Dietary Patterns During Adolescence and Risk of Type 2 Diabetes Mellitus in Middle-Aged Women
- Vasanti S. Malik, SCD1⇓,
- Teresa T. Fung, SCD1,2,
- Rob M. van Dam, PHD1,3,4,5,
- Eric B. Rimm, SCD1,3,4,
- Bernard Rosner, PHD4 and
- Frank B. Hu, MD, PHD1,3,4
- 1Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
- 2Department of Nutrition, Simmons College, Boston, Massachusetts
- 3Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
- 4Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- 5Departments of Epidemiology and Public Health and Medicine, Faculty of Medicine, National University of Singapore, Singapore
- Corresponding author: Vasanti S. Malik, .
OBJECTIVE Whether dietary habits early in life can affect risk of type 2 diabetes (T2DM) in adulthood is unknown. We evaluated the relationship between dietary patterns during adolescence and risk of T2DM in midlife.
RESEARCH DESIGN AND METHODS We examined the 7-year incidence of T2DM in relation to dietary patterns during high school among 37,038 participants in the Nurses’ Health Study II cohort, who completed a food-frequency questionnaire about their diet during high school. Dietary patterns were derived by factor analysis. Cox proportional hazards regression was used to estimate relative risk (RR) and 95% CI.
RESULTS The prudent pattern, characterized by healthy foods, was not associated with risk of T2DM. The Western pattern, characterized by desserts, processed meats, and refined grains, was associated with 29% greater risk of T2DM (RR 1.29; 95% CI 1.00–1.66; P trend 0.04), after adjusting for high school and adult risk factors comparing extreme quintiles, but was attenuated after adjusting for adult weight change (1.19; 0.92–1.54). Women who had high Western pattern scores in high school and adulthood had an elevated risk of T2DM compared to women who had consistent low scores (1.82; 1.35–2.45), and this association was partly mediated by adult BMI (1.15; 0.85–1.56).
CONCLUSIONS A Western dietary pattern during adolescence may increase risk of T2DM in later-life, partly through adult weight gain. Preventive measures should be aimed at developing healthy dietary habits that begin in early-life and continue through adulthood.
- Received February 25, 2011.
- Accepted October 11, 2011.
- © 2011 by the American Diabetes Association.
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