title: A high-fat, high-glycaemic index, low-fibre dietary pattern is prospectively associated with type 2 diabetes in a British birth cohort.
abstract: The combined association of dietary fat, glycaemic index (GI) and fibre with type 2 diabetes has rarely been investigated. The objective was to examine the relationship between a high-fat, high-GI, low-fibre dietary pattern across adult life and type 2 diabetes risk using reduced rank regression. Data were from the MRC National Survey of Health and Development. Repeated measures of dietary intake estimated using 5-d diet diaries were available at the age of 36, 43 and 53 years for 1180 study members. Associations between dietary pattern scores at each age, as well as longitudinal changes in dietary pattern z-scores, and type 2 diabetes incidence (n 106) from 53 to 60-64 years were analysed. The high-fat, high-GI, low-fibre dietary pattern was characterised by low intakes of fruit, vegetables, low-fat dairy products and whole-grain cereals, and high intakes of white bread, fried potatoes, processed meat and animal fats. There was an increasing trend in OR for type 2 diabetes with increasing quintile of dietary pattern z-scores at the age of 43 years among women but not among men. Women in the highest z-score quintile at the age of 43 years had an OR for type 2 diabetes of 5·45 (95 % CI 2·01, 14·79). Long-term increases in this dietary pattern, independently of BMI and waist circumference, were also detrimental among women: for each 1 sd unit increase in dietary pattern z-score between 36 and 53 years, the OR for type 2 diabetes was 1·67 (95 % CI 1·20, 2·43) independently of changes in BMI and waist circumference in the same periods. A high-fat, high-GI, low-fibre dietary pattern was associated with increased type 2 diabetes risk in middle-aged British women but not in men.
authors.affiliation: 1MRC Unit for Lifelong Health and Ageing,University College London,London WC1B 5JU,UK.
authors.forename: Silvia
authors.initials: S
authors.lastname: Pastorino
authors.affiliation: 1MRC Unit for Lifelong Health and Ageing,University College London,London WC1B 5JU,UK.
authors.forename: Marcus
authors.initials: M
authors.lastname: Richards
authors.affiliation: 1MRC Unit for Lifelong Health and Ageing,University College London,London WC1B 5JU,UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Pierce
authors.affiliation: 2School of Population Health,University of Western Australia,Perth, WA 6009,Australia.
authors.forename: Gina L
authors.initials: GL
authors.lastname: Ambrosini
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D004032:Diet / Q000009:adverse effects*; D059305:Diet, High-Fat / Q000009:adverse effects; D066273:Diet, Western / Q000009:adverse effects; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D005260:Female; D038321:Glycemic Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D006113:United Kingdom
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber
keywords: Dietary fibre; Dietary patterns; EER estimated energy requirement; EI energy intake; GI glycaemic index; Glycaemic index; NSHD National Survey of Health and Development; RRR reduced rank regression; Type 2 diabetes; WC waist circumference