Table 4—

RR of type 2 diabetes according to quintiles of nutrient intake in the WHS

Quintile of intake
1 (lowest)2345 (highest)P for trend
Saturated fat
    Median intake (g/day)13.817.119.421.825.8
    Cases/person-years231/65,587268/65,503301/65,758337/65,285421/64,743
    Age, energy adjusted1.001.17 (0.98–1.39)1.31 (1.10–1.55)1.48 (1.26–1.76)1.90 (1.62–2.23)<0.0001
    Multivariate model 1*1.000.96 (0.80–1.14)1.04 (0.87–1.24)1.01 (0.85–1.20)1.10 (0.93–1.31)0.14
    Multivariate model 21.000.95 (0.76–1.18)0.94 (0.73–1.21)0.85 (0.64–1.13)0.89 (0.66–1.21)0.49
Monounsaturated fat
    Median intake (g/day)15.118.921.424.027.9
    Cases/person-years242/65,355242/65,631305/65,635343/65,275426/64,980
    Age, energy adjusted1.000.99 (0.83–1.18)1.25 (1.06–1.48)1.41 (1.20–1.67)1.79 (1.52–2.09)<0.0001
    Multivariate model 1*1.000.91 (0.76–1.09)1.06 (0.89–1.26)1.10 (0.93–1.30)1.14 (0.97–1.35)0.02
    Multivariate model 21.001.01 (0.77–1.32)1.11 (0.80–1.55)1.17 (0.81–1.70)1.27 (0.85–1.91)0.20
n-3 polyunsaturated fat§
    Median intake (g/day)0.951.171.341.541.88
    Cases/person-years283/66,108299/63,856301/66,863322/63,488353/66,562
    Age, energy adjusted1.001.08 (0.92–1.27)1.03 (0.88–1.21)1.16 (0.99–1.36)1.21 (1.04–1.42)0.009
    Multivariate model 1*1.001.08 (0.92–1.28)1.04 (0.88–1.23)1.11 (0.95–1.31)1.09 (0.93–1.28)0.28
    Multivariate model 21.001.09 (0.92–1.29)1.06 (0.89–1.25)1.13 (0.96–1.34)1.10 (0.93–1.30)0.30
n-6 polyunsaturated fat
    Median intake (g/day)7.359.1210.512.014.5
    Cases/person-years260/64,953302/65,430315/65,293331/65,409350/65,791
    Age, energy adjusted1.001.14 (0.97–1.35)1.19 (1.01–1.40)1.24 (1.06–1.46)1.31 (1.12–1.54)0.001
    Multivariate model 1*1.001.06 (0.90–1.26)1.12 (0.95–1.32)1.09 (0.92–1.28)1.03 (0.87–1.21)0.90
    Multivariate model 21.001.06 (0.89–1.26)1.09 (0.91–1.31)1.04 (0.86–1.25)0.95 (0.78–1.16)0.39
trans fatty acid
    Median intake (g/day)1.121.642.092.653.66
    Cases/person-years226/65,788294/64,637306/65,305347/66,054385/65,093
    Age, energy adjusted1.001.34 (1.13–1.59)1.38 (1.16–1.63)1.54 (1.31–1.83)1.76 (1.49–2.08)<0.001
    Multivariate model 1*1.001.21 (1.01–1.44)1.13 (0.95–1.35)1.15 (0.96–1.37)1.14 (0.96–1.35)0.47
    Multivariate model 21.001.21 (1.00–1.46)1.09 (0.89–1.33)1.07 (0.87–1.32)1.03 (0.83–1.28)0.44
Cholesterol
    Median intake (mg/day)147188219253309
    Cases/person-years219/65,594258/65,688303/65,546333/65,315445/64,733
    Age, energy adjusted1.001.19 (0.99–1.42)1.39 (1.17–1.66)1.54 (1.30–1.83)2.13 (1.81–2.51)<0.0001
    Multivariate model 1*1.001.06 (0.89–1.28)1.18 (0.99–1.41)1.13 (0.95–1.34)1.33 (1.12–1.57)0.001
    Multivariate model 21.001.09 (0.90–1.31)1.21 (1.00–1.47)1.15 (0.95–1.40)1.35 (1.11–1.64)0.003
Animal fat
    Median intake (g/day)19.726.030.435.243.1
    Cases/person-years238/65,645237/65,740304/65,547346/65,228433/64,715
    Age, energy adjusted1.001.00 (0.84–1.20)1.30 (1.10–1.54)1.49 (1.27–1.76)1.90 (1.62–2.23)<0.0001
    Multivariate model 1*1.000.93 (0.77–1.11)1.03 (0.87–1.23)1.08 (0.91–1.28)1.17 (0.99–1.38)0.01
    Multivariate model 21.000.94 (0.78–1.15)1.05 (0.86–1.29)1.08 (0.87–1.34)1.13 (0.90–1.43)0.16
Vegetable fat
    Median intake (g/day)16.922.025.930.237.3
    Cases/person-years286/64,927294/65,311326/65,460317/65,535335/65,644
    Age, energy adjusted1.001.01 (0.86–1.19)1.12 (0.95–1.31)1.08 (0.92–1.27)1.14 (0.98–1.34)0.07
    Multivariate model 1*1.000.97 (0.83–1.15)1.10 (0.94–1.30)1.04 (0.89–1.23)0.94 (0.80–1.11)0.59
    Multivariate model 21.000.98 (0.82–1.16)1.08 (0.90–1.28)0.98 (0.81–1.18)0.85 (0.70–1.03)0.08
Animal protein
    Median intake (g/day)39.850.557.865.377.3
    Cases/person-years233/65,541290/65,512306/65,415352/65,274377/65,133
    Age, energy adjusted1.001.25 (1.05–1.48)1.33 (1.12–1.58)1.55 (1.31–1.83)1.70 (1.44–2.00)<0.0001
    Multivariate model 1*1.001.19 (1.00–1.42)1.24 (1.04–1.48)1.34 (1.13–1.59)1.27 (1.08–1.51)0.004
    Multivariate model 21.001.24 (1.03–1.48)1.33 (1.10–1.60)1.48 (1.21–1.79)1.44 (1.16–1.78)0.001
Vegetable protein
    Median intake (g/day)17.120.222.524.929.2
    Cases/person-years393/64,754284/65,550320/65,746314/65,403247/65,423
    Age, energy adjusted1.000.70 (0.60–0.82)0.79 (0.68–0.92)0.77 (0.66–0.89)0.61 (0.52–0.71)<0.0001
    Multivariate model 1*1.000.80 (0.68–0.93)0.95 (0.82–1.11)0.92 (0.79–1.07)0.82 (0.69–0.97)0.10
    Multivariate model 21.000.84 (0.71–0.99)1.03 (0.86–1.23)1.01 (0.83–1.23)0.91 (0.73–1.14)0.83
Heme iron
    Median intake (mg/day)0.590.841.021.221.55
    Cases/person-years216/65,859265/63,533290/67,652349/65,284438/64,548
    Age, energy adjusted1.001.29 (1.07–1.54)1.33 (1.12–1.59)1.67 (1.41–1.98)2.17 (1.84–2.55)<0.0001
    Multivariate model 1*1.001.18 (0.98–1.42)1.13 (0.95–1.36)1.30 (1.09–1.55)1.41 (1.19–1.67)<0.0001
    Multivariate model 21.001.20 (1.00–1.45)1.17 (0.97–1.41)1.35 (1.12–1.63)1.46 (1.20–1.78)<0.0001
Total iron
    Median intake (mg/day)10.011.813.718.033.8
    Cases/person-years304/65,405365/65,431353/65,076267/65,450269/65,514
    Age, energy adjusted1.001.17 (1.00–1.36)1.11 (0.95–1.30)0.83 (0.70–0.98)0.86 (0.73–1.02)0.001
    Multivariate model 1*1.001.18 (1.01–1.38)1.14 (0.97–1.34)0.99 (0.83–1.17)1.03 (0.87–1.22)0.37
    Multivariate model 21.001.24 (1.05–1.45)1.23 (1.04–1.46)1.09 (0.90–1.31)1.13 (0.93–1.37)0.94
  • Data are RR (95% CI).

  • *

    * Multivariate model 1: adjusted for age (continuous), BMI (continuous), total energy intake (quintiles), smoking (current, past, and never), exercise (rarely/never, <1 time/week, 1–3 times/week, and ≥4 times/week), alcohol use (rarely/never, 1–3 drinks/month, 1–6 drinks/week, and ≥1 drink/day), and family history of diabetes (yes/no).

  • Multivariate model 2: model 1 with additional adjustment for dietary intakes of fiber intake (quintiles), glycemic load (quintiles), magnesium (quintiles), and total fat (quintiles).

  • n-3 polyunsaturated fat included 18:3, 20:5, 22:5, and 22:6 while n-6 fat included 18:2 and 20:4 fatty acids.