Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance: 30-year results of the Da Qing Diabetes Prevention Outcome Study

The Jiangnan diet, a healthy diet pattern for Chinese

“…In parallel with this, a huge change in the foods supply and diet components occurred. 8,9 From the early 1960s to late 1970s, China could not provide sufficient food to majority of its people and rationed grain, meat, and oil. Diet was mainly based on whole grain-based carbohydrates, in the form of wheat in the North and rice in the South, with limited cooking oil and variaties of vegetables; infrequent consumption of meat, eggs, and dairy products; and little fried food.…”

“…Recently, energy intake climbed to a high level accompanied with less physical activity, although beginning to decline from the early 1980s. 9 Meanwhile, the dietary patterns and nutrition composition transited from traditional to more-Westernized ones. 12,13 The reduced intake of whole grains and vegetables and the increased consumption of refined grain, red meat, processed meat, sugarsweetened beverages, fried food, and unhealthy fat (rich in saturated fat from animal products and tropical plants), led to overwhelming health care burdens despite moderately increasing intake of fruit, nuts, eggs, milk, and unsaturated fatty acids from fish.…”

“…12,13 The reduced intake of whole grains and vegetables and the increased consumption of refined grain, red meat, processed meat, sugarsweetened beverages, fried food, and unhealthy fat (rich in saturated fat from animal products and tropical plants), led to overwhelming health care burdens despite moderately increasing intake of fruit, nuts, eggs, milk, and unsaturated fatty acids from fish. 9,10,14 In parallel with economic growth, the prevalence of chronic noncommunicable diseases (NCDs), including obesity, diabetes, cardiovascular diseases (CVD), and cancers, increased considerately. 9,[15][16][17] Taking overweight/obesity for example, the prevalence in Chinese adults rocketed up from about 3.7% in 1980 to about 33.0% in 2010, and mean national adult body mass index increased from 21.1 kg/m 2 in 1982 to 23.9 kg/m 2 in 2010-12.…”

Efficacy of metformin in preventing progression to diabetes in a Chinese population with impaired glucose regulation: Protocol for a multicentre, open‐label, randomized controlled clinical study

“…Lifestyle interventions (diet and exercise) [8][9][10][11][12] and pharmacological drug administration 8,[14][15][16][17] have both demonstrated the ability to halt the progression of IGR, but improvements are still needed. While lifestyle modifications are the first-line recommendation to manage IGR, 19 agents such as metformin may have additional advantages, 18 and the combination of both interventions to improve outcomes is of considerable interest to clinicians.…”

“…The relative decrease in the rate of development of diabetes in the active intervention groups was similar whether participants were classified as lean (body mass index [BMI] <25 kg/m 2 ) or overweight (BMI ≥25 kg/m 2 ) . Early intervention for IGR showed significant benefits, even after three decades of follow‐up, as indicated by the 30‐year outcome data from the Da Qing study . However, although the Da Qing study indicated the effectiveness of lifestyle intervention (LSI), ~44% of participants in the LSI groups still developed diabetes, and the median delay in diabetes onset in the intervention group was 4 years compared with the control group .…”