To examine perceived infection risk of COVID-19 and the health and related behavior changes among people with diabetes, compared with people without diabetes, and to examine factors associated with self-reported health during the national quarantine period in China. Methods: The 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media across China. A national sample of 10,545 adults in all 31 provinces in mainland China provided data on sociodemographic characteristics, awareness, attitudes towards COVID-19, lifestyle factors, and health outcomes during the quarantine. Regression models tested associations among study variables adjusting for covariates. Results: Among the 9,016 total participants (42.6% men and 57.4% women), 585 reported having diagnosed diabetes and 8,431 had no diabetes. Participants with diabetes perceived themselves to be at higher risk and were more worried about being infected with COVID-19 when compared to non-diabetic individuals (p < 0.001). During the COVID-19 pandemic, participants with diabetes were more likely to experience food and drug shortages and to increase their physical activity, compared to their counterparts. Among diabetic respondents, a high proportion of current smokers (74.1%) and drinkers (68.5%) reported increased

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Summary Knowledge regarding nutrition transition in Nepal remains limited. This systematic review examined the shifts in undernutrition and overnutrition in Nepal during the past two decades. We searched PubMed for studies and reports published between January 1, 2000, and June 30, 2018. Publications with a sample size greater than or equal to 500 that reported prevalence of nutritional status were included. Six large national reports and 36 studies met study inclusion criteria and were included. Overall, available nationally representative data remained limited. The Nepal Demographic and Health Survey 2001 to 2016 showed that underweight prevalence decreased from 26.7% to 17.2% and prevalence of overweight/obesity increased from 6.5% to 22.1% among women of reproductive age (15‐49 years). In preschool children, prevalence of stunting, wasting, and underweight decreased from 57.2% to 35.8%, 11.2% to 9.7%, and 42.7% to 27.0%, respectively. Prevalence of overweight/obesity was low among children and was higher in higher socio‐economic status (SES) groups. The overweight‐obesity/underweight ratios indicate a shift from undernutrition to overnutrition problem; it was more evident in urban areas and higher SES groups. In conclusion, Nepal is experiencing a nutrition transition. More research is warranted to address this shift, and well‐tailored public health efforts need to combat the double burden of overweight/obesity and undernutrition.

Summary The lack of access to sidewalks is a barrier for physical activity (PA) and may be a risk factor for childhood obesity. However, previous studies reported mixed findings and the association between sidewalk accessibility and childhood obesity remains unclear. This study systematically examined the evidence on the association between sidewalk accessibility and childhood obesity. PubMed, Cochrane Library, and Web of Science were searched for relevant articles (published before 1 January 2019) that reported on the association between neighborhood sidewalk access and weight‐related behaviors and outcomes in children. Seventeen studies conducted in five countries were included. Ten studies used objective measure of access to sidewalks, seven studies measured children's height and weight, and seven studies objectively measured the PA or sedentary behaviors. Ten studies reported on the association of better access to sidewalks with increased PA (β ranging from 0.032 to 2.159; p < 0.05), reduced sedentary behaviors (β ranging from −0.19 to −0.14; p < 0.05), lower body mass index (BMI) (β ranging from −0.261 to −0.144; p < 0.001), or obesity risks (OR ranging from 1.02 to 1.32; p < 0.05); while the remaining seven studies did not report a desirable obesity–sidewalk association. Our findings support the hypothesis that higher sidewalk accessibility is associated with higher PA levels, lower BMI, and obesity risks. Efforts in building healthy environments, including health‐promoting city planning, can help minimize the growing obesity epidemic and promote public health.

Background: China has made large efforts to reduce stroke prevalence. We aimed to systematically examine the prevalence of stroke in China over the past two decades.Methods: Databases, including China National Knowledge Infrastructure, Wanfang, VIP, and PubMed, were systematically searched for studies published in English or Chinese that reported stroke prevalence in China during 2000-2017. Meta-analysis was conducted to estimate the pooled stroke prevalence and the variations in stroke prevalence subgroups stratified by age, gender, time period, and region.Results: In total, 96 papers met the inclusion criteria. Meta-analysis showed that the overall estimated national prevalence was 5.1% (5.0-5.3%) with large variations across regions: 3.1% (2.5-3.6%) in south China, 3.4% (3.0-3.8%) in southwest China, 3.6% (3.3-3.8%) in east China, 5.0% (4.7-5.4%) in central China, 5.8% (4.6-7.1%) in northwest China, 6.0% (5.0-7.0%) in northeast China, and 8.0% (7.4-8.5%) in north China. Men had a higher prevalence than women [7.3% (6.9-7.7%) vs. 5.6% (5.2-6.0%)]. Stroke prevalence increased with age, was 1.2% (1.0-1.3%), 2.9% (2.6-3.2%), 5.9% (5.2-6.5%), and 8.7% (8.0-9.5%) in the 40-49, 50-59, 60-69, and ≥70 years old groups, respectively.Conclusions: Men, people being older, or living in northern China had higher stroke prevalence. More vigorous efforts are needed in China to prevent stroke.

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Objectives This study aimed to evaluate associations between mental distress and COVID-19-related changes in behavioral outcomes and potential modifiers (age, gender, educational attainment) of such associations. Study design This was a cross-sectional study. Methods An online survey using anonymous network sampling was conducted in China from April to May 2020 using a 74-item questionnaire. A national sample of 10,545 adults in 31 provinces provided data on sociodemographic characteristics, COVID-19-related mental distress, and changes in behavioral outcomes. Structural equation models were used for data analyses. Results After adjusting for covariates, greater mental distress was associated with increased smoking (odds ratio [OR] = 1.42, 95% confidence interval [CI]: 1.20–1.68 and OR = 1.54, 95% CI: 1.31–1.82 per one standard deviation [SD] increase in mental distress) and alcohol consumption (OR = 1.67, 95% CI: 1.45–1.92 and OR = 1.47, 95% CI: 1.24–1.75 per one SD increase in mental distress) among current smokers and drinkers and with both increased and decreased physical activity (ORs ranged from 1.32 to 1.56). Underweight adults were more likely to lose body weight (≥1 kg; OR = 1.63, 95% CI: 1.30–2.04), whereas overweight adults were more likely to gain weight (OR = 1.61, 95% CI: 1.46–1.78) by the same amount. Association between mental distress and change in physical activity was stronger in adults aged ≥40 years (ORs ranged from 1.43 to 2.05) and those with high education (ORs ranged from 1.43 to 1.77). Mental distress was associated with increased smoking in males (OR = 1.60, 95% CI: 1.37–1.87) but not females (OR = 1.11, 95% CI: 0.82–1.51). Conclusions Greater mental distress was associated with some positive and negative changes in behavioral outcomes during the pandemic. These findings inform the design of tailored public health interventions aimed to mitigate long-term negative consequences of mental distress on outcomes.

Background This study primarily aimed to evaluate the associations between mental distress and COVID-19-related changes in behavioral outcomes, and potential modifiers (age, gender, and educational attainment) of such associations.Methods An online survey using anonymous network sampling was conducted in China during April-May, 2020 using a 74-item questionnaire distributed through social media. A national sample of 10,545 adults in 31 provinces provided data on socio-demographic characteristics, COVID-19-related mental distress, and changes in behavioral outcomes. Structural equation models were used for data analyses.Results About 13% of adults reported experiencing at least one symptom of mental distress. After adjusting for covariates, greater mental distress was associated with increased smoking and alcohol consumption (among current smokers and drinkers) and with both increased and decreased physical activity. Underweight adults were more likely to lose body weight (≥ 1 kg) whereas overweight adults were more likely to gain weight by the same amount. Association between mental distress and change in physical activity was stronger in adults aged 40 and above and those with high education.Conclusions Mental distress was associated with increased smoking in males but not females. These findings inform the design of tailored public health interventions aimed to mitigate long-term negative consequences of mental distress on outcomes.