Table 3

Changes in the HDS and risk of type 2 diabetes in the SWHS and SMHS (1996–2015)

Changes in the HDS*
Low-lowHigh-lowMediumLow-highHigh-high
Women
 HDS, median17.024.024.524.532.0
 No. of cases/person-years329/51,274222/44,6692,003/434,031212/45,874173/48,756
 Age- and energy-adjusted1.00 (ref.)0.85 (0.74–1.00)0.79 (0.70–0.89)0.81 (0.68–0.96)0.64 (0.53–0.77)
 Multivariable-adjusted1.00 (ref.)0.92 (0.77–1.09)0.85 (0.76–0.96)0.85 (0.71–1.01)0.73 (0.60–0.88)
 Multivariable- and BMI-adjusted1.00 (ref.)0.95 (0.80–1.13)0.90 (0.80–1.02)0.90 (0.76–1.07)0.78 (0.65–0.95)
Men
 HDS, median17.024.524.024.031.5
 No. of cases/person-years158/21,996146/24,8811,056/177,000117/19,867129/30,907
 Age- and energy-adjusted1.00 (ref.)0.82 (0.66–1.03)0.83 (0.70–0.98)0.83 (0.65–1.05)0.58 (0.46–0.73)
 Multivariable-adjusted1.00 (ref.)0.90 (0.72–1.13)0.90 (0.76–1.06)0.88 (0.69–1.12)0.67 (0.52–0.85)
 Multivariable- and BMI-adjusted1.00 (ref.)0.91 (0.72–1.14)0.90 (0.76–1.07)0.89 (0.70–1.14)0.66 (0.52–0.85)
Pooled
 HDS, median17.024.024.524.532.0
 No. of cases/person-years533/83,537343/66,1233,006/597,889344/67,841320/83,863
 Age- and energy-adjusted1.00 (ref.)0.84 (0.73–0.96)0.80 (0.73–0.89)0.81 (0.71–0.94)0.61 (0.53–0.71)
 Multivariable-adjusted1.00 (ref.)0.91 (0.79–1.05)0.87 (0.79–0.96)0.86 (0.74–0.99)0.70 (0.61–0.82)
 Multivariable- and BMI-adjusted1.00 (ref.)0.93 (0.81–1.07)0.90 (0.82–1.00)0.90 (0.78–1.03)0.74 (0.63–0.85)
  • Data are HR (95% CI) unless otherwise stated. ref., reference.

  • *Low-low or high-high group was defined as staying in the lowest or highest quintile of the HDS in all dietary assessments. Low-high or high-low group was defined as the HDS changing from 1st/2nd to 4th/5th quintiles or from 4th/5th to 1st/2nd quintiles between adjacent FFQ assessments. The medium group included those who stayed in the 2nd to 4th quintile or who had small changes in the HDS (e.g., moved one quintile).

  • †Median value of the cumulative average of the HDS.

  • ‡Adjusted for the same covariates as shown in the footnote of Table 2. Results among women and men were combined using a fixed-effect meta-analysis, given that there was no significant heterogeneity by sex.