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Published in: European Journal of Nutrition 3/2024

21-01-2024 | Original Contribution

Chinese Healthy Eating Index (CHEI) and risk of diabetes in Chinese adults: a prospective cohort study

Authors: Zhuangyu Zhang, Fangqu Liu, Xingzhu Yin, Bangfu Wu, Hongxia Li, Fei Peng, Maowei Cheng, Jingjing Li, Jingjing Xiang, Ping Yao, Shuang Liu, Yuhan Tang

Published in: European Journal of Nutrition | Issue 3/2024

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Abstract

Purpose

The Chinese Healthy Eating Index (CHEI) is a valid instrument to assess the diet quality of the Chinese population, but evidence regarding the relationship between CHEI and the risk of diabetes remains limited. We aimed to investigate the prospective association of CHEI with diabetes among Chinese adults.

Methods

1563 adults free of diabetes at baseline and with at least two survey data from 1997 to 2018 were included. Dietary information was collected by three consecutive 24-h recalls combined with household food inventory, and long-term diet quality was evaluated by the CHEI. Diabetes was defined as self-reported physician-diagnosed diabetes and/or fasting blood glucose ≥ 7.0 mmol/L, and/or HbA1c ≥ 6.5%. Cox proportional hazard models and restricted cubic spline analysis were used to estimate the associations between CHEI and diabetes.

Results

During a median follow-up of 12.0 years, 192 (10.3%) participants developed new-onset diabetes. Generally, a five-point higher CHEI score was significantly associated with a 17% lower risk of diabetes (HR, 0.83; 95%CI 0.71–0.97). In stratified analysis, inverse associations between CHEI and diabetes were more vigorous in females (HR, 0.68; 95%CI 0.54–0.85) than in males (P for interaction = 0.01). In addition, there was an L-shaped association between CHEI and diabetes risk in the whole population (P for non-linearity = 0.026), while no significant non-linear association was observed in females or males, respectively.

Conclusion

Our results suggested that a long-term higher-quality diet evaluated by CHEI was significantly associated with lower risks of diabetes, and the favorable associations were more pronounced among females.
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Metadata
Title
Chinese Healthy Eating Index (CHEI) and risk of diabetes in Chinese adults: a prospective cohort study
Authors
Zhuangyu Zhang
Fangqu Liu
Xingzhu Yin
Bangfu Wu
Hongxia Li
Fei Peng
Maowei Cheng
Jingjing Li
Jingjing Xiang
Ping Yao
Shuang Liu
Yuhan Tang
Publication date
21-01-2024
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nutrition / Issue 3/2024
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI
https://doi.org/10.1007/s00394-023-03321-7

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