Hand, foot and mouth disease (HFMD) is a rising public health issue in the Asia-Pacific region. Numerous studies have tried to quantify the relationship between meteorological variables and HFMD but with inconsistent results, in particular for temperature. We aimed to characterize the relationship between temperature and HFMD in various locations and to investigate the potential heterogeneity. We retrieved the daily series of childhood HFMD counts (aged 0-12 years) and meteorological variables for each of 143 cities in mainland China in the period 2009-2014. We fitted a common distributed lag nonlinear model allowing for over dispersion to each of the cities to obtain the city-specific estimates of temperature-HFMD relationship. Then we pooled the city-specific estimates through multivariate meta-regression with city-level characteristics as potential effect modifiers. We found that the overall pooled temperature-HFMD relationship was shown as an approximately inverted V shape curve, peaking at the 91th percentile of temperature with a risk ratio of 1.30 (95% CI: 1.23-1.37) compared to its 50th percentile. We found that 68.5% of the variations of city-specific estimates was attributable to heterogeneity. We identified rainfall and altitude as the two main effect modifiers. We found a nonlinear relationship between temperature and HFMD. The temperature-HFMD relationship varies depending on geographic and climatic conditions. The findings can help us deepen the understanding of weather-HFMD relationship and provide evidences for related public health decisions.

Background: The role of lifestyle factors and their relative contributions to the development and mortality of cardio-renal-metabolic multimorbidity (CRMM) remains unclear. Methods: A study was conducted with 357,554 UK Biobank participants. CRMM was defined as the coexistence of two or three cardio-renal-metabolic diseases (CRMDs), including cardiovascular disease (CVD), type 2 diabetes (T2D) and chronic kidney disease (CKD). The prospective study examined the associations of individual and combined lifestyle scores (diet, alcohol consumption, smoking, physical activity, sedentary behavior, sleep duration and social connection) with longitudinal progression from healthy to first cardio-renal-metabolic disease (FCRMD), then to CRMM, and ultimately to death, using a multistate model. Subsequently, quantile G-computation was employed to assess the relative contribution of each lifestyle factor. Results: During a median follow-up of 13.62 years, lifestyle played crucial role in all transitions from healthy to FCRMD, then to CRMM, and ultimately to death. The hazard ratios (95% CIs) per score increase were 0.91 (0.90, 0.91) and 0.90 (0.89, 0.91) for healthy to FCRMD, and for FCRMD to CRMM, and 0.84 (0.83, 0.86), 0.87 (0.86, 0.89), and 0.90 (0.88, 0.93) for mortality risk from healthy, FCRMD, and CRMM, respectively. Among the seven factors, smoking status contributed to high proportions for the whole disease progression, accounting for 19.88–38.10%. High-risk diet contributed the largest proportion to the risk of transition from FCRMD to CRMM, with 22.53%. Less-frequent social connection contributed the largest proportion to the risk of transition from FCRMD to death, with 28.81%. When we further consider the disease-specific transitions, we find that lifestyle scores had slightly stronger associations with development to T2D than to CVD or CKD. Conclusions: Our study indicates that a healthy lifestyle may have a protective effect throughout the longitudinal progression of CRMM, informing more effective management and treatment. Smoking status, diet, and social connection played pivotal roles in specific disease transitions.

The biological aging process can be modified through lifestyle interventions to prevent age-related diseases and extend healthspan. However, evidence from population-based studies on whether tea consumption could delay the biological aging process in humans remains limited. This study included 7931 participants aged 30–79 years from the China Multi-Ethnic Cohort (CMEC) Study and 5998 participants aged 37–73 years from the UK Biobank (UKB) who participated in both the baseline and first follow-up surveys. Tea consumption information was collected through questionnaires. Biological age (BA) acceleration was calculated using clinical biomarkers and anthropometric measurements based on the Klemera Doubal method (KDM). Change-to-change analyses were performed to estimate the associations between changes in tea consumption status and changes in BA acceleration using multiple linear models. Follow-up adjusted for baseline analyses were further conducted to examine the prospective exposure-response relationship between tea consumption and BA acceleration among individuals with constant tea consumption status. During a median follow-up of 1.98 (1.78, 2.16) years in the CMEC and 4.50 (3.92, 5.00) years in the UKB, tea consumption was consistently associated with attenuated BA acceleration in both cohorts. Transitioning from nondrinking to tea-drinking was associated with decreased BA acceleration (CMEC: β = −0.319, 95% CI: −0.620 to −0.017 years; UKB: β = −0.267, 95% CI: −0.831 to 0.297 years) compared to consistent nondrinking. Even stronger associations were found in consistent tea drinkers. The exposure-response relationship suggested that consuming around 3 cups of tea or 6–8 g of tea leaves per day may offer the most evident anti-aging benefits. Tea consumption was associated with attenuated BA acceleration measured by KDM, especially for consistent tea drinkers with moderate consumption. Our findings highlight the potential role of tea in developing nutrition-oriented anti-aging interventions and guiding healthy aging policies. 10.13039/501100001809 National Natural Science Foundation of China (Grant No. 82273740).