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Background: China witnessed a dramatic growth in the prevalence of obesity in children due to a shift in dietary behavior during the last two decades. The aim is to systematically review the evidence among the eligible primary studies in which the relationship between dietary patterns and risk of obesity/overweight in children and/or adolescents aged 3-17 years in China was assessed. Methods: Bibliographic databases such as Medline, Embase, were searched. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for cross-sectional studies and the Newcastle-Ottawa Scale (NOS) for retrospective cohort studies. The adjusted ORs compared the highest quartile with the lowest quartile of Chinese traditional dietary pattern and western pattern were pooled in forest plots to visualize results. Findings: Among 7 studies included for final analysis, four indicate that greater adherence to a western dietary pattern were significantly positively associated with obesity in children/adolescents aged 3-17 years in China after adjustment of confounding factors. The magnitude of effect varied from study to study: the odds ratios and 95%CIs ranged from (Q4 vs Q1) OR=1.49, 95% CI: 1.21,1.84 to (Q4 vs Q1) OR = 3.10, 95% CI:1.52, 6.32. This positive association is demonstrated in the animal foods, fats, and condiments dominated pattern in a borderline trend (Q4 vs Q1) OR=5.88, 95% CI 1.39, 24.80). One study suggested that greater adherence to the Chinese traditional dietary pattern was significantly associated with a lower risk of obesity (Q4 vs Q1) OR = 0.19, 95%CI: 0.09, 0.40. Interpretation: This systematic review demonstrates western dietary patterns characterized by high fat, energy-dense, low dietary fiber, had a potential higher risk in obesity in children and adolescents aged 3-17 years in China. Fruits and vegetables dominated dietary patterns were less likely to cause obesity in children and adolescents aged 3-17 years. Funding: None to declare. Declaration of Interest: None to declare.

Background Although maternal death is rare in the UK, 90% (510 of 566 deaths) of women who died during or within a year after pregnancy in 2016–18 had multiple health and social problems (MBRRACE-UK). This study aims to estimate the prevalence of pre-existing multimorbidity in pregnant women in the UK. Methods Pregnant women aged 15–49 years with a conception date between Jan 1 and Dec 31, 2018, were included in this cross-sectional study, using routine health-care datasets: Clinical Practice Research Datalink (CPRD) GOLD (UK, n=37 641), Secure Anonymised Information Linkage (SAIL) databank (Wales, n=27 782), and Scottish Morbidity Records (SMR, secondary care) with linked community prescribing data (Tayside and Fife, n=6099). We defined pre-existing multimorbidity (two or more morbidities) preconception from 79 long-term physical and mental health conditions. This definition was identified from the literature and prioritised by the multidisciplinary research advisory group, including patient representatives. The association of women's characteristics preconception with multimorbidity was examined with logistic regression. The University of St Andrews School of Medicine Ethics Committee approved this project. Participant consent was not required as the data used are anonymised. Interpretation Prevalence of multimorbidity was 44·2% (95% CI 43·7–44·7) in CPRD, 46·2% (45·6–46·8) in SAIL, and 19·8% (18·8–20·8) in SMR. Mental health conditions were highly prevalent and involved 70% of multimorbidity (CPRD: prevalence of multimorbidity with one or more mental health conditions 31·3% [30·8–31·8]). Pregnant women with conditions that were leading causes of maternal deaths had a high prevalence of multimorbidity (CPRD: 745 [2·0%] of 37 641 women had cardiovascular disease, of whom 597 [80·1%] had multimorbidity). Higher maternal age (CPRD: adjusted odds ratio 1·81 [95% CI 1·04–3·17] for 45–49 years vs 15–19 years), gravidity (1·68 [1·50–1·89] for ≥5 vs 1), BMI (1·59 [1·44–1·76], for ≥30 vs 18·5–24·9) and smoking (1·61 [1·46–1·77] for smoker vs non-smoker) were significantly associated with multimorbidity. Ethnicity and deprivation were not significantly associated with multimorbidity. Interpretation A significant proportion of women enter pregnancy with pre-existing multimorbidity, especially mental health conditions. Pregnant women with multimorbidity were more likely to smoke and have a raised BMI and support may be required to address this. There may be health-care access inequalities for some health conditions, especially mental health conditions in pregnant women from deprived or ethnic minority groups. Secondary care and linked community prescription dataset captured severe conditions and might underestimate the prevalence of multimorbidity. Urgent research is needed to quantify the consequences of maternal multimorbidity for mother and child. Funding This work was supported by the joint UKRI-NIHR Strategic Priorities Fund consolidator grant (grant number MR/V005243/1). BT was funded by the National Institute for Health Research (NIHR) West Midlands Applied Research Collaboration. AA and SIL were funded as NIHR Academic Clinical Fellows. The views expressed are those of the author and not necessarily those of the funders, the NIHR or the UK Department of Health and Social Care.

Udgivelsesdato: 2010-May-19 Until recently, the study of nutrient patterns was hampered at an international level by a lack of standardization of both dietary methods and nutrient databases. We aimed to describe the diversity of nutrient patterns in the European Prospective Investigation into Cancer and Nutrition (EPIC) study at population level as a starting point for future nutrient pattern analyses and their associations with chronic diseases in multi-center studies. In this cross-sectional study, 36,034 persons aged 35-74 y were administered a single, standardized 24-h dietary recall. Intake of 25 nutrients (excluding intake from dietary supplements) was estimated using a standardized nutrient database. We used a graphic presentation of mean nutrient intakes by region and sex relative to the overall EPIC means to contrast patterns within and between 10 European countries. In Mediterranean regions, including Greece, Italy, and the southern centers of Spain, the nutrient pattern was dominated by relatively high intakes of vitamin E and monounsaturated fatty acids (MUFA), whereas intakes of retinol and vitamin D were relatively low. In contrast, in Nordic countries, including Norway, Sweden, and Denmark, reported intake of these same nutrients resulted in almost the opposite pattern. Population groups in Germany, The Netherlands, and the UK shared a fatty acid pattern of relatively high intakes of PUFA and SFA and relatively low intakes of MUFA, in combination with a relatively high intake of sugar. We confirmed large variability in nutrient intakes across the EPIC study populations and identified 3 main region-specific patterns with a geographical gradient within and between European countries.