Lin Lv

Background/Objectives: Whole-blood fatty acid composition provides an objective biomarker of fatty acid status, but its relationships with nutritional characteristics and subsequent quality-of-life (QoL) changes among cancer survivors remain incompletely understood. We aimed to identify whole-blood fatty acid phenotypes and examine their associations with nutritional characteristics, cross-sectional QoL profiles, and subsequent QoL changes in an overlapping longitudinal subcohort. Methods: In this cohort study, the 2023 baseline investigation included 3175 community-dwelling adult cancer survivors with whole-blood fatty acid profiles and paired questionnaires. After excluding participants with substantial missing QoL data, implausible fatty acid measurements, or missing age, sex, or cancer type, 3009 participants comprised the baseline analytical sample. Among these, 423 overlapped with an independent longitudinal cohort contributing QoL data from June 2021 and June 2024, and 398 had complete covariate data for the core adjusted longitudinal analyses. Whole-blood fatty acid phenotypes were identified using principal component analysis and unsupervised clustering. Nutritional characteristics were assessed using habitual dietary intake, Diet Balance Index 2022 scores, and nutrition literacy measures. QoL was assessed using the EORTC QLQ-C30. Multivariable models examined cross-sectional QoL and annualised QoL changes. An open-source phenotype assignment tool was developed to support reproducible classification in future cohorts. Results: Among 3009 baseline participants (mean [SD] age, 64.9 [7.0] years; 2397 women [79.7%]), five whole-blood fatty acid phenotypes were identified. Phenotypes 2 and 3 were rarely observed in the available general-population reference sample and appeared enriched among survivors. Phenotype 2, a high-SFA/low-PUFA phenotype accompanied by higher red meat intake and greater DBI-22 excess scores for red meat and related animal foods, was associated with statistically significant worsening across multiple QoL domains over 12 months despite relatively favourable baseline QoL. Compared with the general-population-mapped reference pool (Phenotypes 1, 4, and 5), Phenotype 2 showed annualised declines in summary score (−4.66 [95% CI, −8.14 to −1.19]) and role functioning (−5.35 [−9.88 to −0.83]), and worsening pain (8.28 [2.58 to 13.98]), dyspnoea (6.83 [0.16 to 13.50]), and constipation (14.10 [7.30 to 20.90]). Prebaseline annualised QoL changes over the preceding 24 months did not differ significantly across phenotypes. Conclusions: Whole-blood fatty acid profiling identified distinct nutritional-metabolic phenotypes among community-dwelling cancer survivors. The high-SFA/low-PUFA phenotype, accompanied by higher red meat intake and greater DBI-22 excess scores for red meat and related animal foods, was associated with worsening across multiple QoL domains over the subsequent 12 months despite relatively favourable baseline QoL. These findings highlight whole-blood fatty acid phenotyping as a potentially informative framework for characterising nutritional-metabolic heterogeneity and subsequent QoL vulnerability among cancer survivors. The open-source phenotype assignment tool may facilitate reproducible phenotype assignment and external validation in future cohorts.

Suboptimal medication adherence and unhealthy lifestyle behaviors are well‐recognized contributing factors to poor blood pressure control in hypertension patients. We evaluated the effectiveness of comprehensive health management in improving medication adherence and promoting healthy lifestyle behaviors among hypertension patients in China. A cluster randomized trial was implemented in rural areas of three provinces of China. Participants were individuals aged ≥ 40 years with uncontrolled hypertension. The intervention group received multidimensional health management measures codeveloped by healthcare organizations, village doctors, and patients, while the control group received standard care. The coprimary outcomes included the proportion of patients demonstrating good medication adherence and adherence to ≥ 3 healthy lifestyle components. Secondary outcomes comprised the proportion achieving controlled hypertension (BP < 140/90 mm Hg). From May 8th to November 28th, 2018, 9204 participants were enrolled. At 18‐month follow‐up, significantly higher medication adherence was observed in the intervention group compared with the control group, with an absolute difference of 5.0% (95% confidence interval (CI): 2.8–7.2; p < 0.001). Similarly, adherence to ≥ 3 healthy lifestyles was achieved by 45.8% in the intervention group versus 33.7% in controls, yielding a 12.1% between‐group difference (95% CI: 9.9–14.3; p < 0.001). Hypertension control rates differed significantly between groups (43.2% vs. 23.9%; absolute difference 19.2% and 95% CI: 17.2–21.3; p < 0.001). Hypertension patients receiving comprehensive health management in rural China demonstrated superior medication adherence and healthier lifestyle behaviors compared with those receiving standard care over 18 months. Further investigations are warranted to evaluate the cost‐effectiveness and generalizability of this intervention. Trial Registration: ClinicalTrials.gov identifier: NCT03527719

Hypertension remains a major public health challenge globally, with suboptimal adherence to treatment and lifestyle modifications exacerbating cardiovascular risks. This study evaluates multidimensional adherence (medication, diet, and behavior) and its determinants among hypertensive patients in rural Northeast China. A cross‐sectional study enrolled 6352 adults aged ≥ 40 years with diagnosed and poorly controlled hypertension from rural villages across five cities (Benxi, Chaoyang, Dandong, Donggang, and Fuxin) in Liaoning Province, Northeast China, using multistage cluster sampling. Adherence was assessed via standardized questionnaires, with logistic regression analyzing sociodemographic, clinical, and behavioral predictors. Medication adherence was reported by 73.7% of participants, while dietary and behavioral adherence rates were 10.5% and 29.3%, respectively. Ethnic disparities emerged, with Han Chinese exhibiting lower medication adherence (aOR = 0.485, 95% CI: 0.377–0.624). Cohabiting with children enhanced dietary adherence (aOR = 2.184, 95% CI: 1.854–2.573), whereas widowed status reduced both dietary (aOR = 0.698, 95% CI: 0.528–0.924) and behavioral adherence (aOR = 0.726, 95% CI: 0.595–0.887). Higher hypertension knowledge scores positively influenced all adherence domains ( p < 0.05). Adherence among rural hypertensive patients is multidimensional, shaped by cultural, socioeconomic, and behavioral factors. Targeted interventions addressing dietary sodium reduction, family‐based support, and health literacy improvement are urgently needed. This study underscores the importance of integrating region‐specific strategies into hypertension management programs to mitigate cardiovascular morbidity in high‐risk populations.

Background/Objectives: Breast cancer survivors often face an elevated risk of developing co-morbid chronic diseases, which may be exacerbated by nutritional inequalities. This study aimed to comprehensively assess the associations between nutrition literacy, dietary quality, and the risk of co-morbidity in breast cancer survivors in China. Methods: A cross-sectional study was conducted among cancer survivors enrolled in the Shanghai Cancer Rehabilitation Club from March to July 2023. The multivariable models of logistic regression, Poisson regression, and mediation analysis were used to explore the relationship between nutrition literacy, dietary quality, and co-morbid chronic diseases among breast cancer survivors in China. Results: The mean age of the 1552 female breast cancer survivors was 64.5 ± 7.02 years. Nutrition literacy was found to be low, with 49.81% of participants scoring above the threshold for adequate nutrition literacy. The median (IQR) diet quality distance, low bound score, and high bound score were 67.0 (55.0, 81.0), −39.0 (−51.0, −28.0), and 25.0 (16.0, 36.0), respectively. Of the total female breast cancer survivors, 67.27% were reported to have at least one comorbid chronic disease. Hypertension (37.32%) was the most common co-morbid chronic disease. Each score increase of 10 in nutrition literacy (AOR 0.88, 95%CI 0.808–0.962) was associated with a significant reduction in co-morbid chronic disease risk among breast cancer survivors. Poisson regression analysis of the number of chronic diseases was conducted, and consistently, an association between higher nutrition literacy levels and fewer chronic diseases was observed (AOR 0.94, 95%CI 0.911–0.971). The indirect effect of nutrition literacy on comorbidity risk through dietary quality was not significant (indirect effect = 0.994, 95%CI = 0.980–1.008). Conclusions: Nutrition literacy is paramount in breast cancer survivors’ dietary quality and prognosis. Enhancing nutrition literacy may be a crucial strategy for improving dietary quality and mitigating the risk of comorbid chronic diseases in this vulnerable population.