One third of Chinese men will be killed by tobacco if high smoking rates persist

Previous small studies examining differences in testosterone concentrations by ethnicity found mixed results for Caucasians and Chinese men, which might be confounded by age differences and living standards. The aim of the present study is to examine the differences in total, free, and bioavailable testosterone concentrations between healthy young men from the United States (US) and from the most economically developed part of China, i.e., Hong Kong (HK). Cross-sectional analysis based on 365 young men from the Third National Health and Nutrition examination Survey (NHANES III) in the US and 299 Chinese men recruited from university students. All participants were aged from 18 to 29 years. Main outcome measures were total testosterone (TT) and calculated bioavailable testosterone (Bio T) and free testosterone (FT). In both US and Chinese men, TT, FT, and Bio T concentration peaked at 20-24 years of age, at 23.19, 0.49, and 12.23 nmol/l in US men, and 20.72, 0.48 and 12.59 nmol/l in Chinese men, respectively. Among those aged 18-24 years, after adjusting for age, US men had higher TT (mean, 95% confidence interval: 21.64, 21.31-21.99 versus 20.20, 20.12-20.28 nmol/l), but not FT (0.47, 0.47-0.48 versus 0.47, 0.47-0.47 nmol/l) or Bio T (11.90, 11.83-11.97 versus 12.39, 12.35-12.42 nmol/l) than Chinese men. TT, but not FT or Bio T concentrations are lower in young healthy Chinese men than US men. These differences apparent in young men may be important in understanding different patterns of diseases between Western and Asian populations.

Drawing on interviews with 25 young men living in Chengdu, China, this paper examines how Chinese young men practice ‘new man’ masculinity in the face of structural transformation in contemporary China. In this paper, we build on elastic masculinity theory by putting it in explicit dialogue with hybrid masculinities to examine the transformations in Chinese men’s practices of masculinity and how hybrid masculinities may work in the Chinese context. We argue that these Chinese men’s elastic masculine performances suggest that they support gender equality in the family but, in practice, they simultaneously embrace enduring forms of patriarchy. Our findings show that young, heterosexual men perform progressive ‘new man’ masculinity in the family as egalitarian boyfriends by recognizing women’s equal status and challenging the traditional and descending familism; however, they practice hegemonic masculinity by investing in breadwinner roles and relational performance of egalitarianism in the presence of other men to obscure gender inequality. In this sense, these Chinese men practice elastic masculinity associated with enduring systems of gendered power and inequality. This study offers an insight into understanding ‘new man’ masculinity in contemporary China and contributes to our knowledge of how hybrid masculinities look, feel, and work outside of Western societies.

This study aimed to examine the effects of 3-min light-intensity walking every 30 min (3-min) and 6-min light-intensity walking every 60 min (6-min) compared with prolonged sitting (SIT) on the postprandial metabolic responses in young, centrally obese, Chinese men. Twenty-one Chinese men with central obesity (age, 23 ± 4 years; body mass index, 29.8 ± 3.2 kg·m−2; waist circumference, 98.7 ± 7.1 cm; mean ± SD) underwent three 6-h experiments with a 7-day washout period, SIT, 3-min, and 6-min, in randomized order. Compared with SIT, neither walking condition showed differences in total and net incremental area under the curve (tAUC and iAUC, respectively) for glucose, insulin, nor non-esterified fatty acids. The tAUC and iAUC for triglycerides for the SIT condition (10.8 [9.3, 12.2] and 4.4 [3.7, 5.1] mmol·h·L−1, respectively; mean [95% confidence interval]) was higher than 3-min (10.4 [9.0, 11.8] and 3.8 [3.3, 4.3] mmol·h·L−1, respectively, both Ps <0.05) and 6-min (9.6 [8.1, 11.0] and 3.5 [2.9, 4.2] mmol·h·L−1, respectively, both Ps <0.01) conditions. Interrupting prolonged sitting regardless of frequency-reduced postprandial triglycerides. A higher volume of physical activity may be required to obtain greater glycaemic benefits in young Chinese men with central obesity.

Several studies have documented the substantial health and economic burdens associated with sarcopenia among the elderly, but there has been no systematic study among Asians. A cross-sectional survey of elderly community-dwelling Chinese volunteers (262 men and 265 women), aged 70 years and older, was undertaken in Hong Kong. The purposes of this study were to evaluate the prevalence of and risk factors for sarcopenia in elderly Chinese, and to compare these observations with those in white persons. Muscle mass was estimated by dual-energy X-ray absorptiometry. In this study, sarcopenia was defined as a total adjusted skeletal muscle mass two standard deviations or more below the normal mean for young Asian men and women in this study. The relationship between risk factors (alcohol consumption, cigarette smoking, regular exercise, body mass index, medical conditions) and sarcopenia was studied by multiple logistic regression. The prevalence of sarcopenia was 12.3% in Chinese men and 7.6% in Chinese women aged 70 years and older, which was slightly lower than figures observed in white persons. Being underweight was a significant risk factor in both men (odds ratio, 39.1; 95% confidence interval, 11.3 to 134.6) and women (odds ratio, 9.7; 95% confidence interval, 2.8 to 33.8). No other risk factors were found in Chinese men or women. Sarcopenia exists among elderly Chinese men and women, albeit at a lower rate than in white persons. This may be due to the lower muscle mass among young men and women or to an attenuated rate of loss in muscle mass with aging in the Chinese elderly. Being underweight is a major risk factor for sarcopenia in both sexes.

In Singapore, the obesity prevalence is disproportionately higher in the Asian-Indians and Malays than the Chinese. Lower resting energy expenditure (REE) may be a contributory factor. We explored the association between ethnicity and REE in Chinese, Asian-Indian and Malay men living in Singapore and determined the influence of body composition, mass/volume of high metabolic rate organs, represented by brain volume and trunk fat-free mass (FFM), and physical activity on ethnic differences. Two hundred and forty-four men from Singapore (n=100 Chinese, 70 Asian-Indians and 74 Malays), aged 21-40 years and body mass index of 18.5-30.0 kg m(-2), were recruited in this cross-sectional study. REE was assessed by indirect calorimetry and body composition by dual-energy X-ray absorptiometry. Brain volume was measured by magnetic resonance imaging. Physical activity was assessed by the Singapore Prospective Study Program Physical Activity Questionnaire. REE was significantly lower in Asian-Indians compared with that in Chinese after adjusting for body weight. FFM (total, trunk and limb) and total fat mass were important predictors of REE across all ethnic groups. Brain volume was positively associated with REE only in Malays. Moderate and vigorous physical activity was positively associated with REE only in Asian-Indians and Malays. The difference in REE between Asian-Indians and Chinese was attenuated but remained statistically significant after adjustment for total FFM (59±20 kcal per day), fat mass (67±20 kcal per day) and brain volume (54±22 kcal per day). The association between REE and ethnicity was no longer statistically significant after total FFM was replaced by trunk FFM (which includes heart, liver, kidney and spleen) but not when it was replaced by limb FFM (skeletal muscle). We have demonstrated a lower REE in Asian-Indians compared with Chinese who may contribute to the higher rates of obesity in the former. This difference could be accounted for by differences in metabolically active organs.

One important extrinsic factor that causes foot deformity and pain in women is footwear. Women's sports shoes are designed as smaller versions of men's shoes. Based on this, the current study aims to identify foot shape in 1,236 Chinese young adult men and 1,085 Chinese young adult women. Three-dimensional foot shape data were collected through video filming. Nineteen foot shape variables were measured, including girth (4 variables), length (4 variables), width (3 variables), height (7 variables), and angle (1 variable). A comparison of foot measures within the range of the common foot length (FL) categories indicates that women showed significantly smaller values of foot measures in width, height, and girth than men. Three foot types were classified, and distributions of different foot shapes within the same FL were found between women and men. Foot width, medial ball length, ball angle, and instep height showed significant differences among foot types in the same FL for both genders. There were differences in the foot shape between Chinese young women and men, which should be considered in the design of Chinese young adults’ sports shoes.

Chapter 1 begins by introducing the personal experience from which this study arises. Next, it critically reviews existing literature around the major driving forces that have shaped contemporary Chinese society and young men’s identity formation. It focuses in particular on how the process of modernization, individualization and the resilience of Confucianism have been approached differently among scholars in the West and East Asia, as well as their impacts on individual lives in urban China. The chapter moves on to provide a reflexive examination of the research design and the fieldwork process, including background information of the participants and the rationale behind addressing them as ‘ordinary Chinese young men’. The complicated power dynamics during the interviews and challenges in interpreting and representing the data are also discussed.

This book explores Chinese young men's views of manhood and develops a new concept of 'elastic masculinity' which can be stretched and forged differently in response to personal relationships and local realities.

Chapter 18 - Prevention of Cardiovascular Disease Among People Living With HIV: A Tailored Smoking Cessation Program Treating Depression

Current recommendations for cardiovascular disease (CVD) prevention are guided CVD risk classification. This study aims to analyze the level of compliance with pharmacological and non-pharmacological recommendations outlined in the World Health Organization (WHO) CVD prevention clinical practice guideline within the general population of two cities in Argentina. We analyzed the compliance with preventive recommendations from the WHO 2007 Guidelines for Management of Cardiovascular Risk in two cities of Argentina participating in the CESCAS population-based study in the Southern Cone of Latin America. 3990 participants were included. Considering the WHO recommendations, the use of antiplatelet medication was 5.6% (95% CI 3.5, 8.9) in primary prevention and 20.5% (95%= CI 16.0, 25.9) in secondary prevention. Regarding lipid-lowering medication, it was 6.7% (CI 95%= 4.4, 10.1) and 15.4% (CI 95%= 11.6, 20.1), respectively. As per non-pharmacological recommendations in the general population: low intake of fruit and vegetables was 78.4% (CI 95%= 76.8, 79.9); low physical activity was 26.9% (CI 95%= 25.3, 28.5), current cigarette smoking was 28.3% (CI 95%= 26.6, 30.0), overweight/obesity was 73.9% (CI 95%= 72.3, 75.6), and excessive alcohol intake was 2.6% (CI 95%= 2.1, 3.4). It was observed a significantly low compliance with pharmacological and non-pharmacological recommendations for CVD prevention in the general population of two cities in Argentina. Urgent efforts are needed to improve compliance to cardiovascular preventive recommendations promoted by CPG, especially in Low- and Middle- Income Countries.

Appetite loss is a common symptom that occurs in high altitude (HA) for lowlanders. Previous studies indicated that hypoxia is the initiating vital factor of HA appetite loss. PPARA, EPAS1, EGLN1, HIF1A, HIF1AN, and NFE2L2 play important roles in hypoxic responses. We aimed to explore the association of these hypoxia-related gene polymorphisms with HA appetite loss. In this study, we enrolled 416 young men who rapidly ascended to Lhasa (3700 m) from Chengdu (<500m) by plane. PPARA, EPAS1, EGLN1, HIF1A, HIF1AN, and NFE2L2 were genotyped by MassARRAY. Appetite scores were measured to identify HA appetite loss. Logistic regression and multiple genetic models were tested to evaluate the association between the single nucleotide polymorphisms (SNPs) and risk of HA appetite loss in crude and adjusted (age and SaO2) analysis. Subsequently, Haploview software was used to analyze the linkage disequilibrium (LD), haplotype construction and the association of diverse haplotypes with the risk of HA appetite loss. Our results revealed that allele “A” in PPARA rs4253747 was significantly associated with the increased risk of HA appetite loss. Codominant, dominant, recessive, and log-additive models of PPARA rs4253747 showed the increased risk of HA appetite loss in the crude and adjusted analysis. However, only dominant, overdominant, and log-additive models of EPAS1 rs6756667 showed decreased risk of HA appetite loss in the crude and adjusted analysis. Moreover, the results from haplotype-based test showed that the rs7292407-rs6520015 haplotype “AC” was associated with HA appetite loss in the crude analysis rather than the adjusted analysis. In this study, we first established the association of SNPs in PPARA (rs4253747) and EPAS1 (rs6756667) genes with susceptibility to HA appetite loss in Han Chinese young men. These findings provide novel insights into understanding the mechanisms involved in HA appetite loss.

To estimate the age-adjusted prevalence of general and centralized obesity among Chinese men living in urban Shanghai. A cross-sectional study was conducted in 61,582 Chinese men aged 40-75. BMI (kg/m(2)) was used to measure overweight (23 < or = BMI < 27.4) and obesity (BMI > or = 27.5) based on the World Health Organization (WHO) recommended criteria for Asians. Waist-to-hip ratio (WHR) was used to measure moderate (75th < or = WHR < 90th percentile) and severe (WHR > or = 90th percentile) centralized obesity. The average BMI and WHR were 23.7 kg/m(2) and 0.90, respectively. The prevalence of overweight was 48.6% and obesity was 10.5%. The prevalence of general and centralized obesity was higher in men with high income or who were retired, tea drinkers, or nonusers of ginseng than their counterparts. Men with high education had a higher prevalence of overweight and centralized obesity, but had a lower prevalence of obesity and severe centralized obesity compared to those with less education. Current smokers or alcohol drinkers had a lower prevalence of general obesity but higher prevalence of centralized obesity than nonsmokers or nondrinkers of alcohol. Ex-smokers and ex-alcohol drinkers had a higher prevalence of general and centralized obesity compared to nonsmokers and nondrinkers of alcohol. Prevalence of obesity was associated with high energy intake and less daily physical activity. The prevalence of obesity among Chinese men in urban Shanghai was lower than that observed in Western countries but higher than that in other Asian countries, and the prevalence of general and centralized obesity differed by demographic, lifestyle, and dietary factors.

Background and AimIn addition to national policies and interventions, certain regions in England (particularly in the North) coordinate regional tobacco control programmes. This study aimed to (i) examine trends in tobacco smoking prevalence and socioeconomic inequalities in smoking across regions and (ii) explore how trends in smoking prevalence have differed between regions with and without dedicated regional tobacco control activity.DesignObservational study using data drawn from nationally representative monthly cross‐sectional household surveys, conducted between November 2006 and July 2024.SettingEngland.Participants368 057 adults (≥16 years old).MeasurementsWe used logistic regression to estimate time trends in current smoking by region, and tested interactions with occupational social grade to explore differences between more and less advantaged groups.FindingsSmoking prevalence declined most in the North [28.8% to 15.8%; −12.9 percentage points (95% confidence interval −14.4 to −11.5)], similar to the national average in the Midlands [25.2% to 16.0%; −9.2 (−10.6 to −7.9)], and least in the South [22.7% to 17.3%; −5.3 (−6.5 to −4.0)], reducing regional disparities such that prevalence was similar across regions in 2024. Socioeconomic inequalities in smoking prevalence between more and less advantaged social grades fell most in Yorkshire and the Humber [from 17.9 percentage points (14.1−21.8) to 3.7 (0.4−7.0)] and the West Midlands [from 16.1 (12.8−19.6) to 3.0 (−0.03 to 6.0)]. Regions with sustained regional tobacco control activity saw greater declines in smoking prevalence [−13.3 (−15.3 to −11.3)] than regions with none [−9.3 (−10.0 to −8.5)].ConclusionsBetween 2006 and 2024, smoking rates in the North of England fell faster than the national average, narrowing the geographic inequalities in smoking prevalence and bringing the North of England into alignment with other regions by 2024. Regional tobacco control programmes appeared to contribute to this progress.

To investigate the relationship between the duration of moderate-intensity aerobic exercise and the atherogenic index of plasma(AIP) in middle-aged men, in order to provide evidence to formulate strategies for the prevention of cardiovascular diseases. Methods A cross-sectional study was conducted in 27, 827 middle-aged Chinese men who underwent health examinations at our hospital between January, 2014 and June, 2015. The correlation between the duration of moderate-intensity aerobic exercise and AIP was analyzed. Results The mean AIP levels were(0.1166±0.3448), (0.1167±0.3264), and(0.0765±0.3287) in the <1 min/week group, 1-89 min/week group, and ≥90 min/week group, respectively. AIP levels were higher in the <1 min/W group and 1-89min/W group than in the ≥90 min/W group(both P<0.05). Multiple linear regression analysis showed that physical activity significantly reduced AIP after adjustment for age, body mass index, diastolic blood pressure, fasting blood glucose and uric acid levels. The percentage of the population at high risk for atherosclerosis(AIP ≥ 0.21) was significantly lower in the ≥90 min/W group than in the<1 min/W group and 1-89 min/W group(both P<0.05), while no significant difference was found between the <1min/W group and 1-89min/W group. Conclusions The duration of aerobic exercise has a close relationship with AIP. Moderate-intensity aerobic exercise at a weekly duration of 90 min or longer offers cardiovascular health benefits and reduces the risk for atherosclerosis. Key words: Exercise; Atherosclerosis

Tobacco causes many adverse health conditions and may alter the upper gastrointestinal (UGI) microbiome. However, the few studies that studied the association between tobacco use and the microbiome were small and underpowered. Therefore, we investigated the association between tobacco use and the UGI microbiome in Chinese men. We included 278 men who underwent esophageal cancer screening in Henan Province, China. Men were categorized as current, former, or never smokers from questionnaire data. UGI tract bacterial cells were characterized using the Human Oral Microbial Identification Microarray. Counts of unique bacterial species and genera estimated alpha diversity. For beta diversity, principal coordinate (PCoA) vectors were generated from an unweighted UniFrac distance matrix. Polytomous logistic regression models were used for most analyses. Of the 278 men in this study, 46.8% were current smokers and 12.6% were former smokers. Current smokers tended to have increased alpha diversity (mean 42.3 species) compared to never smokers (mean 38.9 species). For a 10 species increase, the odds ratio (OR) for current smoking was 1.29 (95% CI 1.04-1.62). Beta diversity was also associated with current smoking. The first two PCoA vectors were strongly associated with current smoking (PCoA1 OR 0.66; 95% CI 0.51-0.87; PCoA2 OR 0.73; 95% CI 0.56-0.95). Furthermore, Dialister invisus and Megasphaera micronuciformis were more commonly detected in current smokers than in never smokers. Current smoking was associated with both alpha and beta diversity in the UGI tract. Future work should consider how the UGI microbiome is associated with smoking-related diseases.