Prenatal malnutrition could promote renal dysfunction in adulthood, but it is unclear whether the detrimental effect could be transmitted to the next generation. We investigated whether famine exposure was associated with variation of estimated glomerular filtration rate(eGFR) in two generations and explored the mediation role of methylation alterations. The longitudinal analysis included 2909 participants from Suihua rural area. F1 and F2 generations were divided into non-famine and famine group based on their birth year and exposure status of their parents, respectively. The eGFR was calculated by using the chronic kidney disease epidemiology collaboration equation. We applied mixed-effect models to investigate the association between famine and ΔeGFR and tested blood DNA methylomes in 46 families across two generations. The mediation-analysis models were utilized to examine the mediation effect of methylation alterations on the famine-ΔeGFR association. In mixed-effect models, famine exposure was associated with declined ΔeGFR level in F1 (β:-8.32;95%CI:-11.51,-5.12) and in F2 (β:-6.11;95%CI:-11.88,-0.43). Methylation850K BeadChip data showed only 19 of 961 F1 differentially methylated sites showed concordant alterations in F2. The mediation-analysis results showed methylation alterations on AGTR1 and PRKCA might mediate the famine-ΔeGFR association. Overall, prenatal famine exposure may have long-term effects on eGFR decline across consecutive generations which might be partly mediated by methylation alterations on AGTR1 and PRKCA.

Context Emerging evidence suggests that not only the quantity but also the quality and food sources of macronutrients plays an important role in CVD. However, limited studies have examined the association of meal timing of different quality of macronutrients with CVD risk. Objective This study aimed to examine the association of subtypes of macronutrient consumption at dinner vs breakfast with cardiovascular diseases (CVD). Methods A total of 27 911 participants from the National Health and Nutrition Examination Survey (2003-2016) were included. The differences of subtypes of macronutrients at dinner vs breakfast (Δratio) were categorized into quintiles. Multiple logistic regression models and isocaloric substitution effects of subtypes were performed. Results After adjustment of a variety of covariates, participants in the highest quintile of the Δratio of low-quality carbohydrates had a higher risk of angina (odds ratio [OR] = 1.63; 95% CI, 1.16-2.29) (Pfor trend = .007) and heart attack (OR = 1.47; 95% CI, 1.13-1.93) (Pfor trend = .068) compared with the lowest quintile. The highest quintile of the Δratio of animal protein had a higher risk of coronary heart disease (OR = 1.44; 95% CI, 1.06-1.95) (Pfor trend = .014) and angina (OR = 1.44; 95% CI, 1.01-2.07) (Pfor trend = .047). For the Δratio of unsaturated fatty acid (USFA), the highest quintile of the Δratio of USFA was related to lower stroke risk (OR = 0.76; 95% CI, 0.58-0.99) (Pfor trend = .049). Isocaloric substitution of low-quality carbohydrates/animal protein by high-quality carbohydrates/plant protein at dinner reduced CVD risk by around 10%. Conclusion This study indicated that overconsumption of low-quality carbohydrates and animal protein at dinner rather than breakfast was significantly associated with higher CVD risk and USFA consumption at dinner related to lower CVD risk among US adults. Substitution of low-quality carbohydrates or animal protein by high-quality carbohydrates or plant protein at dinner could reduce CVD risk.

OBJECTIVE In this study we investigated the association of the quantity, quality, and timing of carbohydrate intake with all-cause, cardiovascular disease (CVD), and diabetes mortality. RESEARCH DESIGN AND METHODS This secondary data analysis included use of National Health and Nutrition Examination Survey (2003–2014) and National Death Index data from adults (n = 27,623) for examination of the association of total daily and differences in carbohydrate intake with mortality. Participants were categorized into four carbohydrate intake patterns based on the median values of daily high- and low-quality carbohydrate intake. The differences (Δ) in carbohydrate intake between dinner and breakfast were calculated (Δ = dinner − breakfast). Cox regression models were used. RESULTS The participants who consumed more high-quality carbohydrates throughout the day had lower all-cause mortality risk (hazard ratio [HR] 0.88; 95% CI 0.79–0.99), whereas more daily intake of low-quality carbohydrates was related to greater all-cause mortality risk (HR 1.13; 95% CI: 1.01–1.26). Among participants whose daily high- and low-quality carbohydrate intake were both below the median, the participants who consumed more high-quality carbohydrates at dinner had lower CVD (HR 0.70; 95% CI 0.52–0.93) and all-cause mortality (HR 0.82; 95% CI 0.70–0.97) risk; an isocaloric substitution of 1 serving low-quality carbohydrates intake at dinner with high-quality reduced the CVD and all-cause mortality risks by 25% and 19%. There was greater diabetes mortality among the participants who consumed more low-quality carbohydrates at dinner (HR 1.78; 95% CI 1.02–3.11), although their daily high-quality carbohydrate intake was above the median. CONCLUSIONS Consuming more low-quality carbohydrates at dinner was associated with greater diabetes mortality, whereas consuming more high-quality carbohydrates at dinner was associated with lower all-cause and CVD mortality irrespective of the total daily quantity and quality of carbohydrates.

Peoples Republic of China; *Contributed equally Study Objectives: Few studies have examined the association between sleep duration trajectories and hypertension. This study aims to examine association of sleep duration trajectories with risk of hypertension and its related factors.Methods: This study used longitudinal data for 7,397 adults who provided valid responses in questionnaire with regard to information of sleep and hypertension from the China Health and Nutrition Survey (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011). Subgroup analyses included 5,532 participants in whom hypertension-related factors were measured using blood samples. Latent class trajectory analysis was used to identify different sleep duration trajectories. Multivariate Cox regression models and general linear regression models were used to assess association of trajectories with hypertension and its related factors. Results: Compared to stable sleep duration around 8 hours, the trajectory showing a persistent decrease in sleep duration with aging was significantly associated with increased risk of hypertension (hazard ratio 1.12, 95% confidence interval 1.01-1.24), whereas no significant association was observed between the trajectory showing an increase in sleep duration to 9 hours with aging and risk of hypertension (hazard ratio 1.05, 95% confidence interval 0.93-1.19). Further, uric acid levels, fasting glucose levels, total cholesterol levels, and apolipoprotein B levels were significantly higher in the trajectory showing a persistent decrease in sleep duration with aging than the other two trajectories (all P < .05). Conclusions: Decreasing sleep duration during aging is significantly associated with increased risk of hypertension and higher levels of its biomarkers throughout adulthood.

Background The COVID-19 pandemic has brought a lot of working stress to medical workers and has a certain impact on their mental health. Working stress is closely related to the increase in anxiety, but few studies have explored whether their relationship will be affected by positive psychological factors in the special situation. Methods 798 medical workers were investigated online after the outbreak of the COVID-19 (10 February to 1 March 2020) in China. The relevant questionnaires were used to evaluate working stress, anxiety, sense of control, and psychological capital. The moderated mediation model test was performed using the SPSS software and PROCESS macro program. Results Working stress could directly affect anxiety, and indirectly affect anxiety through sense of control. In addition, psychological capital moderated the direct effect of working stress on anxiety, which is more effective at high level of psychological capital. Psychological capital also moderated the second half of the indirect effect of working stress on anxiety, at low level of psychological capital, sense of control was more effective in predicting anxiety. Limitations All the data in this study was collected through online questionnaire. The anxiety response measured in this study cannot be specific to the viral epidemic. Conclusions Under the COVID-19 epidemic situation, for medical workers, low sense of control and low level of psychological capital may be important risk factors of anxiety caused by working stress. Thus, strengthening the sense of control and psychological capital of medical workers would be helpful to reduce their anxiety and maintain their mental health.

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