Magnesium Nutritional Status,Risk Factors,and the Associations with Glucose Parameters of Childbearing Women in the China Adult Chronic Disease and Nutrition Surveillance (2015)

Magnesium is an essential element and participates in many metabolic pathways. Inadequate magnesium levels may lead to various health problems such as type 2 diabetes (T2DM), hypertension, and cancer. But the role of Mg in childbearing women of China is still a relatively narrow researched field. We aimed to assess the Mg nutritional status, explore the risk factors of Mg deficiency, and the associations between Mg and glucose parameters among childbearing women in a nationally representative sample. A total of 1895 18–44 years childbearing women were recruited from the China Adult Chronic Disease and Nutrition Surveillance (2015). Multivariate logistic regression was used to explore the risk factors for Mg deficiency and estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for the risk of hyperglycemia. The mean value of Mg was 0.87 mmol/L and the prevalence of deficiency was 4.69%. The risk factors of Mg deficiency (Mg < 0.75 mmol/L) was city-type of rural (p = 0.045), while calcium (p = 0.001), LDL-C (p = 0.024), age group of 26–35 years (p = 0.016), 36–44 years (p = 0.006), and CNNM2 rs3740393 genotypes of GC (p = 0.027) were protective factors. It was also found that magnesium deficiency induces an increase in plasma glucose (p = 0.001). Compared with the reference range, Mg < 0.75 mmol/L would have a 6.53 fold risk for T2DM, a 5.31 fold risk for glucose-hyperglycemia, and a 9.60 fold risk for HbA1c-hyperglycemia. Consistently, there was a negative association between plasma Mg and blood glucose parameters in the dose–response study. More attention should be paid to the nutritional status of magnesium and the impact of magnesium deficiency on human health.     

Study on Reference Range of Zinc,Copper and Copper/Zinc Ratio in Childbearing Women of China

Background: Copper and zinc are both essential elements in humans, that play various biological roles in body functions. Population-based reference values have not yet been established in China especially in childbearing women. The aim of this study is to establish a reference value of Zn, Cu and Cu/Zn ratios in childbearing women aged 18–44 from a representative population in China. Method: A total of 191 healthy childbearing women aged 18–44 years old were enrolled from the China Adult Chronic Disease and Nutrition Surveillance (2015) in this study with a series strict inclusion criteria. Basic biological indicators (weight, height, waist, blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein, total cholesterol, triglyceride, fast glycose, HbA1c, blood pressure, uric acid) and elements levels in plasma and whole blood were collected. The 2.5th to 97.5th was used to represent the reference range of Cu, Zn and Cu/Zn ratio. Results: The reference range of Zn, Cu and Cu/Zn ratio in plasma were 70.46–177.53 µg/dL, 74.30–170.68 µg/dL and 0.54–1.68, respectively. The reference range of Zn, Cu and Cu/Zn ratios in whole blood were 402.49–738.05, 74.63–124.52 and 0.13–0.25 µg/dL, respectively. Conclusion: The reference range of Zn, Cu and Cu/Zn ratios in plasma and whole blood of healthy Chinese childbearing women could be used as an indicator to evaluate the status of element deficiency and overload.     

Evaluation of Serum Zinc Status of Pregnant Women in the China Adult Chronic Disease and Nutrition Surveillance (CACDNS) 2015

Objective: The purpose of this study was to evaluate serum zinc status of pregnant women in the China Adult Chronic Disease and Nutrition Surveillance (CACDNS) in 2015–2016. Methods: A total of 7147 apparently healthy pregnant women were randomly selected in 302 national monitoring sites. Information on age, race, residence region, education, pregnancy, and family income per annum was collected, and the concentration of serum zinc was determined. The evaluation of serum zinc status was further performed according to the recommendations by the International Zinc Nutrition Consultative Group (IZiNCG). Results: The median concentration of serum zinc was 858.9 μg/L with an interquartile range (IQR) of 712.9 μg/L and 1048.9 μg/L, while the overall prevalence of zinc deficiency was 3.5% with a 95% confidence interval (CI) of 3.0% and 3.9%. Serum zinc status of pregnant women changed greatly in the different categories, particular in pregnancy and family income per annum (p < 0.05), but no significant difference was observed in the prevalence of zinc deficiency (p > 0.05). Conclusions: The lower prevalence of zinc deficiency generally indicated a better zinc status for pregnant women in the CACDNS in 2015–2016. However, a well-designed evaluation system of zinc status for pregnant women should be continually optimized and improved by inducing more parameters such as biochemical, dietary, or functional indicators.     

Zinc Nutritional Status and Risk Factors of Elderly in the China Adult Chronic Disease and Nutrition Surveillance 2015

Objectives: To analyze the serum zinc nutrition status of the Chinese elderly, and to assess the risk factor for zinc deficiency. Methods: 3727 elderly people over 60 years old were randomly selected from 302 monitoring points in 31 provinces of China Adult Chronic Disease and Nutrition Surveillance (CACDNS) 2015. Blood samples were selected from the biological sample bank of CACDNS 2015 and the basic information were collected by questionnaires. The criteria of serum zinc deficiency recommended by the International Zinc Nutrition Consulting Group (IZiNCG) were adopted, and the related factors were also analyzed. Results: The median serum zinc concentration of Chinese elderly was 99.2 (84.3~118.7) μg/dL. The overall adjusted prevalence of zinc deficiency was 8.68%, with a 95% confidence interval (CI) of 7.74% and 9.61%. Significant differences were found in different sex, age groups, Body Mass Index (BMI), residence region, race and education level in terms of serum zinc status in the elderly (p < 0.05). Participants who are males, aged above 70y, with BMIs of less than 18.5 kg/m², living in rural areas, minority, and with the lowest income had a higher prevalence of zinc deficiency in the subgroups under different classifications. The risk of zinc deficiency in the elderly over 70y was 1.44 higher than those aged 60–69y (OR = 1.44, 95%CI 1.14–1.82), and the minority elderly has a 1.39 higher risk than Han nationality (OR = 1.39, 95%CI 1.01–1.91), while overweight/obesity and female elderly were at lower risk (OR < 1, p < 0.05). Conclusions: The overall prevalence of zinc deficiency in the elderly was highest in all adults in the CACDNS. It is recommended that the male elderly, over 70 years, and the minority elderly should pay more attention to the zinc nutrition status of their own.     

Association between Dietary Fiber Intake and Hyperuricemia among Chinese Adults: Analysis of the China Adult Chronic Disease and Nutrition Surveillance (2015)

This study aimed to assess the association of dietary fiber intake with serum uric acid (SUA) levels and risk of hyperuricemia (HUA) among Chinese adults using the latest nationally representative data. A total of 66,427 Chinese adults aged 18 years and over from the China Adult Chronic Disease and Nutrition Surveillance in 2015 were included in this study. Dietary intakes were measured with a 3-day 24 h dietary recall and the household condiment weighing method. Mixed-effect linear and logistic regression models were used to evaluate the associations of dietary fiber intake with SUA levels and risk of HUA, respectively. Compared to the lowest intake group, the coefficient and 95% confidence in the highest intake group of total fiber were −0.06 (−0.08, −0.04) (p-trend < 0.001), −0.18 (−0.2, −0.16) (p-trend < 0.001) for cereal fiber, 0.03 (0.01, 0.04) (p-trend = 0.051) for legume fiber, 0 (−0.01, 0.02) (p-trend = 0.869) for vegetable fiber and 0.01 (−0.001, 0.04) (p-trend = 0.296) for fruit fiber. The odds ratio (OR) and 95% confidence interval (CI) of HUA for the highest vs. lowest intake group of total fiber were 0.88 (0.84, 0.91) (p-trend = 0.001), 0.67 (0.63, 0.71) (p-trend < 0.001) for cereal fiber, 1.05 (1, 1.09) (p-trend = 0.248) for legume fiber, 1.01 (0.97, 1.05) (p-trend = 0.982) for vegetable fiber and 1.06 (1, 1.12) (p-trend = 0.264) for fruit fiber. Our findings suggest that consumption of total fiber and cereal fiber were significantly inversely associated with SUA levels and HUA risk among the Chinese adult population. Developing and implementing effective public education programs are urgently needed to increase the intake of dietary fiber, especially cereal fiber among Chinese adults.     

云南省农村孕产妇孕前保健知信行调查

目的 了解云南省农村育龄妇女孕前保健知识、态度和行为.方法 采用整群随机抽样抽取甲县5个乡镇.乙县3个乡镇,符合随访条件的共4 367名农村孕产妇进行问卷调查.结果 (1)农村育龄人群对健康生育的要求非常强烈,出生缺陷预防知识点知晓率较为满意.(2)在甲县有51.7%的人在围孕期或孕期补充过叶酸,有31.6%的人能正确服用;乙县该百分比分别为5.4%和1.1%.(3)农村孕前检查率较低.特别是对于一些相对特殊、专业性较强的检查.如梅毒血清学试验、染色体检查等项目则检查率非常低.结论 在出生缺陷干预工作中,计划生育系统应充分发挥系统优势,在搞好宣传教育的同时,进一步加强自身技术建设,为育龄群众提供可及、可得和可接受的孕前保健技术服务.     

Development of Fatty Acid Reference Ranges and Relationship with Lipid Biomarkers in Middle-Aged Healthy Singaporean Men and Women

Dietary fatty acids (FA) are essential for overall human health, yet individual FA reference ranges have yet to be established. Developing individual FA reference ranges can provide context to reported concentrations and whether an individual displays deficient, or excess amounts of FA. Reference ranges of sixty-seven individual FA (μmol/L) were profiled and analyzed using gas chromatography with a flame ionization detector from serum samples collected from 476 middle-aged Singaporean males (BMI:23.3 ± 2.9) and females (BMI:21.8 ± 3.6). Measures of triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol (TC) (mmol/L) were also collected. The mean FA concentration seen in this cohort (11,458 ± 2478 was similar to that of overweight North American cohorts assessed in past studies. Ten biologically relevant FA were compared between sexes, with females exhibiting significantly higher concentrations in four FA (p < 0.05). A multiple regression model revealed the ten FA contributed significantly to nearly all lipid biomarkers (p < 0.05). A majority of participants who had FA concentrations in the ≥95th percentile also exhibited TG, HDL, LDL, and TC levels in the “high” risk classification of developing cardiovascular disease. Future studies profiling individual FA reference ranges in many unique, global cohorts are necessary to develop cut-off values of individual FA concentrations highly related to disease-risk.     

海南省育龄期妇女破伤风类毒素接种与新生儿破伤风病例监测的流行病学效果

为了实现消除新生儿破伤风 (NNT)的目标 ,1996年卫生部、联合国儿童基金会与海南省合作 ,在三亚市、琼中县开展了消除NNT试点研究工作。方法是 :采用按容量比例概率抽样 (PPS)方法调查项目市、县活动前后育龄期妇女破伤风类毒素 (TT)接种率 ,育龄期妇女未接种TT的主要原因。育龄期妇女TT接种以突击接种为主 ,并逐步纳入常规计划免疫系统 ,NNT病例监测纳入急性弛缓性麻痹 (AFP)病例监测系统同时运行。通过项目的开展TT3 接种率分别提高到 87 3 %、88 8% ,NNT发病率下降到1/ 10 0 0个活产儿以下 ,TT未接种的主要原因为外出打工。监测系统报告男女病例比例 1 2 5 :1。建议 :①提高新法接生率 ;②将育龄期妇女TT接种纳入常规计划免疫运转 ,并应与计划生育、优生、优育工作密切结合     

Vitamin D Nutritional Status of Chinese Pregnant Women,Comparing the Chinese National Nutrition Surveillance (CNHS) 2015–2017 with CNHS 2010–2012

Optimal vitamin D (vitD) status is beneficial for both pregnant women and their newborns. The aim of this study was to evaluate the vitamin D status of Chinese pregnant women in the latest China Nutrition and Health Surveillance (CNHS) 2015–2017, analyze the risk factors of vitamin D deficiency (VDD), and compare them with those in CNHS 2010–2012. Serum 25 hydroxyvitamin D (25(OH)D) was measured by ELISA method. City type, district, latitude, location, age, vitamin D supplements intake, education, marital status, annual family income, etc., were recorded. The median 25(OH)D concentration was 13.02 (10.17–17.01) ng/mL in 2015–2017, and 15.48 (11.89–20.09) ng/mL in 2010–2012. The vitamin D sufficient rate was only 12.57% in 2015–2017, comparing to 25.17% in 2010–2012. The risk factors of vitamin D inadequacy (25(OH)D < 20 ng/mL) in 2015–2017 were not exactly consistent with that in 2010–2012. The risk factors included season of spring (p < 0.0001) and winter (p < 0.001), subtropical (p < 0.001), median (p < 0.0001) and warm temperate zones (p < 0.0001), the western (p = 0.027) and the central areas (p = 0.041), while vitD supplements intake (p = 0.021) was a protective factor in pregnant women. In conclusion, vitD inadequacy is very common among Chinese pregnant women. We encourage pregnant women to take more effective sunlight and proper vitD supplements, especially for those from the subtropical, warm and medium temperate zones, the western and the central, and in the seasons of spring and winter.     

云南省孕妇和哺乳期妇女的碘营养水平监测结果分析

目的：监测孕妇和哺乳妇食用新标准食盐[碘含量（18～33 mg／kg ）]的碘营养水平,指导全省碘缺乏病防控工作。方法选取安宁市、牟定县、南涧县、宁洱县、梁河县,每个县（市）选择城区和近城区农村、偏远山区农村各1个乡镇,每个乡镇抽取至少30名孕妇或哺乳妇,检查其甲状腺大小,采集其尿样及其家中的食用盐分别测定尿碘含量和盐碘含量,采集项目点饮用水测定水碘含量,对受检人群进行碘缺乏病健康教育知晓率调查。结果抽取的水样中碘含量中位数为1．59μg／L ;盐碘中位数为23．7 m g／kg ,碘盐合格率为95．9％,合格碘盐食用率为94．8％;尿碘中位数为168．7μg／L ,总体上5个县的尿碘之间具有统计学差异（ P＜0．01）;孕妇和乳妇尿碘中位数分别为175．5μg／L、163．6μg／L ,孕妇＜150μg／L占39．9μg／L ,乳妇＜100μg／L 占22．2μg／L ;孩子半岁后乳妇的平均尿碘高于半岁前的乳妇,二者尿碘中位数构成分布有统计学差异（ P＜0．05）;城区和农村尿碘中位数分别为158．8μg／L、172．5μg／L ,农村高于城区,二者尿碘有统计学差异（ P＜0．01）;甲肿率（B超法）为0．9％。碘缺乏病健康教育知晓率为69.6％。结论孕妇和乳妇尿碘中位数总体适宜,但部分人群存在碘营养不足的健康风险,通过增加食用富碘食品和碘营养制剂增加碘摄入,或者给这些特殊人群供应较高浓度的食用碘盐[碘含量30mg／kg（21～39mg／kg）],以保障孕期和哺乳期适宜的碘营养水平。     

郴州市健康体检人群血脂水平分析与参考范围研究

目的了解郴州市健康体检人群血脂水平现状及该地区血脂参考范围。方法应用西门子1800全自动生化分析仪检测郴州市8 502例成人空腹血脂水平。血脂指标包括TG、CHOL、HDL和LDL,并比较不同性别和年龄组间血脂水平差别。结果 55岁以下男、女组间比较,CHOL、HDL、TG、LDL差异均有统计学意义（P〈0.01）,55岁以上男、女组间比较,CHOL、HDL、LDL差异有统计学意义（P〈0.01）,TG差异无统计学意义（P〉0.05）。男性55岁以上组与55岁以下组比较分析,CHOL、TG、HDL、LDL差异均有统计学意义（P〈0.01）;女性体检者55岁以上组与55岁以下组比较分析,CHOL、TG、HDL、LDL差异均有统计学意义（P〈0.01）。血脂参考范围分别为：1）男性55岁以下组血脂四项水平为：CHOL 3.44~7.12 mmol/L,TG0.66~5.60 mmol/L,HDL0.86~1.95 mmol/L,LDL1.31~4.21 mmol/L。2）男性55岁以上组血脂四项水平为：CHOL3.38~7.34 mmol/L,TG0.67~5.08 mmol/L,HDL0.88~2.09 mmol/L,LDL1.29~4.47mmol/L。3）女性55岁以下组血脂四项水平为：CHOL 3.26~6.91 mmol/L,TG0.51~3.72 mmol/L,HDL0.96~2.32mmol/L,LDL1.19~4.06 mmol/L。4）女性55岁以上组血脂四项水平为：CHOL3.69~7.88 mmol/L,TG 0.67~4.26mmol/L,HDL0.93~2.31 mmol/L,LDL1.37~4.74 mmol/L。结论血脂水平与性别、年龄相关,郴州市成人血脂水平部分指标参考范围与全国合适水平有差异,可为该地区血脂异常防治工作提供依据。     

低体重婴儿体外循环血浆Ca++、Mg++的监控

体外循环(CPB)心内直视手术期间低钙,低镁已受到重视[1,2],且也比较注意补钙,以支持心肌收缩,取得较好的效果.但小婴儿,特别是低体重先天性心脏病小婴儿CPB期间血浆Ca2 、Mg2 的变化规律及如何补钙问题报道甚少.作者于2003年1～7月对20例6kg以下婴儿体外循环期间血浆Ca 、Mg 水平进行监测,以便为CPB期间补钙提供参考.     

Attention Should Be Paid to Adolescent Girl Anemia in China: Based on China Nutrition and Health Surveillance (2015–2017)

Adolescent girls are in the key stages of rapid physical and psychological development and have a great demand for iron. Anemia affects adolescent girls’ health, future development, and even the health of their offspring. There has been limited study of adolescent girl anemia at the national and provincial levels in China. We investigated the anemia status of adolescent girls in China based on data from the China Nutrition and Health Surveillance (CNHS, 2015–2017). The anemia prevalence in Chinese adolescent girls aged 10–17 years is 8.5%, with mild anemia and moderate anemia accounting for 65.9 and 31.8%, respectively, and severe anemia accounting for only 2.3%. Significant urban–rural disparities and regional disparities were found in adolescent girl anemia. The anemia prevalence in adolescent girls varied from 3 to 13.4% in different provinces, and 90% of the provinces had anemia prevalence higher than 5%. Having started menstruating (OR = 2.58, p < 0.01) and living in rural areas (OR = 1.18, p < 0.05) were risk factors for anemia; having a mother with higher education was a protective factor (OR = 0.87, p < 0.05). As for food intake, consuming meat ≥35 g per day was a protective factor (OR = 0.90, p < 0.05). Consuming vegetables ≥3 times per day was also a protective factor (OR = 0.72, p < 0.01), while consuming vegetables ≥400 g per day was a risk factor (OR = 1.24, p < 0.01). Special attention should be paid to adolescent girls, especially to those already having started menstruating, living in rural areas, to those whose mother has a low education level, and to those with a relatively unbalanced diet. Comprehensive measures, including paying special attention to vulnerable areas and vulnerable subgroups of adolescent girls, would reduce the risk of anemia.     

Trimester-Specific Reference Ranges for Saturated,Monounsaturated and Polyunsaturated Fatty Acids in Serum of Pregnant Women: A Cohort Study from the ECLIPSES Group

In the course of pregnancy, increasing importance is being placed on maintaining optimal fatty acid (FA) levels and particularly n-3 PUFAs to ensure correct fetal development. However, reference ranges for FA have been reported in only a few studies. Our objective is to provide quantitative reference intervals for SFAs, MUFAs, and PUFAs (n-6 and n-3) in a large population of healthy pregnant women from a developed country. A prospective study of pregnant women (n = 479) was conducted from the first trimester (T1) to the third trimester (T3). A total of 11 fatty acids were analyzed in serum by gas chromatography mass spectrometry and were expressed as absolute (µmol/L) and relative (percentage of total FA) concentration units. Serum concentrations of SFAs, MUFAs, n-6 PUFAs, n-3 PUFAs, various FA ratios, and the EFA index were determined. The reference intervals (2.5/97.5 percentiles) in absolute values from T1 ranged from 1884.32 to 8802.81 µmol/L for SFAs, from 959.91 to 2979.46 µmol/L for MUFAs, from 2325.77 to 7735.74 µmol/L for n-6 PUFAs, and from 129.01 to 495.58 µmol/L for n-3 PUFAs. These intervals mainly include the values of other studies from European populations. However, reference ranges vary according to some maternal factors. The FA levels proposed, obtained from a large sample of pregnant women, will be a useful tool for assessing the degree of adequacy of FAs in pregnant women and will help to carry out dietary interventions based on certain maternal factors.     

DHA in Pregnant and Lactating Women from Coastland,Lakeland, and Inland Areas of China: Results of a DHA Evaluation in Women (DEW) Study

Few studies have examined docosahexaenoic acid (DHA) in pregnant and lactating women in developing countries like China, where DHA-enriched supplements are increasingly popular. We aimed to assess the DHA status among Chinese pregnant and lactating women residing areas differing in the availability of aquatic products. In total, 1211 women in mid-pregnancy (17 ± 2 weeks), late pregnancy (39 ± 2 weeks), or lactation (42 ± 7 days) were enrolled from Weihai (coastland), Yueyang (lakeland), and Baotou (inland) city, with approximately 135 women in each participant group by region. DHA concentrations were measured using capillary gas chromatography, and are reported as weight percent of total fatty acids. Mean plasma DHA concentrations were higher in coastland (mid-pregnancy 3.19%, late pregnancy 2.54%, lactation 2.24%) and lakeland women (2.45%, 1.95%, 2.26%) than inland women (2.25%, 1.67%, 1.68%) (p values < 0.001). Similar differences were observed for erythrocyte DHA. We conclude that DHA concentrations of Chinese pregnant and lactating women are higher in coastland and lakeland regions than in inland areas. DHA status in the study population appears to be stronger than populations from other countries studied to date.     

Trends and Urban-Rural Disparities of Energy Intake and Macronutrient Composition among Chinese Children: Findings from the China Health and Nutrition Survey (1991 to 2015)

The nutrition status of children is gaining more attention with a rapid nutrition transition. This study aimed to investigate trends and urban-rural differences in dietary energy and macronutrient composition among Chinese children. A total of 7565 participants aged 6 to 17 years were obtained from three rounds (1991, 2004 and 2015) of the Chinese Health and Nutrition Survey (CHNS). The individual diet was evaluated via three consecutive 24-hour dietary recalls and compared with the Chinese Dietary Reference Intakes (DRIs). From 1991 to 2015, there was a significant increase in children’s fat intake, the proportion of energy intake from fat, and the proportion of children with more than 30% of energy from fat and less than 50% of energy from carbohydrates (p < 0.001). Compared with the DRI, the proportion with higher fat and lower carbohydrate intakes were, respectively, 64.7% and 46.8% in 2015. The urban-rural disparities in fat and carbohydrate intake gradually narrowed, while the gap in protein intake increased notably over time (p < 0.001). Chinese children experienced a rapid transformation to a low-carbohydrate and high-fat diet. Urban-rural disparities persistently existed; further nutritional interventions and education were of great significance, so as to ensure a more balanced diet for Chinese children.     

Knowledge of Treatment to Reduce Perinatal Human Immunodeficiency Virus (HIV) Transmission and Likelihood of Testing for HIV: Results from Two Surveys of Women of Childbearing Age

Objective: To determine whether knowledge of zidovudine treatment to reduce the risk of mother-to-child transmission of HIV increases the likelihood of HIV testing among women of childbearing age at increased risk for HIV infection. Method: Data from two samples were analyzed. The Young Women Survey was a population-based, door-to-door survey of 2,545 women aged 18 to 29 years who were living in lower-income neighborhoods. For the Perinatal Survey, women receiving prenatal care or who had delivered within the previous six months (N = 850) were recruited at randomly selected sites. Most (71.2%) of these participants were covered by public payment sources for their prenatal care. Data were collected within California counties with high rates of HIV among newborns, high rates of HIV among female clients of alternative test sites, and high rates of AIDS among female injection drug users. Most participants from both surveys were women of color. Results: Participants who knew about zidovudine therapy for HIV-positive pregnant women were more likely to have had an HIV test, regardless of race/ethnicity, age, education, or number of previous births. The majority of women (79.3%) from both samples stated that they were more likely to take a test for HIV knowing about zidovudine treatment. Conclusions: HIV educators should include information on zidovudine therapy in campaigns designed to promote HIV testing among women. Prenatal care providers should incorporate a brief discussion about the benefits of zidovudine treatment when providing HIV counseling to patients.     

Bone Metabolic Abnormalities Associated with Well-Controlled Type 1 Diabetes (IDDM) in Young Adult Women: A Disease Complication Often Ignored or Neglected

Objectives: This investigation on a homogenous cohort of young adult Caucasian type 1 diabetic (IDDM) patients (1) aimed at studying the occurrence of low bone mineral density (BMD) at an early stage prior to menopause (i.e., during the first decade after peak bone mass) and (2) elucidating the possible mechanisms underlying IDDM-induced bone complication.

Methods: Twenty-seven female patients with insulin-treated and well-controlled diabetes, without renal complications, and 32 well-matched healthy controls, aged between 30 and 40 years and fulfilling rigorous inclusion criteria to minimize bone-confounding factors, were enrolled. Areal BMD was evaluated by dual energy X-ray absorptiometry at axial (lumbar spine) and appendicular (femur) sites, using diagnostic WHO reference (T-scores). Osteoblast functions, bone metabolism, related key minerals, and 2 osteoclast-stimulating calciotropic hormones regulating their serum levels were assessed biochemically.

Results: The number of cases with low BMD (T-score below ?1.1 SD) was almost 2-fold greater (p < 0.01) in the IDDM group. BMD was significantly lower in this group for 3 lumbar sites (p < 0.01) and femur Ward's triangle (p < 0.05). Bone formation was reduced, as evidenced by the suppressions of osteocalcin (OC; p < 0.01) and IGF-I (p < 0.001). However, bone alkaline phosphatase (bALP) was induced (p < 0.01), in contrast to what is usually observed in cases of reduced bone formation. Correlated total ALP activity was also significantly increased. There was no change in the specific marker of bone resorption (urinary deoxypyridinoline). Serum calcium was significantly elevated, particularly after adjustment for albumin (p < 0.001), despite lower 1,25(OH)₂D₃ (p < 0.001) and no elevation of PTH. All significant bone-related biochemical changes were significantly correlated with glycosylated hemoglobin, a clinical indicator of long-term glycemic control, indicating a direct effect of the disease.

Conclusions: Bone loss in the IDDM group results from a decrease in bone formation rather than an increase of bone resorption. The induction of bALP is indicative of impaired osteoblast differentiation and maturation, which delayed (down-regulated) later stages of matrix mineralization, as evidenced by lower OC and BMD.     

Intake of Vitamin E and C in Women of Reproductive Age: Results from the Latin American Study of Nutrition and Health (ELANS)

Vitamin E was identified as a lipophilic compound essential to maintain rat pregnancy. Low vitamin E intake during early pregnancy associates with congenital malformations and embryonic loss in animals and with miscarriage and intrauterine growth restriction in humans. Vitamin E protects cell membranes from lipoperoxidation and exerts non-antioxidant activities. Its function can be restored by vitamin C; thus, intake and circulating levels of both micronutrients are frequently analyzed together. Although substantial vitamin E inadequacy was reported worldwide, its consumption in Latin America (LatAm) is mostly unknown. Using data from the Latin American Study of Nutrition and Health (Estudio Latinoamericano de Nutrición y Salud, ELANS), we evaluated vitamin E and C intake in women of reproductive age (WRA) from eight LatAm countries and identified their main food sources. Two non-consecutive 24-h dietary recalls in 3704 women aged from 15 to 49 years and living in urban locations showed low average intake of vitamin E (7.9 mg/day vs. estimated average requirement (EAR) of 12 mg/day) and adequate overall vitamin C consumption (95.5 mg/day vs. EAR of 60 mg/day). The mean regional inadequacy was 89.6% for vitamin E and 36.3% for vitamin C. The primary food sources of vitamin E were fats and oils, as well as vegetables. Vitamin C intake was explained mainly by the consumption of fruit juices, fruits, and vegetables. Combined deficient intake of both vitamins was observed in 33.7% of LatAm women. Although the implications of low antioxidant vitamins’ consumption in WRA are still unclear, the combined deficient intake of both vitamins observed in one-third of ELANS participants underscores the need for further research on this topic.     

Anemia of School-Age Children in Primary Schools in Southern China Should Be Paid More Attention despite the Significant Improvement at National Level: Based on Chinese Nutrition and Health Surveillance Data (2016–2017)

Globally, anemia among school-age children (SAC) remains a serious public health problem, impacting their growth, development, educational attainment and future learning potential. National and subnational anemia prevalence among SAC in China has not been assessed recently. Based on data from Chinese Nutrition and Health Surveillance (2016–2017), the current anemia status of SAC in primary schools in China was investigated. Anemia prevalence of SAC in primary schools in China was 4.4%, dropping 63.6% compared with that in 2002. Even though anemia was no longer a significant public health problem at the national level, there were significant spatial disparities of anemia prevalence in different areas: anemia prevalence in 63% of provinces of northern and eastern China has lowered to below 5%, while in provinces of southern China, it was still ranging from 5% to 11.0%, about 3 times of other areas. For those children in southern China, mother’s education level (OR = 1.24, p = 0.04) and father’s education level (OR = 1.27, p = 0.01) below senior high school, eating meat less than 3 times per week (OR = 1.18, p = 0.01) were risk factors of anemia. Older age (OR = 0.35–0.72, p < 0.01) was a protective factor. Targeted interventions should be taken to improve SAC anemia in Southern China, despite anemia of SAC in primary schools no longer being a significant public health problem.