Dietary patterns and risk of incident type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA).
OBJECTIVE
We characterized dietary patterns and their relation to incident type 2 diabetes in 5,011 participants from the Multi-Ethnic Study of Atherosclerosis (MESA).


METHODS
White, black, Hispanic, and Chinese adults, aged 45-84 years and free of cardiovascular disease and diabetes, completed food frequency questionnaires at baseline (2000-2002). Incident type 2 diabetes was defined at three follow-up exams (2002-2003, 2004-2005, and 2005-2007) as fasting glucose >126 mg/dl, self-reported type 2 diabetes, or use of diabetes medication. Two types of dietary patterns were studied: four empirically derived (principal components analysis) and one author-defined (low-risk food pattern) as the weighted sum of whole grains, vegetables, nuts/seeds, low-fat dairy, coffee (positively weighted), red meat, processed meat, high-fat dairy, and soda (negatively weighted).


RESULTS
The empirically derived dietary pattern characterized by high intake of tomatoes, beans, refined grains, high-fat dairy, and red meat was associated with an 18% greater risk (hazard ratio per 1-score SD 1.18 [95% CI 1.06-1.32]; P(trend) = 0.004), whereas the empirically derived dietary pattern characterized by high intake of whole grains, fruit, nuts/seeds, green leafy vegetables, and low-fat dairy was associated with a 15% lower diabetes risk (0.85 [0.76-0.95]; P(trend) = 0.005). The low-risk food pattern was also inversely associated with diabetes risk (0.87 [0.81-0.99]; P(trend) = 0.04). Individual component food groups were not independently associated with diabetes risk. Associations were not modified by sex or race/ethnicity.


CONCLUSIONS
Multiple food groups collectively influence type 2 diabetes risk beyond that of the individual food groups themselves.
Division of Epidemiology and Disease Control, University of Texas Health Sciences Center, Houston, Texas, USA. jennifer.a.nettleton@uth.tmc.edu
Jennifer A
JA
Nettleton
Lyn M
LM
Steffen
Hanyu
H
Ni
Kiang
K
Liu
David R
DR
Jacobs
D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D050197:Atherosclerosis / Q000150:complications*; D044383:Black People; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology; D018450:Disease Progression; D005006:Ethnicity; D005247:Feeding Behavior / Q000145:classification*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D044465:White People