Seafood consumption and incident diabetes mellitus in middle-aged and elderly Chinese: results from the 4 C study

BACKGROUND: There is an urgent need to implement population-based actions to prevent diabetes mellitus (DM) in China. However, the current knowledge is limited on a prospective association of seafood intake with DM risk in Chinese adults. We aimed to determine the association between seafood consumption and the incident DM in a nationwide cohort of Chinese populations. METHODS: A prospective cohort study of 104,816 participants, free of DM, aged ≥ 40 years across various geographical regions in China was conducted at baseline (China Cardiometabolic Disease and Cancer study). Habitual consumptions of seafood were assessed using a semi-quantitative food frequency questionnaire, and DM was diagnosed according to the WHO 1999 criteria. Primary outcomes were the incident DM, presented as hazard rations (HRs) with 95% confidence intervals (CIs) that were examined with Cox proportional model with adjustments for relevant covariates across quartiles of seafood consumptions, with the lowest quartile as the reference. Dose-response analyses were evaluated using the restricted cubic spline regression with tests for nonlinearity. RESULTS: During the mean follow-up period of 3.60 years, 7,105 incident DM cases were present among the 104,816 participants. Participants at the highest quartile of seafood-consumption amount had a lower risk of DM than those at the lowest (HR: 0.87, 95% CI: 0.80-0.94). There is a steep decrease in the risk of DM with the increasing consumption of seafood within the cumulative amount of 200.00 g/week, which further strengthened gradually thereafter (P for nonlinearity < 0.001). CONCLUSIONS: In the middle-aged, elderly Chinese population, higher seafood consumption was nonlinearly associated with a lower risk of incident DM, and the cutoff amount of 200.00 g/week was appropriate.

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Journal
Nutrition Journal
Published
2026-05-27
DOI
https://doi.org/10.1186/s12937-026-01338-2
Primary Topic
Nutritional Studies and Diet
Type
article
Field-Weighted Citation Impact
0.00

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article

Seafood consumption and incident diabetes mellitus in middle-aged and elderly Chinese: results from the 4 C study

GU Xue-jiang, Ruying Hu, Xue‐Feng Yu, L Yan et al.
Nutrition Journal
Nutritional Studies and Diet
article

Seafood consumption and incident diabetes mellitus in middle-aged and elderly Chinese: results from the 4 C study

GU Xue-jiang, Ruying Hu, Xue‐Feng Yu, L Yan, T Wang, Li-Juan Yang, Fei-Xia Shen, W L Wang, Huihui Deng, G P Chen, Zhang Yin-fei, L ong Chen, Wei Xing Pan, Qi Li, Yue Wang, Zhao Jia-jun, Gui-Jun Qin, Yi-Ming Mu, Yu-Fang BI, Ya-Nan Huo, Luo Zuo-jie, Taoyue Yang, Ying-Fen Qin, Tian-shu Zeng, Liang Wang, Bo Yang, Hua-cong Deng, Gui-xia Wang, Zheng-nan Gao, Yu Xu, Zhi-yun Zhao, Xiang Hu, Sheng-li Wu, Qin Wan, Xu-lei Tang, Li-xin Shi, Mian Li, Qing Su, Guang Ning, Jie-li Lu, Min Xu, Zhen Ye, Meng-ying Chen, Chao Liu
article en

Abstract

BACKGROUND: There is an urgent need to implement population-based actions to prevent diabetes mellitus (DM) in China. However, the current knowledge is limited on a prospective association of seafood intake with DM risk in Chinese adults. We aimed to determine the association between seafood consumption and the incident DM in a nationwide cohort of Chinese populations. METHODS: A prospective cohort study of 104,816 participants, free of DM, aged ≥ 40 years across various geographical regions in China was conducted at baseline (China Cardiometabolic Disease and Cancer study). Habitual consumptions of seafood were assessed using a semi-quantitative food frequency questionnaire, and DM was diagnosed according to the WHO 1999 criteria. Primary outcomes were the incident DM, presented as hazard rations (HRs) with 95% confidence intervals (CIs) that were examined with Cox proportional model with adjustments for relevant covariates across quartiles of seafood consumptions, with the lowest quartile as the reference. Dose-response analyses were evaluated using the restricted cubic spline regression with tests for nonlinearity. RESULTS: During the mean follow-up period of 3.60 years, 7,105 incident DM cases were present among the 104,816 participants. Participants at the highest quartile of seafood-consumption amount had a lower risk of DM than those at the lowest (HR: 0.87, 95% CI: 0.80-0.94). There is a steep decrease in the risk of DM with the increasing consumption of seafood within the cumulative amount of 200.00 g/week, which further strengthened gradually thereafter (P for nonlinearity < 0.001). CONCLUSIONS: In the middle-aged, elderly Chinese population, higher seafood consumption was nonlinearly associated with a lower risk of incident DM, and the cutoff amount of 200.00 g/week was appropriate.

Nutrition Journal
Fujian Medical University (CN), Nanchang University (CN), Shandong University (CN), Harbin Medical University (CN), Baylor University (US), Sun Yat-sen University (CN), Guangxi Medical University (CN), Shanghai Jiao Tong University (CN), Jilin University (CN), Anhui Medical University (CN), Wenzhou Medical University (CN), XinHua Hospital (CN), Ruijin Hospital (CN), First Affiliated Hospital of Wenzhou Medical University (CN), Affiliated Hospital of Southwest Medical University (CN), Jiading District Central Hospital (CN), Sun Yat-sen Memorial Hospital (CN), Dalian Municipal Central Hospital (CN), Jiangxi Provincial People's Hospital (CN), Shandong Provincial Hospital (CN), First Hospital of Jilin University (CN), First Affiliated Hospital of GuangXi Medical University (CN), Wuhan Union Hospital (CN), The Affiliated Yongchuan Hospital of Chongqing Medical University (CN), Second Affiliated Hospital of Harbin Medical University (CN), Zhejiang Center for Disease Control and Prevention (CN), First Affiliated Hospital of Anhui Medical University (CN), Fujian Provincial Hospital (CN), Karamay Central Hospital (CN), Jiangsu Province Hospital (CN), First Affiliated Hospital of Zhengzhou University (CN), Tongji Hospital (CN), Chinese People's Liberation Army (CN), Qilu Hospital of Shandong University (CN), First Hospital of Lanzhou University (CN), Huazhong University of Science and Technology (CN), Lanzhou University (CN), Nanjing Medical University (CN), Chongqing Medical University (CN)
National Natural Science Foundation of China, Ministry of Science and Technology of the People's Republic of China, Natural Science Foundation of Zhejiang Province
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Nutritional Studies and Diet
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