A Prospective Study of Overall Diet Quality and Risk of Type 2 Diabetes in Women

  1. Teresa T. Fung, SCD12,
  2. Marjorie McCullough, SCD3,
  3. Rob M. van Dam, PHD2 and
  4. Frank B. Hu, MD, PHD45
  1. 1Department of Nutrition, Simmons College, Boston, Massachusetts
  2. 2Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
  3. 3Epidemiology and Surveillance Research, American Cancer Society, Atlanta, Georgia
  4. 4Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts
  5. 5Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
  1. Address correspondence and reprint requests to Teresa Fung, Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA 02115. E-mail: fung{at}simmons.edu

Abstract

OBJECTIVE— The aim of this article was to assess the association between the Alternate Healthy Eating Index (AHEI) and risk of type 2 diabetes in women.

RESEARCH DESIGN AND METHODS— A total of 80,029 women aged 38–63 years 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 (RRs) 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 had a lower risk (RR comparing top to bottom score quintile 0.64 [95% CI 0.58–0.71], Ptrend < 0.0001) for diabetes. Women with consistently high AHEI scores throughout follow-up, compared with those with consistently low scores, had the lowest risk for diabetes. In addition, women whose AHEI scores improved during follow-up, even during recent years, had a lower risk of diabetes than did women whose (low) score did not change.

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

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 11 April 2007. DOI: 10.2337/dc06-2581.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted March 29, 2007.
    • Received December 20, 2006.
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  1. Published online before print April 11, 2007, doi: 10.2337/dc06-2581 Diabetes Care July 2007 vol. 30 no. 7 1753-1757
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