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What is already known about this topic? The prevalence of underweight malnutrition largely decreased in Chinese adults in recent thirty years while obesity became increasingly concerning. However, underweight malnutrition still affected elderly populations and increased risk of anemia, infection diseases, some non-communicable chronic diseases and disability. What is added by this report? In this study, data from 4 national surveys from 1992 to 2015 were analyzed to study underweight malnutrition. There was an 80.5% reduction for underweight malnutrition nationally, including a 67.5% reduction in rural areas and 67.4% in urban areas, and 76.2% in males and 79.4% in females. What are the implications for public health practice? Underweight malnutrition seriously affects the health and quality of life for older people and will lead to heavy burdens for families and society overall. Therefore, efforts should be maintained to screen, treat, and safeguard elderly populations with underweight malnutrition using nutritional improvement strategies, especially for the oldest elderly individuals in rural areas.

Nutrition is closely related to the health of the elderly population. This study aimed to provide a comprehensive picture of the nutrition status of elderly Chinese and its related dietary, geographical, and socioeconomic factors.A total of 13,987 ≥ 60-year-old persons from the 2010-2013 Chinese National Nutrition and Health Survey were included to evaluate various aspects of malnutrition, including underweight, overweight or obesity, and micronutrient inadequacy.Overall, the prevalence of obesity, overweight, and underweight was 12.4%, 34.8%, and 5.7%, respectively, with disparities both geographically and socioeconomically. The prevalence of underweight was higher among the older old (≥ 75 years), rural residents and those with low income, with low education status, and residing in undeveloped West areas. More than 75% of the elderly do not meet the Dietary Reference Intakes for vitamins A, BObesity epidemic, inadequacy of micronutrient intake, and high prevalence of underweight and anemia in susceptible older people are the major nutrition challenges for the rapidly aging population in China.

Early diagnosis of neural changes causing cognitive impairment is critical for development of preventive therapies for dementia. Biomarkers currently characterized cannot be extensively applied due to the invasive sampling of cerebrospinal fluid. The other imaging approaches are either expensive or require a high technique. Phospholipids (PLs), which are basic constituents of neurons, might be a key variable in the pathogenesis of cognitive impairment. Changes in plasma PL provide the possibility for development of novel biomarkers with minimal invasion and high patient acceptance. In this work, a HILIC-ESI-IT-TOF-MS system was introduced for untargeted profiling of plasma PLs to investigate the relationship between changes of plasma PL profiles and cognitive impairment. A total of 272 types of PL molecular structures were characterized in human plasma and quantified through the internal standard method. Univariate analysis shows 29 PLs were significantly different between the control (n = 41) and the cognitive impairment (CI) group (n = 41). Multivariate analysis (PCA and OPLS-DA) was conducted based on these 29 potential PL biomarkers. Both univariate and multivariate analyses show abnormality of PL metabolism in the CI group, and the downregulation of ethanolamine plasmalogen (pPE) supply, especially those with PUFAs, in the circulation system should be strongly associated with neurodegeneration. A discriminative model was established with satisfied fit (R2) and prediction (Q2) abilities, and the classification test showed better recognition of the CI group than the control group indicating that this model of PL biomarkers could be used as indicators for screening of CI. Graphical abstract Characterization of potential plasma biomarkers related to cognitive impairment by untargeted profiling of phospholipids.

OBJECTIVE To investigate the trends of lipid profiles and dyslipidemia among Chinese adults from 2002 to 2015. METHODS Data were collected from three nationally representative cross-sectional surveys. Fasting venous blood samples were collected and serum lipids were tested by biochemical analysis and enzymatic determination. Lipid levels and the prevalence of dyslipidemia among adults were analyzed with complex sampling weighting adjustment for age and gender. RESULTS The weighted means of TC, TG, and LDL-c significantly increased linearly from 3.93, 1.12, and 2.12 mmol/L in 2002 to 4.59, 1.41, and 2.78 mmol/L in 2010 and then to 4.63, 1.47, and 2.87 mmol/L in 2015, respectively; by contrast, HDL-c levels decreased significantly from 1.30 mmol/L to 1.26 mmol/L over the same period. Similar trends in mean non-HDL-c and lipid-related ratios were observed. The weighted dyslipidemia prevalence linearly increased; in particular, hypercholesterolemia increased from 1.6% to 5.6% and then to 5.8%, hypertriglyceridemia increased from 5.7% to 13.6% and then to 15.0%, low HDL-c increased from 18.8% to 35.5% and then to 24.9%, and high LDL-c increased from 1.3% to 5.6% and then to 7.2% (P for trend0.001). CONCLUSION Dyslipidemia increased among Chinese adults from 2002 to 2015. Development of a comprehensive strategy to decrease lipid levels in this population is urgently required.

Simultaneous profiling of serum vitamin D (VD) metabolites with similar structures is a big challenge. Thus, we developed and validated a SFC-MS/MS method, which is capable of eluting hydrophobic molecules, for quantification of VD2/VD3, 25-OH VD2/VD3, 3-epi-25-OH VD2/VD3, 1,25-(OH)2 VD2/VD3 and 24,25-(OH)2 VD2/VD3. VD metabolites were extracted from human serum using acetonitrile solvent. Column stationary phase, elution gradients, flow rate, column temperature, ion-source type and buffer system in post-column make-up solvent were optimized. Baseline separation of 10 VD metabolites can be achieved using PFP column within 10 min; and detection performed under positive electrospray ionization mode allowed quantification of VD metabolites in serum matrix with a limit of quantification (LOQ) varrying from 0.071 to 0.704 ng/mL. The accuracy was controlled with relative bias lower than 5.5% for QC and NIST samples. The developed method showed excellent intra-assay (0.52–7.93% RSD) and inter-assay (1.35–9.04% RSD) precision. The methodology shows enhanced efficiency and sensitivity as compared to LC-MS/MS method using the same column and mass spectrometer, along with significant correlation and low mean difference bias on measurements. For analysis of trace 1,25-(OH)2 VD2 and 1,25-(OH)2 VD3 in normal human serum or plasma, further improvement of LOQ (like derivatization) should be considered. In conclusion, the use of supercritical fluid not only enhanced safety with reduced solvent cost, but also improved retention and sensitivity as compared to LC-MS/MS method. The developed SFC-MS/MS method is appropriate for high throughput analysis of multiple VD metabolites in human serum with reduced solvent and economic cost.

Undernutrition is highly prevalent among older people. The aim of this study was to estimate the prevalence of undernutrition in elderly Chinese residents and explore the relationship between undernutrition and dietary factors.Data were collected from 2,552 elderly people aged 75 years and over from the Chinese Nutrition and Health Surveillance during 2010-2012 using questionnaires, anthropometric measurement, and individual consecutive 3-day 24-hour dietary records.The present study showed that 10.5% of participants had undernutrition. The prevalence was higher among the population living in rural areas, those living in the South region, those who smoked, and those with low income levels. Most participants failed to meet the Chinese Dietary Reference Intakes for energy (66.1%) and protein (72.1%). When comparing quartiles of food intake, high rice consumption [odds ratio (OR) = 2.44, 95% confidence interval (CI): 1.35-4.40)], animal oil intake (OR = 1.60, 95% CI: 1.18-2.17), and high fat intake from animal sources (OR = 1.56, 95% CI: 1.06-2.31) were positively associated with underweight whereas high wheat consumption (OR = 0.44, 95% CI: 0.26-0.74), a proper proportion (24%-32%) of energy intake from fat (OR = 0.54, 95% CI: 0.35-0.83), and high fat intake from plant sources (OR = 0.67, 95% CI: 0.46-0.99) were inversely related.The prevalence of undernutrition was high among elderly Chinese people, especially in rural areas. Dietary factors, such as high consumption of rice, were associated with undernutrition.

Nuts, a class of fatty natural food, are associated with a series of health benefit. Lipid, which is the most abundant nutrient in nuts, could be one of the major contributors to many beneficial effects. In previous studies, only the composition of fatty acids was investigated. To better understand the nutritional value of nuts, phospholipids (PLs), with widely confirmed bioactivities, should be profiled as well. In this work, a HILIC-ESI-IT-TOF-MS system is applied to characterize PL profiles in six kinds of nut, including almonds, cashews, pecans, pistachios, walnuts and peanuts. A total of 165 PL molecular species were characterized and quantified. The obtained results showed that pistachios, cashews and walnuts are favorable nuts with diverse and high content of PLs; peanuts consist of abundant PL species but lower concentration of PLs; almonds and pecans might not be the first choice for PLs with relatively low species abundance and content.

To study the risk factors on anemia among elderly women in rural areas of Xiuning county, Anhui province, China.Xiuning county was selected as working field and elderly women aged 50-75 y were selected as subjects. Finger hemoglobin (Hb) was measured and basic health survey was face-to-face interviewed. 220 elderly women with anemia entered into the case group; and matched by age, another 220 women with normal Hb concentration entered the control group. Survey on diet, questionnaire regarding health and lifestyle and related blood indexes were studied and tested.When comparing the data from both case and control groups, weight was (49.4 +/- 7.3) kg vs. (52.5 +/- 8.4) kg (t = 3.97, P0.01), waist circumference was (75.8 +/- 7.8) cm vs. (79.1 +/- 9.3) cm (t = 3.85, P0.01), BMI was (21.8 +/- 2.6) kg/m2 vs. (22.9 +/- 3.2) kg/m2 (t = 3.775, P0.01), respectively. The total protein was (76.4 +/- 5.0) g/L vs. (78.4 +/- 5.6)g/L (t = 3.83, P0.01), albumin was (45.7 +/- 3.1) g/L vs. (47.3 +/- 2.9)g/L (t = 5.24, P0.01), serum iron was ( 10.3 +/- 4.1) micromol/L vs. (12.7 +/- 4.6) micromol/L (t = 5.48, P0.01), and saturation of transferrin was (19.0 +/- 7.6)% vs. (23.1 +/- 9.1) % (t = 4.90, P0.01), respectively. Results from multifactor conditioned logistic regression analysis showed that the odd ratios (OR) for anemia with staple food, BMI and vitamin A were 1.54, 1.89, 1.69, and the OR for anemia with BMI, staple food, animal food, carbohydrate and vitamin A were 2.0, 1.6, 1.6, 1.4, 1.6, with their confidence intervals (CI) as 1.3-2.9, 1.1-2.3, 1.0-2.3, 1.0-2.1, 1.1-2.4, respectively.The quality of diet, health status and related blood indexes on anemia among elderly women were lower than that in control group. Lower BMI, less staple food and animal food, less carbohydrate and vitamin A intake appeared to be risk factors of anemia.

To study the related risk factors of anemia of rural elderly women in Huangling county, Shanxi, northwest of China.Elderly women aged 50-75 years in Huangling (northwest of China) were selected as study objects. Finger hemoglobin (Hb) was measured and basic health survey was face-to-face questioned. Two-hundred anemia elderly women were entered into the case group; and by age-matching, 200 with normal Hb concentration were entered into the control group. Dietary survey, health and lifestyle questionnaire were undertaken, and related blood indexes were tested.In case and control group, annual income was (446.1 +/- 107.9) vs (903.8 +/- 179.1) yuan (t = 3.06, P0.01), daily average physical active time was (9.6 +/- 3.2) vs (10.3 +/- 3.1) hours (t = 1.94, P0.05), proportion of experiencing food scarce period was 31.8% vs 22.6% (chi2 = 4.14, P0.05), waist circumference was (76.2 +/- 7.3) vs (79.5 +/- 8.9) cm (t = 4.08, P0.01), respectively; the total protein was (78.0 +/- 5.8) vs (81.9 +/- 6.0) g/L(t = 5.94, P0.01), serum iron was (13.9 +/- 5.7) vs (16.1 +/- 5.0) micromol/L (t = 4.19, P0.01), serum ferritin was (94.9 +/- 76.4) vs (116.6 +/- 85.2) microg/L (t = 2.58, P0.01), saturation of transferrin was 22.9% +/- 10.0% vs 25.6% +/- 8.7% (t = 3.16, P0.01), respectively. Multifactor conditioned logistic regression analysis showed that the odd ratio (OR) for anemia with annual income, whether experiencing food scarce period, daily average physical active time, staple food, soybean products, energy was 0.57, 4.74, 0.06, 0.59, 0.55, 0.65, respectively; their confidence interval (CI) was 0.45 - 0.71, 0.73 - 30.56, 0.01 - 0.52, 0.38 - 0.91, 0.34 - 0.87, 0.44 - 0.98, respectively.The quality of diet, health status and related blood indexes in anemia elderly women were lower than those in control group; lower income, less active time, less staple food, soybean products and energy intake should be risk factors of anemia.

To study the distribution of prevalence on hypercholesterolemia and borderline high cholesterol of Chinese residents aged 20 years and above.To detect the total fasting plasma cholesterol in 48 299 subjects among 20 year-olds and above.Within a certain age range, the prevalence of both hypercholesterolemia and borderline high cholesterol increased with age, but there was a decreasing trend after 60-years of age in some regions. The prevalence of hypercholesterolemia increased to 12.53% in over 70 year-olds group from 1.36% in urban 20-year-olds, and increased to 5.15% from 60-year-olds group comparing to 0.98% of the 20-year-old group in rural areas. When comparing to the 20-year-old age group, the prevalence of borderline high cholesterol of the 70 age group in urban and rural increased by 4.4 and 4.2 times, respectively. The prevalence of hypercholesterolemia in each age group in urban were higher than that of in rural areas. In Rural I, it was higher than that of in Rural II , Rural III and Rural IV. The prevalence rates of both hypercholesterolemia and borderline high cholesterol of the males in the less than 50 year-olds group were higher than that in females, which was quite different from the group older than 50 years of age. As to borderline high cholesterol, similar result was also noticed.Within a certain age range, there was a trend that the prevalence of both hypercholesterolemia and borderline high cholesterol increased with age and related to regions which were classified by economic status. A distinct difference between males and females also existed.

To investigate the plasma lipid levels in a national representative sample of subjects and to determine the prevalence of dyslipidemia in the Chinese population.Plasma lipid profile was analyzed using the data obtained during the Chinese national nutrition and health survey (CNHS) in 2002 which involved 14 252 participants at the age of 18 years or older.The mean levels of total cholesterol (TC), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) in the participants were 3.81 mmol/L, 1.10 mmol/L, and 1.30 mmol/L, respectively. In the groups of participants at the age of 18-44 years, 45-59 years, and over 60 years the mean TC level was 3.70 mmol/L, 4.09 mmol/L and 4.21 mmol/L, respectively, and the mean TG level was 07 mmol/L, 1.21 mmol/L, 1.20 mmol/L, 1.29 mmol/L, 1.33 mmol/L, and 1.33 mmol/L, respectively. The prevalence of dyslipidemia in Chinese adults was 18.6% and 22.2% in males and 15.9% in females. Dyslipidemia prevalence was higher in urban districts than in rural areas (21.0% vs. 17.7%). The prevalence of hypercholesterolemia, hypertriglyceridemia, and low HDL cholesterol was 2.9%, 11.9%, and 7.4% respectively among the participants.Dyslipidemia has become one of the important health risk factors in the Chinese population. There is no significantly difference in the prevalence of dyslipidemia between the groups of participants at the age of 45-59 years and over 60 years. This study provides important lipid profile data for policy making and guideline development for the prevention of dyslipidemia in the Chinese population.

To study plasma total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) levels of Chinese adults among different areas in China.Analysis of fasting plasma lipid in 49,252 subjects aged 18 years and above was made.The mean TC, TG and HDL-C were 3.81 mmol/L, 1.10 mmol/L and 1.30 mmol/L, respectively. The mean TC, TG and HDL-C is 3.96 mmol/L, 1.16 mmol/L, 1.30 mmol/L in adults in urban and 3.75 mmol/L, 1.07 mmol/L and 1.30 mmol/L in adults in rural areas. In age groups of 18 - 44 years, 45 - 59 years and 60 years above, the mean values were 3.70 mmol/L, 4.09 mmol/L, 4.21 mmol/L for TC; 1.07 mmol/L, 1.21 mmol/L, 1.20 mmol/L for TG; and 1.29 mmol/L, 1.33 mmol/L, 1.33 mmol/L for HDL-C.The results of this study might provide the national representative data of plasma lipid level. TC and TG levels of adults in urban might be higher than those adults in rural. With increasing of age, the plasma TC level should be increased. There is no significant difference in TG levels between the adults aged 45-49 years and over 60 years, while the TG level of both age groups should be higher than those of adults aged 18-44 years.

To study the difference in prevalence of dyslipidemia, hypercholesterolemia, hypertriglyceridemia and low blood high-density lipoprotein cholesterol (HDL-C) between the residents of urban and rural areas of varied regions in China.Fasting plasma levels of total cholesterol, triglyceride and HDL-C were determined with the enzyme methods for 49,252 subjects aged 18 and over during August to December, 2002.Prevalence of dyslipidemia in Chinese adults aged 18 and over was 18.6%, with 17.0%, 22.9% and 23.4% in the groups of 18-44, 45-59 and over 60 years old, respectively, 22.2% and 15.9% in males and females, respectively, and 21.0% and 17.7% in urban and rural areas, respectively. Prevalence of hypercholesterolemia, hypertriglyceridemia and low blood HDL-C in those aged 18 and over was 2.9%, 11.9% and 7.4%, respectively.Dyslipidemia has become one of important risk factors threatening health of Chinese people, with hypertriglyceridemia and low blood HDL-C as two major types in those aged 18 and over. Prevalence of dyslipidemia was nearly the same in the middle-aged and in the elderly people, and not significantly different in those living in urban areas from those in rural areas. It is very important to pay more attention to earlier comprehensive prevention and control of dyslipidemia.