Dietary Patterns and Risk of Incident Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)
Article Figures & Tables
Tables
- Table 1—
Demographic, lifestyle, clinical, and dietary characteristics of 5,011 participants in MESA stratified by type 2 diabetes status
Free of type 2 diabetes through follow-up Type 2 diabetes diagnosed at one of three follow-up exams P n 4,598 413 Age (years) 61.7 ± 0.2 61.5 ± 0.5 0.69 Sex (% male) 47.3 49.4 0.41 Race/ethnicity (%) <0.001 White 44.4 33.2 Black 19.6 27.6 Hispanic 23.7 27.9 Chinese 12.3 11.4 High school degree (%) 85.0 79.9 0.006 Active leisure activity (MET min/week) 2,522 ± 45 2,345 ± 151 0.26 Inactive leisure activity (MET min/week) 1,664 ± 16 1,815 ± 55 0.008 Current smokers (%) 14.3 13.8 0.79 Weekly supplement use (%) 58.3 56.4 0.54 BMI (kg/m2) 27.6 ± 0.1 31.2 ± 0.3 <0.001 Waist circumference (cm) 96.1 ± 0.2 106 ± 0.7 <0.001 Systolic blood pressure (mmHg) 125 ± 0.3 130 ± 1 <0.001 LDL cholesterol 118 ± 0.5 117 ± 2 0.52 HDL cholesterol 52.1 ± 0.2 46.6 ± 0.7 <0.001 Triglycerides (mg/dl) 125 ± 1 149 ± 4 <0.001 Fasting insulin (mg/dl) 6.1 ± 0.1 9.7 ± 0.2 <0.001 Fasting glucose (mg/dl) 88.3 ± 0.1 103 ± 0.5 <0.001 Total energy intake (kcal) 1,676 ± 11 1,802 ± 38 0.001 Protein (% of total kcal) 16 ± 0.1 16 ± 0.2 0.49 Total fat (% of total kcal) 34 ± 0.1 35 ± 0.3 0.01 Saturated fat (% of total kcal) 11 ± 0.04 11 ± 0.1 0.44 Monounsaturated fat (% of total kcal) 12 ± 0.04 13 ± 0.1 0.01 Polyunsaturated fat (% of total kcal) 7.7 ± 0.03 8.0 ± 0.1 0.07 Carbohydrate (% of total kcal) 50 ± 0.1 49 ± 0.4 0.06 Fiber (g/day) 18 ± 0.1 18 ± 0.3 0.36 Whole grains (servings/day) 0.60 ± 0.01 0.54 ± 0.03 0.02 Vegetables (servings/day)* 2.3 ± 0.02 2.2 ± 0.07 0.25 Nuts/seeds (servings/day) 0.29 ± 0.01 0.25 ± 0.02 0.04 Low-fat dairy (servings/day) 0.79 ± 0.02 0.68 ± 0.05 0.07 Coffee (servings/day) 1.2 ± 0.02 1.1 ± 0.1 0.17 Red meat (servings/day) 0.38 ± 0.004 0.39 ± 0.01 0.22 Processed meat (servings/day) 0.17 ± 0.004 0.18 ± 0.01 0.34 High-fat dairy (servings/day)† 0.50 ± 0.01 0.57 ± 0.03 0.05 White potatoes (servings/day)‡ 0.20 ± 0.003 0.20 ± 0.01 0.84 Regular soda (servings/day)§ 0.40 ± 0.01 0.45 ± 0.04 0.22 -
Data are means ± SE. Except for total energy intake, dietary variables are adjusted for energy intake (kcal/day). P for difference by F test from linear regression (continuous variables) or χ2 (categorical variables).
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↵* Vegetables include green leafy vegetables, cruciferous vegetables, dark-yellow vegetables, other vegetables, and tomatoes (food groups used in the principal components analyses were combined).
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↵† High-fat dairy combines whole milk and high-fat cheese/cream sauces (food groups used in the principal components analyses were combined).
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↵‡ White potatoes include white potatoes (baked, boiled, or mashed) and fried potatoes (food groups used in the principal components analyses were combined).
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↵§ Regular soda includes nondiet soda, sweetened mineral water, and nonalcoholic beer (participant response to single question listing these three beverages).
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- Table 2—
Risk of type 2 diabetes according to two dietary patterns derived by principal components analysis and one a priori–defined low-risk food pattern in 5,011 men and women from MESA
Incident diabetes per person-years of follow-up Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5 Ptrend HR (95% CI) per 1-score SD* “Beans, tomatoes, and refined grains” 78/4,311 68/3,394 75/4,433 83/4,446 109/4,344 Model 1† 1.00 0.92 (0.66–1.28) 1.02 (0.74–1.41) 1.07 (0.77–1.48) 1.25 (0.87–1.81) 0.004 1.18 (1.06–1.32) Model 2‡ 1.00 0.92 (0.66–1.28) 1.02 (0.74–1.41) 1.06 (0.76–1.47) 1.23 (0.85–1.78) 0.004 1.18 (1.06–1.32) Model 3§ 1.00 0.99 (0.71–1.38) 1.09 (0.78–1.51) 1.09 (0.78–1.52) 1.28 (0.88–1.84) 0.003 1.19 (1.06–1.33) “Whole grains and fruit” 108/4,328 82/4,341 76/4,435 76/4,410 71/4,414 Model 1† 1.00 0.76 (0.56–1.02) 0.71 (0.52–0.97) 0.71 (0.52–0.98) 0.63 (0.45–0.89) 0.002 0.84 (0.75–0.94) Model 2‡ 1.00 0.76 (0.56–1.02) 0.73 (0.53–1.99) 0.72 (0.52–0.99) 0.66 (0.47–0.93) 0.005 0.85 (0.76–0.95) Model 3§ 1.00 0.74 (0.54–1.99) 0.76 (0.55–1.03) 0.77 (0.56–1.07) 0.73 (0.52–1.04) 0.05 0.89 (0.79–1.00) A priori, low-risk food pattern‖ 106/4,263 84/4,401 101/4,336 68/4,451 54/4,477 Model 1† 1.00 0.88 (0.65–1.20) 1.16 (0.86–1.57) 0.79 (0.57–1.10) 0.59 (0.42–0.84) 0.02 0.88 (0.80–0.98) Model 2‡ 1.00 0.93 (0.69–1.26) 1.22 (0.90–1.66) 0.83 (0.60–1.16) 0.62 (0.44–0.88) 0.04 0.87 (0.81–0.99) Model 3§ 1.00 1.00 (0.73–1.33) 1.31 (0.94–1.74) 0.92 (0.66–1.29) 0.72 (0.51–1.03) 0.18 0.93 (0.84–1.03) -
Data are n or HR (95% CI). Ptrend calculated with dietary pattern modeled as a continuous variable (score units).
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↵* For incident type 2 diabetes per 1-SD change in dietary pattern score. For the “beans, tomatoes, and refined grains” and “whole grains and fruit” dietary patterns, SD was 1.00. For the a priori, low-risk food pattern, SD was 3.8.
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↵† For incident type 2 diabetes with quintile 1 as the reference category adjusted for energy intake (kcal/day), study center (California, Minnesota, Maryland, New York, Illinois, or North Carolina), age (years), sex, and race/ethnicity (white, black, Chinese, or Hispanic).
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↵‡ For incident type 2 diabetes with quintile 1 as the reference category adjusted for the above plus education (less than a high school degree, a high school degree, and more than a high school degree), active leisure-time physical activity (MET minutes per week), inactive leisure-time physical activity (MET minutes per week), current smoking status (yes or no), smoking pack-years, and current weekly supplement use (yes or no).
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↵§ For incident type 2 diabetes with quintile 1 as the reference category adjusted for the above plus waist circumference (cm).
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↵‖ The a priori, low type 2 diabetes–risk food pattern is the sum of servings per day from 10 food groups (standardized to mean 0.00, SD 1.00). Positive (+1) weights were assigned to whole grains, fruit, vegetables, nuts/seeds, low-fat dairy, and coffee. Negative (−1) weights were assigned to red meat, processed meat, high-fat dairy, and regular soda.
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