title: Dietary patterns and the incidence of hyperglyacemia in China.
abstract: OBJECTIVE
  Epidemiological studies have examined associations between dietary patterns and the risk of type 2 diabetes. However, information on dietary patterns and the risk of type 2 diabetes in Chinese populations is scarce. The aim of the present study was to identify dietary patterns and examine their association with incident hyperglycaemia in Nanjing, China.
  
  
  METHODS
  A community-based prospective cohort study. Dietary assessment was carried out using a validated eighty-seven-item FFQ. Dietary patterns were identified by exploratory factor analysis. Participants were categorized into tertiles of dietary factor score for each dietary pattern. The relationship between dietary patterns and hyperglycaemia risk was analysed using multivariable linear and Cox regression.
  
  
  METHODS
  Seven communities from two urban districts in Nanjing, China.
  
  
  METHODS
  A total of 2900 of Chinese local residents aged 30 years or above, free of hyperglycaemia and other serious diseases, who participated in the baseline survey from June to September 2007 were followed up 3 years later from June to September 2010 for the development of hyperglycaemia. Fasting blood samples were collected at both baseline and 3-year follow-up surveys. Hyperglycaemia was defined as fasting plasma glucose concentration of ≥6·1 mmol/l or already taking oral hyperglycaemia agents for treatment of type 2 diabetes.
  
  
  RESULTS
  Five major dietary patterns were identified: (i) the 'condiments' pattern; (ii) the 'animal and plant protein' pattern; (iii) the 'healthy traditional' pattern; (iv) the 'fruits, eggs and juice' pattern; and (v) the 'alcohol, milk and tea' pattern. A total of 2093 (72·2 %) individuals completed the follow-up survey and the 3-year cumulative incidence of hyperglycaemia was 7·5 % (158/2093). A 1-unit increase in the score for the 'healthy traditional' pattern was associated with a decrease of 0·054 mmol/l in fasting plasma glucose (P=0·017), while a 1-unit increase in the 'fruits, eggs and juice' pattern score was associated with an increase of 0·050 mmol/l in fasting plasma glucose (P=0·023) by multivariable linear regression. For men, tertile 3 of the 'fruits, eggs and juice' pattern was associated with an 88 % greater risk (hazard ratio=1·88; 95 % CI 1·04, 3·54) of hyperglycaemia than tertile 1 of this pattern. Being in tertile 3 of the 'alcohol, milk and tea' pattern was associated with a 35 % greater risk (hazard ratio=1·35; 95 % CI 1·04, 2·16) relative to tertile 1 in women, while for the ''healthy traditional' pattern tertile 3 was associated with a 41 % lower risk (hazard ratio=0·59; 95 % CI 0·35, 0·99) compared with tertile 1. The 'condiments' and the 'animal and plant protein' patterns were not independently associated with hyperglycaemia.
  
  
  CONCLUSIONS
  Our findings suggest that modifying dietary patterns could reduce hyperglycaemia incidence in the mainland Chinese adult population.
authors.affiliation: 1Department of Non-communicable Disease Prevention,Nanjing Municipal Center for Disease Control & Prevention,2 Zizhulin,Nanjing 210003,People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Hong
authors.affiliation: 1Department of Non-communicable Disease Prevention,Nanjing Municipal Center for Disease Control & Prevention,2 Zizhulin,Nanjing 210003,People's Republic of China.
authors.forename: Fei
authors.initials: F
authors.lastname: Xu
authors.affiliation: 1Department of Non-communicable Disease Prevention,Nanjing Municipal Center for Disease Control & Prevention,2 Zizhulin,Nanjing 210003,People's Republic of China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Wang
authors.affiliation: 1Department of Non-communicable Disease Prevention,Nanjing Municipal Center for Disease Control & Prevention,2 Zizhulin,Nanjing 210003,People's Republic of China.
authors.forename: Yaqiong
authors.initials: Y
authors.lastname: Liang
authors.affiliation: 1Department of Non-communicable Disease Prevention,Nanjing Municipal Center for Disease Control & Prevention,2 Zizhulin,Nanjing 210003,People's Republic of China.
authors.forename: Jiequan
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D004032:Diet; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology* / Q000517:prevention & control; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose
keywords: China; Dietary patterns; Factor analysis; Hyperglycaemia