Abstract
BackgroundThe effect of the overall diet quality on cardiometabolic diseases has been well studied in the Western population. However, evidence is still in need regarding dietary patterns depicting unique Chinese dietary habits and their associations with cardiometabolic diseases.MethodsA prospective cohort recruited around 0.5 million Chinese residents aged 30–79 years from 10 diverse survey sites during 2004–08. Dietary patterns were obtained using factor analysis based on the habitual consumption of 12 food groups collected at baseline. Among 477,465 eligible participants free of prior heart disease, stroke and cancer, linkages to multiple registries and health insurance database recorded 137,715 cardiovascular diseases (CVD) and 17,412 diabetes cases (among 451,846 non-diabetic participants) until 31 December 2017. Adjusted hazard ratios (HRs) were estimated to compare the risks of cardiometabolic diseases across quintiles of dietary pattern scores using the Cox regression.ResultsTwo dietary patterns were derived: the traditional northern pattern, characterised by wheat, other staples, egg and dairy products; and the modern pattern, featured with fresh fruit, meat, poultry, fish, dairy products and soybean. Adherence to either dietary pattern was associated with lower risks of major cardiometabolic diseases in a dose-response relationship way. After multivariate adjustment, participants adhering to the traditional northern pattern the most had an 8% (95%CI: 5–11%) lower risk of CVD in comparison with those adhering the least. Corresponding risk reductions were 12% (11–32%) for haemorrhagic stroke (HS), 14% (8–19%) for ischaemic stroke (IS), and 15% (6–24%) for diabetes, respectively. When comparing extreme quintiles of the modern pattern, the adjusted HR of HS was 0.67 (95%CI: 0.59–0.77). Corresponding HRs were 0.89 (0.86–0.92) for CVD, 0.88 (0.77–0.99) for MCE, 0.85 (0.80–0.89) for IS, and 0.89 (0.81, 0.97) for diabetes.ConclusionAmong Chinese adults, both traditional northern and modern dietary patterns were associated with lower risks of cardiovascular disease and diabetes beyond other risk factors.
Highlights
Cardiometabolic diseases, including cardiovascular disease (CVD) and diabetes, were accountable for 34% of 57 million deaths globally and 45% of 10 million China’s deaths in 2016 [1]
Our study aimed to identify major dietary patterns in the Chinese population and investigate their associations with cardiometabolic diseases in the China Kadoorie Biobank (CKB)
The present study showed that compliance with the traditional northern dietary pattern was associated with reduced risks of major CVD and diabetes
Summary
Cardiometabolic diseases, including cardiovascular disease (CVD) and diabetes, were accountable for 34% of 57 million deaths globally and 45% of 10 million China’s deaths in 2016 [1]. Priori diet indices like the Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) were designed based on hypotheses and have been proved to prevent CVD directly in the high-risk group or through reducing blood pressure [2,3,4], as well as diabetes risk [3, 5, 6] Previous studies using this approach have identified healthy dietary patterns, characterised with high intakes of vegetable, fruit, fish, poultry, whole grain and low-fat dairy products, were associated with decreased CVD mortality [7, 8]. Evidence is still in need regarding dietary patterns depicting unique Chinese dietary habits and their associations with cardiometabolic diseases
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