Zumin Shi

Adolescence is last chance for curbing the consequences of malnutrition and breaking the intergenerational cycle of malnutrition and poor health. This study aimed to assess the prevalence and the factors associated with stunting and thinness among in-school adolescents in northern Ethiopia using the 2006 World Health Organization (WHO) standards. In-school adolescents (n = 348, 10-19 years old) were randomly selected to participate in this cross-sectional study. Anthropometric measurements were carried out to determine the proportion of adolescents who were stunted (height-for-age < -2 Standard Deviation (SD)) and thin (body-mass-index-for-age < -2 SD). T-test was employed to evaluate mean weight and height differences between groups. Pearson chi-square, chi-square trend and Fisher's exact tests were used to explore the crude association of categorical outcome variables and associated factors. Crude and adjusted associations between the outcome variables (stunting and thinness) and independent variables (socio-demographic, eating behavior and sanitation) were also determined using logistic regression. Stata version 11.1 was used to analyze the data. The height of the adolescents was 147.6 ± 11.2 cm (mean ± SD) and weight was37.2 ± 9.5 kg. The mean Z-scores of height-for-age and body-mass-index (BMI)-for-age of adolescents were -1.49 and -1.29, respectively. The prevalence of stunting and thinness among adolescents was 28.5 % (boys = 37.7 %; girls = 21.2 %; P = 0.001) and 26.1 % (boys = 32.4; girls = 21.6 %; p = 0.017), respectively. Adolescents in 13-15 year old age group (Adjusted Odds ratio (AOR) = 2.23; 95 % CI: 1.22, 4.08), boys (AOR = 2.53; 95 % CI: 1.52, 4.21) and rural residents (AOR = 2.15; 95 % CI: 1.20, 3.86) had significantly higher odds of being stunted compared to their counterparts. Furthermore, boys had higher (AOR = 1.97; 95 % CI: 1.19, 3.25) odds of being thin compared to girls. Compared to those 10 to 12 years of age, adolescents in 16 to 19 years of age were 53 % (AOR = 0.47; 95 % CI: 0.23, 0.95) less likely to be thin. Undernutrition is widely prevalent among adolescents in northern Ethiopia. Sex, age and area of residence significantly associated with adolescent undernutrition. The study underlines the need for nutrition interventions targeting rural and boy adolescents.

Few studies have applied the Chinese Diet Balance Index (DBI) in evaluating dietary quality for Chinese people. The present cross-sectional study assessed dietary quality based on DBI for older people, and the associated factors, in four socioeconomically distinct regions in China. The China Health and Nutrition Survey (CHNS) involves 2745 older Chinese people, aged 60 or over, from four regions (Northeast, East Coast, Central and West) in 2009. Dietary data were obtained by interviews using 24 hour-recall over three consecutive days. Four indicators: Total Score (TS), Lower Bound Score (LBS), Higher Bound Score (HBS) and Diet Quality Distance (DQD) from DBI were calculated for assessing dietary quality in different aspects. 68.9% of older people had different levels of excessive cereals intake. More than 50% of older people had moderate or severe surplus of oil (64.9%) and salt (58.6%). Intake of vegetables and fruit, milk and soybeans, water, and dietary variety were insufficient,...

Little is known about the macronutrient intake status of older Chinese people. The present study evaluated the macronutrient intake status of older Chinese people (aged ≥ 60 years), investigated whether they had intake levels that met the Dietary Reference Intakes (DRI), and explored the associations between macronutrient intakes and age groups, sex, education levels, work status, BMI groups, urbanicity levels and four socio-economic regions of China (Northeast, East Coast, Central and Western). Dietary intake data of 2746 older Chinese with complete dietary intake data in the Longitudinal China Health and Nutrition Survey (2009 wave) carried out across four diverse regions were analysed. Dietary intake data were obtained by interviews using 24 h recalls over three consecutive days. The MUFA:SFA ratios were calculated based on the Chinese Food Composition Table. Less than one-third of the older Chinese people included in the present study had intake levels meeting the adequate intake for carbohydrate-energy and fat-energy; less than one-fifth had intake levels meeting the recommended nutrient intake for protein-energy; and more than half of the older people had fat-energy intakes higher than the DRI. There were strong associations between the proportions of energy from the three macronutrients and education levels, urbanicity levels and the four socio-economic regions of China, with older people living in the East Coast region having different patterns of macronutrient-energy intakes when compared with those living in the other three regions. Macronutrient intakes across different urbanicity levels in the four regions revealed considerable geographical variations in dietary patterns, which will affect the risk factors for non-communicable diseases. Clinical interventions and public health policies should recognise these regional differences in dietary patterns.

This study was carried out to explore the relationship between the SES, mental health and the NLTC of the Japanese elderly, with the aim of providing useful information to lower the NLTC. A longitudinal survey was carried out in Tama City, Tokyo in 2001 and 2004. Data were collected from the urban-dwelling older adults, aged 65 years old and above, through self-reported questionnaires, which was participated by 7905 respondents (47.6% male and 52.4% female). Chi-square test, Kendall tau-b correlation analysis and structural equation modeling (SEM) were used to identify the association between SES, mental health and NLTC. The results of the SEM analysis indicated that mental health would exert a negative effect on NLTC for both the elderly men and the elderly women, while the effect was stronger for the elderly women; SES was significantly and negatively associated to NLTC, both for the elderly men and elderly women; a significant and positive relationship was observed between SES and mental health for both genders, but slightly stronger for the elderly men. These findings have implications for targeting the interventions that are aimed to delaying the NLTC and the financing of LTC system.

The intake of iron is positively related to the risk of diabetes, whilst magnesium intake is inversely related. However, it is unknown whether there is an interaction between dietary magnesium and iron expressed as a ratio and diabetes. This is a cross-sectional household survey carried out in 2002 in Jiangsu Province, China. A total of 2849 men and women aged >or = 20 years participated (participation rate 89.0%). Iron and magnesium intake was assessed by 3-day weighed food records. Fasting plasma glucose, serum ferritin and haemoglobin were measured. The mean intake of iron and magnesium was 25 mg/day and 332 mg/day, respectively. The prevalence of diabetes was 3.0% in men and 2.6% in women. Magnesium intake was negatively associated with diabetes when adjusted for age and sex, but not in a fully adjusted model. A strong inverse association between magnesium : iron intake ratio and diabetes was observed. In the fully adjusted model, the odds ratios of diabetes across quartiles of magnesium : iron intake ratio were: 1.0, 0.63 [95% confidence interval 0.32-1.25], 0.36 (0.16-0.81) and 0.48 (0.20-1.14) (P for trend 0.038). There was an interaction between central obesity and magnesium : iron ratio. Magnesium : iron intake ratio is an independent risk marker for diabetes in Chinese adults. As this is a cross-sectional study, we cannot establish any causal relationship.

To investigate the associations between socio-demographic status, lifestyle factors, dietary patterns and urinary total phthalate concentration in a cohort of South Australian men. We randomly selected 1527 males aged 39 to 84 from wave two of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study. Total phthalate concentration was examined in fasting morning urine samples. Socio-demographic and lifestyle factors were assessed by questionnaire. Food intake was assessed by food frequency questionnaire (FFQ). Dietary patterns were constructed using factor analysis. Total phthalates were detected in 99.6% of the urine samples. The overall geometric mean (95% CI) of total phthalate concentration was 112.4 (107.5-117.5) ng/mL. The least square geometric means (LSGMs) of total phthalate concentration were significantly higher among people who were obese (127.8 ng/mL), consuming less than two serves fruit per day (125.7 ng/mL) and drinking more than one can (375mL) o...

To determine the prevalence of anaemia and the metabolic syndrome with special interest in the coexistence of these two problems as well as the possible links. In a cross-sectional household survey, 1294 men and 1522 women aged 20 years and above were interviewed; anthropometric measurements and blood samples were taken. Metabolic syndrome was defined according to IDF 2005 standard. Anaemia was defined as haemoglobin level below 13 g/dL for men and 12 g/dL for women. The age-adjusted prevalence of metabolic syndrome was 11.2% and of anaemia 24.4%. About 3 percent of the participants had both anaemia and metabolic syndrome. Women had a higher prevalence of both the metabolic syndrome and anaemia than men (14.0 vs 8.4%, 31.5% vs 16.1%). Anaemia coexisted significantly with all the individual components of the metabolic syndrome. Only 7.0% of the sample had anaemia without any individual component of metabolic syndrome. In women, the prevalence of combined anaemia and metabolic syndrom...

To evaluate dietary zinc and other divalent minerals intake among the population of Jiangsu Province. 3,867 subjects aged 4-89 years were representatively sampled in two urban and six rural areas of Jiangsu Province. Dietary intake was assessed using 24-hour recalls on three consecutive days. Insufficient zinc intake was calculated based on the Chinese Dietary Reference Intakes. Overall, the percentage of subjects with insufficient intake of zinc was 22.9%, with a declining trend with age. Except for the group>or=50 years, mean zinc intake of all other groups were below the age- and sex- specific Recommended Nutrition Intakes (RNI). Approximately 2/3rds of the subjects<or=17 years of age had insufficient zinc intakes. Compared with the age group below 11 years, risk of insufficient zinc intake increased in the adolescents aged 11-17 years (OR: 2.10, 95% CI: 1.86-2.36), but decreased in adults aged 18-49 years and >or=50 years (OR: 0.76, 95% CI: 0.66-0.8; OR:0.55, 95%CI: 0.4...

Objective:To identify the differences in food habits and preferences among the adolescents according to socio-demographic characteristics.Design:Cross-sectional, cluster design survey in 2002.Setting:Eight middle schools in two distinct socio-economic areas of the Jiangsu province, China.Subjects:Some 824 young adolescents (12–14 y) attending public schools with a response rate of 99%.Methods:A self-administered questionnaire containing questions on food and meal frequencies, food preferences and socio-demographic

To prospectively examine the associations between zinc intake, the zinc to heme iron ratio and the incidence of hyperglycemia in Chinese. We followed 1056 healthy adults aged 20 and older from 2002 to 2007. Dietary data were collected using 3-day food record and food frequency questionnaire. Hyperglycemia was defined as fasting plasma glucose > 5.6 mmol/l. During the 5 years of follow-up, we documented 125 incident cases of hyperglycemia. Zinc intake alone was not associated with the risk of hyperglycemia. The zinc to heme iron ratio was inversely associated with the risk of hyperglycemia: odds ratios (OR, 95% CI) across increasing quartiles of the zinc to heme iron ratio were 1.00, 0.78(0.44-1.37), 0.40(0.19-0.83), and 0.21(0.08-0.54)(p for trend= 0.001). Adjustment for lifestyle covariates did not significantly change the associations. This cohort study suggests that the zinc to heme iron intake ratio was significantly associated with a decreased risk of hyperglycemia in Chinese adults.

To examine the association between breastfeeding pattern and growth in the first year of life. A cross-sectional survey was carried out on 349 mothers with infants <12 months in a rural and a semi-urban community in Mangochi district, Malawi. Data on socio-demographic characteristics, infant weight, length and feeding patterns since birth were collected. Multivariate linear regression was performed to test the association between feeding pattern and infant anthropometric status. Exclusive breastfeeding (EBF) until 6 months was practised by 13.1% semi-urban and 1.3% rural mothers. No infant was exclusively breastfed beyond 6 months. Breastfeeding was continued among all infants who had stopped EBF. Among infants 6-12 months of age, duration of EBF during the first 6 months was positively associated with length-for-age Z-score (LAZ) (regression coefficient=0.19, 95% confidence interval: 0.06, 0.31) in a model adjusted for socio-demographic factors. Urban residence and female gender yielded positive associations in the same model. The model explained 27% of the variation in LAZ. Among infants <6 months, duration of EBF was not significantly associated with LAZ, but being female and urban residence yielded positive associations. Breastfeeding patterns were not associated with weight-for-age Z-score (WAZ) or weight-for-height Z-score (WLZ) either in the 0-6-month or in the 6-12-month group. Birth outside a health facility was negatively associated with WAZ and WLZ in the older group. EBF in the first 6 months of life was associated with increased linear growth, but not weight gain, in later infancy. Promotion of EBF could reduce the prevalence of chronic child undernutrition in the study area.

To describe perceptions of weight of adolescents and associated factors. Cross-sectional survey in 2002. Eight public middle schools in two distinct socio-economic areas of Jiangsu Province, China. Eight hundred and twenty-four adolescents (aged 12-14 years) and 628 of their parents. Self-administered questionnaires for students and their parents were used to collect the data. Height and weight of the students were measured. One-third of the girls perceived themselves as overweight, while only 8.9% were actually overweight or obese according to the World Health Organization definition. On the other hand, 15.0% of the girls considered themselves underweight, while 5.6% were underweight according to the definition. Among the boys, one-fifth of those defined as overweight perceived their weight as normal. Furthermore, 23.9% perceived themselves as underweight when in fact only 4.9% were classified as underweight according to the definition. About one-quarter of the students dieted in the past year. Adolescents who perceived themselves to be overweight dieted and skipped breakfast more often. They also had lower intake frequencies of animal foods, Western foods and milk/yoghurt. No disparity was observed in the intake frequency of fruits and vegetables between the groups of different weight perception. Parents' weight norms seemed to favour overweight in both genders, but especially among boys. Both overweight and underweight concerns were common among girls, while a higher body weight was favoured by normal-weight boys and their parents. Distorted weight perceptions in adolescents, as well as dieting, are problems that need appropriate intervention.

This cross-sectional study aimed at investigating infant feeding practices and their sociodemographic correlates in Mangochi District, Malawi. Questionnaire data from 157 rural and 192 semiurban mother-infant pairs were obtained. Early breastfeeding (< 1 hour after delivery) was practiced among 68.2% of the rural and 63% of the semiurban mothers. Colostrum was given by 96% of the sampled mothers. Exclusive breastfeeding rates in the sample at 2, 4, and 6 months were 39.1%, 27.5%, and 7.5%, respectively. At 4 months, exclusive breastfeeding was significantly higher in the semiurban (46.8%) than in the rural (4.7%) group. Living in the rural area (OR = 1.87; 95% CI 1.26-2.76) and giving birth outside a health facility (OR = 1.36; 95% CI 1.00-1.85) were risk factors for stopping exclusive breastfeeding before 6 months. The results suggest that semiurban mothers are more likely to practice optimum breastfeeding and that health facilities have an important role in its promotion.

The objective of this article was to describe the relationship between sociodemographic factors and nutritional status (body mass index [BMI], height for age, and anemia) in adolescents. In 2002, a cross-sectional study comprising 824 students aged 12 to 14 years from 8 schools in 2 prefectures in Jiangsu province of China had their height, weight, and hemoglobin level measured. Self-administered questionnaires were used to collect sociodemographic information. The prevalence of underweight was low in the overall sample (5.2%). The prevalence of stunting also was low (2.9%), and the differences between residential areas and sociodemographic groups were small. The percentage of overweight/obesity was higher among boys (17.9%) than girls (8.9%). Male students having fathers with a high educational level had the highest percentage of overweight and obesity (27.8%). Household socioeconomic status (SES) was associated positively with BMI. Family size, gender, and the father's level of education also were related to BMI. The percentage of anemia was somewhat higher among girls (23.4%) than boys (17.2%). Anemia coexisted with underweight. No urban/rural or SES differences in the percentage of students with anemia were observed in the sample, but differences between regions and schools were very significant. Undernutrition was not a problem in the research area. Nutritional status was associated with SES and region. Overnutrition and anemia in adolescents are important nutritional problems in Jiangsu, China. Intervention programs are needed to address these problems.