Dietary quality is an important factor influencing prediabetes, but few studies have applied the Chinese Diet Balance Index (DBI-16) to evaluate the dietary quality of individuals with prediabetes and explore the associations between dietary quality and prediabetes. In our study, the lower-bound score, higherbound score and diet quality distance, were respectively calculated to assess dietary quality based on each food group. Logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (95%CI) of unfavorable dietary quality leading to prediabetes in every subgroup. The results were shown that individuals with prediabetes had excessive intake in the categories of cereals, salt and inadequate intake in vegetables, fish and diet variety than participants without prediabetes (all p < 0.01). Unfavourable dietary quality was significantly associated with an increased risk of prediabetes (OR: 1.45, 95%CI: 1.29-1.63), especially among the subjects who lived in rural areas (OR: 1.63, 95%CI: 1.25-1.76), those who had abdominal obesity (OR: 1.58, 95%CI: 1.36-1.85), those who smoked (OR: 1.58, 95%CI: 1.30-1.93), those who consumed alcohol (OR: 1.57, 95%CI: 1.28-1.93) and those who did not drink tea (OR: 1.64, 95%CI: 1.42-1.88). In Conclusion, unfavourable dietary quality was significantly associated with an increased risk of prediabetes.Prediabetes and diabetes have become a serious global problem in recent decades, along with the development of the social economy and changes in people's lifestyles. Prediabetes is characterised by glucose levels that do not meet the criteria for diabetes but that are too high to be considered normal 1 . The International Diabetes Federation (IDF) reported that there were approximately 350 million people with prediabetes worldwide and 48.6 million people with prediabetes in China 2 . People with prediabetes have a high risk of developing diabetes, and 70~90% of individuals with prediabetes will eventually develop diabetes 3 .Dietary quality is an important factor influencing prediabetes and diabetes. Healthier dietary intake can reduce the risk of the progression from prediabetes to diabetes by 40~70% 3 . Among people with prediabetes who changed their dietary model, 40.5% achieved normal glucose tolerance, and their fasting plasma glucose level, body mass index (BMI), glycated haemoglobin (HbA1C) level and blood pressure decreased significantly as well 4 . Therefore, several dietary evaluation indexes have been developed around the world in recent years. In China, researchers mainly use the Diet Balance Index-16 (DBI-16) to assess human dietary quality, and the index was updated based on the latest Chinese Dietary Guidelines and the Chinese Balanced Diet Pagoda 5 . The DBI-16 can be used to evaluate the overall dietary quality mainly through three indicators: the lower-bound score (LBS), higher-bound score (HBS), and diet quality distance (DQD). The LBS represents insufficient intake, HBS represents excessive intake and DQD represents the overall imbalance of the...

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Objectives This study aims to estimate the losses of quality-adjusted life expectancy (QALE) due to the joint effects of cognitive impairment and multimorbidity, and to further confirm additional losses attributable to this interaction among middle-aged and elderly Chinese people. Methods The National Cause of Death Monitoring Data were linked with the China Health and Retirement Longitudinal Study (CHARLS). A mapping and assignment method was used to estimate health utility values, which were further used to calculate QALE. Losses of QALE were measured by comparing the differences between subgroups. All the losses of QALE were displayed at two levels: the individual and population levels. Results At age 45, the individual-level and population-level losses of QALE attributed to the combination of cognitive impairment and multimorbidity were 7.61 (95% CI: 5.68, 9.57) years and 4.30 (95% CI: 3.43, 5.20) years, respectively. The losses for cognitive impairment alone were 3.10 (95% CI: 2.29, 3.95) years and 1.71 (95% CI: 1.32, 2.13) years at the two levels. Similarly, the losses for multimorbidity alone were 3.53 (95% CI: 2.53, 4.56) years and 1.91 (95% CI: 1.24, 2.63) years at the two levels. Additional losses due to the interaction of cognitive impairment and multimorbidity were indicated by the 0.98 years of the individual-level gap and 0.67 years of the population-level gap. Conclusion Among middle-aged and elderly Chinese people, cognitive impairment and multimorbidity resulted in substantial losses of QALE, and additional QALE losses were seen due to their interaction at both individual and population levels.

The aim of this study was to expound the dietary effects of different proportions of carbohydrate and fat on hypertension in the Chinese population. Methods:We used data derived from the China Health and Nutrition Survey (CHNS) from 1991 to 2011. In total, 10 459 Chinese participants aged over 12 years were included in the final analysis. A multivariable Cox regression was used to calculate the hazard ratio and 95% confidence interval (95% CI) of hypertension in each group, and the medium proportion of carbohydrate and fat (MPCF) diet intake group was used as the reference.Results: Compared with the participants who consumed an MPCF diet, the individuals who consumed a highcarbohydrate and low-fat (HCLF) diet had a higher risk of developing hypertension (hazard ratio: 1.295, 95% CI: 1.167-1.436), especially the individuals who were young (hazard ratio: 1.422, 95% CI: 1.106-1.828), were living in rural areas (hazard ratio: 1.373, 95% CI: 1.206-1.565) and consumed alcohol (hazard ratio: 1.363, 95% CI: 1.153-1.611). In addition, a low-carbohydrate and highfat (LCHF) diet was not associated with hypertension (hazard ratio: 0.861, 95% CI: 0.694-1.068). Moreover, these associations were observed at the majority energy intake level. Conclusion:An HCLF diet was significantly associated with an increased risk of hypertension.

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