title: Association of Mediterranean diet and cardiorespiratory fitness with the development of pre-diabetes and diabetes: the Coronary Artery Risk Development in Young Adults (CARDIA) study.
abstract: OBJECTIVE
  To better understand the association between a modified Mediterranean diet pattern in young adulthood, cardiorespiratory fitness in young adulthood, and the odds of developing pre-diabetes or diabetes by middle age.
  
  
  METHODS
  Participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study who did not have pre-diabetes or diabetes at baseline (year 0 (Y0), ages 18-30) and who had data available at the Y0 and year 25 (Y25) visits were included in this analysis (n=3358). Polytomous logistic regression models were used to assess the association between baseline dietary intake and fitness data and odds of pre-diabetes or diabetes by middle age (Y25, ages 43-55).
  
  
  RESULTS
  At the Y25 visit, 1319 participants (39%) had pre-diabetes and 393 (12%) had diabetes. Higher baseline fitness was associated with lower odds of pre-diabetes and of diabetes at Y25. After adjustment for covariates, each SD increment in treadmill duration (181 s) was associated with lower odds for pre-diabetes (OR 0.85, 95% CI 0.75 to 0.95, p=0.005) and for diabetes (OR 0.71, 95% CI 0.60 to 0.85, p=0.0002) when compared to normal glycemia. A modified Mediterranean diet pattern was not associated with either pre-diabetes or diabetes. No interaction between cardiorespiratory fitness and dietary intake was observed, but baseline fitness remained independently associated with incident pre-diabetes and diabetes following adjustment for diet.
  
  
  CONCLUSIONS
  Higher cardiorespiratory fitness in young adulthood, but not a modified Mediterranean diet pattern, is associated with lower odds of pre-diabetes and of diabetes in middle age.
  
  
  BACKGROUND
  NCT00005130.
authors.affiliation: Division of Endocrinology and Diabetes, Department of Medicine , University of Minnesota , Minneapolis, Minnesota , USA.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Bantle
authors.affiliation: Division of Endocrinology and Diabetes, Department of Medicine , University of Minnesota , Minneapolis, Minnesota , USA.
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Chow
authors.affiliation: Division of Epidemiology and Community Health , School of Public Health, University of Minnesota , Minneapolis, Minnesota , USA.
authors.forename: Lyn M
authors.initials: LM
authors.lastname: Steffen
authors.affiliation: Clinical and Translational Science Institute, University of Minnesota , Minneapolis, Minnesota , USA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Division of Biostatistics , School of Public Health, University of Minnesota , Minneapolis, Minnesota , USA.
authors.forename: John
authors.initials: J
authors.lastname: Hughes
authors.affiliation: Division of Pediatrics and Adolescent Medicine, Department of Pediatrics , University of Alabama at Birmingham , Birmingham, Alabama , USA.
authors.forename: Nefertiti H
authors.initials: NH
authors.lastname: Durant
authors.affiliation: Department of Exercise Science and Sport Management , Kennesaw State University , Kennesaw, Georgia , USA.
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Ingram
authors.affiliation: Division of Cardiovascular Sciences , National Heart, Lung, and Blood Institute , Bethesda, Maryland , USA.
authors.forename: Jared P
authors.initials: JP
authors.lastname: Reis
authors.affiliation: Division of Epidemiology and Community Health , School of Public Health, University of Minnesota , Minneapolis, Minnesota , USA.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Schreiner
keywords: Adult Diabetes; Diet; Fitness; Risk Factors