Despite the importance of vitamin D in early stages of life, data are lacking on the levels of vitamin D intake and serum 25-hydroxyvitamin D (25-(OH)D) among Chinese school-age children. The aims of this study were to investigate the vitamin D intake and serum 25-(OH)D concentration of children aged 7 to 12 years in China, and to measure the associations between vitamin D status and children’s growth and development parameters. We obtained data on vitamin D intake, serum 25-(OH)D concentration, and anthropometric measurements from a cross-sectional study on school-aged children in China. Multiple linear regression and multivariable logistic regression analyses assessed the associations mentioned above. A total of 563 children (9.5 ± 1.6 years) from six areas of China were included. Among them, 86.1% had a vitamin D intake below the recommended nutrient intake (10 μg/day), and 54.7% had vitamin D deficiency (serum 25-(OH)D <15 ng/mL). We also found that high vitamin D intake was inversely associated with the risk of vitamin D deficiency (OR = 0.836, 95% confidence interval: 0.713, 0.980), and serum 25-(OH)D concentration was positively associated with the intelligence score and body mass index-for-age Z-score (BAZ) (p < 0.05). Insufficient vitamin D intake and serum 25-(OH)D are prevalent among Chinese school-aged children. A negative association was observed between vitamin D intake and the risk of vitamin D deficiency. Moreover, vitamin D status was positively associated with intelligence and BAZ, which await confirmation in future studies.

Background: Some eating habits may be related to the development of gastrointestinal diseases, obesity, and related metabolic dysfunctions. Because of long working hours, and shift schedules, physicians are more likely to form such eating habits and have a high risk of developing these diseases.Objectives: We aimed to investigate the association between physicians’ eating habits and their health perception and diseases.Methods: Between 24 June and 5 August 2020, we performed convenience sampling of in-service physicians in hospitals in mainland China. A questionnaire was administered to collect data pertaining to basic sociodemographic characteristics, eating habits, health-related information such as body mass index classification, and prevalence of common diseases. The associations among eating habits and perceived suboptimal health status, micronutrient deficiency-related diseases, obesity, and related metabolic diseases were analysed.Results: The prevalence of unhealthy eating habits was high: more eating out-of-home (53.4% in hospital canteens, 23.0% in restaurants and takeaways), fewer meals at home, irregular meals (30.5%), and eating too fast (the duration <10 min, 34.6%). Among those with the above eating habits, the prevalence rates of sub-optimal health and disease were higher than among those without the above eating habits.Conclusion: Eating habits such as frequent eating out-of-home, irregular meals, and eating too fast were common among physicians, and were significantly related to perceived sub-optimal health status and disease occurrence.

Sugar intake has been linked to the global rise in diabetes. However, the unique diabetogenic effect of sugar, independent of weight gain, remains controversial. This study aimed to investigate the associations between total and added sugar intake and diabetes status, and to test whether the sugar–diabetes associations were moderated or mediated by the body mass index (BMI). We performed a nationwide cross-sectional study on 12,889 Chinese adults who were enrolled in the China Health and Nutrition Survey (CHNS) 2011. The data for the total and added sugar intake were measured using three consecutive 24 h recalls, and determined based on the U.S. Department of Agriculture (USDA) National Nutrient Database for Standard Reference, Release 28 (SR28), the Food Patterns Equivalents Database (FPED) 2015–2016, and the labeled ingredients and nutrient contents. A multivariable logistic regression model was used to analyze the associations between the total and added sugar intake and diabetes. A nutrient density model was used to adjust for the total energy intake. A mediation analysis for significant sugar–diabetes associations shown in multivariable logistic analysis (p < 0.05), and a subgroup analysis according to the BMI category were performed, to examine the mediating and moderating effects of the BMI on the sugar–diabetes association, respectively. We included 12,800 individuals, with a mean age of 50.5, in the final analysis. The means of the total and added sugar intake, total sugar (%E), and added sugar (%E) were 28.2 ± 0.2 g/d, 5.0 ± 0.1 g/d, 6.0 ± 0.0%, and 1.0 ± 0.0%, respectively. The overall prevalence of self-reported physician-diagnosed diabetes was 4.0%. A significant association between the total sugar intake and an increased risk of diabetes was found (odds ratio [OR] =1.008, 95% CI 1.001–1.016). The mediation analysis showed a significant mediation effect through the BMI of the effect of the total sugar on diabetes status (p < 0.001), where 11.7% (95% CI: 4.7–35.7%) of the effect of the total sugar on diabetes was mediated through the BMI. The total sugar intake had a significant direct effect on diabetes around the BMI (estimated coefficient = 0.0004, p < 0.001). The overall total-sugar-intake–diabetes association remained significant in normal-weight participants in the subgroup analysis (OR =1.012, 1.000–1.024). In conclusion, although the BMI moderated and mediated the association between the total sugar intake and diabetes, the total sugar still showed some unique weight-independent diabetogenic effects. Our findings call for efforts to prevent and control diabetes by reducing sugar intake, and losing weight appropriately.

A high level of sugar intake has been linked to poor dietary quality and a wide range of chronic diseases. However, data on sugar intake are still scarce in China. This study aimed to provide time trends in the total and added sugar intakes among Chinese children and adolescents from 1997 to 2011. A nationwide ongoing open prospective cohort study of Chinese children and adolescents aged 3–17 years (n = 13,212) was conducted by using data from the China Health and Nutrition Survey (CHNS) 1997–2011 (six 1-year cycles). An individual dietary intake was collected from three consecutive 24-h recalls during randomly allocated home visits. Data for total and added sugar contents were determined based on the U.S. Department of Agriculture (USDA) National Nutrient Database for Standard Reference, Release 28 (SR28), the Food Patterns Equivalents Database (FPED) 2015–2016, and the labeled ingredients and nutrient contents. General linear regression was used to estimate time trends. Over the 15-year period, total sugar and added sugar intakes increased among all age groups studied (3–17 years: total sugar increased from 11.2 ± 0.3 g/d to 28.1 ± 0.5 g/d, added sugar increased from 1.0 ± 0.1 g/d to 7.2 ± 0.3 g/d; 3–6 years: 9.5 ± 0.6 g/d to 25.1 ± 0.9 g/d, 1.3 ± 0.2 g/d to 6.9 ± 0.4 g/d; 7–12 years: 11.4 ± 0.5 g/d to 28.1 ± 0.8 g/d, 0.9 ± 0.1 g/d to 7.1 ± 0.5 g/d; 13–17 years: 11.8 ± 0.4 g/d to 31.4 ± 1.1 g/d, 1.0 ± 0.2 g/d to 7.6 ± 0.6 g/d) (all p for trend < 0.001). Adolescents aged 13–17 years had the highest total sugar intake, and children aged 3–6 years had the highest added sugar intake, except for 2011. Children and adolescents living in urban areas and who were overweight had much higher total and added sugar intakes than those residing in rural areas and of non-overweight/obesity. Furthermore, the dietary sources of total and added sugars have become more diverse over the study period. In conclusion, we observed a notable rise in total and added sugar intakes among children and adolescents across all age groups, both genders, both urban and rural areas, and all BMI categories, with dietary sources of total and added sugars becoming more diverse in China over 15 years.

Frailty has been linked to an increased risk of mental disorders. However, little is known about the impact of nutritional frailty, a crucial phenotype of frailty, on depression and anxiety. We aimed to examine the prospective associations between nutritional frailty and the incidence and progression of depression and anxiety among middle-aged and older adults. Data were obtained from a large prospective cohort study with over 500,000 participants. Nutritional frailty was defined as the copresence of physical frailty (assessed by weight loss, exhaustion, low physical activity level, slowness, and weakness) and nutritional imbalance (assessed by body mass index, skeletal muscle index, and sodium, potassium, and iron intake). Depression, anxiety, and their comorbidity were identified via the International Statistical Classification of Diseases and Related Health Problems, Ninth Revision and Tenth Revision, on the basis of the primary or secondary diagnosis. We performed Cox proportional hazards models to investigate the associations between nutritional frailty and incident depression, anxiety, and their comorbidity. Multistate models were used to examine how nutritional frailty influences transitions from a baseline state to single mental disorders, their comorbidity, and mortality. We included 176,987 participants with a mean age of 56.1 years (SD 8.0), of whom 2648 (1.5%) had nutritional frailty at baseline. During a median follow-up of 12.2 years, 4794 (2.7%) developed depression, 6081 (3.4%) developed anxiety, and 1610 (0.9%) developed both conditions. Individuals with nutritional frailty had a significantly greater risk of developing depression, anxiety, and their comorbidity than robust individuals and those with physical frailty and nutritional imbalance (depression: nutritional frailty HR 3.21 [95% CI 2.77-3.73]; physical frailty 3.11 [2.70-3.58]; nutritional imbalance 1.19 [1.11-1.28]; anxiety: 2.25 [1.93-2.63], 2.17 [1.87-2.51], 1.20 [1.13-1.28]; comorbidity: 3.69 [2.92-4.66], 3.43 [2.74-4.28], 1.31 [1.15-1.50]), even after multivariable adjustment. Baseline nutritional frailty adversely impacts transitions from a baseline state to single mental disorders (depression: 2.89 [2.49-3.36], anxiety: 1.82 [1.54-2.16]) and death (1.95 [1.71-2.22]), from single mental disorders to their comorbidity (depression: 1.96 [1.32-2.89]; anxiety 1.78 [1.17-2.71]), and from comorbidity to death (2.04 [1.07-3.91]). Nutritional frailty is an independent risk factor for incident depression, anxiety, and their comorbidity and adversely influences the progression of these conditions among middle-aged and older adults.