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Much as the modern Western world is concerned with diets, health, and anti-aging remedies, many early medieval Chinese Daoists also actively sought to improve their health and increase their longevity through specialized ascetic dietary practices. Focusing on a fifth-century manual of herbal-based, immortality-oriented recipes—the Lingbao Wufuxu (The Preface to the Five Lingbao Talismans of Numinous Treasure)—Shawn Arthur investigates the diets, their ingredients, and their expected range of natural and supernatural benefits. Analyzing the ways that early Daoists systematically synthesized religion, Chinese medicine, and cosmological correlative logic, this study offers new understandings of important Daoist ideas regarding the body's composition and mutability, health and disease, grain avoidance (bigu) diets, the parasitic Three Worms, interacting with the spirit realm, and immortality. This work also employs a range of cross-disciplinary scientific and medical research to analyze the healing properties of Daoist self-cultivation diets and to consider some natural explanations for better understanding Daoist asceticism and its underlying world view.

Background The health benefits of physical activity (PA) have been well recognized, while which types of PA are most beneficial are still unclear, especially for older adults. The study aimed to explore associations of different PAs (physical work, regular exercise, and leisure activities) with mortality among Chinese older adults, considering genetic risk. Methods A total of 9690 older adults from the Chinese Longitudinal Health Longevity Survey (CLHLS, 1998–2018) were included. Self-reported PAs information on physical work, regular exercise, and leisure activities were collected through face-to-face interviews. Leisure activities were interviewed about their engagement in 6 typical activities (i.e., housework tasks, personal outdoor activities, gardening, rearing domestic animals/pets, playing cards/mahjong, and attending in social activities). A weighted genetic risk score (GRS) was constructed based on 11 lifespan-related loci and divided into two groups according to the median scores (0.21). The Cox proportional risk model was used to assess the association between different types of PAs and genetic risk with all-cause mortality. Results During 63,832 person-years of follow-up, 5678 deaths were documented. The hazard ratios (HRs) for all-cause mortality between different PAs (lowest activity vs highest activity) were 0.85 (95% CI 0.79–0.92) for leisure activities, 0.93 (95% CI 0.87–0.99) for regular exercise, and 0.93 (95% CI 0.86–1.01) for physical work, respectively. Compared with low leisure activities, high leisure activities were associated with 16% reduction in all-cause mortality for individuals with low longevity GRS (HR 0.84, 95% CI 0.76–0.93), and 14% reduction in all-cause mortality for individuals with high longevity GRS (HR 0.86, 95% CI 0.78–0.96). Adherence to regular exercise was associated with 11% reduction in all-cause mortality for individuals with high longevity GRS (HR 0.89, 95% CI 0.81–0.97), while there was no statistically significance for those with low longevity GRS (HR 0.97, 95% CI 0.89–1.06) compared with those without regular exercise. There was no additive or multiplicative interaction between PAs and longevity genetics ( P interaction  > 0.05). Conclusions Leisure activities, as a low-risk, low-intensity, simple and inexpensive PA, rather than regular exercise, might bring the greatest health benefits, even for individuals with less longevity genes, highlighting the importance of providing individualized PA recommendations for older adults.

China is the world’s largest producer of reactive nitrogen (Nr), and Nr in the form of synthetic fertilizer has contributed substantially to increased food production there. However, Nr losses from overuse and misuse of fertilizer, combined with industrial emissions, represent a serious and growing cause of air and water pollution. This paper presents a substantially complete and coherent Nr budget for China and for 14 subsystems within China from 1980 to 2010, evaluates human health/longevity and environmental consequences of excess Nr, and explores several scenarios for Nr in China in 2050. These scenarios suggest that reasonable pathways exist whereby excess Nr could be reduced substantially, while at the same time benefitting human well-being and environmental health. Reactive nitrogen (Nr) plays a central role in food production, and at the same time it can be an important pollutant with substantial effects on air and water quality, biological diversity, and human health. China now creates far more Nr than any other country. We developed a budget for Nr in China in 1980 and 2010, in which we evaluated the natural and anthropogenic creation of Nr, losses of Nr, and transfers among 14 subsystems within China. Our analyses demonstrated that a tripling of anthropogenic Nr creation was associated with an even more rapid increase in Nr fluxes to the atmosphere and hydrosphere, contributing to intense and increasing threats to human health, the sustainability of croplands, and the environment of China and its environs. Under a business as usual scenario, anthropogenic Nr creation in 2050 would more than double compared with 2010 levels, whereas a scenario that combined reasonable changes in diet, N use efficiency, and N recycling could reduce N losses and anthropogenic Nr creation in 2050 to 52% and 64% of 2010 levels, respectively. Achieving reductions in Nr creation (while simultaneously increasing food production and offsetting imports of animal feed) will require much more in addition to good science, but it is useful to know that there are pathways by which both food security and health/environmental protection could be enhanced simultaneously.

Many leaf traits strongly vary with tree size and environmental factors, but the importance of these factors to intraspecific variations of leaf traits in forest trees has rarely been simultaneously evaluated. We measured needle longevity and specific leaf area (SLA) and nitrogen (N) content of every needle age (0‐ to 4‐year old) for 65 individuals with 0.3–100 cm diameter at breast height (DBH) for an evergreen coniferous species, Pinus koraiensis Sieb. et Zucc., in Northeast China. We simultaneously evaluated the effects of tree size (DBH or tree height) and environment factors (light intensity, soil N content and water availability) on the needle longevity, SLA, foliage N content as well as the slopes of regressions of SLA and foliage N content against needle age. All of the studied leaf traits and slopes of regressions of SLA and foliage N content against needle age were significantly related to tree size. Tree height had a greater impact on SLA and area‐based leaf N content (Narea), whereas DBH was more important for needle longevity and mass‐based leaf N content (Nmass). The environment variables, light intensity, soil N content and water availability, were rather minor factors for trait variations compared with tree size. Significant influence of light intensity was found only on needle longevity, and soil N and water availability had no effects on the leaf traits. Our study clearly showed that tree size is an important driver of intraspecific variations in the key leaf traits of P. koraiensis in a natural forest. We also emphasize the importance of DBH or tree height varies depending on leaf traits, suggesting various mechanisms of size effects on the intraspecific variations in leaf traits. We suggest that ecological significance of leaf trait variations needs reconsideration incorporating tree size effect. A free Plain Language Summary can be found within the Supporting Information of this article. A free Plain Language Summary can be found within the Supporting Information of this article.

Only two genome-wide significant loci associated with longevity have been identified so far, probably because of insufficient sample sizes of centenarians, whose genomes may harbor genetic variants associated with health and longevity. Here we report a genome-wide association study (GWAS) of Han Chinese with a sample size 2.7 times the largest previously published GWAS on centenarians. We identified 11 independent loci associated with longevity replicated in Southern-Northern regions of China, including two novel loci (rs2069837- IL6 ; rs2440012- ANKRD20A9P ) with genome-wide significance and the rest with suggestive significance ( P  < 3.65 × 10 −5 ). Eight independent SNPs overlapped across Han Chinese, European and U.S. populations, and APOE and 5q33.3 were replicated as longevity loci. Integrated analysis indicates four pathways (starch, sucrose and xenobiotic metabolism; immune response and inflammation; MAPK; calcium signaling) highly associated with longevity ( P  ≤ 0.006) in Han Chinese. The association with longevity of three of these four pathways (MAPK; immunity; calcium signaling) is supported by findings in other human cohorts. Our novel finding on the association of starch, sucrose and xenobiotic metabolism pathway with longevity is consistent with the previous results from Drosophilia. This study suggests protective mechanisms including immunity and nutrient metabolism and their interactions with environmental stress play key roles in human longevity.

The oldest-old (those aged ≥80 years) are the most rapidly growing age group globally, and are most in need of health care and assistance. We aimed to assess changes in mortality, disability in activities of daily living, and physical and cognitive functioning among oldest-old individuals between 1998 and 2008. We used data from the Chinese Longitudinal Healthy Longevity Study. Three pairs of cohorts aged 80–89 years, 90–99 years, and 100–105 years (in total, 19 528 oldest-old participants) were examined; the two cohorts in each pair were born 10 years apart, with the same age at the time of the assessment in the 1998 and 2008 surveys. Four health outcomes were investigated: annual death rate, Activities of Daily Living (ADL), physical performance in three tests and cognitive function measured by Mini-Mental State Examination (MMSE). We used different tests and multivariate regression analyses to examine the cohort differences. Controlling for various confounding factors, we noted that annual mortality among oldest-old individuals was substantially reduced between 0·2% and 1·3% in 1998–2008 compared with individuals of the same age born 10 years previously, and that disability according to activities of daily living had significantly reduced annually between 0·8% and 2·8%. However, cognitive impairment in the later cohorts increased annually between 0·7% and 2·2% and objective physical performance capacity (standing up from a chair, picking up a book from the floor, and turning around 360°) decreased anually between 0·4% and 3·8%. We also noted that female mortality was substantially lower than male mortality among the oldest-old, but that women's functional capacities in activities of daily living, cognition, and physical performance were worse than their male counterparts. Advances in medications, lifestyle, and socioeconomics might compress activities of daily living disability, that is, benefits of success, but lifespan extension might expand disability of physical and cognitive functioning as more frail, elderly individuals survive with health problems, that is, costs of success. National Natural Science Foundation of China, National Institute on Aging/National Institutes of Health, United Nations Funds for Population Activities.

China has undergone rapid demographic and epidemiological changes in the past few decades, including striking declines in fertility and child mortality and increases in life expectancy at birth. Popular discontent with the health system has led to major reforms. To help inform these reforms, we did a comprehensive assessment of disease burden in China, how it changed between 1990 and 2010, and how China's health burden compares with other nations. We used results of the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) for 1990 and 2010 for China and 18 other countries in the G20 to assess rates and trends in mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE). We present results for 231 diseases and injuries and for 67 risk factors or clusters of risk factors relevant to China. We assessed relative performance of China against G20 countries (significantly better, worse, or indistinguishable from the G20 mean) with age-standardised rates and 95% uncertainty intervals. The leading causes of death in China in 2010 were stroke (1·7 million deaths, 95% UI 1·5–1·8 million), ischaemic heart disease (948 700 deaths, 774 500–1 024 600), and chronic obstructive pulmonary disease (934 000 deaths, 846 600–1 032 300). Age-standardised YLLs in China were lower in 2010 than all emerging economies in the G20, and only slightly higher than noted in the USA. China had the lowest age-standardised YLD rate in the G20 in 2010. China also ranked tenth (95% UI eighth to tenth) for HALE and 12th (11th to 13th) for life expectancy. YLLs from neonatal causes, infectious diseases, and injuries in children declined substantially between 1990 and 2010. Mental and behavioural disorders, substance use disorders, and musculoskeletal disorders were responsible for almost half of all YLDs. The fraction of DALYs from YLDs rose from 28·1% (95% UI 24·2–32·5) in 1990 to 39·4% (34·9–43·8) in 2010. Leading causes of DALYs in 2010 were cardiovascular diseases (stroke and ischaemic heart disease), cancers (lung and liver cancer), low back pain, and depression. Dietary risk factors, high blood pressure, and tobacco exposure are the risk factors that constituted the largest number of attributable DALYs in China. Ambient air pollution ranked fourth (third to fifth; the second highest in the G20) and household air pollution ranked fifth (fourth to sixth; the third highest in the G20) in terms of the age-standardised DALY rate in 2010. The rapid rise of non-communicable diseases driven by urbanisation, rising incomes, and ageing poses major challenges for China's health system, as does a shift to chronic disability. Reduction of population exposures from poor diet, high blood pressure, tobacco use, cholesterol, and fasting blood glucose are public policy priorities for China, as are the control of ambient and household air pollution. These changes will require an integrated government response to improve primary care and undertake required multisectoral action to tackle key risks. Analyses of disease burden provide a useful framework to guide policy responses to the changing disease spectrum in China. Bill & Melinda Gates Foundation.

Background: The cognitive function of the elderly has become a focus of public health research. Little is known about the changes of cognitive function and the risk factors for cognitive impairment in the Chinese elderly; thus, the purposes of this study are as follows: (1) to describe changes in cognitive function in the Chinese elderly from 2005–2014 and (2) to explore risk factors for cognitive impairment of the Chinese elderly. Design and setting: A total of 2603 participants aged 64 years and above participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and were followed up from 2005 to 2014. Cognitive function and cognitive impairment were assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Binary logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) of cognitive impairment. Results: Results revealed that the cognitive function of the Chinese elderly shows diversified changes: deterioration (55.09%), unchanged (17.21%) and improvement (27.70%). In addition, there are significant demographic differences in gender, age, education, marriage and other aspects when it comes to the changes of cognitive function in Chinese elderly. In the binary logistic regression analysis, female, increased age, lower education level, no spouse, less income, worse PWB (psychological well-being), less fresh fruit and vegetable intake, more activities of daily living (ADL) limitations, lower social engagement were significantly associated with higher odds for cognitive impairment. Conclusions: Various interventions should be implemented to maintain cognitive function in Chinese elderly.

Healthy ageing plays an important role in ageing societies in many countries, and centenarians are a sign of longevity. Longevity and its determinants have become issues of global concern and also a focus of research. Although many disciplines have conducted out a series of studies on longevity phenomena, few studies have systematically considered the impact of geographical environmental factors. Guangxi is one of the provinces with the highest centenarian ratio in mainland China, while Hechi City has the highest ratio of centenarians in Guangxi Province, and contains the world-famous longevity belt. This study took Hechi City, “the world’s longevity city”, as a model research area. First, the basic characteristics of the geographical environmental factors in Hechi City were analysed, and then geographical information system techniques and eXtreme Gradient Boosting machine learning methods were applied to systematically analyse the coupling relationship between the spatial distribution of the longevity population and the geographical environmental factors. In addition, the geographical environmental factors closely related to longevity were filtered and investigated. It was found that the centenarian is distributed along a belt-like pattern. It is mostly located in rocky mountainous areas with low elevations, small to medium undulations, medium slopes and brown calcareous soils, but is rarely found near the non-ferrous mining industry. This work provides a scientific basis for identifying the mechanisms that contribute to regional longevity and theoretical references for improving the health level of the elderly population according to local conditions.