title: Consumption of restaurant foods and incidence of type 2 diabetes in African American women.
abstract: BACKGROUND
  Type 2 diabetes is a major problem in Western nations. Profound secular changes in the food environment and eating habits may play a role. In particular, consumption of foods prepared outside the home has greatly increased.
  
  
  OBJECTIVE
  We investigated the relation of restaurant meal consumption to incidence of type 2 diabetes among African American women with the use of data from the prospective Black Women's Health Study.
  
  
  METHODS
  The participants have completed mailed follow-up questionnaires every 2 y since 1995, including food-frequency questionnaires that asked about the frequency of eating restaurant meals of various types. Cox proportional hazards models were used to calculate incidence rate ratios and 95% CIs for the association of type 2 diabetes incidence with various categories of consumption of each restaurant food relative to the lowest category, with adjustment for diabetes risk factors.
  
  
  RESULTS
  Among 44,072 participants aged 30-69 y and free of diabetes at baseline, 2873 incident cases of type 2 diabetes occurred during 10 y of follow-up. Consumption of restaurant meals of hamburgers, fried chicken, fried fish, and Chinese food were independently associated with an increased risk of type 2 diabetes. Incidence rate ratios for > or = 2 such meals per week relative to none were 1.40 (95% CI: 1.14, 1.73) for hamburgers and 1.68 (95% CI: 1.36, 2.08) for fried chicken. Control for body mass index greatly reduced the estimates, which suggests that the associations are mediated through weight gain and obesity.
  
  
  CONCLUSIONS
  The present study has identified a risk factor for type 2 diabetes that may be readily modifiable by dietary changes.
authors.affiliation: Slone Epidemiology Center, Boston University, 1010 Commonwealth Avenue, Boston, MA 02215, USA.
authors.forename: Supriya
authors.initials: S
authors.lastname: Krishnan
authors.forename: Patricia F
authors.initials: PF
authors.lastname: Coogan
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Boggs
authors.forename: Lynn
authors.initials: L
authors.lastname: Rosenberg
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology*; D004435:Eating / Q000208:ethnology / Q000502:physiology; D005247:Feeding Behavior / Q000208:ethnology / Q000502:physiology; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012147:Restaurants; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology