TY - JOUR
T1 - Associations Between Dietary Patterns and Incident Type 2 Diabetes
T2 - Prospective Cohort Study of 120,343 UK Biobank Participants
AU - Gao, Min
AU - Jebb, Susan A.
AU - Aveyard, Paul
AU - Ambrosini, Gina L.
AU - Perez-Cornago, Aurora
AU - Papier, Keren
AU - Carter, Jennifer
AU - Piernas, Carmen
N1 - Funding Information:
Acknowledgments. This research was con ducted using the UK Biobank resource under application number 14990. Funding. C.P. received a British Nutrition Foundation pump-priming award that paid for the access to the data. S.A.J. and C.P. are funded by the Oxford and Thames Valley National Institute of Health Research (NIHR) Applied Research Centre. S.A.J. and P.A. are NIHR senior investigators. S.A.J. and J.C. are funded by NIHR Oxford Biomedical Research Centre. J.C. is supported by core grants to Clinical Trial Service Unit from the Medical Research Council and the British Heart Foundation (grant CH/1996001/9454).
Funding Information:
C.P. received a British Nutrition Foundation pump-priming award that paid for the access to the data. S.A.J. and C.P. are funded by the Oxford and Thames Valley National Institute of Health Research (NIHR) Applied Research Centre. S.A.J. and P.A. are NIHR senior investigators. S.A.J. and J.C. are funded by NIHR Oxford Biomedical Research Centre. J.C. is supported by core grants to Clinical Trial Service Unit from the Medical Research Council and the British Heart Foundation (grant CH/1996001/9454). The funders had no role in designing the study, the analysis, or the decision to submit the paper. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2022 by the American Diabetes Association.
PY - 2022/6
Y1 - 2022/6
N2 - OBJECTIVE To identify dietary patterns (DPs) characterized by a set of nutrients of concern and their association with incident type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS A total of 120,343 participants from the U.K. Biobank study with at least two 24 h dietary assessments were studied. Reduced rank regression was used to derive DPs explaining variability in energy density, free sugars, saturated fat, and fiber intakes. We investigated prospective associations with T2D using Cox propor-tional hazard models. RESULTS Over 8.4 years of follow-up from the latest dietary assessment, 2,878 participants developed T2D. Two DPs were identified that jointly explained a total of 63% var-iation in four nutrients. DP1 was characterized by high intakes of chocolate and confectionery, butter, low-fiber bread, and sugars and preserves, and low intakes of fruits and vegetables. DP1 was linearly associated with T2D in multivariable models without BMI adjustment (per z score, hazard ratio [HR] 1.11 [95% CI 1.08–1.14]) and after BMI adjustment (HR 1.09 [95% CI 1.06–1.12]). DP2 was characterized by high intakes of sugar-sweetened beverages, fruit juice, table sugars and preserves, and low intakes of high-fat cheese and butter, but showed no clear association with T2D. There were significant interactions between both DPs and age, with increased risks among younger people in DP1 (HR 1.13 [95% CI 1.09–1.18]) and DP2 (HR 1.10 [95% CI 1.05–1.15]), as well as with DP1 and BMI, with increased risks among people with obesity (HR 1.11 [95% CI 1.07–1.16]). CONCLUSIONS A DP characterized by high intakes of chocolate and confectionery, butter, low-fiber bread, and added sugars, and low in fresh fruits and vegetables intake is associated with a higher incidence of T2D, particularly among younger people and those with obesity.
AB - OBJECTIVE To identify dietary patterns (DPs) characterized by a set of nutrients of concern and their association with incident type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS A total of 120,343 participants from the U.K. Biobank study with at least two 24 h dietary assessments were studied. Reduced rank regression was used to derive DPs explaining variability in energy density, free sugars, saturated fat, and fiber intakes. We investigated prospective associations with T2D using Cox propor-tional hazard models. RESULTS Over 8.4 years of follow-up from the latest dietary assessment, 2,878 participants developed T2D. Two DPs were identified that jointly explained a total of 63% var-iation in four nutrients. DP1 was characterized by high intakes of chocolate and confectionery, butter, low-fiber bread, and sugars and preserves, and low intakes of fruits and vegetables. DP1 was linearly associated with T2D in multivariable models without BMI adjustment (per z score, hazard ratio [HR] 1.11 [95% CI 1.08–1.14]) and after BMI adjustment (HR 1.09 [95% CI 1.06–1.12]). DP2 was characterized by high intakes of sugar-sweetened beverages, fruit juice, table sugars and preserves, and low intakes of high-fat cheese and butter, but showed no clear association with T2D. There were significant interactions between both DPs and age, with increased risks among younger people in DP1 (HR 1.13 [95% CI 1.09–1.18]) and DP2 (HR 1.10 [95% CI 1.05–1.15]), as well as with DP1 and BMI, with increased risks among people with obesity (HR 1.11 [95% CI 1.07–1.16]). CONCLUSIONS A DP characterized by high intakes of chocolate and confectionery, butter, low-fiber bread, and added sugars, and low in fresh fruits and vegetables intake is associated with a higher incidence of T2D, particularly among younger people and those with obesity.
UR - http://www.scopus.com/inward/record.url?scp=85131270536&partnerID=8YFLogxK
U2 - 10.2337/dc21-2258
DO - 10.2337/dc21-2258
M3 - Article
C2 - 35299247
AN - SCOPUS:85131270536
SN - 0149-5992
VL - 45
SP - 1315
EP - 1325
JO - Diabetes Care
JF - Diabetes Care
IS - 6
ER -
