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Torres-Gonzalez M, Pikosky MA, Ricklefs-Johnson K, Fulgoni K, Fulgoni VL, Agarwal S, Cifelli CJ. Whole milk intake is associated with lower body weight and body mass index in American adults. Nutr Res 2024; 132:180-189. [PMID: 39608078 DOI: 10.1016/j.nutres.2024.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Revised: 10/25/2024] [Accepted: 11/01/2024] [Indexed: 11/30/2024]
Abstract
The objective was to determine if whole milk intake or total milk intake behaviors are associated with body weight (weight) and related parameters in adults. We hypothesize that whole milk intake would be inversely associated with body weight measures. Whole milk (including flavored whole milk) intake was assessed using 24-hour dietary recall data of the National Health and Nutrition Examination Survey 2001-2018 for adults age 20+ years (N = 43,038). Weight and related parameters were measured, and history of self-reported weights and total milk intake were obtained from questionnaire data. The association of whole milk intake with weight was assessed via regression after adjusting for demographic and lifestyle-related covariates. The average body mass index (BMI) was about 29 kg/m2 and weight was 76 to 89 kg. About 66% of the population were overweight or obese. Average whole milk intake among consumers was 1.0 to 1.4 cups eq/d. Whole milk intake was inversely associated (P < .05) with weight, BMI, waist circumference, and the prevalence of obesity. Whole milk intake was also inversely associated (P < .01) with trying to lose weight in the past year. In most cases, milk intake behavior at ages 5 to 12, 13 to 17, or 18 to 35 years was not associated with BMI. The results indicate that whole milk intake was inversely associated with weight, BMI, and prevalence of obesity, and these findings may provide additional evidence to support dietary recommendations for whole milk.
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Sualeheen A, Khor BH, Lim JH, Balasubramanian GV, Chuah KA, Yeak ZW, Chinna K, Narayanan SS, Sundram K, Daud ZAM, Karupaiah T. Investigating the impact of dietary guidelines transition on cardiometabolic risk profile: a forensic analysis using diet quality metrics. Sci Rep 2024; 14:19983. [PMID: 39198625 PMCID: PMC11358446 DOI: 10.1038/s41598-024-70699-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 08/20/2024] [Indexed: 09/01/2024] Open
Abstract
Evaluating dietary guidelines using diet quality (DQ) offers valuable insights into the healthfulness of a population's diet. We conducted a forensic analysis using DQ metrics to compare the Malaysian Dietary Guidelines (MDG-2020) with its former version (MDG-2010) in relation to cardiometabolic risk (CMR) for an adult Malaysian population. A DQ analysis of cross-sectional data from the Malaysia Lipid Study (MLS) cohort (n = 577, age: 20-65yrs) was performed using the healthy eating index-2015 (HEI-2015) framework in conformation with MDG-2020 (MHEI2020) and MDG-2010 (MHEI2010). Of 13 dietary components, recommended servings for whole grain, refined grain, beans and legumes, total protein, and dairy differed between MDGs. DQ score associations with CMR, dietary patterns and sociodemographic factors were examined. Out of 100, total DQ scores of MLS participants were 'poor' for both MHEI2020 (37.1 ± 10.3) and MHEI2010 (39.1 ± 10.4), especially among young adults, males, Malays, and those frequently 'eating out' as well as those with greatest adherence to Sugar-Sweetened Beverages pattern and lowest adherence to Food Plant pattern. Both metrics shared similar correlations with CMR markers, with MHEI2020 exhibiting stronger correlations with WC, BF%, TG, insulin, HOMA2-IR, and smallLDL than MHEI2010, primarily attributed to reduced refined grain serving. Notably, participants with the highest adherence to MHEI2020 scores exhibited significantly reduced odds for elevated TG (AOR 0.44, 95% CI 0.21-0.93, p = 0.030), HOMA2-IR (AOR 0.44, 95% CI 0.21-0.88, p = 0.022), and hsCRP (AOR 0.54, 95% CI 0.31-0.96, p = 0.040, compared to those with the lowest adherence. Each 5-unit increase in MHEI2020 scores reduced odds for elevated BMI (- 14%), WC (- 9%), LDL-C (- 32%), TG (- 15%), HOMA2-IR (- 9%) and hsCRP (- 12%). While MHEI2020 scores demonstrated better calibration with CMR indicators, the overall sub-optimally 'poor' DQ scores of this population call for health promotion activities to target the public to achieve adequate intake of healthful fruits, non-starchy vegetables and whole grain, and moderate intake of refined grain, added sugar and saturated fat.
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Affiliation(s)
- Ayesha Sualeheen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, University Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Jun-Hao Lim
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | | | - Khun-Aik Chuah
- Nutrition Program, Faculty of Health Sciences, University Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Zu-Wei Yeak
- Nutrition Program, Faculty of Health Sciences, University Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Sreelakshmi Sankara Narayanan
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, 47500, Subang Jaya, Selangor, Malaysia
- Food Security and Nutrition Impact Lab, Taylor's University, 47500, Subang Jaya, Selangor, Malaysia
| | - Kalyana Sundram
- Malaysia Palm Oil Council, Menara Axis, 46100, Petaling Jaya, Selangor, Malaysia
| | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
- Department of Dietetics, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Tilakavati Karupaiah
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, 47500, Subang Jaya, Selangor, Malaysia.
- Food Security and Nutrition Impact Lab, Taylor's University, 47500, Subang Jaya, Selangor, Malaysia.
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Taormina VM, Unger AL, Kraft J. Full-fat dairy products and cardiometabolic health outcomes: Does the dairy-fat matrix matter? Front Nutr 2024; 11:1386257. [PMID: 39135556 PMCID: PMC11317386 DOI: 10.3389/fnut.2024.1386257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/27/2024] [Indexed: 08/15/2024] Open
Abstract
Reducing dairy fat intake is a common dietary guideline to limit energy and saturated fatty acid intake for the promotion of cardiometabolic health. However, research utilizing a holistic, food-based approach to assess the consumption of the fat found in dairy, a broad and diverse food group, may provide new insight into these guidelines. Dairy fat is comprised of a diverse assembly of fatty acids, triacylglycerols, sterols, and phospholipids, all uniquely packaged in a milk fat globule. The physical structure of this milk fat globule and its membrane is modified through different processing methods, resulting in distinctive dairy-fat matrices across each dairy product. The objectives of this narrative review were to first define and compare the dairy-fat matrix in terms of its unique composition, physical structure, and fat content across common dairy products (cow's milk, yogurt, cheese, and butter). With this information, we examined observational studies and randomized controlled trials published within the last 10 years (2013-2023) to assess the individual effects of the dairy-fat matrix in milk, yogurt, cheese, and butter on cardiometabolic health and evaluate the implications for nutrition guidance. Searches conducted on Ovid MEDLINE and PubMed® utilizing search terms for cardiometabolic health, both broadly and regarding specific disease outcomes and risk factors, yielded 59 studies that were analyzed and included in this review. Importantly, this review stratifies by both dairy product and fat content. Though the results were heterogeneous, most studies reported no association between intake of these individual regular-fat dairy products and cardiometabolic outcome measures, thus, the current body of evidence suggests that regular-fat dairy product consumption may be incorporated within overall healthy eating patterns. Research suggests that there may be a beneficial effect of regular-fat milk and yogurt intake on outcome measures related to body weight and composition, and an effect of regular-fat cheese intake on outcome measures related to blood lipids, but more research is necessary to define the directionality of this relationship. Lastly, we identify methodological research gaps and propose future research directions to bolster the current evidence base available for ascertaining the role of dairy fat in a healthy diet.
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Affiliation(s)
- Victoria M. Taormina
- Department of Animal and Veterinary Sciences, The University of Vermont, Burlington, VT, United States
| | - Allison L. Unger
- Department of Pathology and Laboratory Medicine, The University of Vermont, Burlington, VT, United States
- National Dairy Council, Rosemont, IL, United States
| | - Jana Kraft
- Department of Animal and Veterinary Sciences, The University of Vermont, Burlington, VT, United States
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, The University of Vermont, Colchester, VT, United States
- Department of Nutrition and Food Sciences, The University of Vermont, Burlington, VT, United States
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Geng J, Wu Y, Tian H, Dong J. Alleviation of High-Fat Diet-Induced Hyperlipidemia in Mice by Stachys sieboldii Miq. Huangjiu via the Modulation of Gut Microbiota Composition and Metabolic Function. Foods 2024; 13:2360. [PMID: 39123552 PMCID: PMC11312184 DOI: 10.3390/foods13152360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
Hyperlipidemia is a chronic disease that is difficult to cure, and long-term pharmacotherapy may have negative consequences. Dietary therapy is a very promising strategy, and Chinese rice wine (Huangjiu) will play an important role because of its many biologically active components. In this work, the alleviating effect of Stachys sieboldii Miq. Huangjiu (CSCHJ) on high-fat diet-induced hyperlipidemia in mice was investigated, which is brewed from the wheat Qu with the addition of Stachys sieboldii Miq. and contains 15.54 g/L of polysaccharides. The experimental results showed that CSCHJ inhibited appetite, reduced body weight and blood sugar levels, and downregulated the serum levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) while concurrently upregulating high-density lipoprotein cholesterol (HDL-C) in the high-fat diet-induced hyperlipidemia mice. At the same time, it was discovered that alcohol worsens hyperlipidemia symptoms and related physiological markers, implying that CSCHJ polysaccharides may play a role in hyperlipidemia treatment. Through the assessment of organ indices, liver and kidney function, and tissue staining, CSCHJ demonstrated efficacy in repairing liver, kidney, and colon mucosal damage in hyperlipidemic mice. Furthermore, 16S rDNA sequencing and gas chromatography studies revealed that CSCHJ effectively restored the intestinal microbial structure and enhanced the quantity of fecal short-chain fatty acids (SCFAs) in hyperlipidemic mice. Therefore, the alleviating effect of CSCHJ on hyperlipidemia in mice may be attributed to its regulation of energy metabolism by repairing liver, kidney, and colon mucosal damage and restoring the gut microbiota structure, among other mechanisms. Overall, our findings provide evidence that CSCHJ contains active ingredients capable of alleviating hyperlipidemia, thereby laying a theoretical foundation for the extraction of bioactive substances from Huangjiu for future medical or dietary use.
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Affiliation(s)
- Jingzhang Geng
- Shaanxi Province Key Laboratory of Bio-Resources, QinLing-Bashan Mountains Bioresources Comprehensive Development C. I. C., Qinba State Key Laboratory of Biological Resources and Ecological Environment, Shaanxi University of Technology, 1 East 1st Ring Road, Hanzhong 723001, China; (J.G.); (Y.W.); (H.T.)
- School of Life Science and Technology, Xi’an Jiaotong University, Xianning West Road, Xi’an 710049, China
| | - Yunxia Wu
- Shaanxi Province Key Laboratory of Bio-Resources, QinLing-Bashan Mountains Bioresources Comprehensive Development C. I. C., Qinba State Key Laboratory of Biological Resources and Ecological Environment, Shaanxi University of Technology, 1 East 1st Ring Road, Hanzhong 723001, China; (J.G.); (Y.W.); (H.T.)
| | - Honglei Tian
- Shaanxi Province Key Laboratory of Bio-Resources, QinLing-Bashan Mountains Bioresources Comprehensive Development C. I. C., Qinba State Key Laboratory of Biological Resources and Ecological Environment, Shaanxi University of Technology, 1 East 1st Ring Road, Hanzhong 723001, China; (J.G.); (Y.W.); (H.T.)
| | - Jianwei Dong
- Shaanxi Province Key Laboratory of Bio-Resources, QinLing-Bashan Mountains Bioresources Comprehensive Development C. I. C., Qinba State Key Laboratory of Biological Resources and Ecological Environment, Shaanxi University of Technology, 1 East 1st Ring Road, Hanzhong 723001, China; (J.G.); (Y.W.); (H.T.)
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Wang K, Zhao X, Yang S, Qi X, Li A, Yu W. New insights into dairy management and the prevention and treatment of osteoporosis: The shift from single nutrient to dairy matrix effects-A review. Compr Rev Food Sci Food Saf 2024; 23:e13374. [PMID: 38847750 DOI: 10.1111/1541-4337.13374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/23/2024] [Accepted: 05/12/2024] [Indexed: 06/13/2024]
Abstract
Dairy is recognized as a good source of calcium, which is important for preventing osteoporosis. However, the relationship between milk and bone health is more complex than just calcium supplementation. It is unwise to focus solely on observing the effects of a single nutrient. Lactose, proteins, and vitamins in milk, as well as fatty acids, oligosaccharides, and exosomes, all work together with calcium to enhance its bioavailability and utilization efficiency through various mechanisms. We evaluate the roles of dairy nutrients and active ingredients in maintaining bone homeostasis from the perspective of the dairy matrix effects. Special attention is given to threshold effects, synergistic effects, and associations with the gut-bone axis. We also summarize the associations between probiotic/prebiotic milk, low-fat/high-fat milk, lactose-free milk, and fortified milk with a reduced risk of osteoporosis and discuss the potential benefits and controversies of these dairy products. Moreover, we examine the role of dairy products in increasing peak bone mass during adolescence and reducing bone loss in old age. It provides a theoretical reference for the use of dairy products in the accurate prevention and management of osteoporosis and related chronic diseases and offers personalized dietary recommendations for bone health in different populations.
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Affiliation(s)
- Kaili Wang
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Xu Zhao
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Sijia Yang
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Xiaoxi Qi
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Aili Li
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
- Dairy Processing Technology Research Centre, Heilongjiang Green Food Science Research Institute, Harbin, China
| | - Wei Yu
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
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Li A, Han X, Liu L, Zhang G, Du P, Zhang C, Li C, Chen B. Dairy products and constituents: a review of their effects on obesity and related metabolic diseases. Crit Rev Food Sci Nutr 2023; 64:12820-12840. [PMID: 37724572 DOI: 10.1080/10408398.2023.2257782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Obesity has become a global public health problem that seriously affects the quality of life. As an important part of human diet, dairy products contain a large number of nutrients that are essential for maintaining human health, such as proteins, peptides, lipids, vitamins, and minerals. A growing number of epidemiological investigations provide strong evidence on dairy interventions for weight loss in overweight/obese populations. Therefore, this paper outlines the relationship between the consumption of different dairy products and obesity and related metabolic diseases. In addition, we dive into the mechanisms related to the regulation of glucose and lipid metabolism by functional components in dairy products and the interaction with gut microbes. Lastly, the role of dairy products on obesity of children and adolescents is revisited. We conclude that whole dairy products exert more beneficial effect than single milk constituent on alleviating obesity and that dairy matrix has important implications for metabolic health.
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Affiliation(s)
- Aili Li
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Xueting Han
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Libo Liu
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Guofang Zhang
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Peng Du
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Chao Zhang
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Chun Li
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
- Heilongjiang Green Food Research Institute, Harbin, China
| | - Bingcan Chen
- Department of Plant Sciences, North Dakota State University, Fargo, North Dakota, USA
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Torres-Gonzalez M. The Relationship between Whole-Milk Dairy Foods and Metabolic Health Highlights an Opportunity for Dietary Fat Recommendations to Evolve with the State of the Science. Nutrients 2023; 15:3570. [PMID: 37630760 PMCID: PMC10459826 DOI: 10.3390/nu15163570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/26/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
The science of dietary fats has evolved, and a body of evidence indicates they are complex bioactive nutrients that have different effects on health depending on their food source, chain length, degree of saturation, and other factors that can be affected by food processing, handling, and storage. As such, it is becoming increasingly clear that the effects of foods on obesity and metabolic health cannot be predicted simply with their fat content. The aim of this opinion article is to provide a brief overview of select recent research on the effects of whole-milk dairy foods on body composition and indicators of metabolic health across the lifespan to show the gap between current knowledge and dietary guidance. As the state of the science on dietary fats and human health evolves to consider the complexity of food matrices, the total nutrient package they deliver, and the health impacts associated with dietary patterns, so too must guidelines for dietary fat.
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Tucker LA. Legume Intake, Body Weight, and Abdominal Adiposity: 10-Year Weight Change and Cross-Sectional Results in 15,185 U.S. Adults. Nutrients 2023; 15:nu15020460. [PMID: 36678331 PMCID: PMC9864712 DOI: 10.3390/nu15020460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/25/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
There were three objectives: (1) evaluate the relationship between legume intake and weight change across the previous 10 years, (2) examine the cross-sectional associations between legume consumption, BMI, and abdominal adiposity, and (3) determine if the relationship between legume intake and the outcomes were influenced by multiple covariates, particularly fiber intake. The sample included 15,185 randomly selected adults representative of the U.S. population. Percent change in weight was used as the outcome measure for the 10-year analysis. BMI, and waist circumference, corrected for height, were employed as the outcomes for the cross-sectional analyses. Legume, fiber, and energy intakes were measured using the average of two 24-h dietary recalls. Legume intake was divided into three categories. Five demographic and five lifestyle covariates were controlled statistically. There was an inverse dose-response relationship between legume intake and percent weight change over the previous 10 years after adjusting for 9 of the covariates (F = 6.5, p = 0.0028). However, after controlling for fiber with the other covariates, there were no differences across the three legume intake groups (F = 1.9, p = 0.1626). The cross-sectional findings showed similar inverse dose-response results until fiber intake was controlled. Then the associations became non-significant. In conclusion, legume intake is a good predictor of percent weight change over the previous 10 years, and it is also a significant predictor of BMI and abdominal adiposity cross-sectionally. These relationships are strongly influenced by fiber consumption. Evidently, legumes have dietary advantages, especially high fiber levels, that seem to be valuable in the battle against weight gain and obesity.
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Affiliation(s)
- Larry A Tucker
- College of Life Sciences, Brigham Young University, Provo, UT 84602, USA
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Na X, Xi Y, Qian S, Zhang J, Yang Y, Zhao A. Association between Dairy Product Intake and Risk of Fracture among Adults: A Cohort Study from China Health and Nutrition Survey. Nutrients 2022; 14:nu14081632. [PMID: 35458193 PMCID: PMC9027602 DOI: 10.3390/nu14081632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/03/2022] [Accepted: 04/12/2022] [Indexed: 01/27/2023] Open
Abstract
Background: The current literature reports inconsistent associations between dairy product intake and fracture. This study assessed the association between dairy product intake and the risk of fracture among Chinese adults and examined the mediation effects of height and body mass index (BMI) on the association. Methods: Data in 1997−2015 from the China Health and Nutrition Survey were used. Dietary data were collected by a 24-hour dietary recall, and occurrences of fracture were obtained by self-report of participants. Cumulative average intake of daily dairy products was calculated by the sum of the dairy product intake and divided by the total waves of participating in the surveys before fracture. Cox proportion hazard regressions were performed to explore the associations between dairy product intake and the risk of fracture. Mediation analysis models were established to examine the mediation effects of height and BMI on the associations. Results: A total of 14,711 participants were included. Dairy product intake of 0.1−100 g/day was associated with a decreased risk of fracture, while no association was observed among participants with dairy product intake of >100 g/day. The indirect effects of dairy product intake on the fracture mediated by height and BMI were much smaller than the direct effects. Conclusions: Dairy product intake with 0.1−100 g/day is associated with a lower risk of fracture, and the association is mainly a direct result of nutrients in dairy products and much less a result of the mediation effects of height or BMI. Dairy product intake of 0.1−100 g/day might be a cost-effective measure for Chinese adults to decrease fracture incidence.
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Affiliation(s)
- Xiaona Na
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (X.N.); (Y.Y.)
- Institute for Healthy China, Tsinghua University, Beijing 100084, China
| | - Yuandi Xi
- School of Public Health, Capital Medical University, Beijing 100069, China;
| | - Sicheng Qian
- Faculty of Science, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Jian Zhang
- School of Public Health, Peking University, Beijing 100091, China;
| | - Yucheng Yang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (X.N.); (Y.Y.)
- Institute for Healthy China, Tsinghua University, Beijing 100084, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (X.N.); (Y.Y.)
- Institute for Healthy China, Tsinghua University, Beijing 100084, China
- Correspondence:
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