sodium intake of males (4 272.1 mg/d) was higher than that of females (3 716.6 mg/d). Across age subgroups, sodium intake was highest among residents aged 45-59 years (4 257.0 mg/d; 18-44 years old, 3 867.1 mg/d; ≥60 years old, 3 799.0 mg/d). Sodium intake was higher in rural area (4 042.9 mg/d) than in urban area (3 866.8 mg/d), higher in north (4 229.2 mg/d) than in south (3 806.8 mg/d) (all P values<0.05). 11.8% of residents with dietary sodium intake were below 2 000 mg/d. The main sources of dietary sodium were condiments (79.4%), regular cooking foods (11.9%) and processed foods (8.7%). Among the condiments, the salt and soy sauce accounted for 63.6% and 10.4%, respectively. Conclusion In 2015, Chinese adult residents had higher dietary sodium intake with gender and regional differences. Condiments were the main source of dietary sodium.

Objective To analyze the status of dietary sodium intake of Chinese adult residents in fifteen provinces in 2015. Methods Data were collected from 2015 China Nutrition Transition Cohort Study. This cohort study used a three consecutive 24?h retrospective method to record food intake and weighing method to record household condiment consumption. In this study, 14 847 residents aged 18 years and over with complete data from 15 provinces in 2015 were selected for the comparison of dietary sodium intake (median) with different characteristics. Results Among the 14 847 residents, 47.1% were males, and the rural and northern residents accounted for 60.1% and 37.7%, respectively. Median sodium intake was 3 960.0 mg/d among residents in 2015. The sodium intake of males (4 272.1 mg/d) was higher than that of females (3 716.6 mg/d). Across age subgroups, sodium intake was highest among residents aged 45-59 years (4 257.0 mg/d; 18-44 years old, 3 867.1 mg/d; ≥60 years old, 3 799.0 mg/d). Sodium intake was higher in rural area (4 042.9 mg/d) than in urban area (3 866.8 mg/d), higher in north (4 229.2 mg/d) than in south (3 806.8 mg/d) (all P values<0.05). 11.8% of residents with dietary sodium intake were below 2 000 mg/d. The main sources of dietary sodium were condiments (79.4%), regular cooking foods (11.9%) and processed foods (8.7%). Among the condiments, the salt and soy sauce accounted for 63.6% and 10.4%, respectively. Conclusion In 2015, Chinese adult residents had higher dietary sodium intake with gender and regional differences. Condiments were the main source of dietary sodium.

The receiver operating characteristic (ROC) curve analysis has been widely used in the evaluation of screening validity in Epidemiology and in determining the optimal operating point. At present, theories about ROC curves and computation methods have been established mainly based on cross-sectional data. It is important to understand the characteristics and the progress of ROC application in order to explore more researches on optimal cut-off value, which could also give suggestions on non-communicable diseases (NCD) prevention and control. This study reviewed the application of ROC curve analysis and softwares in NCD and pointed out the future work.
Cross-Sectional Studies ; Humans ; Mass Screening ; ROC Curve ; Software

Objective To identify the trends of vegetables and fruits consumption among Chinese adults aged 18 to 44 years old from 1991 to 2011.Methods Twenty four hour dietary recall data from China Health and Nutrition Survey (1991,1993,1997,2000,2004,2006,2009 and 2011) were used to identify the trends of vegetables and fruits consumption among Chinese between 18 and 44 years old.Results From 1991 to 2011,the proportion of daily consumption of vegetables rarely varied,while the vegetables intake declined significantly; and the proportion of daily consumption and intake of fruits kept increasing as follows.By 2011,the proportion of daily consumption and intake of vegetables and fruits among the respondents were 99.7％,48.0％,321.6 g/d,and 90.1 g/d respectively.A significant drop was found in the vegetables intake among the respondents against the vegetables intake as recommended by the Chinese dietary guidelines,up to 50.2％ in 2011; a significant rise was found in the fruits intake of the respondents against the fruits intake as recommended by the said guidelines,up to 17.4％ in 2011.Conclusion The average daily intake of vegetables and fruits of young and middle-aged residents (18-44 age group) in nine provinces in China was found lower than that recommended in the Chinese dietary guidelines;in view of the high proportion of people having less vegetables and fruits intake that those recommended by the Chinese dietary guidelines,further measures are expected to encourage their vegetables and fruits intake.