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Rapid economic growth and urbanization have brought notable changes in China. This trend had dramatic impacts to food industry and diet-related behaviors, which leads to increasing prevalence of overweight and obesity as well as diet-related non-communicable diseases (NCDs). With a rapid development of internet and e-commerce market, another emerging trend that should not be overlooked is the change in food shopping habits induced by the popularity of online-to-offline (O2O) food delivery service in China. The O2O food market is a booming industry in China, the market scale of O2O food industry is increasing with remarkable speed. More than 1/5 of total population in China has already became the users of O2O food delivery market. Development of this new trend in food environment is inevitable. This game-changing trend brings great opportunities to improve food accessibility and availability but meanwhile poses inevitable challenges to the whole public health system and social environment in China. This paper offers a unique perspective of the opportunities and challenges that the new industry brings to food environment, health outcomes caused by related behavior change, and its broader influence on social environment.

Among the issues that threaten human health, noncommunicable diseases (NCDs) remain a leading concern. Much of the increase in NCDs results from preventable risk factors, with alcohol use and an unhealthy diet among the top four [1]. Thus, identifying the influences of different dietary factors (such as food and alcohol/beverage consumption) on health is an urgent matter.

BackgroundSome studies have suggested that daytime napping may increase the risk of type 2 diabetes. However, limited data have revealed the association between nap duration and other metabolic diseases. Data from the baseline survey of Lanxi Cohort Study, a population-based study of natural residents in Zhejiang Province, China, were used to investigate the relationship between nap duration and metabolic abnormalities.MethodsA total of 3236 participants underwent a physical examination, laboratory tests, and face to face interview. They were categorized into four groups according to nap duration. Logistic regression models were used to examine the odds ratios (ORs) of napping duration with four metabolism-related diseases. Stratified analysis was further used to explore the interaction effects of gender and age on results.ResultsCompared to the no daytime napping group, people who napped during the daytime for more than 1 h were independently associated with a greater prevalence of diabetes (OR 1.56). Those who napped during the daytime within a half hour showed a lower prevalence of fatty liver, dyslipidemia, and central obesity. To be more specific, those who habitually napped during the daytime for more than 1 h exhibited an increasing prevalence of diabetes among female older than 50 years old. Those who habitually napped during the daytime within a half hour exhibited a decreasing prevalence of fatty liver and dyslipidemia among male <50 years old, and that of central obesity among female <50 years old.ConclusionsShort daytime napping duration is associate with reduced rate of metabolism-related diseases and may protects people from negative health conditions, whereas long daytime napping duration is associate with higher prevalence of diabetes, which then can be harmful for health.

ObjectivesCommunity food environment is closely associated with residents’ health status, and it has received substantial research attention in recent years. However, such studies are sparse in China. This study aims to reveal the characteristics of food environment in China.SubjectsA ground-truthing field census of food outlets was conducted in Xi Hu district, Hangzhou. A novel categorizing system was developed to better characterize food outlets in the study area. Geocoding and food environment analysis were performed by Arc-GIS software.ResultsA total of 9274 food outlets were identified, of these, 6161 (66.43%) were food service places and 3113 (33.57%) were food stores. Fast-food restaurants (2692) and convenience stores (1764) were the two most numerous outlet types. The density of food outlets was 29.72/km2 and 113.97/10,000 people. Availability of BMI-unhealthy food outlets was four times greater than that of BMI-healthy ones. Further, 41.86% of total food outlets provided food-delivery services; among them, fast-food restaurants were the highest (65.53%) providers. In the urban area, the average density of food outlets was 104/km2. While, it was only 29/km2 in the rural area.ConclusionsAvailability of food outlets was excellent in our study area, though it showed regional imbalance. Food environment tends to be obesogenic and high prevalence of food delivery service might increase this trend. Thus, policy makers should guarantee the smooth development of catering industry in China, so as to ensure a balanced nutrition environment.

To investigate the relationship between dry eye and sleep quality in a large community-based Chinese population. A total of 3,070 participants aged 18-80 were recruited from a community-based study in Hangzhou, China during 2016-2017. Sleep quality was evaluated using the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), and dry eye was evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Multivariable linear regression and logistic regression models were used to investigate the associations, adjusting for age, smoking, drinking, season, and other potential confounders. Overall, CPSQI score and sleep dysfunction were significantly associated with mild, moderate, and severe dry eye (ORs for CPSQI score: 1.07, 1.13, 1.14, all p < 0.001; for sleep dysfunction: 1.31, 1.73, 1.66, all p < 0.05). Furthermore, worse OSDI score was presented in participants with worse CPSQI score or sleep dysfunction (CPSQI score > 7) (β: 0.13, 0.54; all p < 0.001). In addition, six of the seven components of CPSQI showed significant associations with dry eye (all p < 0.001), except for the component of sleep medication use. Moreover, we observed significant associations of dry eye in all three subscales of OSDI with CPSQI score and sleep dysfunction. Our large, community-based study showed a strong association between poor sleep quality and an increased severity of dry eye, suggesting that preventing either one of the discomforts might alleviate the other.

BackgroundThough tea drinking years and menopause stages have been indicated to be related with bone mineral density (BMD), most human studies have not considered the impact of tea drinking beginning time. Whether drinking tea before or after menopause plays a role in BMD is still unclear. This study aims to analyze whether drinking tea before or after menopause influences BMD in Chinese postmenopausal women.MethodsA total of 1377 postmenopausal women under 80 years were enrolled from the baseline survey of the Lanxi Cohort Study. Participants were initially categorized into non-tea drinking, tea drinking beginning after menopause and tea drinking beginning before menopause groups. Tea drinking groups were subdivided according to tea drinking frequency, concentration and type. Multiple linear regression models were applied to evaluate associations between tea drinking before or after menopause and BMD and the impacts of tea drinking frequency, concentration and type on their associations in analyses including all participants. Interactions of tea drinking frequency, concentration and type with drinking tea before or after menopause were further analyzed.ResultsAfter adjusting for confounding factors, women who began drinking tea before menopause had significantly higher total and regional BMD than non-tea drinking participants and participants who began drinking tea after menopause. Differences in spine BMD were more significant among those who drank tea ≥four times per week. In addition, significant associations between tea drinking and BMD were found among participants who began drinking tea before menopause in both models, irrespective of the concentration and type of tea. No significant associations were found in subgroups of participants who began drinking tea after menopause in either model.ConclusionsThe results indicate that drinking tea before menopause is related to higher BMD in Chinese postmenopausal women. The relationship is independent of tea drinking concentration and type.

Competitive interactions between species can be mitigated or even reversed in the presence of anthropogenic influences. The thrips species Frankliniella occidentalis and Thrips tabaci are highly invasive and damaging agricultural pests throughout the world. Where the species co-occur, one species tends to eventually predominate over the other. Avermectin and beta-cypermethrin are commonly used insecticides to manage thrips in China, and laboratory bioassays demonstrated that F. occidentalis is significantly less susceptible than T. tabaci to these insecticides. In laboratory cage trials in which both species were exposed to insecticide treated cabbage plants, F. occidentalis became the predominant species. In contrast, T. tabaci completely displaced F. occidentalis on plants that were not treated with insecticides. In field trials, the species co-existed on cabbage before insecticide treatments began, but with T. tabaci being the predominant species. Following application of avermectin or beta-cypermethrin, F. occidentalis became the predominant species, while in plots not treated with insecticides, T. tabaci remained the predominant species. These results indicate that T. tabaci is an intrinsically superior competitor to F. occidentalis, but its competitive advantage can be counteracted through differential susceptibilities of the species to insecticides. These results further demonstrate the importance of external factors, such as insecticide applications, in mediating the outcome of interspecific interactions and produce rapid unanticipated shifts in the demographics of pest complexes.

Background Eating speed has been reported to be associated with energy intake, body weight, waist circumference (WC), and total body fat. However, no study has explored the association between eating speed and body fat distribution, especially its difference among different age or body mass index (BMI) groups. Methods 4770 participants aged 18–80 years were recruited from the baseline survey of the Lanxi Cohort Study. They were categorized into three groups according to meal duration. Linear regression analyses were performed among all participants and separately by age group and obesity status to evaluate the associations of WC and total and regional fat mass percentages (FM%) with eating speed. Results After adjusting for confounding factors, eating slowly was significantly related to lower WC, lower total, trunk, and android FM%, lower android-to-gynoid fat mass ratio, and higher leg and gynoid FM%. After stratification by age or obesity status, the associations were especially prominent among participants aged 18–44 years or those with BMI < 24 kg/m 2 . No significant trends were found for participants aged 65–80 years or those who were overweight/obese. Conclusions Eating slowly is closely related with better fat distribution among Chinese adults, especially for those aged 18–44 years and those with BMI < 24 kg/m 2 . If confirmed prospectively, it might be a potential efficient approach to improve fat distribution.

This study aims to investigate the impact of COVID-19 lockdown on lifestyle behaviors and depressive symptom among patients with NCDs (noncommunicable diseases). We incorporated a COVID-19 survey to the WELL China cohort, a prospective cohort study with the baseline survey conducted 8–16 months before the COVID-19 outbreak in Hangzhou, China. The COVID-19 survey was carried out to collect information on lifestyle and depressive symptom during lockdown. A total of 3327 participants were included in the COVID-19 survey, including 2098 (63.1%) reported having NCDs at baseline and 1457 (44%) without NCDs. The prevalence of current drinkers decreased from 42.9% before COVID-19 lockdown to 23.7% during lockdown, current smokers from 15.9 to 13.5%, and poor sleepers from 23.9 to 15.3%, while low physical activity increased from 13.4 to 25.2%, among participants with NCDs (P < 0.05 for all comparisons using McNemar's test). Participants with NCDs were more likely than those without to have depressive symptom (OR, 1.30; 95% CI 1.05–1.61), especially among those who need to refill their medication during the COVID-19 lockdown (OR, 1.52; 95% CI 1.15–2.02). Our findings provide insight into the development of targeted interventions to better prepare patients with NCDs and healthcare system to meet the challenge of future pandemic and lockdown.

Background The associations between body flexibility and sarcopenia were not well understood. This study aimed to explore the cross‐sectional and longitudinal associations of flexibility with sarcopenia. Methods Our study selected participants aged 50–80 from the WELL‐China cohort and the Lanxi cohort. Participants from the urban area of the Lanxi cohort were followed up 4 years later. Body flexibility was measured by the sit‐and‐reach test. Muscle mass was evaluated by dual‐energy X‐ray absorptiometry. Muscle strength was evaluated using handgrip strength. Sarcopenia was defined as having both low muscle mass and low muscle strength. We used multivariable logistic regressions to assess the cross‐sectional associations of body flexibility with low muscle mass, low muscle strength and sarcopenia. We also used multivariable logistic regressions to explore the associations of baseline flexibility and 4‐year changes in flexibility with incident low muscle mass, low muscle strength and sarcopenia. Results A total of 9453 participants were enrolled in the cross‐sectional study, and 1233 participants were included in the longitudinal analyses. In the cross‐sectional analyses, compared with low body flexibility, high body flexibility was inversely associated with low muscle mass (odds ratio [OR], 0.58; 95% confidence interval [CI], 0.50–0.68; P < 0.001), low muscle strength (OR, 0.62; 95% CI, 0.55–0.69; P < 0.001) and sarcopenia (OR, 0.52; 95% CI, 0.41–0.65; P < 0.001), and these associations did not differ in different age groups, sex or physical activity levels. In the longitudinal analyses, compared with participants with low body flexibility, participants with high body flexibility had lower risk of the incident low muscle strength (OR, 0.53; 95% CI, 0.38–0.74; P < 0.001) and sarcopenia (OR, 0.36; 95% CI, 0.21–0.61; P < 0.001), but not incident low muscle mass (OR, 0.59; 95% CI, 0.33–1.06; P = 0.076). Every 1‐cm increase in flexibility during 4 years was associated with reduced risk of incident low muscle mass (OR, 0.96; 95% CI, 0.93–1.00; P = 0.025), low muscle strength (OR, 0.96; 95% CI, 0.94–0.98; P = 0.002) and sarcopenia (OR, 0.96; 95% CI, 0.93–0.99; P = 0.007). Conclusions High flexibility was associated with reduced risk of incident low muscle strength and sarcopenia. Increases in flexibility were associated with reduced risk of incident low muscle mass, low muscle strength and sarcopenia. Flexibility exercises and monitoring the dynamic change of flexibility might be helpful in preventing sarcopenia among adults aged 50 years or over.