Garlic consumption and risk of diabetes mellitus in the Chinese elderly: A population-based cohort study

Background and Objectives: Diabetes mellitus (DM) is a major public health problem worldwide. Numerous traditional plants are used for preventing DM. However, limited evidence supports the association between garlic consumption and DM. Methods and Study Design: Data used in this study was from the 2008-2018 Chinese Longitudinal Healthy Longevity Survey. Data on garlic consumption was obtained by questionnaire, and DM by self-reported diagnosis. A multivariate adjusted Cox regression model was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) to determine the incidence of DM. Results: A total of 1927 participants were included in this study, of which 24.08% consumed garlic daily and 20.08% developed DM. The HR for daily garlic consumption decreased by 42%, when compared to rare or no garlic consumption. Our subgroup analyses revealed that daily garlic consumption significantly reduced the risk of DM in older adults aged 65-79, rural, nondrinkers informal education, financial dependence, and working in agriculture (aged 65-79: HR = 0.54, 95% CI: 0.36-0.80; rural area: HR = 0.48, 95% CI: 0.29-0.77; non-drinkers: HR = 0.60, 95% CI: 0.41-0.86; informal education: HR = 0.46, 95% CI: 0.29-0.74; financial dependence: HR = 0.39, 95% CI: 0.23-0.65; agricultural work: HR = 0.49, 95% CI: 0.32-0.76). Conclusions: Garlic consumption can reduce the risk of DM in older Chinese adults. This benefit varies by age, current residence, drinking status, education level, occupation, and economic source. Future efforts should focus on developing dietary intervention strategies that consider demographic, educational, financial, and occupational disparities to effectively prevent diabetes in older populations.