Dietary patterns are associated with lower incidence of type 2 diabetes in middle-aged women: the Shanghai Women's Health Study (original) (raw)
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Relationship between dietary patterns and incidence of type 2 diabetes
International Journal of Preventive Medicine, 2019
Introduction: Increasing rate of type 2 diabetes (T2D) prevalence during the recent years has caused concern about significant risks for the public health. Dietary patterns have recently attracted great attention in the evaluation of the relationship between diet and health. In the present study, we investigated the relationship between the major identified dietary patterns and T2D. Methods: In this matched case-control study, 315 individuals (125 newly diagnosed cases and 190 controls); 18-60 years of age were selected. A valid semiquantitative food frequency questionnaire was used to collect dietary intakes of individuals. Anthropometric characteristics and blood pressure were measured with standard instructions and body mass index and waist to hip ratio were calculated. Factor analysis was used to identify major dietary patterns. The relationship between major food patterns and T2D was assessed by logistic regression analysis. Results: Two dietary patterns were identified: healthy and Western dietary patterns. The second tertile of the healthy dietary pattern had significantly association with decreased risk of T2D in the crude model (Odds ratios [OR]: 0.51, 95% Confidence interval [CI]: 0.29-0.9; P for trend = 0.018), Model II (OR: 0.5, 95% CI: 0.27-0.9; P for trend = 0.019), and Model III (OR: 0.56, 95% CI: 0.23-1.4 P for trend = 0.048). The inverse association of the second tertile of Western dietary pattern score with the T2D was significant in crude (OR: 9.25, 95% CI: 4.95-17.4; P for trend <0.001) and multivariable-adjusted model (OR: 16.65, 95% CI: 2.99-92.84; P for trend <0001). Conclusions: Our study found an inverse relationship between adherence of healthy pattern and direct association with Western dietary pattern and the risk of T2D.
Generalizability of dietary patterns associated with incidence of type 2 diabetes mellitus
American Journal of Clinical Nutrition, 2009
Background: Reduced rank regression (RRR) has been used to derive dietary pattern scores that predict linear combinations of disease biomarkers. The generalizability of these patterns to independent populations remains unknown. Objective: The goal was to examine the generalizability of dietary patterns from the following prior studies using RRR to predict type 2 diabetes mellitus (T2DM): the Nurses' Health Study (NHS), European Prospective Investigation into Cancer and Nutrition Germany (EPIC), and Whitehall II Study (WS). Design: The relative weights of food groups of each dietary pattern were used to generate each dietary pattern score in the Framingham Offspring Study (n = 2879). Each of the external scores (confirmatory scores) was examined to determine whether it could predict incident T2DM during 7 y of follow-up as well as scores developed internally in the Framingham Offspring Study using a Coxproportional hazard model adjusted for T2DM risk factors. Results: Intakes of meat products, refined grains, and soft drinks (caloric and noncaloric) were found to be common predictive components of all confirmatory scores, but fried foods, eggs, and alcoholic beverages were predictive in some, but not in all, confirmatory scores. On the basis of a continuous increase in the score by 1 SD, the NHS-based confirmatory score predicted T2DM risk (hazard ratio: 1.44; 95% CI: 1.25, 1.66). However, T2DM risk was only weakly predicted by the EPIC-based score (hazard ratio: 1.14; 95% CI: 0.99, 1.32) and the WS-based score (hazard ratio: 1.16; 95% CI: 1.00, 1.35). Conclusions: The study suggested that dietary patterns that predict T2DM risk in different populations may not be generalizable to different populations. Additional dietary pattern studies should be conducted with regard to generalizability.
Journal of Nutritional Science and Vitaminology, 2019
Observational and interventional studies have showed associations between dietary patterns and the risk of type 2 diabetes (T2DM). The aim of the present study was to identify dietary patterns and examine their association with incident of T2DM and physiopathologic mechanism in the Uygur population of Xinjiang, China. A community-based case control study in Urumqi, Xinjiang Uygur Autonomous Region, China. We enrolled 836 Uygur adults (345 newly diagnosed T2DM and 491 healthy controls) receiving physical examination in community health service centers. Dietary patterns were evaluated using a validated 121 items semi-quantitative food frequency questionnaire (SQFFQ). Dietary patterns were identified by exploratory factor analysis. Data on demographic, anthropometric, socioeconomic characteristics were collected. Homeostasis model assessment index for insulin resistance (HOMA-IR) and for b cell function (HOMA-b) were calculated. Multivariate logistic regression were used to estimate the associations between dietary patterns and the risk of T2DM and multiple linear regression were used to evaluate the association between dietary patterns and fasting plasm glucose (FPG), fasting insulin (FINS), HOMA-IR and HOMA-b, adjusting for confounding factors. Five major dietary patterns were identified: (1) the "vegetable and tubes" pattern; (2) the "fruit and nut" pattern; (3) the "refined grains and meat" pattern; (4) the "dairy, legume and egg" pattern; and (5) the "oil and salt" pattern. Logistic regression results demonstrated that the "vegetable and tubes" dietary pattern and the "fruit and nut" dietary pattern were related to T2DM, OR values were 0.223 (95% CI: 0.135-0.371), 0.160 (95% CI: 0.093-0.275), respectively. The "refined grains and meat" dietary pattern and the "oil and salt" dietary pattern were related to T2DM, OR values were 6.146 (95% CI: 3.217-11.739), 9.554 (95% CI: 5.668-16.104), respectively. Multiple linear regression analysis showed that the above five dietary patterns were related to log (FPG), b values were 20.040, 20.039, 0.028, 20.010 and 0.036, respectively, all p,0.05. The "vegetable and tubes" pattern, the "fruit and nut" pattern, the "refined grains and meat" pattern and the "oil and salt" pattern were related to log (HOMA-IR), b values were 20.061, 20.060, 0.045, and 0.042, and were related to log (HOMA-b), b values were 0.071, 0.063, 20.035 and 20.070, respectively, all p,0.05. The "refined grains and meat" dietary pattern and the "oil and salt" dietary pattern may be the important reason for the rapid increase of T2DM incidence among Chinese Uygur residents. Our findings suggest that modifying dietary patterns could reduce T2DM incidence in the adult Uygur population.
Dietary habits contribute to define the risk of type 2 diabetes in humans
Clinical Nutrition ESPEN, 2019
Background and aims: Type 2 diabetes (T2D) is a frequent disorder largely preventable. The aim of this review was to summarize information on the association between dietary habits and the risk of developing T2D. Methods: We conducted a comprehensive literature search using the PubMed database from its inception to June, 2019. Articles were restricted to those written in English and concerning human subjects. Relevant manuscripts found in the list of references of the retrieved articles were also used in preparation for the review. Results: Animal protein consumption increases the risk of T2D independently of body mass index. Intake of both unprocessed meat and processed meat is strongly and consistently associated with increased risk of developing T2D. In contrast, consumption of high-quality vegetable foods prevents the disease. Highquality plant foods include whole grains, nuts, legumes, fruits, and vegetables. Among less healthy plantbased foods are fruit juices, sweetened beverages, refined grains, potatoes, sweets, and desserts. Carbohydrate-restricted diets that encourage consumption of animal products promote T2D. Low intake of animal products is linked to high educational level so that well-informed individuals tend to consume diets with elevated content of vegetable food. According to the American Dietetic Association, "appropriately planned vegetarian diets including vegan diets are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases". Conclusions: restricting animal products while increasing healthy plant-based foods intake facilitates T2D prevention. To neutralize worldwide the burden of T2D and its devastating complications, animal products consumption should be limited or discontinued.
Dietary Patterns and Incident Type 2 Diabetes in Chinese Men and Women
Diabetes Care, 2011
OBJECTIVE To empirically derive dietary patterns and examine their association with incident type 2 diabetes. RESEARCH DESIGN AND METHODS We used data from the Singapore Chinese Health Study, including 43,176 Chinese men and women (aged 45–74 years), free of diabetes, cardiovascular disease, and cancer at baseline (1993–1998) and followed up through 2004. Two major dietary patterns were identified using principal components analysis: a vegetable, fruit, and soy-rich pattern (VFS) and a dim sum and meat-rich pattern (DSM). Pattern scores for each participant were calculated and examined with type 2 diabetes risk using Cox regression. RESULTS The associations of the two dietary patterns with diabetes risk were modified by smoking status. Neither pattern was associated with risk of diabetes in ever smokers. In never smokers, the VFS dietary pattern was inversely associated with risk of type 2 diabetes. Compared with the lowest quintile of the VFS dietary pattern score, the hazard ratio...
The Review of Diabetic Studies, 2016
AIM: To identify dietary patterns among apparently healthy individuals and to determine their long-term effect on diabetes incidence. METHODS: During 2001-2002, a random sample of 3,042 men and women (18-89 years old), living in greater Athens, was randomly selected to participate in the study. During 2011-2012, the 10-year follow-up was performed in 2,583 participants (15% drop-out rate). After excluding participants with diabetes at baseline and those for whom no information on diabetes status was available at follow-up, the working sample consisted of 1,485 participants. Dietary habits were assessed by means of a validated semiquantitative, food frequency questionnaire. Factor analysis was performed to extract dietary patterns from 18 food groups. RESULTS: Diabetes diagnosis at follow-up was made in 191 participants, yielding an incidence rate of 12.9%. Six factors (i.e. dietary patterns) were identified that explained 54% of the variation in consumption. After adjusting for major confounders, and stratification by age-group, logistic regression revealed that the most healthful pattern consisted of the consumption of fruits, vegetables, legumes, bread, rusk, and pasta which reduced the 10-year diabetes risk by 40%, among participants aged 45-55 years. The association reached marginal statistical significance (95% CI: 0.34, 1.07), while no significant association was observed for the other age-groups. When the analysis was additionally adjusted for carbohydrate percentage, statistical significance was lost completely, suggesting a possibly mediating effect of this macronutrient. CONCLUSIONS: The results confirm the potentially protective effect of a plant-based dietary pattern in the primary prevention of diabetes, in particular among middle-aged people. Carbohydrate content may be a specific factor in this relationship; other micronutrients found in plant-based food groups may also play a role.
Public Health Nutrition, 2011
Objective: To study the relationship between dietary intake and the development of type 2 diabetes among Chinese adults. Design: A prospective cohort study. Dietary assessment was carried out using a validated FFQ. Principal component analysis was used to identify dietary patterns. Dietary glycaemic load and variety of snacks were also calculated. Setting: A hospital-based centre at the Queen Mary Hospital in Hong Kong SAR, China. Subjects: A total of 1010 Chinese adults aged 25-74 years who participated in a territory-wide dietary and cardiovascular risk factor prevalence survey in 1995-1996 were followed up for 9-14 years for the development of diabetes. Results: A total of 690 (68?3 %) individuals completed follow-up during 2005-2008 and seventy-four cases of diabetes were identified over the follow-up period. Four dietary patterns were identified ('more snacks and drinks', 'more vegetables, fruits and fish', 'more meat and milk products' and 'more refined grains'). After adjustment for age, sex, BMI, waist-to-hip ratio, smoking, alcohol intake, participation in exercise/sports and family history of diabetes, the more vegetables, fruits and fish pattern was associated with a 14 % lower risk (OR per 1 SD increase in score 5 0?76; 95 % CI 0?58, 0?99), whereas the more meat and milk products pattern was associated with a 39 % greater risk of diabetes (OR per 1 SD increase in score 5 1?39; 95 % CI 1?04, 1?84). Dietary glycaemic load, rice intake, snack intake and variety of snacks were not independently associated with diabetes. Conclusions: The more vegetables, fruits and fish pattern was associated with reduced risk and the more meat and milk products pattern was associated with an increased risk of diabetes.
The Journal of Nutrition, 2011
Coronary heart disease (CHD) is the leading cause of death in women. A nested case-control study tested whether dietary patterns predicted CHD events among 1224 participants in the Women's Health Initiative-Observational Study (WHI-OS) with centrally confirmed CHD, fatal or nonfatal myocardial infarct compared to 1224 WHI-OS controls matched for age, enrollment date, race/ethnicity, and absence of CHD at baseline or follow-up. The first six principal components explained .75% of variation in dietary intakes and K-mean analysis based on these six components produced three clusters. Diet cluster 1 was rich in carbohydrate, vegetable protein, fiber, dietary vitamin K, folate, carotenoids, a-linolenic acid [18:3(n-3)], linoleic acid [18:2(n-6)], and supplemental calcium and vitamin D. Diet cluster 2 was rich in total and animal protein, arachidonic acid [20:4(n-6)], DHA [22:6(n-3)], vitamin D, and calcium. Diet cluster 3 was rich in energy, total fat, and trans fatty acids (all P , 0.01). Conditional logistic regression analysis demonstrated diet cluster 1 was associated with lower CHD risk than diet cluster 2 (reference group) adjusted for smoking, education, and physical activity [OR = 0.79
European Journal of Epidemiology, 2017
The aim of this systematic review and metaanalysis was to synthesize the knowledge about the relation between intake of 12 major food groups and risk of type 2 diabetes (T2D). We conducted a systematic search in PubMed, Embase, Medline (Ovid), Cochrane Central, and Google Scholar for prospective studies investigating the association between whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSB) on risk of T2D. Summary relative risks were estimated using a random effects model by contrasting categories, and for linear and non-linear dose-response relationships. Six out of the 12 food-groups showed a significant relation with risk of T2D, three of them a decrease of risk with increasing consumption (whole grains, fruits, and dairy), and three an increase of risk with increasing consumption (red meat, processed meat, and SSB) in the linear doseresponse meta-analysis. There was evidence of a non-linear relationship between fruits, vegetables, processed meat, whole grains, and SSB and T2D risk. Optimal consumption of risk-decreasing foods resulted in a 42% reduction, and consumption of risk-increasing foods was associated with a threefold T2D risk, compared to non-consumption. The meta-evidence was graded ''low'' for legumes and nuts; ''moderate'' for refined grains, vegetables, fruit, eggs, dairy, and fish; and ''high'' for processed meat, red meat, whole grains, and SSB. Among the investigated food groups, selecting specific optimal intakes can lead to a considerable change in risk of T2D.