Association Of Dietary Quality And Structure With The Risk Of Hyperglycemia In Chinese Adults

BackgroundAt present,the prevalence of diabetes and hyperglycemia in China is rising rapidly,and the number of patients has ranked first in the world.Hyperglycemia is an important risk factor for many cardiovascular and cerebrovascular diseases or malignant tumors,and its complications and complications tend to increase the burden of disease.In recent years,medical nutrition and treatment research has played a great role in the diagnosis and treatment of various chronic diseases.People have gradually paid more attention to the influence of dietary management in the prevention and treatment of diabetes.There are many studies on the influence of dietary quality and structure on the risk of hyperglycemia in foreign countries,but there are few reports on the influence of nationally representative dietary quality and structure on the risk of hyperglycemia in China.ObjectiveTo evaluate the dietary quality of Chinese adults with hyperglycemia and non-hypertensive population and analyze the differences between the two populations.At the same time,we try to explore the relationship between diet quality and structure and the risk of hyperglycemia,aiming to provide an important basis for guiding Chinese people to eat a reasonable diet and a healthy life.Objects and methodsThe data we used in this study comes from the 2009 China Health and Nutrition Survey(CHNS),which is a cross-sectional study.CHNS mainly investigates the residents’personal information,health status,physical activity,nutritional status,etc..The aim was to study how the economic transformation of Chinese society and its nutrition and health plans affect the health and nutritional status of its population.The first and second parts of this article included 8401 and 8044 subjects respectively,and we mainly used the Chinese Diet Balance Index(DBI-16)to analyze and compare the dietary quality and differences of the study population.Furthermore,we define a highly imbalanced diet as the unfavourable diet quality,and others diet quality is defined as non-unfavourable diet quality which act as the reference group.The different dietary structures are defined by different carbohydrate and fat ratios,which are divided into low-carbohydrate and high-fat diets,medium ratios of carbohydrate-fat diet and the high-carbohydrate and low-fat diet.Quantitative data are represented by (?)±s.Two independent sample t-tests are used for the comparison of the two groups of values and the analysis of variance is used for the comparison of multiple groups.The qualitative data is expressed by rate,and the difference of rates between different groups is compared by the chi-square test.The two-category Logistic regression model was used for multivariate analysis.The two parts of the study are based on whether the person is hyperglycemia as the outcome of the study.Compared with the control group,calculate the odds ratio(OR)value and 95%CI(Confidence interval,CI)of the other groups that show the degree of association between the different dietary quality and structure and the risk of hyperglycemia.The statistical software was SAS 9.4 and the confidence level α=0.05.Results1.A study on the relationship between dietary quality and hyperglycemia of Chinese residents found that:1.1 This part of the study included 8401 people,including 3921 males and 4480 females.It was found that the age,smoking rate,tea drinking rate,BMI,WC,hypertension rate,hemoglobin level,physical activity level,HBS,LBS and DQD levels of people with hyperglycemia were higher than those with normal blood glucose(P<0.05).1.2 Compared with the normal blood glucose population,the hyperglycemia population has a higher degree of insufficient intake and excessive intake(P<0.05).At the same time,the overall diet quality of the hyperglycemic population is worse than that of the normal blood glucose population(P<0.05).Among people with hyperglycemia,a large proportion of grains,meat,salt,and oil were exceed the recommended intake.Moreover,there is a problem of insufficient intake of vegetables,fruits,dairy products,fish and shrimp,and food types.In addition,high level of insufficient intake of vegetables,fish,shrimps,and kinds of food in the hyperglycemic population was higher than the normal blood glucose population(P<0.05),and the salt intake in the hyperglycemic population was higher than the normal blood glucose population(P<0.05).1.3 Compared with the reference group,people with unfavourable dietary quality have a higher risk of hyperglycemia(OR=1.375,95%CI:1.239-1.525),especially those living in rural areas(OR=1.538,95%CI):1.347-1.756),abdominal obesity(OR=1.469,95%CI:1.272-1.696),smoking(OR=1.544,95%CI:1.267-1.882),drinking(OR=1.499,95%CI:1.224-1.836)and those who do not drink tea(OR=1.557,95%CI:1.355-1.788)are at higher risk.2.A study on the relationship between Chinese residents’ dietary structure and hyperglycemia found that:2.1 A total of 8044 people were included in this section,including 3770 males and 4274 females.Among them,1272 people mainly consumed a low-carbohydrate and high-fat diet,accounting for 15.8%;5088 people consumed a medium-proportioned carbohydrate-fat diet,accounting for 63.3%;1684 The intake of high-carbohydrate and low-fat diet accounted for 20.9%.Compared with the medium proportion of carbohydrate-fat diet intake group,the high-carbohydrate and low-fat group has a higher risk of hyperglycemia(OR=1.270,95%CI:1.122-1.437),especially in the young population(OR=1.384,95%CI:1.117)-1.715),elderly people(OR=1.409,95%CI:1.124-1.765),people who living in rural areas(OR=1.353,95%CI:1.178-1.544),people who do not drink tea(OR=1.375,95%CI:1.188-1.592)and smokers(OR=1.353,95%CI:1.085-1.689).Meanwhile,there was no statistically significant association between low-carbohydrate and high-fat diets and hyperglycemia in all groups.2.2 The high-carbohydrate and low-fat diet groups have a higher risk of hyperglycemia in the low and medium energy intake groups,especially in the low energy level group(OR=1.830,95%CI:1.206,2.777),while there is no statistical significance difference in the high energy group.Conclusion1.Unbalanced dietary intake is common among Chinese residents.Compared with people with normal blood glucose,people with hyperglycemia have a higher degree of insufficient dietary intake,excessive intake and poor overall quality.2.The quality of diet is significantly associated with the risk of hyperglycemia,especially in people with abdominal obesity,living in rural areas,smoking,drinking,and not drinking tea.3.The dietary structure of the population is related to hyperglycemia,that is,the intake of a high-carbohydrate and low-fat diet is significantly associated with the risk of hyperglycemia.Among them,young people,the elderly,living in rural areas,people who do not drink tea and smoke has a higher risk of hyperglycemia.4.When subjects eating high energy levels,dietary structure adjustment is no longer the priority,and people who consume medium and low energy levels need to appropriately reduce the proportion of carbohydrate-fat intake to reduce the risk of hyperglycemia.