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A prospective study of overall diet quality and risk of type 2 diabetes in women

¹Department of Nutrition, Simmons College, Boston, MA
²Department of Nutrition, Harvard School of Public Health, Boston, MA
³Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA
⁴Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA
⁵Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA

ABSTRACT

Objectives:To assess the association between the Alternate Healthy Eating Index (AHEI) and risk of type 2 diabetes in women.

Research design and methods:80,029 women aged 38-63 in the Nurses' Health Study were followed from 1984 to 2002. The AHEI score was computed from dietary information collected from five repeated food frequency questionnaires administered between 1984 and 1998. Relative risks for type 2 diabetes were calculated using Cox proportional hazards models and adjusted for known diabetes risk factors. We also examined how changes in score in 4, 6-8, and 10--12 years are associated with diabetes risk.

Results:We ascertained 5,183 incident cases of type 2 diabetes during 18 years of follow-up. Women who scored high on the AHEI were at lower risk (relative risk comparing top to bottom score quintile=0.64 (95%CI=0.58-0.71, p trend <0.0001) for diabetes. Women with consistently high AHEI scores throughout follow-up, compared with those with consistently low scores, were at the lowest risk for diabetes. In addition, women whose AHEI scores improved during follow-up, even during recent years, were at lower risk of diabetes than were women whose (low) score did not change.

Conclusions:A higher AHEI score is associated with lower risk of type 2 diabetes in women. Therefore, the AHEI score maybe a useful clinical tool to assess diet quality and to recommend for the prevention of diabetes.

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