Dietary patterns and the risk of type 2 diabetes in overweight and obese individuals

• Published in: European journal of nutrition Vol. 52; no. 3; pp. 1127 - 1134
• Main Authors: Bauer, Florianne, Beulens, Joline W. J., van der A, Daphne L., Wijmenga, Cisca, Grobbee, Diederick E., Spijkerman, Annemieke M. W., van der Schouw, Yvonne T., Onland-Moret, N. Charlotte
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.04.2013; Springer Nature B.V
• Subjects: Aged; Body Mass Index; Carbonated Beverages - adverse effects; Chemistry; Chemistry and Materials Science; Cohort Studies; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - etiology; Diet - adverse effects; Fast Foods - adverse effects; Female; Follow-Up Studies; Humans; Male; Middle Aged; Netherlands - epidemiology; Nutrition; Obesity - physiopathology; Original Contribution; Overweight - physiopathology; Proportional Hazards Models; Prospective Studies; Risk Factors; Sedentary Lifestyle; Snacks; Netherlands; Type 2 diabetes; Obesity; Epidemiology; Dietary pattern
• ISSN: 1436-6207; 1436-6215
• DOI: 10.1007/s00394-012-0423-4

Purpose Although overweight is an important determinant of diabetes risk, it remains unclear whether food choices can still influence the risk for type 2 diabetes in overweight persons. In this paper, we aim to clarify the role of dietary patterns in the development of type 2 diabetes in overweight and obese individuals. Methods We studied 20,835 overweight and obese participants in the Dutch part of the European Investigation into Cancer and Nutrition (EPIC-NL) study. Dietary intake was measured using a validated food frequency questionnaire, and dietary patterns were generated using factor analysis. Incident type 2 diabetes was verified against medical records. Cox proportional hazards models were used to assess the association between the dietary patterns (factor scores categorized in quartiles) and incident type 2 diabetes. Results Scoring on Pattern 1, characterized by fish, wine, chicken, raw vegetables and fruit juices, was not associated with type 2 diabetes risk after confounder adjustment. A high score on Pattern 2, characterized by soft drinks, fries and snacks, was associated with higher risk of type 2 diabetes (HR Q4 vs. Q1 (95 % CI): 1.70 (1.31; 2.20), p trend  ≤ 0.0001), particularly among less active individuals [less active: HR Q4 vs. Q1 (95 % CI): 2.14 (1.48; 3.09), p trend  = 0.00004, more active: HR Q4 vs. Q1 (95 % CI): 1.35 (0.93; 1.97), p trend  = 0.01; p interaction  = 0.02]. Conclusions A high score on a pattern high in soft drinks, fries and snacks and low in fruit and vegetables was associated with higher risk of type 2 diabetes in overweight and obese subjects especially among physically less active individuals.