Dietary patterns in association with the risk of elevated blood pressure, lipid profile and fasting plasma glucose among adults in Jiangsu Province of China

Exploring the traditional Chinese diet and its association with health status-a systematic review

CONTEXT

Increased adherence to a traditional Chinese diet (TCD) could reduce the increasing prevalence of noncommunicable diseases. Currently, there is no consistent definition of the TCD in the literature, and its associations with health outcomes have not yet been identified.

OBJECTIVE

This systematic review aimed to assess the definition of the TCD, in the literature, and to evaluate whether the TCD, as described, is associated with health outcomes.

DATA SOURCES

Fourteen databases were searched up to April 25, 2022.

DATA EXTRACTION

Three reviewers (in pairs) independently screened and extracted data. A modified risk-of-bias tool was used to assess the quality of the studies assessing the TCD definition; the Newcastle-Ottawa Scale and the Cochrane Risk-of-Bias tool were used to assess the quality of the observational studies and randomized controlled trials assessing associations between the TCD and health outcomes.

DATA ANALYSIS

Ninety-nine studies were identified that assessed the TCD definition. In at least 75% of the studies, rice and leafy vegetables were consistently reported as food groups that characterize the TCD; the most frequently cited food items were white rice, spinach, bokchoy, and cabbage. Fish and seafood, pork, and pork products were consistently reported in studies exclusively referring to the TCD consumed in southern China (n = 21 studies), whereas wheat and wheat products were commonly reported in studies focusing on northern China (n = 14 studies). Fifteen studies reported on the quantities of food groups that are characteristic of the TCD, but their findings were inconsistent. Of the 99 studies, 54 assessed associations with health outcomes. The TCD was overall inversely associated with obesity risk and weight gain, while relationships between the TCD and other health outcomes were inconsistent.

CONCLUSION

Further studies are needed to determine the quantities of foods consumed in the TCD and to establish a consistent definition for further exploration of the TCD's potential role in preventing non-communicable diseases.

Postprandial hyperglycemia in patients with type 2 diabetes is reduced by raw insoluble fiber: A randomized trial

BACKGROUND AND AIMS

A lower risk of type 2 diabetes mellitus (T2DM) is associated with the intake of insoluble fiber. This contradicts the postulate that insoluble fibers do not decrease postprandial glycemic response and that only viscous gel-forming soluble fibers would do this. This study aimed to investigate the effect of a dose of insoluble fibers that meets dietary recommendations on postprandial hyperglycemia in T2DM patients.

METHODS AND RESULTS

This is a randomized crossover clinical trial. Nineteen T2DM men randomly ate a balanced breakfast either without (Control) or with prior consumption of insoluble fibers (5.8 g) in the form of 15 g of raw wheat bran (RWB). Glycemia was measured at fasting and 15, 30, 45, 60, 90, and 120 min postprandially. Markers of taste intensity and palatability were assessed after breakfast intake. The glucose peak rise of 87 mg/dL and the incremental area under the curve (AUC) elicited by the breakfast were decreased by RWB (15.80 % and 23.14 %, respectively). Time-to-glucose-peak did not differ between groups. The addition of the RWB to the meal decreased its level of creaminess and tasty and increased the sourness and bitterness.

CONCLUSIONS

The postprandial hyperglycemia in T2DM patients in response to complex carbohydrates was decreased by prior intake of a recommended dose of raw insoluble fibers. This antihyperglycemic effect is in accordance with the acarbose-like property of raw insoluble fibres, but not of heated ones (e.g., bread and pasta), to inhibit the activities of the carbohydrate-digesting enzymes alpha-glucosidase/alpha-amylase.

REGISTRATION NUMBER FOR CLINICAL TRIALS

RBR-98tx28b (https://ensaiosclinicos.gov.br/rg/RBR-98tx28b).

The association between dietary patterns and cardiovascular disease risk factors in Iranian adults: a cross-sectional study

BACKGROUND

Dietary patterns are important factors associated with cardiovascular diseases (CVDs). We examined the association between dietary patterns derived from factor analysis and CVD risk factors.

METHODS

In the present cross-sectional study, a total of 3,687 adults (aged 40 to 70 years) with one or more types of CVDs were enrolled as participants. A validated semi-quantitative food-frequency questionnaire was utilized to assess food intakes, and then dietary patterns were extracted by factor analysis. Fasting blood sugar (FBS), lipid profile, anthropometric indices, and blood pressure (BP) were measured. Multivariable-adjusted logistic regression analysis was employed to ascertain the odds ratio (OR) of CVD risk factors associated with posteriori dietary patterns. In this study, healthy and unhealthy dietary patterns were identified.

RESULTS

Adherence to a healthy dietary pattern was associated with a decrease in systolic BP (SBP) (OR = 0.78; 95% confidence interval (CI): 0.62-0.99) and high-density lipoprotein cholesterol (HDL-C) levels (OR = 1.32; 95% CI: 1.06-1.64). Additionally, greater adherence to the unhealthy dietary pattern was positively associated with SBP (OR = 1.43; 95% CI: 1.13-1.80) and diastolic BP (DBP) (OR = 1.33; 95% CI: 1.01-1.76).

CONCLUSIONS

We concluded that greater adherence to an unhealthy dietary pattern was associated with an increase in SBP and DBP. On the other hand, greater adherence to a healthy dietary pattern could be effective in reducing SBP. Further investigation is recommended to validate these findings.

Dietary patterns and metabolic syndrome amongst adult residents: A cross-sectional study in a rapidly urbanized Southern Chinese city

We aimed to investigate and summarize dietary patterns and explore the association between dietary patterns and metabolic syndrome (MS) and its components among adult residents in a rapidly urbanized city. We employed a multi-stage random sampling method to select 1000 adult residents who underwent a comprehensive survey, including questionnaires, physical examinations, and laboratory tests. The diagnosis of metabolic syndrome was made when the participant met 3 or more of the 5 criteria outlined in the "2017 Chinese Guidelines for the Prevention and Treatment of Type 2 diabetes." Factor analysis and a nonconditioned logistic regression model were used. Nine hundred seventy-five participants with a mean (SD) age of 41.08 (11.06) were included. The prevalence of metabolic syndrome was 19.4% (n = 189). Significant differences were observed between the MS and non-MS groups in terms of patient characteristics in terms of sex (P < .001), age (P < .001), education (P < .001), marital status (P = .025), smoking (P < .001), and alcohol consumption (P = .044). Three dietary patterns were summarized: traditional, coastal, and meat. The coastal pattern was associated with a significantly lower prevalence of MS (P < .001), elevated blood pressure (P < .001), and high triglyceride levels (P = .03). However, in the multivariate analysis, we found no significant associations between dietary patterns and MS or its components after adjusting the demographic characteristics and behaviors, even when the P-value was close to .05. In this study, we did not find an association between dietary patterns and MS and its components after adjusting covariates as much as possible in Pingshan, Shenzhen, a rapidly urbanized city, but underscore the potential health benefits of the coastal dietary pattern, which highlights the importance of conducting further research for a comprehensive understanding.

Novel use of structural equation modelling to examine diet and metabolic traits associated with microvascular endothelial dysfunction in middle-aged Chinese males: a cross-sectional study

BACKGROUND

The present study aims to use structural equation modelling (SEM) with multiple regression pathways to examine direct and indirect links from diet and metabolic traits to microvascular endothelial dysfunction (ED) among middle-aged Chinese males.

METHODS

The study was conducted in middle-aged Chinese males, who underwent a health check-up between 2018 and 2019. Data on lifestyle behaviour factors (physical activity, diet pattern, sleep quality and diet data underwent factor analysis in advance) and metabolic risk factors referring to metabolic traits were introduced into the SEM to examine inter-relationship among these factors and their association with ED, as evaluated by the reactive hyperaemia index (RHI).

RESULTS

Both exploratory factor analysis and confirmatory factor analysis identified two major dietary patterns: 'prudent pattern' and 'western pattern'. The univariate test suggested that only triglycerides (TGs) and prudent dietary pattern were directly associated with RHI. Furthermore, prudent dietary pattern had an indirect association with RHI via TG (prudent diet→TG: β=-0.15, p<0.05; TG→RHI: β=-0.17, p<0.001). As to confirming the hypothesised association between variables apart, physical activity frequency was correlated to the decrease in TG (β=-0.29, p<0.001), but had no direct correlation to RHI.

CONCLUSION

The network of direct and indirect associations among diet pattern and cardiometabolic risk factors with RHI measured ED among middle-aged males. The most significant modifiable factors identified were TG and prudent diet pattern, which needs to be targeted as preventive strategies for early microvascular impairment.

The Relationship between Dietary Patterns and High Blood Glucose among Adults Based on Structural Equation Modelling

The aim of this study was to examine the association between dietary patterns and high blood glucose in Jiangsu province of China by using structural equation modelling (SEqM). Methods: Participants in this cross-sectional study were recruited through the 2015 Chinese Adult Chronic Disease and Nutrition Surveillance Program in Jiangsu province using a multistage stratified cluster random sampling method. Dietary patterns were defined by exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) was used to test the fitness of EFA. SEqM was used to investigate the association between dietary patterns and high blood glucose. Results: After exclusion, 3137 participants with complete information were analysed for this study. The prevalence of high blood glucose was 9.3% and 8.1% in males and females, respectively. Two dietary patterns: the modern dietary pattern (i.e., high in red meats and its products, vegetables, seafood, condiments, fungi and algae, main grains and poultry; low in other grains, tubers and preserves), and the fruit−milk dietary pattern (i.e., high in milk and its products, fruits, eggs, nuts and seeds and pastry snacks, but low in vegetable oils) were established. Modern dietary pattern was found to be positively associated with high blood glucose in adults in Jiangsu province (multivariate logistic regression: OR = 1.561, 95% CI: 1.025~2.379; SEqM: β = 0.127, p < 0.05). Conclusion: The modern dietary pattern—high intake of red meats—was significantly associated with high blood glucose among adults in Jiangsu province of China, while the fruit−milk dietary pattern was not significantly associated with high blood glucose.