Background: Existing studies which regarding to the association between individual socioeconomic status (SES) and obesity are still scarce in developing countries. The major aim of this study is to estimate such association in an adult population which was drawn from an economically prosperous province of China. Methods: Study population was determined by multilevel randomized sampling. Education and income were chosen as indicators of individual SES, general obesity and abdominal obesity were measured by body mass index (BMI) and waist circumference (WC). Descriptive statistical methods were used to depict overall and factor-specific distributions of general and abdominal obesity among 16,013 respondents. Two-step logistic regression models were fitted on gender basis. Results: The age-and-sex adjusted rates of general overweight, general obesity, abdominal overweight and abdominal obesity in study population were 28.9% (95%CI: 27.9%-29.9%), 7.5% (95%CI: 7.0%-8.1%), 32.2% (95%CI: 31.2%-33.3%) and 12.3% (95%CI: 11.6%-13.1%), respectively. Based on model fitting results, a significant inverse association between education and obesity only existed in women, while in men, income rather than education was positively related to obesity. Conclusions: The atypical SES-obesity relationship we found reflected the on-going social economy transformation in affluent regions of China. High-income men and poorly-educated women were at higher risk of obesity in Zhejiang province, thus merit intense focuses.

Introduction: Increasing research has focused on the influence of diet on mental health and well-being. This study aimed to investigate dietary habits status and their associations with emotional and behavioral problems (EBPs) in pre-teen children, as well as explore the mediating effect of child self-concept in the associations between healthy dietary habits and EBPs.Methods: A cross-sectional survey using stratified random sampling was conducted to recruit third-grade children and their caregivers. Dietary habits and self-concept were assessed with self-administrated questionnaires in children. Information on children’s EBPs was collected through questionnaires completed by their caregivers. Multilevel logistic regression models were used to estimate the associations between dietary habits and self-concept and EBPs, respectively. The mediation analysis was employed to test the mediating role of self-concept in the association between dietary habits and EBPs.Results: Of 1,126 caregiver-child dyads (Mean age of children: 9.53, 52.8% boys) included, only 37.4 and 54.2% of children met the healthy standard of milk/soy milk and fruit, respectively. Healthy fresh fruit (odds ratio [OR] = 0.57, 95% confidence intervals [CI] 0.40–0.78) and vegetables intake (OR = 0.54, 95% CI 0.38–0.76) were associated with a higher self-concept while frequent consumption of sweet foods (OR = 1.58, 95% CI 1.05–2.36) and street foods (OR = 1.61, 95% CI 1.14–2.28) were associated with a lower self-concept. Children who had unhealthy sugar-sweetened beverages intake were at an elevated risk of EBPs (OR = 1.41, 95% CI 1.03–1.95). Moreover, the relationship between healthy dietary habits and EBPs was mediated by self-concept (indirect effect β = −0.09, p < 0.001, total effect β = −0.13, p < 0.001), the proportion of mediation was 29%.Conclusion: This study revealed that the dietary habits of pre-adolescents need improvement, and dietary habits of certain foods, such as fresh fruits and sugar-sweetened beverages, were significantly associated with child mental health. Furthermore, dietary practices were related to the reduced EBPs through an enhanced self-concept. The findings provide an evidence base for developing dietary improvement strategies for pre-adolescent children in families, schools, and other health service settings, thereby contributing to the United Nations’ Sustainable Development Goals related to zero hunger and good health and well-being.

Objective: Our study aimed to investigate the nutritional vitamin D status of school children aged 9–15 years and white-collar workers in Zhejiang province, and evaluate the efficacy of low-dose-oral vitamin D supplementation in both populations. Methods: We conducted a prospective controlled trial during March 2014 to November 2015, comparing the efficacy of vitamin D supplements (400 IU/day) with non-intervention for 18 months in school children aged 9–15 years. Meanwhile, a before-after study was conducted among white-collar workers for 1 year. Serum 25(OH)D concentration was measured at baseline and after vitamin D supplementation, respectively. Results: At the baseline, 95% of school children and 84% of adult participants had vitamin D deficiency (<20 ng/mL). In school children, no difference was observed between the intervention and control groups with regard to anthropometric data. Serum 25(OH)D concentrations of the school children intervention group, school children control group and white-collar workers were 12.77 ± 3.01 ng/mL, 14.17 ± 3.59 ng/mL and 16.58 ± 3.66 ng/mL at baseline and increased to 17.34 ± 3.78 ng/mL, 18.04 ± 4.01 ng/mL and 17.75 ± 5.36 ng/mL after vitamin D supplementation, respectively. Although, after adjusting for potential confounders, the 400 IU oral vitamin D supplementation increased serum 25(OH)D concentration in school children (β = 0.81, p = 0.0426) as well as in white-collar workers (p = 0.0839), the prevalence of vitamin D deficiency was still very high among school children (79.23% in intervention group and 72.38% in control group) and white-collar workers (76.00%). Conclusions: High prevalence of vitamin D deficiency was common in these two study populations. Daily doses of 400 IU oral vitamin D supplementation was not able to adequately increase serum 25(OH)D concentrations. A suitable recommendation regarding the level of vitamin D supplementation is required for this Chinese population.

Background/Objectives: Precise prevention strategies for mild cognitive impairment (MCI) are an urgent public health priority. This study aimed to investigate the association of the Composite Dietary Antioxidant Index and alcohol consumption, as well as their interaction, with the risk of MCI. Methods: A multicenter cross-sectional study was conducted in 2020, involving 1084 individuals aged ≥55 years, in Zhejiang Province, China. Data were collected on demographics, cognitive function, alcohol consumption, depression scale, dietary intake and physical examinations. The Composite Dietary Antioxidant Index (CDAI) was calculated based on the converted Food Frequency Questionnaire (FFQ) Food Composition Tables and the data of the FFQ. CDAI values were divided into four groups by interquartile ranges: Quartile-1 (Q1), Quartile-2 (Q2), Quartile-3 (Q3) and Quartile-4 (Q4). Multivariate logistic regression models were used to evaluate the association of CDAI and alcohol consumption with MCI risk and their interaction. Results: The prevalence of MCI was 24.6%. After adjusting for gender, age, educational level, job, marriage, Body Mass Index (BMI), central obesity, frequency of social activities, depression, sleep disturbances, smoking, diabetes, and energy intake, the Q2 (OR = 0.63, 95% CI: 0.42~0.95), Q3 (OR = 0.52, 95% CI: 0.34~0.81) and Q4 (OR = 0.25, 95% CI: 0.14~0.48) of CDAI were significantly associated a reduced risk of MCI. In contrast, alcohol consumption 1~2 times per week (OR = 2.38, 95% CI: 1.02~5.59) and at least 3 times a month (OR = 2.04, 95% CI: 1.19~3.50) was significantly associated with an increased risk of MCI. Interaction analysis indicated a negative additive interaction between alcohol consumption and CDAI on MCI risk, with the detrimental effects of alcohol predominating. Conclusions: A higher CDAI is associated with a reduced risk of MCI, while alcohol consumption is associated with an increased risk. There may be a negative additive interaction between CDAI and alcohol intake in relation to MCI. Targeted strategies that reduce alcohol consumption and improve dietary antioxidant intake are essential for MCI prevention.

Background/Objectives: Plant-based diets are associated with reduced chronic disease risk, though regional variations persist. In Zhejiang, China, where plant-based food intake is high, this study aimed to explore the association between plant-based diets and metabolic syndrome (MetS) in adults aged 35–75. Methods: This cross-sectional study utilized data from the 2024 Zhejiang Nutrition and Health Survey (ZJNHS). Three plant-based diet indices were calculated: the overall plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Multivariate logistic regression models evaluated associations between diet index quintiles and MetS and its components. Results: Among the 4695 participants included in the study, 23.9% (n = 1122) had MetS. After adjusting for demographic and lifestyle factors, individuals in the highest uPDI quintile showed a significantly higher MetS risk compared to the lowest quintile (OR = 1.37, 95% CI: 1.08–1.73, p-trend = 0.013). Subgroup analyses revealed significant gender interaction (p for interaction < 0.001), with women exhibiting elevated MetS risk (OR = 1.03, 95% CI: 1.01–1.04, p < 0.001). For MetS components, the highest uPDI quintile was associated with increased risks of abdominal obesity (OR = 1.32, 95% CI: 1.05–1.66; p-trend = 0.032), elevated blood pressure (OR = 1.41, 95% CI: 1.12–1.78; p-trend = 0.003), and elevated fasting glucose (OR = 1.27, 95% CI: 1.01–1.59; p-trend = 0.037). Conclusions: Unhealthy plant-based foods are associated with increased MetS risk, particularly in women. Reducing intake of such foods, considering sex differences, and implementing precision nutrition interventions are essential.

Background: Little is known about variation in vitamin B12 and folate status among Chinese women 2 years postpartum. This study assessed intake of vitamin B12 and folate and biomarkers of nutrient status among Chinese women postpartum. Methods: Demographic information, multi-/single-nutrient supplementation, dietary data, serum vitamin B12 and serum folate were assessed in 982 women within 2 years postpartum, using ten investigation sites in Zhejiang Province from the National Nutritional Study 2016–2017, which is a nationally representative cross-sectional study, to form a representative provincial sample of Zhejiang Province. The dietary diversity score (DDS) was used for assessing the dietary pattern. Results: Vitamin B12 increased slightly at the early stage of postpartum and then dropped over time. Serum folate level elevated with postpartum time. The median serum vitamin B12 concentration was 494.59 (373.21–650.20) pg/mL, and folate was 7.58 (5.02–10.34) ng/mL. Correspondingly, vitamin B12 levels suggesting marginal deficiency (200–300 pg/mL) and deficiency (<200 pg/mL) resulted as 9.27% and 3.26%, respectively, and folate level suggesting deficiency (<3 ng/mL) was 9.16%. Multi-/single-nutrient supplementation during pregnancy was associated with log-transformed serum vitamin B12 and folate level after adjusting for potential confounders (vitamin B12: ß (SE) = 0.124 (0.028), p < 0.001; folate: 0.128 (0.035), <0.001). Additionally, postpartum nutrient supplementation was associated with log-transformed serum folate level, especially for lactating women (ß (SE) = 0.204 (0.062), p = 0.001). Increased DDS was significantly associated with elevated serum vitamin B12 and folate levels (vitamin B12: ß (SE) = 0.028 (0.011), p = 0.011; folate: 0.030 (0.014), 0.031). In addition, age and educational level were influencing factors for serum vitamin B12 and folate concentrations among postpartum women. Conclusion: Serum vitamin B12 level decreased and folate level increased with postpartum age among Chinese women. Nutrient supplementation during pregnancy was related to elevated serum vitamin B12 and folate concentrations. Postpartum nutrient supplementation was associated with the increased serum folate level of lactating women. Dietary diversity was related to increased serum vitamin B12 and folate levels, especially among postpartum women with younger age and lower educational level.