ArticleFrontiers in public health2026
Dietary quality across the life course and metabolic syndrome: evidence from two decades of follow-up in rural China young adults.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The global prevalence of metabolic syndrome (MetS) among young adults has reached 17.4%. We examined associations of three dietary indices and life-course dietary quality trajectories with MetS and its components using a birth cohort. Methods: Participants from rural western China were followed at four time points: infancy, school age, adolescence, and young adulthood (mean age 20 years). Three dietary indices-Dietary Diversity Score (DDS), healthy Plant-based Diet Index (h-PDI), and EAT-Lancet score-were compared. Group-based trajectory modeling (GBTM) characterized dietary quality trajectories across the four stages. Results: Among 741 young adults (53% male), 29 (5.1%) had MetS, 217 (38.2%) had at least one metabolic abnormality, and 122 (21.1%) were overweight or obese. Higher DDS was inversely associated with overweight/obesity (T3 vs. T1: OR 0.26, 95% CI 0.10-0.69) and high waist-to-height ratio (WHtR) (OR 0.26, 95% CI 0.09-0.73). Higher h-PDI was positively associated with high WHtR (OR 3.01, 95% CI 1.11-8.15). The EAT-Lancet score was inversely associated with overweight/obesity (OR 0.34, 95% CI 0.15-0.78). After stratified Benjamini-Hochberg correction, these four associations remained significant (adjusted Conclusion: In this rural Chinese cohort, higher DDS and EAT-Lancet were associated with lower odds of overweight/obesity after FDR correction. An increasing dietary trajectory from infancy to young adulthood was also protective. All three indices showed similar discriminative ability. These findings support life-course dietary health promotion.
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