A population-based survey for dietary patterns and prediabetes among 7555 Chinese adults in urban and rural areas in Jiangsu Province

Abstract

Background: Prediabetes is an important public health problem concern globally, to which dietary patterns have shown varied effects. This study aims to analyze the relationship between dietary patterns and prediabetes in Chinese adults. Methods: A total of 7555 adults from Jiangsu province, China, were recruited using a stratified multistage cluster sampling method. Information on diet intake, demographic, blood glucose and other indices were collected by structured questionnaires. Four dietary patterns of Meat diet, Healthy diet, Traditional diet and Fried food with staple diet were identified using Principle Component Analysis and followingly divided into T1-T4 groups according to their quartiles of factor scores. Multivariate logistic regression analysis was used to investigate the association between dietary patterns and prediabetes. Results: Healthy diet was found to be associated with the lowest prevalence of prediabetes (P < 0.05). Multivariate logistic regression analysis after adjusting the confounding factors demonstrated that the lowest odds ratio with prediabetes was associated with the third quartile (T3 group) of Healthy diet (Odds Ratio = 0.745, 95% Confidence Interval: 0.645-0.860, P < 0.01), compared with the lower quartile (T1 group). The Meat diet was a potential risk factor for the isolated IFG (Odds Ratio = 1.227, 95%Confidence Interval: 1.070-1.406, P-value<0.01) while Fried food with staple diet was positively linked to the presence of IFG combined with IGT (Odds Ratio = 1.735, 95% Confidence Interval: 1.184-2.543, P-value < 0.01). Conclusions: Dietary patterns rich in meat but low in fresh fruit, fresh vegetable, milk, and fish are positively associated with higher risk of prediabetes, particularly the IFG. Higher Healthy diet consumption was associated with significantly lower risk of prediabetes. Recent global statistics showed that there were 424.9 million people (20-79 years) living with diabetes and 352.1 million people with impaired glucose tolerance (IGT) while the numbers are expected to be 628.6 million and 531.6 million respectively in 2045 1. Diabetes is prevalent in China. In 2010, the age-standardized prevalence of diabetes and prediabetes was 9.7% and 15.5% among Chinese people aged 20 years of age or older, equivalent to 92.4 million of adults with diabetes and 148.2 million with prediabetes 2. Prediabetes refers to the level of glycemic parameters higher than the normal but lower than the diagnostic threshold of diabetes. People with prediabetes is known to be at a higher risk to develop diabetes with an annual conversion rate of 5-10%, and approximately 70% of people with prediabetes may develop diabetes in later life according to the statistics of the American Diabetes

Food Consumption and Dietary Patterns of Local Adults Living on the Tibetan Plateau: Results from 14 Countries along the Yarlung Tsangpo River

“…China, which were “local traditional diet”, “Han diet”, “Beverage diet” and “Outsourcing diet”. Similar to the present study, Cao et al (2020), in a survey of 7555 adults from Jiangsu province, China, showed four dietary patterns in the Chinese Han population by using PCA; these include the “meat diet”, “Healthy diet”, “Traditional diet” and “Fried food with staple food” [ 2 ]. Cattafesta et al (2020) identified three dietary patterns that include “local traditional”, “traditional Brazilian” and “industrialized” in a cross-sectional epidemiological study of 740 farmers in Brazil [ 7 ].…”

“…Dietary patterns were named in accordance with the interpretability and characteristics of the items retained in each pattern and the items with the highest factor loadings were the ones that most influenced the interpretation and denomination of factors [ 17 ]. Food items with factor loadings ≥0.3 or ≤−0.3 was considered significant for this sample size ( Supplementary Table S3 ) [ 2 , 8 ]. The contributions of food items (top 10 food items that contribute the most) for each dietary pattern are shown in Figure 6 .…”

“…Numerous epidemiological studies provide evidence that there is a definite association between regional chronic disease and dietary patterns [ 1 , 2 ]. Therefore, increased attention has been paid to the rational dietary structure and balanced nutrient intake.…”

“…Food consumption surveys are fundamental to the analysis of food security, the assessment of diet and nutrient intake and the developing nutrition interventions [ 3 , 4 ]. The food frequency questionnaire (FFQ) is one of the most commonly used assessment tools for diet assessment, which is a better measurement than those obtained using three days weighting method or 24 h dietary recall [ 2 ] and has been extensively used in epidemiological studies [ 1 , 2 , 3 ]. Meanwhile, dietary patterns use the FFQ and food intake data to identify the type of foods that are significant for a disease [ 1 , 2 ] or a specific group of people [ 5 , 6 ].…”

“…The food frequency questionnaire (FFQ) is one of the most commonly used assessment tools for diet assessment, which is a better measurement than those obtained using three days weighting method or 24 h dietary recall [ 2 ] and has been extensively used in epidemiological studies [ 1 , 2 , 3 ]. Meanwhile, dietary patterns use the FFQ and food intake data to identify the type of foods that are significant for a disease [ 1 , 2 ] or a specific group of people [ 5 , 6 ]. Compared with the traditional analysis of single food or nutrients, dietary pattern analysis has been identified as a more comprehensive method to characterize diet [ 1 ] and it can offer a broader picture of food consumption, reflect a more realistic dietary habit and provide some practical approaches to disease prevention.…”