Regional Disparities in the Association between Cereal Consumption and Metabolic Syndrome: Results from the China Health and Nutrition Survey

This study examines regional disparities in the association between cereal consumption and metabolic syndrome (MetS) among Chinese adults. We used data from the longitudinal China Health and Nutrition Survey (CHNS) for 2892 healthy adults aged 18-75 years (1088 in northern China, 1804 in southern China) who had no non-communicable chronic diseases or MetS at the initial visit in 2009 and the follow-up in 2015. We used a 74-item food frequency questionnaire (FFQ) to assess the dietary intake. We defined MetS according to the International Diabetes Federation (IDF) criteria. Multiple logistic regressions stratified by region were performed to estimate the association between cereal consumption and the risk of MetS, and the quantile regression analyzed the relationship between cereal consumption and individual components of MetS in 2015. The rice consumption in southern China (9.00 kg/month) was more than twice that in northern China (3.60 kg/month). Consumption of wheat and wheat products in northern China (4.20 kg/month) was more than twice that in southern China (1.50 kg/month). After we adjusted for potential confounders, rice consumption was inversely associated with a risk of MetS 0.709 (95% CI: 0.458-1.003), the intake of wheat and wheat products was positively associated with a risk of MetS 1.925 (95% CI: 1.292-2.867) in southern China. We found no association between the intake of cereal and the prevalence of MetS in northern China. The quantile regression showed that various cereals were differentially associated with the components of MetS. The association between cereal consumption and the risk of MetS, and the components of MetS varied across these two regions of China.