Seven-year trends in dietary patterns and their association with hyperglycemia risk in a Chinese city: a comparative analysis of two cross- sectional surveys (2014–2021)
A seven-year comparative analysis in Jiangyin, China, reveals that a dietary shift toward Westernized fast-food and pastry consumption, alongside a decline in traditional plant-based and cereal-rich diets, coincided with a significant increase in hyperglycemia risk.
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In the bustling cities of China, as in many places around the world, the way people eat is changing. For generations, the typical diet relied heavily on grains, vegetables, and modest amounts of meat, a balance that had sustained families for centuries. But as economies grow and incomes rise, food choices often shift toward more processed items, sugary snacks, and fast food. This shift, known as a nutritional transition, is not just about changing tastes; it is about how the body handles sugar. When blood sugar levels stay too high for too long, a condition called hyperglycemia, it can lead to serious health problems like diabetes and heart disease. While doctors have long known that diet matters, understanding exactly how the overall mix of foods we eat—rather than just one specific nutrient like sugar or fat—affects our risk of high blood sugar requires looking at the whole picture of daily eating habits.
A team of researchers from the Wuxi Center for Disease Control and Prevention set out to see how these eating habits changed over time in Jiangyin, a city in eastern China, and what that meant for the health of its residents. They did not follow a single group of people for seven years; instead, they took two distinct snapshots of the community, one in 2014 and another in 2021. In both years, they interviewed hundreds of local adults, asking detailed questions about what they had eaten over the previous year. They also measured the participants' blood sugar levels after an overnight fast. By comparing the data from these two groups, the researchers could see how the city's diet had evolved and whether those changes were linked to a rise in high blood sugar.
The analysis revealed that the residents of Jiangyin had moved away from their traditional way of eating. In 2014, the most common eating pattern was a balanced mix of cereals, vegetables, and meat. By 2021, this traditional pattern had become less common. At the same time, a new pattern emerged and grew stronger: a diet heavy on fast food, pastries, and other convenient, processed snacks. The researchers identified three main ways of eating in the city. The first was the traditional mix of grains, veggies, and meat. The second was a pattern focused on plant proteins, fruits, and nuts. The third was the fast-food and pastry style. Over the seven-year period, the scores for the traditional and plant-based patterns dropped significantly, while the score for the fast-food pattern rose sharply.
This shift in diet coincided with a worrying change in health. The researchers found that the risk of having high blood sugar was 65 percent higher in 2021 than it had been in 2014, even after accounting for factors like age, income, and education. The data showed a clear link between what people ate and their blood sugar levels. Those who stuck closer to the traditional diet of grains, vegetables, and meat had a lower risk of high blood sugar. In fact, following this traditional pattern appeared to be protective. On the other hand, those who adopted the fast-food and pastry-heavy diet faced a much higher risk. The study found that people with higher scores for this Western-style diet were nearly twice as likely to have high blood sugar compared to those who ate less of these foods. Interestingly, the plant-based pattern, which included soy, fruits, and nuts, did not show a strong connection to blood sugar levels in this specific study, possibly because the amounts people were eating had dropped too low to provide a clear benefit.
The findings suggest that as a region becomes wealthier, it does not automatically become healthier. In Jiangyin, rising incomes were accompanied by a move toward a more Westernized diet, and this change came with a cost to public health. The researchers noted that the traditional diet, with its balance of different food groups, offers protection, but this balance is being eroded. The rise of ultra-processed foods, which are often high in refined sugars and unhealthy fats, appears to be a primary driver of the increasing risk of high blood sugar. The study does not prove that the diet change caused the health problem in every individual, but the strong association over time points to a clear trend. It highlights that simply having more money does not guarantee better health outcomes if the food environment encourages the consumption of processed items over traditional, balanced meals. To protect the health of growing populations, the authors suggest that public health efforts need to go beyond individual advice and address the broader food environment, perhaps by making healthy traditional foods more accessible and affordable while discouraging the spread of unhealthy processed options.
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