Dietary Inflammatory and Insulinemic Potential and Risk of Type 2 Diabetes: Results From Three Prospective U.S. Cohort Studies.

Publisher: American Diabetes Association Country of Publication: United States NLM ID: 7805975 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1935-5548 (Electronic) Linking ISSN: 01495992 NLM ISO Abbreviation: Diabetes Care Subsets: MEDLINE

Publication: Alexandria Va : American Diabetes Association
Original Publication: New York, American Diabetes Assn.

Diabetes Mellitus, Type 2/*epidemiology ; Diabetes Mellitus, Type 2/*etiology ; Diet/*adverse effects ; Food/*adverse effects ; Hyperinsulinism/*complications; Adult ; Aged ; Aged, 80 and over ; Biomarkers/blood ; C-Peptide/blood ; Female ; Follow-Up Studies ; Humans ; Incidence ; Inflammation/complications ; Male ; Middle Aged ; Nurses ; Obesity/complications ; Proportional Hazards Models ; Prospective Studies ; Risk ; Self Report ; United States/epidemiology

Objective: To examine whether proinflammatory and hyperinsulinemic diets are associated with increased risk of type 2 diabetes.
Research Design and Methods: We prospectively followed 74,767 women from the Nurses' Health Study (1984-2016), 90,786 women from the Nurses' Health Study II (1989-2017), and 39,442 men from the Health Professionals Follow-up Study (1986-2016). Using repeated measures of food-frequency questionnaires, we calculated empirical dietary inflammatory pattern (EDIP) and empirical dietary index for hyperinsulinemia (EDIH) scores, which are food-based indices that characterize dietary inflammatory or insulinemic potential based on circulating biomarkers of inflammation or C-peptide. Diagnoses of type 2 diabetes were confirmed by validated supplementary questionnaires.
Results: We documented 19,666 incident type 2 diabetes cases over 4.9 million person-years of follow-up. In the pooled multivariable-adjusted analyses, individuals in the highest EDIP or EDIH quintile had 3.11 times (95% CI 2.96-3.27) and 3.40 times (95% CI 3.23-3.58) higher type 2 diabetes risk, respectively, compared with those in the lowest quintile. Additional adjustment for BMI attenuated the associations (hazard ratio 1.95 [95% CI 1.85-2.05] for EDIP and hazard ratio 1.87 [95% CI 1.78-1.98] for EDIH), suggesting adiposity partly mediates the observed associations. Moreover, individuals in both highest EDIP and EDIH quintiles had 2.34 times higher type 2 diabetes risk (95% CI 2.17-2.52), compared with those in both lowest quintiles, after adjustment for BMI.
Conclusions: Higher dietary inflammatory and insulinemic potential were associated with increased type 2 diabetes incidence. Findings suggest that inflammation and hyperinsulinemia are potential mechanisms linking dietary patterns and type 2 diabetes development.
(© 2020 by the American Diabetes Association.)

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UM1 CA176726 United States CA NCI NIH HHS; P30 DK046200 United States DK NIDDK NIH HHS; UM1 CA186107 United States CA NCI NIH HHS; R00 CA207736 United States CA NCI NIH HHS; K99 DK122128 United States DK NIDDK NIH HHS; UM1 CA167552 United States CA NCI NIH HHS

figshare 10.2337/figshare.12739601

0 (Biomarkers)
0 (C-Peptide)

Date Created: 20200903 Date Completed: 20210520 Latest Revision: 20211102

20231215

PMC7576428

10.2337/dc20-0815

32873589