Cooking Oil Consumption Is Positively Associated with Risk of Type 2 Diabetes in a Chinese Nationwide Cohort Study

Substitution of animal-based with plant-based foods on cardiometabolic health and all-cause mortality: a systematic review and meta-analysis of prospective studies

BACKGROUND

There is growing evidence that substituting animal-based with plant-based foods is associated with a lower risk of cardiovascular diseases (CVD), type 2 diabetes (T2D), and all-cause mortality. Our aim was to summarize and evaluate the evidence for the substitution of any animal-based foods with plant-based foods on cardiometabolic health and all-cause mortality in a systematic review and meta-analysis.

METHODS

We systematically searched MEDLINE, Embase, and Web of Science to March 2023 for prospective studies investigating the substitution of animal-based with plant-based foods on CVD, T2D, and all-cause mortality. We calculated summary hazard ratios (SHRs) and 95% confidence intervals (95% CI) using random-effects meta-analyses. We assessed the certainty of evidence (CoE) using the GRADE approach.

RESULTS

In total, 37 publications based on 24 cohorts were included. There was moderate CoE for a lower risk of CVD when substituting processed meat with nuts [SHR (95% CI): 0.73 (0.59, 0.91), n = 8 cohorts], legumes [0.77 (0.68, 0.87), n = 8], and whole grains [0.64 (0.54, 0.75), n = 7], as well as eggs with nuts [0.83 (0.78, 0.89), n = 8] and butter with olive oil [0.96 (0.95, 0.98), n = 3]. Furthermore, we found moderate CoE for an inverse association with T2D incidence when substituting red meat with whole grains/cereals [0.90 (0.84, 0.96), n = 6] and red meat or processed meat with nuts [0.92 (0.90, 0.94), n = 6 or 0.78 (0.69, 0.88), n = 6], as well as for replacing poultry with whole grains [0.87 (0.83, 0.90), n = 2] and eggs with nuts or whole grains [0.82 (0.79, 0.86), n = 2 or 0.79 (0.76, 0.83), n = 2]. Moreover, replacing red meat for nuts [0.93 (0.91, 0.95), n = 9] and whole grains [0.96 (0.95, 0.98), n = 3], processed meat with nuts [0.79 (0.71, 0.88), n = 9] and legumes [0.91 (0.85, 0.98), n = 9], dairy with nuts [0.94 (0.91, 0.97), n = 3], and eggs with nuts [0.85 (0.82, 0.89), n = 8] and legumes [0.90 (0.89, 0.91), n = 7] was associated with a reduced risk of all-cause mortality.

CONCLUSIONS

Our findings indicate that a shift from animal-based (e.g., red and processed meat, eggs, dairy, poultry, butter) to plant-based (e.g., nuts, legumes, whole grains, olive oil) foods is beneficially associated with cardiometabolic health and all-cause mortality.

Perinatal Plasma Carotenoids and Vitamin E Concentrations with Glycemia and Insulin Resistance in Women during and after Pregnancy

We examined the associations of perinatal plasma carotenoids and E vitamers concentrations with glycemia, insulin resistance, and gestational and type 2 diabetes mellitus during pregnancy and post-pregnancy in GUSTO women. Plasma carotenoid and E vitamer concentrations were measured at delivery, and principal component analysis was used to derive the patterns of their concentrations. Fasting and 2 h glucose levels and fasting insulin were measured at 26-28 weeks gestation and 4-6 years post-pregnancy, with the derivation of homeostatic model assessment for insulin resistance (HOMA-IR). In 678 women, two carotenoid patterns (CP1: α- and β-carotene and lutein; CP2: zeaxanthin, lycopene, and β-cryptoxanthin) and one E vitamer pattern (VE: γ-, δ-, and α-tocopherols) were derived. A higher CP1 score (1-SD) was associated with lower gestational fasting glucose (β (95%CI): -0.06 (-0.10, -0.02) mmol/L) and lower gestational (-0.17 (-0.82, 0.01) mmol/L, p = 0.06) and post-pregnancy HOMA-IR (-0.11 (-0.15, -0.08) mmol/L). A higher VE score (1 SD) was associated with higher gestational and post-pregnancy fasting and 2 h glucose (gestational: 0.05 (0.01, 0.08) and 0.08 (0.01, 0.16); post-pregnancy: 0.19 (0.07, 0.31) and 0.24 (0.06, 0.42) mmol/L). Higher α- and β-carotene and lutein may be beneficial for gestational fasting glycemia, but higher vitamin E may increase gestational and post-pregnancy glycemia, although these findings require confirmation in cohorts with prospective longitudinal measurements of these vitamins.

National and subnational incidence, mortality and associated factors of colorectal cancer in China: A systematic analysis and modelling study

Background

Due to their known variation by geography and economic development, we aimed to evaluate the incidence and mortality of colorectal cancer (CRC) in China over the past decades and identify factors associated with CRC among the Chinese population to provide targeted information on disease prevention.

Methods

We conducted a systemic review and meta-analysis of epidemiolocal studies on the incidence, mortality, and associated factors of CRC among the Chinese population, extracting and synthesising data from eligible studies retrieved from seven global and Chinese databases. We pooled age-standardised incidence rates (ASIRs) and mortality rates (ASMRs) for each province, subregion, and the whole of China, and applied a joinpoint regression model and annual per cent changes (APCs) to estimate the trends of CRC incidence and mortality. We conducted random-effects meta-analyses to assess the effect estimates of identified associated risk factors.

Results

We included 493 articles; 271 provided data on CRC incidence or mortality, and 222 on associated risk factors. Overall, the ASIR of CRC in China increased from 2.75 to 19.39 (per 100 000 person-years) between 1972 and 2019 with a slowed-down growth rate (APC1 = 5.75, APC2 = 0.42), while the ASMR of CRC decreased from 12.00 to 7.95 (per 100 000 person-years) between 1974 and 2020 with a slight downward trend (APC = -0.89). We analysed 62 risk factors with synthesized data; 16 belonging to the categories of anthropometrics factors, lifestyle factors, dietary factors, personal histories and mental health conditions were graded to be associated with CRC risk among the Chinese population in the meta-analysis limited to the high-quality studies.

Conclusions

We found substantial variation of CRC burden across regions and provinces of China and identified several associated risk factors for CRC, which could help to guide the formulation of targeted disease prevention and control strategies.

Registration

PROSPERO: CRD42022346558.

Effect of Lard or Plus Soybean Oil on Markers of Liver Function in Healthy Subjects: A Randomized Controlled-Feeding Trial

Humans have consumed lard for thousands of years, but in recent decades, it has become much less popular because it is regarded as saturated fat. Animal studies showed that lard plus soybean oil (blend oil) was more advantageous for liver health than using either oil alone. This study aims to assess the effects of blend oil on liver function markers in healthy subjects. The 345 healthy subjects were randomized into 3 isoenergetic diet groups with different edible oils (30 g/day) (soybean oil, lard, and blend oil (50% lard and 50% soybean oil)) for 12 weeks. The reductions in both aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were greater in the blend oil group than in the two other groups (p = 0.001 and <0.001 for the interaction between diet group and time, respectively). The reductions in AST and ALT in the blend oil group were more significant compared with those in the soybean oil group (p < 0.001) or lard group (p < 0.001). There were no significant differences in the other liver function markers between the groups. Thus, blend oil was beneficial for liver function markers such as AST and ALT compared with soybean oil and lard alone, which might help prevent non-alcoholic fatty liver disease in the healthy population.

Dietary Patterns of Patients with Prediabetes and Type 2 Diabetes

Given the worldwide high prevalence of type 2 diabetes, the prevention and control of this disease has become an urgent priority. In this research, we report the results from a cross-sectional study conducted in the counties of Suceava and Iasi, northeast of Romania, on 587 patients with type 2 diabetes and 264 patients with prediabetes. By employing a factor analysis (principal component) on 14 food groups followed by varimax orthogonal rotation, three dietary patterns were identified for each group. In prediabetes, a low adherence to a specific dietary pattern (1 and 2) was associated with lower fasting plasma glucose, blood pressure and serum insulin, compared to increased adherence. In patients with diabetes, a low adherence to Pattern 1 was associated with lower systolic blood pressures, while a low adherence to Pattern 3 was associated with a lower HbA1c, compared to high adherence. Statistically significant differences between the groups were observed for fats and oils, fish and fish products, fruit, potatoes, sugars, preserves and snacks intake. The study demonstrated that certain food patterns are associated with increased blood pressure, fasting blood glucose and serum insulin.

Consumption of sweetened beverages is associated with the incidence of type 2 diabetes in Brazilian adults (CUME project)

BACKGROUND AND AIM

To evaluate the association between the energy consumption of sweetened beverages (SBs) adjusted for daily energy intake and the incidence of type 2 diabetes.

METHODS AND RESULTS

This was a prospective study with 2480 type 2 diabetes mellitus (T2DM)-free Cohort of Universities of Minas Gerais (CUME) participants at baseline and 2-4 years of follow-up. A longitudinal analysis was performed with generalized equation estimation to verify the effect of SB consumption, adjusted for sociodemographic and lifestyle variables, on the incidence of T2DM. The incidence of T2DM was 2.78%. The median calorie intake of daily SB consumption adjusted for energy was 47.7 kcal/day. Participants with the highest consumption of SBs (≥47.7 kcal/day) were 63% (odds ratio [OR] = 1.63; p value-0.049) more likely to acquire T2DM over time compared to the lowest consumption (<47.7 kcal/day).

CONCLUSIONS

Higher energy consumption from SBs favored a higher incidence of T2DM among CUME participants. The results reinforce the need for marketing restrictions on these foods and taxation to reduce the consumption of these beverages to prevent T2DM and other chronic noncommunicable diseases.

Associations between Conventional and Emerging Indicators of Dietary Carbohydrate Quality and New-Onset Type 2 Diabetes Mellitus in Chinese Adults

Dietary glycemic index (GI), carbohydrate to fiber ratio (CF) and carbohydrate quality index (CQI) are conventional and emerging indicators for carbohydrate quality. We aimed to investigate the associations between these indicators and new-onset type 2 diabetes mellitus (T2DM) risk among Chinese adults. This prospective cohort study included 14,590 adults from the China Health and Nutrition Survey without cardiometabolic diseases at baseline. The associations between dietary GI, CF and CQI and T2DM risk were assessed using Cox proportional hazard regression analysis and dose-response relationships were explored using restricted cubic spline and threshold analysis. After a mean follow-up duration of 10 years, a total of 1053 new-onset T2DM cases occurred. There were U-shaped associations between dietary GI and CF and T2DM risk (both P-nonlinear < 0.0001), and T2DM risk was lowest when dietary GI was 72.85 (71.40, 74.05) and CF was 20.55 (17.92, 21.91), respectively (both P-log likelihood ratio < 0.0001). Inverse associations between CQI and T2DM risk specifically existed in participants < 60 y or attended middle school or above (both P-trend < 0.05). These findings indicated that moderate dietary GI and CF range and a higher dietary CQI score may be suggested for T2DM prevention in Chinese adults.

Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD)

Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.

Factors of Obesity and Metabolically Healthy Obesity in Asia

The East Asian region (China, Japan, and South Korea) is comprised of almost 1.5 billion people and recent industrialization has brought with it a pandemic of rising obesity, even in children. As these countries are rapidly aging and functioning at sub-replacement birthrates, the burgeoning costs of obesity-related care may threaten socialized healthcare systems and quality of life. However, a condition called metabolically healthy obesity (MHO) has been found to be without immediate cardiopulmonary or diabetic risk. Thus, maintenance of the MHO condition for the obese in East Asia could buffer the burden of long-term obesity care on medical systems and knowledge of the biochemical, genetic, and physiological milieu associated with it could also provide new targets for intervention. Diverse physiological, psychological, environmental, and social factors play a role in obesogenesis and the transition of MHO to a metabolically unhealthy obesity. This review will give a broad survey of the various causes of obesity and MHO, with special emphasis on the East Asian population and studies from that region.

Dietary Copper and Selenium Intakes and the Risk of Type 2 Diabetes Mellitus: Findings from the China Health and Nutrition Survey

The long-term associations between dietary copper (Cu) and selenium (Se) intakes and type 2 diabetes mellitus (T2DM) risk are unclear. We aimed to examine the prospective associations between dietary Cu and Se intakes and T2DM risk in Chinese adults. A total of 14,711 adults from the China Health and Nutrition Survey (1997–2015) were included. Nutrient intakes were assessed by 3 consecutive 24 h recalls and food-weighing methods. T2DM was identified by a validated questionnaire and laboratory examination. Cox regression models were used for statistical analysis. A total of 1040 T2DM cases were diagnosed during 147,142 person-years of follow-up. In fully adjusted models, dietary Cu or Se intake was not associated with T2DM risk. Dietary Se intake significantly modified the association between dietary Cu intake and T2DM risk, and dietary Cu intake was positively associated with T2DM risk when Se intake was lower than the median (p-interaction = 0.0292). There were no significant effect modifications on the associations by age, sex, BMI, or region. Although dietary Cu or Se intake was not independently associated with T2DM risk in Chinese adults free from cardiometabolic diseases and cancer at the baseline, there was a significant interaction between dietary Cu and Se intakes on T2DM risk.

Relationship Between Dietary Patterns and Chronic Diseases in Rural Population: Management Plays an Important Role in the Link

Objective

Health dietary pattern is related with reduced risk of chronic metabolic disease, but the benefits were not fully clear in the Chinese population. The aim of this study was to explore the association between dietary patterns and multiple chronic metabolic diseases in middle-aged and elderly Chinese.

Methods

A total of 718 Chinese adults aged ≥ 45 who lived in the Huairou regions of Beijing were included in the present cross-sectional analysis from 2019 to 2020. Dietary data were obtained by food frequency questionnaires (FFQs). Dietary patterns were identified by principal components analysis (PCA). Logistic regression analysis and hierarchical analysis were used to examine the relationship among dietary patterns, health management, and chronic diseases.

Results

Five dietary patterns were discovered in the subjects. The pattern with the higher percentage of energy supply by lipid was a risk factor for hypertension [odds ratio (OR) = 2.067, p = 0.013]. Lower energy intake (OR = 0.512, p = 0.012) and a reasonable ratio of dietary energy supply (OR = 0.506, p = 0.011) were beneficial to diabetes. The substitution of potato for grain might be an effective way of reducing diabetes (OR = 0.372, p &lt; 0.001). The higher intake of high-quality protein was the protective factor for coronary heart disease (CHD; OR = 0.438, p = 0.008). Moderate intervention (OR = 0.185, p = 0.033) and appropriate health education (OR = 0.432, p = 0.016) could greatly subserve the prevention of chronic diseases, especially for hyperlipidemia. Men were more likely to be affected by health education, intervention, and follow-up than women. The prevalence of multimorbidity was higher in women (43.2%) than men (41.5%). The staple food intake and health management were also important factors to prevent multimorbidity.

Conclusion

Dietary pattern with appropriate energy intake, a reasonable source of energy supply, high quality of macronutrients, and moderate management was associated with decreased risk of chronic metabolic diseases. Further studies are needed to clarify the cause–effect relationship between dietary patterns, health management, and chronic diseases and give suggestions to chronic metabolic disease prevention in middle-aged and elderly people in a rural area.

Dietary carbohydrate intake and new-onset diabetes: A nationwide cohort study in China

AIM

The association of carbohydrate intake with diabetes risk remains uncertain. We aimed to evaluate the prospective associations of the amount and types of carbohydrate intake with new-onset diabetes.

METHODS

A total of 16,260 non-diabetic participants from the China Health and Nutrition Survey (CHNS) were included. Dietary intake was collected by three consecutive 24-h dietary recalls combined with a household food inventory. Participants with self-reported physician diagnosed diabetes, or fasting plasma glucose ≥7.0 mmol/L or glycated hemoglobin ≥6.5% during the follow-up were defined having new-onset diabetes.

RESULTS

During a median follow-up of 9 years (158,930 person-years), 1100 participants developed diabetes. Overall, there was a U-shaped association between percent of energy from carbohydrate intake and new-onset diabetes, with minimal risk at 49-56% of energy from total carbohydrate intake (quartile 2) (P for nonlinearity <0.001). Moreover, there was an L-shaped association between high-quality carbohydrate intake and new-onset diabetes (P for nonlinearity <0.001), and a J-shaped association of low-quality carbohydrate intake with new-onset diabetes (P for nonlinearity <0.001). Furthermore, there was an inverse association between the plant-based low-carbohydrate diet scores for low-quality carbohydrate and new-onset diabetes. However, a reversed J-shaped association was found between the animal-based low-carbohydrate diet scores for low-quality carbohydrate and new-onset diabetes (P for nonlinearity <0.001).

CONCLUSIONS

There was a U-shape association between percent of total carbohydrate intake and new-onset diabetes, with the lowest risk at 49-56% carbohydrate intake. Our findings provide some evidence for the intake of high-quality carbohydrate, and the substitution of plant-based products for low-quality carbohydrate for primary prevention of diabetes.

Distribution of 2-tert-butyl-1,4-benzoquinone and its precursor, tert-butylhydroquinone, in typical edible oils and oleaginous foods marketed in Hangzhou City, China

This study aimed to obtain a reliable evaluation about addition of tert-butylhydroquinone (TBHQ), and distribution of TBHQ and 2-tert-butyl-1,4-benzoquinone (TBBQ) contents in typical edible oils and oleaginous foods marketed in Hangzhou City. Briefly, the probability of labeled with addition of TBHQ in foods decreased from 36.45 ± 2.6% to 28.78 ± 3.7% in the period from 2018 to 2020. In the 135 analyzed samples, TBHQ contents were far less than the maximum legal additive amount, and TBBQ contents ranged from below its limit of quantification (LOQ) to 13.54 ± 1.15 mg/kg. The conversion rate from TBHQ to TBBQ in edible oils was 2.94 ± 1.17%, much lower than that in other food categories. Further research determined that the process method and food composition were the main factors for different conversion rates from TBHQ to TBBQ in various food categories. In addition, oil consumption was found to be the primary source of dietary intake of TBHQ and TBBQ.

Prevalence and Risk Factors of Type 2 Diabetes and Prediabetes Among 53,288 Middle-Aged and Elderly Adults in China: A Cross-Sectional Study

BACKGROUND

Diabetes is a metabolic disorder that causes a heavy burden on healthcare systems worldwide. The aim of this study was to determine the prevalence of type 2 diabetes and prediabetes and its associated factors among eight communities in Nanchong, China.

METHODS

This was an observational cross-sectional study conducted throughout eight communities in Nanchong, China. The participants were 53,288 individuals aged 45 years or older. The participants' characteristics, comorbidities, health behaviors, family history, and dietary intake were assessed. Multinomial logistic regression models were fitted to identify factors associated with type 2 diabetes and prediabetes.

RESULTS

The prevalence of diabetes and prediabetes was 13.9% (95% confidence interval [CI], 13.6-14.2) and 3.1% (95% CI, 2.9-3.2) of the population, respectively. After adjusting for other risk factors, advanced age, overweight, obesity, abdominal obesity, comorbidities, smoking, a family history of diabetes, and Chinese cooking vegetable intake were associated with an increased risk of type 2 diabetes and prediabetes.

CONCLUSION

The prevalence of type 2 diabetes in the Chinese population is rising compared with data from the past. The risk factors of type 2 diabetes and prediabetes identified in this study will aid the identification of individuals at a high-risk of diabetes and the implementation of effective health promotion programs and campaigns.

CLINICAL TRIAL REGISTRY NUMBER

ChiCTR-HOC-17013200.