Dietary patterns and the risk of type 2 diabetes in overweight and obese individuals |
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Authors: | Florianne Bauer Joline W J Beulens Daphne L van der A Cisca Wijmenga Diederick E Grobbee Annemieke M W Spijkerman Yvonne T van der Schouw N Charlotte Onland-Moret |
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Institution: | 1. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Mailbox: Str. 6.131, PO Box 85500, 3508 GA, Utrecht, The Netherlands 2. Complex Genetics Section, Department of Medical Genetics-DBG, University Medical Center Utrecht, Utrecht, The Netherlands 3. Center for Nutrition and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands 4. University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands 5. Julius Center, University of Malaya Medical Center, Kuala Lumpur, Malaysia 6. Center for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Abstract: | Purpose Although overweight is an important determinant of diabetes risk, it remains unclear whether food choices can still influence the risk for type 2 diabetes in overweight persons. In this paper, we aim to clarify the role of dietary patterns in the development of type 2 diabetes in overweight and obese individuals. Methods We studied 20,835 overweight and obese participants in the Dutch part of the European Investigation into Cancer and Nutrition (EPIC-NL) study. Dietary intake was measured using a validated food frequency questionnaire, and dietary patterns were generated using factor analysis. Incident type 2 diabetes was verified against medical records. Cox proportional hazards models were used to assess the association between the dietary patterns (factor scores categorized in quartiles) and incident type 2 diabetes. Results Scoring on Pattern 1, characterized by fish, wine, chicken, raw vegetables and fruit juices, was not associated with type 2 diabetes risk after confounder adjustment. A high score on Pattern 2, characterized by soft drinks, fries and snacks, was associated with higher risk of type 2 diabetes (HR Q4 vs. Q1 (95 % CI): 1.70 (1.31; 2.20), p trend ≤ 0.0001), particularly among less active individuals less active: HR Q4 vs. Q1 (95 % CI): 2.14 (1.48; 3.09), p trend = 0.00004, more active: HR Q4 vs. Q1 (95 % CI): 1.35 (0.93; 1.97), p trend = 0.01; p interaction = 0.02]. Conclusions A high score on a pattern high in soft drinks, fries and snacks and low in fruit and vegetables was associated with higher risk of type 2 diabetes in overweight and obese subjects especially among physically less active individuals. |
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