Isocaloric-restricted Mediterranean Diet and Chinese Diets High or Low in Plants in Adults With Prediabetes

Abstract

Context Calorie restriction plus dietary advice is suggested as a preventive strategy for individuals with obesity and prediabetes, however, optimal diet is still debatable. We aimed to compare the effects of Mediterranean diet (MD) and Chinese diets high or low in plants on body weight and glucose homeostasis among high risk Chinese. Subjects and Methods In this parallel-arm randomized controlled trial, 253 Chinese adults aged 25-60 years with BMI ≥24.0 kg/m 2 and fasting blood glucose ≥5.6 mmol/L were randomly assigned to three isocaloric-restricted diets: MD (n = 84), a traditional Jiangnan Diet high in plants (TJD, n = 85), or a control diet low in plants (CD, n = 84). During the 6-month trial, a 5-weekday full feeding regimen was followed, along with mobile app-based monitoring. Abdominal fat measurement (magnetic resonance imaging), oral glucose tolerance test (OGTT), and continuous glucose monitoring (CGM) were conducted at baseline, 3- and 6-month. Results With a 25% calorie-restriction for 6 months, weight deduction was 5.72 kg (95% CI: 5.03, 6.40) for MD, 5.05 kg (4.38, 5.73) for TJD and 5.38 kg (4.70, 6.06) for CD (Ptime < 0.0001). No between-group differences were found for fasting glucose, insulin, and the Matsuda index from OGTT. Notably, CD had significantly longer time below range (glucose < 3.9 mmol/L) than MD [0.81% ( 0.21, 1.40), P = 0.024] and marginally longer time than TJD [0.56% (-0.03,1.15), P = 0.065], as measured by CGM. Conclusions With the 6-month isocaloric-restricted feeding, TJD and MD achieved comparable weight deduction and improved glucose homeostasis, whereas CD showed a higher risk for hypoglycemia.

A whole blood-based transcriptional risk score for nonobese type 2 diabetes predicts dynamic changes in glucose metabolic traits

“…In our study, the wb-TRS could well predict dynamic changes in glucose metabolism in response to 6 months of 25% calorie restriction dietary intervention in overweight/obese subjects [23]. In our trial (DPMH), a 25% calorie restriction produced an appreciable weight reduction and improved glucose homeostasis [23].…”

“…In our study, the wb-TRS could well predict dynamic changes in glucose metabolism in response to 6 months of 25% calorie restriction dietary intervention in overweight/obese subjects [23]. In our trial (DPMH), a 25% calorie restriction produced an appreciable weight reduction and improved glucose homeostasis [23]. Calorie restriction improves cardiometabolic risk including atherogenic dyslipidemia (elevated triglycerides and fasting glucose, reduced HDL-C, diabetes, hypertension, and large waist circumference) [30, 31].…”

“…To validate the predictive value of wb-TRS for the dynamic changes in glucose metabolism, we performed analysis using data of 3 repeated blood-based transcriptome data and glucose metabolism in the Dietary Pattern and Metabolic Health (DPMH) study, a parallel-arm randomized controlled feeding trial conducted in 2019 (URL: https://www. clinicaltrials.gov; Unique identifier: NCT03856762) [23]. A total of 253 overweight/obese participants (aged 25 to 60 years, BMI ≥ 24.0 kg/m 2 , fasting glucose ≥ 5.6 mmol/l) with transcriptome data and glucose metabolic traits at baseline, the first (3-months) and second (6-months) follow-up visits were included in the validation analysis.…”

Geographic Variations in Dietary Patterns and Their Associations with Overweight/Obesity and Hypertension in China: Findings from China Nutrition and Health Surveillance (2015–2017)

“…Unexpectedly, PD spatially clustered in areas where the traditional Jiangnan diet is located; however, PD was different from the higher intake of wheat and processed meat [ 11 , 38 , 62 ]. We speculated that PD might represent a North–South fusion diet since people in developed areas, such as the Yangtze River Delta region and urban areas, might integrate diverse dietetic cultures, which in turn enriched local diets [ 10 , 63 ].…”

Dietary patterns and cardiometabolic health: Clinical evidence and mechanism

“…215 Studies have demonstrated that the benefits of the traditional Jiangnan diet for reducing weight, BP, and blood glucose levels are comparable to those of the Mediterranean diet and that the benefits for preventing hypoglycemia and maintaining nocturnal glucose homeostasis are superior to those of the Mediterranean diet. 216 Other studies have demonstrated that the Jiangnan diet is also effective in reducing loss of muscle mass, preventing sarcopenia, and promoting healthy aging compared with other Chinese diets that allow the consumption of red meat and beans. 217 The traditional Japanese diet, "washoku," consists of one bowl of rice, one bowl of soup, and one main and two side dishes.…”