Nutrient intake was estimated by 3 consecutive 24-h dietary recalls (2weekdays and 1weekend day) at baseline, 6 and 12 months, respectively. Nutrient intake was calculated based on the nutrient content listed in the Chinese Food Composition Table. Physical activity was assessed using the International Physical Activity Questionnaire (long form) at the baseline examination27. Homeostatic model assessment of insulin resistance (HOMA-IR) was calculated as follows: Fasting plasma insulin (mU/L) *fasting plasma glucose (mmol/L)/22.5.

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