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Dietary patterns and risk for type 2 diabetes mellitus in U.S. men.
Authors: Van Dam RM, Rimm EB, Willett WC, Stampfer MJ, Hu FB
- Journals: Ann Intern Med
- Pages: 201-209
- Volume: 136
Background: The role of diet in the development of type 2 diabetes mellitus remains unsettled.
Objective: To examine the association between major dietary patterns and risk for type 2 diabetes mellitus. Design: Prospective cohort study. Setting: United States. Participants: 42 504 male health professionals; 40 to 75 years of age; without diagnosed diabetes; cardiovascular disease; or cancer at baseline. Measurements: Using factor analysis based on data from food frequency questionnaires; we identified and validated two major dietary patterns that we labeled Âprudent (characterized by higher consumption of vegetables; fruit; fish; poultry and whole grains) and Âwestern (characterized by higher consumption of red meat; processed meat; French fries; high-fat dairy products; refined grains; and sweets and desserts). Relative risks and 95% CIs were adjusted for potential confounders; including body mass index (BMI); physical activity; and cigarette smoking. Results: During 12 years of follow-up (466 508 person-years); we documented 1321 cases of type 2 diabetes. The prudent dietary pattern score was associated with a modestly lower risk for type 2 diabetes (relative risk for extreme quintiles; 0.84 [CI; 0.70 to 1.00]). In contrast; the western dietary pattern score was associated with an increased risk for type 2 diabetes (relative risk; 1.59 [CI; 1.32 to 1.93]; P < 0.001 for trend). A high score for the western dietary pattern combined with low physical activity (relative risk comparing extreme quintiles of dietary pattern score and physical activity; 1.96 [CI; 1.35 to 2.84]) or obesity (relative risk for BMI =30 kg/m2 vs. <25 kg/m2; 11.2 [CI; 8.07 to 15.6]) was associated with a particularly high risk for type 2 diabetes. Conclusion: Our findings suggest that a western dietary pattern is associated with a substantially increased risk for type 2 diabetes in men.
Objective: To examine the association between major dietary patterns and risk for type 2 diabetes mellitus. Design: Prospective cohort study. Setting: United States. Participants: 42 504 male health professionals; 40 to 75 years of age; without diagnosed diabetes; cardiovascular disease; or cancer at baseline. Measurements: Using factor analysis based on data from food frequency questionnaires; we identified and validated two major dietary patterns that we labeled Âprudent (characterized by higher consumption of vegetables; fruit; fish; poultry and whole grains) and Âwestern (characterized by higher consumption of red meat; processed meat; French fries; high-fat dairy products; refined grains; and sweets and desserts). Relative risks and 95% CIs were adjusted for potential confounders; including body mass index (BMI); physical activity; and cigarette smoking. Results: During 12 years of follow-up (466 508 person-years); we documented 1321 cases of type 2 diabetes. The prudent dietary pattern score was associated with a modestly lower risk for type 2 diabetes (relative risk for extreme quintiles; 0.84 [CI; 0.70 to 1.00]). In contrast; the western dietary pattern score was associated with an increased risk for type 2 diabetes (relative risk; 1.59 [CI; 1.32 to 1.93]; P < 0.001 for trend). A high score for the western dietary pattern combined with low physical activity (relative risk comparing extreme quintiles of dietary pattern score and physical activity; 1.96 [CI; 1.35 to 2.84]) or obesity (relative risk for BMI =30 kg/m2 vs. <25 kg/m2; 11.2 [CI; 8.07 to 15.6]) was associated with a particularly high risk for type 2 diabetes. Conclusion: Our findings suggest that a western dietary pattern is associated with a substantially increased risk for type 2 diabetes in men.