Diet quality is critical for postpartum type 2 diabetes mellitus (T2DM) progression among women with a history of gestational diabetes mellitus (GDM). The Chinese Healthy Eating Index (CHEI) is a dietary index developed according to the latest Chinese Dietary Guidelines (CDG-2016). Our study aimed to assess the diet quality of women with previous GDM in rural areas of Hunan Province by applying the CHEI. Women with previous GDM in two counties of Hunan were enrolled. Their food intake data, which were used to calculate their CHEI scores, were collected by a 24-h dietary recall. The association of CHEI with sociodemographic and anthropometric variables was evaluated via linear regression models. 404 women were included in the final analysis. The mean score of the total CHEI was 54.9 (SD 7.9). The components of whole grains and mixed beans, seeds and nuts, tubers, dairy, and poultry scored extremely low. Ethnic minority groups and women younger than 30 years had lower CHEI scores. Our study observed an unsatisfactory diet quality among women with previous GDM in rural areas of Hunan Province. Future dietary education focusing on the CDG is needed to improve their diet quality and help in T2DM prevention among this population, especially young and ethnic minority women.

Healthy diet is essential to type 2 diabetes mellitus (T2DM) prevention for women with previous gestational diabetes mellitus (GDM). To evaluate the effect of a lifestyle intervention program on diet quality for rural women who were previously diagnosed with GDM, we conducted a randomized controlled study in two counties located in south-central China. A total of 404 eligible women were allocated into an intervention group and control group. Participants in the intervention group received 6-month lifestyle intervention including six group seminars and eight telephone consultations. Dietary data were collected at baseline and 18 months via a 24 h dietary recall, and dietary quality was measured by two indicators, Chinese Healthy Eating Score (CHEI) and Minimum Dietary Diversity for Women (MDD-W). Baseline CHEI scores (54.4 vs. 53.5, p = 0.305) and the proportions of participants who met MDD-W (73.8% vs. 74.5%, p = 0.904) were comparable between the two groups. The intervention group achieved a higher CHEI score (62.2 vs. 58.9, p = 0.001) and higher MDD-W proportion (90.6% vs. 81.2%, p = 0.023) at 18 months. Lifestyle intervention was associated with the change of CHEI (p = 0.049) but not with MDD-W (p = 0.212). In conclusion, compared with usual care, lifestyle intervention resulted in greater improvement of dietary quality among rural women with previous GDM.

Although previous studies have discussed the association between trajectories of blood pressure (BP) and risk of cardiovascular diseases (CVDs), the association among the non-hypertensive general population of youth and middle age has not been elucidated. We used the growth mixture model to explore the trajectories of BP among the non-hypertensive Chinese population and applied Cox regression to evaluate the association between trajectories of BP and the risk of stroke or myocardial infarction (MI). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were categorized into three classes, respectively. Statistically significant associations were observed between SBP trajectories and stroke (range of adjusted hazard ratios (aHR): 1.369–3.837) or MI (rang of aHR = 6.047–13.017). Association between DBP trajectories and stroke (aHR: 3.685) or MI (range of aHR = 1.312–2.821) were also observed, although they did not reach statistical significance. Trajectories of SBP were more important risk factors than that of DBP in stroke and MI in our study population. BP management is important among pre-hypertensive adults to prevent stroke and MI when they age. Well-designed research with a larger sample size is required to confirm our findings and develop efficient methods to prevent CVDs.

Different lines of evidence indicate that knowledge of low-glycemic index (GI) foods and the practice of eating them play important roles in blood glucose management and preventing T2DM in women with prior gestational diabetes mellitus (GDM). According to the theory of planned behavior (TPB), intention is a critical factor in complying with health-related behaviors. However, an instrument for assessing the intention to eat low-GI foods is lacking in China. We aimed to (1) adapt and validate a Chinese version of the intentions to eat low-GI foods questionnaire (CIELQ) and (2) apply the CIELQ among rural Chinese women to explore the associations between CIELQ scores and glycemic status. A cross-sectional study was conducted on 417 nondiabetic, nonpregnant participants with a history of GDM in Hunan, China. After cultural adaptation and validation, the CIELQ was applied in a target population. Glycemic status, anthropometric variables, dietary intake, and physical activity were measured; a self-developed, standard questionnaire was applied to collect relevant information. The CIELQ showed good internal consistency; model fitness was acceptable based on the confirmatory factor analysis results. Awareness of the glycemic index was low among the study population. TPB factors were found to be associated with each other; education level and parents’ diabetes history were associated with specific factors. The score for instrumental attitude showed a positive association with the risk for a high level of the 2-h 75-g oral glucose tolerance test (odds ratio, OR = 1.330), while the score for perceived behavior control (PBC) showed a negative association with the risk for a high level (OR = 0.793). The CIELQ was determined to be a valid instrument for assessing the intention to eat a low-GI diet among the study population. The awareness of the GI was poor among the study population. The score for instrumental attitude showed a positive association with the risk of a high level on the 2-h 75-g oral glucose tolerance test (OGTT), and the score for PBC showed a negative association with the risk for a high level on OGTT.