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This study investigated the relationships of fat mass (FM) and lean mass (LM) with estimated hip bone strength in Chinese men aged 50-80 years (median value: 62.0 years). A cross-sectional study including 889 men was conducted in Guangzhou, China. Body composition and hip bone parameters were generated by dual-energy X-ray absorptiometry (DXA). The relationships of the LM index (LMI) and the FM index (FMI) with bone phenotypes were detected by generalised additive models and multiple linear regression. The associations between the FMI and the bone variables in LMI tertiles were further analysed. The FMI possessed a linear relationship with greater estimated hip bone strength after adjustment for the potential confounders ( p < 0.05). Linear relationships were also observed for the LMI with most bone phenotypes, except for the cross-sectional area ( p < 0.05). The contribution of the LMI (4.0%-12.8%) was greater than that of the FMI (2.0%-5.7%). The associations between the FMI and bone phenotypes became weaker after controlling for LMI. Further analyses showed that estimated bone strength ascended with FMI in the lowest LMI tertile ( p < 0.05), but not in the subgroups with a higher LMI. This study suggested that LM played a critical role in bone health in middle-aged and elderly Chinese men, and that the maintenance of adequate FM could help to promote bone acquisition in relatively thin men.

This study aimed to elucidate the associations of age, BMI, and years of menstruation with proximal femur strength in Chinese postmenopausal women, which may improve the prediction of hip fracture risk. A cross-sectional study was conducted in 1322 Chinese postmenopausal women recruited from communities. DXA images were used to generate bone mineral density (BMD) and geometric parameters, including cross-sectional area (CSA), outer diameter (OD), cortical thickness (CT), section modulus (SM), buckling ratio (BR) at the narrow neck (NN), intertrochanter (IT), and femoral shaft (FS). Relationships of age, BMI, and years of menstruation with bone phenotypes were analyzed with the adjustment of height, age at menarche, total daily physical activity, education, smoking status, calcium tablet intake, etc. Age was associated with lower BMD, CSA, CT, SM, and higher BR (p < 0.05), which indicated a weaker bone strength at the proximal femur. BMI and years of menstruation had the positive relationships with proximal femur strength (p < 0.05). Further analyses showed that the ranges of absolute value of change slope per year, per BMI or per year of menstruation were 0.14%-1.34%, 0.20%-2.70%, and 0.16%-0.98%, respectively. These results supported that bone strength deteriorated with aging and enhanced with higher BMI and longer time of years of menstruation in Chinese postmenopausal women.

Background Many studies have investigated the effects of soy isoflavones on weight control, but few have focused on the role of equol, a gut-derived metabolite of daidzein with greater bioavailability than other soy isoflavones. Objectives This study examined the association of equol production with obesity and explored the mediating roles of equol-related gut microbiota and microbial carnitine metabolites. Methods This 6.6-y prospective study included 2958 Chinese adults (2011 females and 947 males) aged 60.6 ± 6.0 y (mean ± SD) at baseline. Urinary equol and isoflavones were measured using HPLC–tandem MS. BMI, percentage fat mass (%FM), and serum triglycerides (TGs) were assessed every 3 y. Metagenomics sequencing and assessment of carnitine metabolites in feces were performed in a subsample of 897 participants. Results Urinary equol, but not daidzein and genistein, was independently and inversely associated with the obesity-related indicators of BMI, %FM, and a biomarker (TGs). Equol producers (EPs) had lower odds of adiposity conditions and a reduced risk of 6.6-y obesity progression than non-EPs among total participants. Gut microbial analyses indicated that EPs had higher microbiome species richness (P =  3.42 × 10−5) and significantly different β-diversity of gut microbiota compared with the non-EP group (P  = 0.001), with 20 of 162 species differing significantly. EPs (compared with non-EPs) had higher abundances of Alistipes senegalensis and Coprococcus catus but lower abundances of Ruminococcus gnavus (false discovery rate <0.05). Among the 7 determined fecal acylcarnitine metabolites, palmitoylcarnitine, oleylcarnitine 18:1, and stearylcarnitine were inversely associated with EPs but positively correlated with obesity conditions and progression. Path analyses indicated that the beneficial association between equol and obesity might be mediated by gut microbiota and decreased production of 3 acylcarnitines in feces. Conclusions This study suggests a beneficial association between equol and obesity, mediated by the gut microbiome and acylcarnitines, in adults. This trial was registered at clinicaltrials.gov as NCT03179657. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have suggested that serum carotenoids might be inversely associated with non-alcoholic fatty liver disease (NAFLD), but little data came from longitudinal studies. We prospectively examined the associations between serum-carotenoid levels and NAFLD severity and the intermediary effects of retinol-binding protein 4 (RBP4), HOMA insulin-resistance index (HOMA-IR), body mass index (BMI), and serum triglycerides in middle-aged and elderly Chinese adults. Methods: This prospective study included 3336 Chinese adults (40–75 years). We assessed serum concentrations of carotenoids at baseline and determined serum RBP4, triglycerides, and HOMA-IR levels at year 3. Abdominal ultrasonography was conducted to assess the presence and degree of NAFLD at years 3 and 6. Results: The 2687 subjects who completed both NAFLD tests were classified into stable, improved and progressed groups according to changes in the degree of NAFLD between two visits. Analyses of covariance showed that ln-transformed serum concentrations of α-carotene, β-cryptoxanthin, β-carotene, lycopene, lutein/zeaxanthin, and total carotenoids were positively associated with NAFLD improvement (all p-trend < 0.05). After multivariable adjustment, mean differences in serum carotenoids were higher by 29.6% (β-carotene), 18.2% (α-carotene), 15.6% (β-cryptoxanthin), 11.5% (lycopene), 8.9% (lutein/zeaxanthin), and 16.6% (total carotenoids) in the improved vs. progressed subjects. Path analyses indicated the carotenoid–NAFLD association was mediated by lowering serum RBP4, triglycerides, HOMA-IR, and BMI, which were positively associated with the prevalence and progression of NAFLD. Conclusions: In middle-aged and elderly adults, higher serum-carotenoid concentrations were favorably associated with NAFLD improvement, mediated by reducing serum RBP4, triglycerides, HOMA-IR, and BMI. Trial registrations: This study has been registered at http://www.clinicaltrials.gov as NCT03179657. [ABSTRACT FROM AUTHOR]

Purpose: Evidence of an association between n-3 polyunsaturated fatty acids (PUFAs) and metabolic syndrome (MS) is limited and inconsistent. We investigated the association between n-3 PUFAs in erythrocytes and the presence of MS in Chinese adults. Methods: The levels of α-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) in erythrocytes were measured using gas chromatography in 3072 participants (900 men and 2172 women) aged 30-75 years from Guangzhou, China. Cardiometabolic factors were determined, and MS was defined using the updated Adult Treatment Panel III criteria. Other covariates were collected via interviewer-administered questionnaires. Results: After adjusting for age and other confounders, higher levels of marine-derived n-3 PUFAs, including EPA, DPA, and DHA, were associated with a lower presence of metabolic syndrome in both men and women. The odds ratios (95 % confidence interval) for MS obtained by comparing extreme quartiles were 0.55 (0.35-0.88) (EPA), 0.54 (0.34-0.87) (DPA), 0.45 (0.27-0.73) (DHA), and 0.52 (0.32-0.84) (total n-3 PUFAs) in men ( p trend <0.05 for all results); and 0.74 (0.56-0.99) (EPA), 0.73 (0.55-0.98) (DPA), 0.75 (0.56-1.02) (DHA), and 0.71 (0.53-0.96) (total n-3 PUFAs) in women, respectively. No significant association of ALA with MS was observed ( p trend > 0.05). Conclusion: Higher levels of total n-3 PUFAs, EPA, DPA, and DHA, but not of ALA, in erythrocyte membranes are associated with a lower presence of metabolic syndrome in Chinese adults. [ABSTRACT FROM AUTHOR]

Objective: Previous studies suggested that magnesium (Mg) might protect against atherosclerosis, but data were scarce in an Asian population. We examined the association of Mg levels in serum and urine with carotid intima-media thickness (cIMT) and serum lipids in Chinese adults. Methods: This community-based cross-sectional study recruited 2,837 participants aged 40-75 years in Guangzhou, China. General information, lifestyle factors, serum and urinary concentrations of Mg and cardiometabolic factors were determined. The cIMTs of the common carotid artery (CCA) and the carotid bifurcation (BIF) were measured ultrasonographically. Results: The mean (SD) concentration of serum Mg was 0.85 (0.07) mmol/L and median (IQR) for urinary Mg excretion was 2.29 (1.56-3.51) mmol/L. After adjustment for potential covariates, both serum and the urinary concentrations of Mg were inversely associated with CCA-IMT, but not with BIF-IMT. The regression coefficients (standard errors) were −100 (29) µm (total), −86 (34) µm (women) and −117 (52) µm (men) CCA-IMT per 1 mmol/L of serum Mg, and −41 (8) µm (total), −41 (10) µm (women) and −44 (15) µm (men) CCA-IMT per 1 unit of urinary Mg/creatinine (log mmol/mmol) (all p < 0.05), respectively. Higher serum Mg levels were associated with higher total cholesterol, HDLc, LDLc and triglyceride, but lower non-HDLc/HDLc in total population (all p < 0.05). Similar relationships of urinary Mg with lipoproteins were also found in total population (all p < 0.05). Conclusion: Higher levels of serum and urinary Mg are associated with lower CCA-IMTs, and the role of Mg in lipid metabolism needs further investigation. [ABSTRACT FROM AUTHOR]

Previous studies have suggested that vitamin E (VE) may affect bone health, but the findings have been inconclusive. We examined the relationship between VE status (in both diet and serum) and bone mineral density (BMD) among Chinese adults. This community-based study included 3203 adults (2178 women and 1025 men) aged 40–75 years from Guangzhou, People’s Republic of China. General and dietary intake information were collected using structured questionnaire interviews. The serum α-tocopherol (TF) level was quantified by reversed-phase HPLC. The BMD of the whole body, the lumbar spine and left hip sites (total, neck, trochanter, intertrochanter and Ward’s triangle) were measured using dual-energy X-ray absorptiometry. In women, the dietary intake of VE was significantly and positively associated with BMD at the lumbar spine, total hip, intertrochanter and femur neck sites after adjusting for covariates (Ptrend: 0·001–0·017). Women in quartile 3 of VE intake typically had the highest BMD; the covariate-adjusted mean BMD were 2·5, 3·06, 3·41 and 3·54 % higher, respectively, in quartile 3 (v. 1) at the four above-mentioned sites. Similar positive associations were observed between cholesterol-adjusted serum α-TF levels and BMD at each of the studied bone sites (Ptrend: 0·001–0·022). The covariate-adjusted mean BMD were 1·24–4·83 % greater in quartile 4 (v. 1) in women. However, no significant associations were seen between the VE levels (dietary or serum) and the BMD at any site in men. In conclusion, greater consumption and higher serum levels of VE are associated with greater BMD in Chinese women but not in Chinese men. [ABSTRACT FROM AUTHOR]

Purpose: The associations between specific carotenoid intake and colorectal cancer risk remain inconsistent. The aim of this study was to examine the association between specific dietary carotenoid intake with colorectal cancer risk in Chinese adults. Method: From July 2010 to October 2013, 845 eligible colorectal cancer cases and 845 frequency-matched controls (age and sex) completed in-person interviews. A validated food frequency questionnaire was used to estimate dietary intake. Multivariate logistical regression models were used to calculate the odds ratio (OR) and 95 % confidence intervals (95 % CIs) of colorectal cancer risk after adjusting for various confounders. Results: A strong inverse association was found between β-cryptoxanthin intake and colorectal cancer risk. Compared with the lowest quartile, the highest quartile intake showed a risk reduction of 77 % (OR 0.23, 95 % CI 0.17-0.33, P < 0.01) after adjustment for various confounding variables. The inverse associations were also observed for α-carotene (OR 0.50, 95 % CI 0.37-0.68, P < 0.01), β-carotene (OR 0.67, 95 % CI 0.49-0.91, P < 0.01), and lycopene (OR 0.51, 95 % CI 0.37-0.70, P < 0.01). There was no statistically significant association between lutein/zeaxanthin intake and colorectal cancer risk. These findings were consistent across cancer site, sources of controls, and smoking status. The inverse associations between dietary α-carotene, β-cryptoxanthin, and lycopene intake and colorectal cancer risk were found in both males and females, while inverse associations between β-carotene intake and colorectal cancer risk were only observed in males. Conclusions: Consumption of α-carotene, β-carotene, β-cryptoxanthin, and lycopene was inversely associated with colorectal cancer risk. No significant association was found between lutein/zeaxanthin intake and colorectal cancer risk. [ABSTRACT FROM AUTHOR]

The colour of the edible portion of vegetables and fruit reflects the presence of specific micronutrients and phytochemicals. No existing studies have examined the relationship between the intake of vegetable and fruit colour groups and the risk of colorectal cancer. The present study, therefore, aimed to investigate these associations in a Chinese population. A case–control study was conducted between July 2010 and July 2014 in Guangzhou, China, in which 1057 consecutively recruited cases of colorectal cancer were frequency-matched to 1057 controls by age (5-year interval), sex and residence (rural/urban). A validated FFQ was used to collect dietary information during face-to-face interviews. Vegetables and fruit were classified into four groups according to the colour of their primarily edible parts: green; orange/yellow; red/purple; white. Unconditional logistic regression models were used to estimate the OR and 95 % CI. A higher consumption of orange/yellow, red/purple and white vegetables and fruit was inversely associated with the risk of colorectal cancer, with adjusted OR of 0·16 (95 % CI 0·12, 0·22) for orange/yellow, 0·23 (95 % CI 0·17, 0·31) for red/purple and 0·53 (95 % CI 0·40, 0·70) for white vegetables and fruit when the highest and lowest quartiles were compared. Total vegetable intake and total fruit intake have also been found to be inversely associated with colorectal cancer risk. However, the intake of green vegetable and fruit was not associated with colorectal cancer risk. The results of the present study, therefore, suggest that a greater intake of orange/yellow, red/purple and white vegetables and fruit is inversely associated with the risk of colorectal cancer. [ABSTRACT FROM PUBLISHER]

Background and Aim: Previous studies have indicated that neck circumference is a valuable predictor for obesity and metabolic syndrome, but little evidence is available for fatty liver disease. We examined the association of neck circumference with fatty liver disease and evaluated its predictive value in Chinese adults. Methods: This cross-sectional study comprised 4053 participants (1617 women and 2436 men, aged 20-88) recruited from the Health Examination Center in Guangzhou, China between May 2009 and April 2010. Anthropometric measurements were taken, abdominal ultrasonography was conducted and blood biochemical parameters were measured. Covariance, logistic regression and receiver operating characteristic curve analyses were employed. Results: The mean neck circumference was greater in subjects with fatty liver disease than those without the disease in both women and men after adjusting for age (P<0.001). Logistic regression analysis showed that the age-adjusted ORs (95% CI) of fatty liver disease for quartile 4 (vs. quartile 1) of neck circumference were 7.70 (4.95-11.99) for women and 12.42 (9.22-16.74) for men. After further adjusting for other anthropometric indices, both individually and combined, the corresponding ORs remained significant (all P-trends<0.05) but were attenuated to 1.94-2.53 for women and 1.45-2.08 for men. An additive interaction existed between neck circumference and the other anthropometric measures (all P<0.05). A high neck circumference value was associated with a much greater prevalence of fatty liver disease in participants with both high and normal BMI, waist circumference and waist-to-hip ratio values. Conclusions: Neck circumference was an independent predictor for fatty liver disease and provided an additional contribution when applied with other anthropometric measures. [ABSTRACT FROM AUTHOR]

Objective: The discriminatory capability of different adiposity indices for atherosclerosis and lipid abnormalities remains uncertain. This study aimed to identify the best adiposity index for predicting early atherosclerosis and abnormal lipid profiles among anthropometric parameters and body fat measures in middle-aged and elderly Chinese. Method: A total of 2,063 women and 814 men (57.6±5.2 y) were recruited for this community-based cross-sectional study. Body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were assessed. Body fat mass and its percentage values for the whole body and trunk were measured by bioelectrical impedance analysis (BIA). The intima-media thicknesses (IMTs) of the common carotid arteries (CCA), internal carotid arteries (ICA) and bifurcation (BIF) were determined via B-mode ultrasound. The fasting lipid profiles were assessed. Results: With per SD increase of adiposity indices, the magnitude of the changes of IMT values and lipid profiles was more substantial for WC, WHR and WHtR in both genders. A multivariate logistic regression analysis indicated that WC, WHR and WHtR were more sensitive in predicting the presence of intima-media thickening at the three segments as well as the lipids disturbances in women and men. In general, BIA-derived measures have no added predictive value for IMT-thickening as opposed to those three traditional abdominal measures. Conclusion: Our findings suggest that abdominal anthropometric measures including WC, WHR and WHtR are sensitive for discriminating carotid atherosclerosis and lipids abnormalities. WC is the best index because of its simplicity in routine use. [ABSTRACT FROM AUTHOR]

The protective effect of dietary carotenoid intake on the risk of breast cancer is inconclusive. Moreover, data on dietary carotenoids in relation to breast cancer in non-Western populations are scarce. The aim of the present study was to examine the association between dietary carotenoid intake and the risk of breast cancer among Chinese women. A total of 561 cases and 561 controls who were frequency matched by age (5-year interval) and residence were recruited in the present case–control study. Dietary intake information was collected by a face-to-face interview using a validated FFQ. The OR and 95 % CI were assessed by multivariate logistic regression after adjusting for various potential confounders. An inverse association was observed between the consumption of α-carotene, β-carotene, β-cryptoxanthin and lutein/zeaxanthin and the risk of breast cancer. The multivariate-adjusted OR for the highest quartile of intake compared with the lowest quartile of intake were 0·61 (95 % CI 0·43, 0·88) for α-carotene, 0·54 (95 % CI 0·38, 0·78) for β-carotene, 0·38 (95 % CI 0·26, 0·52) for β-cryptoxanthin and 0·49 (95 % CI 0·34, 0·71) for lutein/zeaxanthin. Lycopene intake was not found to be associated with the risk of breast cancer, with the adjusted OR of 0·89 (95 % CI 0·61, 1·30). These inverse associations were more evident among pre-menopausal women and women who were exposed to second-hand smoke. The protective effect of specific carotenoid intake was observed for all subtypes of hormone receptor status of breast cancer. The present study indicated that a greater intake of specific carotenoids was associated with a decreased risk of breast cancer among Chinese women residing in Guangdong. [ABSTRACT FROM PUBLISHER]

Background: Although many adiposity indices may be used to predict obesity-related health risks, uncertainty remains over which of them performs best. Objective: This study compared the predictive capability of direct and indirect adiposity measures in identifying people at higher risk of metabolic abnormalities. Methods: This population-based cross-sectional study recruited 2780 women and 1160 men. Body weight and height, waist circumference (WC), and hip circumference (HC) were measured and body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were calculated. Body fat (and percentage of fat) over the whole body and the trunk were determined by bioelectrical impedance analysis (BIA). Blood pressure, fasting lipid profiles, and glucose and urine acid levels were assessed. Results: In women, the ROC and the multivariate logistic regression analyses both showed that WHtR consistently had the best performance in identifying hypertension, dyslipidemia, hyperuricemia, diabetes/IFG, and metabolic syndrome (MetS). In men, the ROC analysis showed that WHtR was the best predictor of hypertension, WHtR and WC were equally good predictors of dyslipidemia and MetS, and WHtR was the second-best predictor of hyperuricemia and diabetes/IFG. The multivariate logistic regression also found WHtR to be superior in discriminating between MetS, diabetes/IFG, and dyslipidemia while BMI performed better in predicting hypertension and hyperuricemia in men. The BIA-derived indices were the second-worst predictors for all of the endpoints, and HC was the worst. Conclusion: WHtR was the best predictor of various metabolic abnormalities. BMI may be used as an alternative measure of obesity for identifying hypertension in both sexes. [ABSTRACT FROM AUTHOR]

Most previous studies have examined the associations between carotenoids and anthropometrics with cross-sectional designs. Few studies have investigated the associations between serum carotenoids and fat mass and fat distribution (general vs central type). This study aimed to explore the associations of serum carotenoids with body fat and fat distribution in Chinese adults. Cross-sectional and longitudinal analyses of a prospective, community-based cohort were performed. There were 4,048 participants aged 40 to 75 years recruited in the Guangzhou Nutrition and Health Study from 2008 to 2013. Serum carotenoids were assessed at baseline. Anthropometrics, fat mass (FM), and percentage FM (%FM) over the total body, trunk, limbs, and android and gynoid regions were obtained by dual-energy x-ray absorptiometry for 3,002 participants between 2011 and 2013 and for 2,537 participants after 3.1 years. Cross-sectional and longitudinal analyses were performed to compare the mean differences in adiposity indices among the quartiles of carotenoids. Covariance analyses showed significant inverse associations between serum total carotenoid levels and adiposity indices cross-sectionally (all P trends<0.05). The percentage mean differences in quartile 4 (vs 1) in FM and %FM were much more pronounced in the trunk (–15.4% and –7.74%) and android area (–16.6% and –8.59%) than those in the limbs (–8.31% and –4.51%) and gynoid area (–7.76% and –2.71%) (all P <0.001). Longitudinal results revealed that higher total carotenoids were associated with significantly lower 3-year increases in body mass index (calculated as kg/m2); waist circumference; waist-to-hip ratio; body FM in the limbs and android and gynoid area; and %FM in total body, trunk, and limbs (all P trends<0.05). Regarding individual carotenoids, β-carotene tended to have the most notable beneficial associations with the majority of fat indices, especially for cross-sectional analyses. Serum carotenoid concentrations are inversely associated with body fat, especially in the abdominal region, in Chinese adults. [ABSTRACT FROM AUTHOR]