Eating patterns and type 2 diabetes risk in older women: breakfast consumption and eating frequency

• Published in: The American journal of clinical nutrition Vol. 98; no. 2; pp. 436 - 443
• Main Authors: Mekary, Rania A, Giovannucci, Edward, Cahill, Leah, Willett, Walter C, van Dam, Rob M, Hu, Frank B
• Format: Journal Article
• Language: English
• Published: Bethesda, MD American Society for Clinical Nutrition 01.08.2013; American Society for Nutrition; American Society for Clinical Nutrition, Inc
• Subjects: Adult; Biological and medical sciences; Blood Glucose - analysis; Body Mass Index; Breakfast; Breakfast foods; cardiovascular diseases; clinical nutrition; Correlation analysis; Diabetes; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; Dietary Fiber - administration & dosage; eating habits; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding Behavior; Feeding. Feeding behavior; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; hazard characterization; Humans; ingestion; Medical sciences; Middle Aged; noninsulin-dependent diabetes mellitus; nurses; Nutrition Assessment; Older people; Proportional Hazards Models; Prospective Studies; risk; Risk assessment; Risk Factors; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Women; United States; Endocrinopathy; Type 2 diabetes; Human; Breakfast; Nutrition; Diet; Food intake; Risk factor; Metabolic diseases; Female; Risk; Feeding
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.112.057521

Background: Little is known about the association between eating patterns and type 2 diabetes (T2D) risk in women.Objective: The objective was to examine prospectively associations between regular breakfast consumption, eating frequency, and T2D risk in women.Design: Eating pattern was assessed in 2002 in a cohort of 46,289 US women in the Nurses’ Health Study who were free of T2D, cardiovascular disease, or cancer and were followed for 6 y. We used Cox proportional hazards analysis to evaluate associations with incident T2D.Results: We documented 1560 T2D cases during follow-up. After adjustment for known risk factors for T2D—except for body mass index (BMI), a potential mediator—women who consumed breakfast irregularly (0–6 times/wk) were at higher risk of T2D than were women who consumed breakfast daily (RR: 1.28; 95% CI: 1.14, 1.44). This association was moderately attenuated after adjustment for BMI (RR: 1.20; 95% CI: 1.07, 1.35). In comparison with women who ate 3 times/d, the RRs were 1.09 (0.84, 1.41) for women who ate 1–2 times/d, 1.13 (1.00, 1.27) for women who ate 4–5 times/d, and 0.99 (0.81, 1.21) for women who ate ≥6 times/d. Among irregular breakfast consumers, women with a higher eating frequency (≥4 times/d) had a significantly greater T2D risk (RR: 1.47; 95% CI: 1.23, 1.75) than did women who consumed breakfast daily and ate 1–3 times/d. Adjustment for BMI attenuated this association (RR: 1.24; 95% CI: 1.04, 1.48).Conclusion: Irregular breakfast consumption was associated with a higher T2D risk in women, which was partially but not entirely mediated by BMI.