Background: Coffee can regulate glucose homeostasis but the underlying mechanism is unclear. This study investigated the preventive and therapeutic effects of chlorogenic acid (CGA), a polyphenol that is found in coffee, on obesity and obesity-related metabolic endotoxemia.Method: Male 4-week-old C57BL/6 mice were fed either normal chow or a high-fat diet or 20 weeks and half the mice in each group were gavaged with CGA. Oral glucose tolerance tests (OGTTs) and insulin tolerance tests (ITTs) were performed. Markers of inflammation and intestinal barrier function were assayed. The composition of the gut microbiota was analyzed by 16S rRNA high-throughput pyrosequencing. The role of CGA-altered microbiota in metabolic endotoxemia was verified by fecal microbiota transplantation.Results: CGA protected against HFD-induced weight gain, decreased the relative weight of subcutaneous and visceral adipose, improved intestinal barrier integrity, and prevented glucose metabolic disorders and endotoxemia (P <0.05). CGA significantly changed the composition of the gut microbiota and increased the abundance of short chain fatty acid (SCFA)-producers (e.g., Dubosiella, Romboutsia, Mucispirillum, and Faecalibaculum) and Akkermansia, which can protect the intestinal barrier. In addition, mice with the CGA-altered microbiota had decreased body weight and fat content and inhibited metabolic endotoxemia.Conclusion: CGA-induced changes in the gut microbiota played an important role in the inhibition of metabolic endotoxemia in HFD-fed mice.

Maternal body mass index is linked to short- and long-term unfavorable health outcomes both for child and mother. We conducted a systematic review and meta-analysis of population-based cohort studies to evaluate maternal BMI and the risk of harmful neonatal outcomes in China. Six databases identified 2454 articles; 46 met the inclusion criteria for this study. The dichotomous data on maternal BMI and harmful neonatal outcomes were extracted. Pooled statistics (odds ratios, ORs) were derived from Stata/SE, ver. 12.0. Sensitivity analyses assessed the robustness of the results. Meta-regression and subgroup meta-analyses explored heterogeneity. The meta-analysis revealed that compared with normal BMI, high maternal BMI is associated with fetal overgrowth, defined as macrosomia ≥4000 g (OR 1.91, 95% CI 1.75–2.09); birth weight ≥ 90% for gestational age (OR 1.88, 95% CI 1.64–2.15); and increased risk of premature birth (OR 1.38, 95% CI 1.25–2.52) and neonatal asphyxia (OR 1.74, 95% CI 1.39–2.17). Maternal underweight increased the risk of low birth weight (OR 1.61, 95% CI 1.33–1.93) and small for gestational age (OR 1.75, 95% CI 1.51–2.02). Raised as well as low pre-pregnancy BMI is associated with adverse neonatal outcomes. Management of weight during pregnancy might help reduce their adverse neonatal outcomes in future intervention studies or programmes.

Background: The sleep quality of pregnant women in the third trimester is related to mental health. However, there is still a lack of large-scale cohort research exploring this relationship in the second trimester. Thus, we assessed the associations of sleep quality during the second trimester with antenatal stress and antenatal and postnatal depression. Methods: We examined 1152 pregnant women from a prospective cohort study in China to assess the associations of sleep quality in the second trimester with antenatal stress, antenatal depression, and postnatal depression. We used linear regression models and logistic regression models to examine the associations of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) during pregnancy with perinatal stress (Pregnancy Pressure Scale [PPS]) and depression (Edinburgh Postnatal Depression Scale [EPDS]) status. We further assessed the relationship in groups divided according to maternal age. Results: PSQI scores were positively associated with antenatal PPS scores (β: 1.52, 95% confidence interval [CI]: 1.28, 1.76), antenatal EPDS scores (β: 0.68, 95% CI: 0.58, 0.78), and postpartum EPDS scores (β: 0.51, 95% CI: 0.38, 0.64). Poor sleep quality (PSQI scores ≥5) was associated with antenatal stress status (odds ratio [OR]: 2.60, 95% CI: 1.79, 3.77), antenatal depression status (OR: 3.42, 95% CI: 2.48, 4.72), and postpartum depression status (OR: 2.40, 95% CI: 1.58, 3.64) after adjusting maternal age, BMI, gestational age, smoking, educational level, annual household income and social support. The association of poor sleep quality (PSQI scores ≥5) in the second trimester with postnatal depression status was significant among women more than or equal to 30 years old (OR: 4.12, 95% CI: 2.18, 7.78) but not among women less than 30 years old after adjusting covariates above. Conclusion: Poor sleep quality in the second trimester among Chinese pregnant women is associated with stress and depression symptoms. Strategies to boost sleep quality should be considered during prenatal health care to improve women’s mental health status.

Associations of dietary patterns in Chinese adolescents and children with later obesity have not previously been investigated. The purpose of the present study was to evaluate the associations between dietary patterns and the risk of obesity in Chinese adolescents and children by using a longitudinal design. Data from the China Health and Nutrition Survey (CHNS), a nationally representative survey, were used for our analysis. 489 participants 6–14 years of age were followed from 2006 to 2011. Factor analysis was used to identify the dietary patterns in Chinese adolescents and children. Ordered logistic regression models were used to examine the association between dietary patterns and later obesity. Two dietary patterns were revealed by factor analysis, the traditional Chinese dietary pattern (with high intake of rice, vegetables, poultry, pork and fish and the modern dietary pattern (with high intake of wheat, processed meat and fast food). Children in the highest quartile and the second-highest quartile of the traditional Chinese dietary pattern was inversely associated with later obesity compared with children in the lowest quartile over 5 years (OR = 0.19, 95%CI: 0.09, 0.40 for Q4; OR = 0.47, 95%CI: 0.33, 0.67 for Q3); Children in the highest quartile of the modern dietary pattern was positively associated with later obesity compared with children in the lowest quartile over 5 years (OR = 2.02, 95%CI: 1.17, 3.48). Dietary patterns in Chinese adolescents and children are associated with later obesity. These findings further confirm the importance of children’s dietary patterns in later obesity and lay groundwork for dietary culture-specific interventions targeted at reducing rates of obesity in children and adolescents.

Over the last three decades, various instruments were developed and employed to assess medical professionalism, but their measurement properties have yet to be fully evaluated. This study aimed to systematically evaluate these instruments’ measurement properties and the methodological quality of their related studies within a universally acceptable standardized framework and then provide corresponding recommendations. A systematic search of the electronic databases PubMed, Web of Science, and PsycINFO was conducted to collect studies published from 1990–2015. After screening titles, abstracts, and full texts for eligibility, the articles included in this study were classified according to their respective instrument’s usage. A two-phase assessment was conducted: 1) methodological quality was assessed by following the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist; and 2) the quality of measurement properties was assessed according to Terwee’s criteria. Results were integrated using best-evidence synthesis to look for recommendable instruments. After screening 2,959 records, 74 instruments from 80 existing studies were included. The overall methodological quality of these studies was unsatisfactory, with reasons including but not limited to unknown missing data, inadequate sample sizes, and vague hypotheses. Content validity, cross-cultural validity, and criterion validity were either unreported or negative ratings in most studies. Based on best-evidence synthesis, three instruments were recommended: Hisar’s instrument for nursing students, Nurse Practitioners’ Roles and Competencies Scale, and Perceived Faculty Competency Inventory. Although instruments measuring medical professionalism are diverse, only a limited number of studies were methodologically sound. Future studies should give priority to systematically improving the performance of existing instruments and to longitudinal studies.