Nettleton Jennifer A, Steffen Lyn M, Ni Hanyu, Liu Kiang, Jacobs David R
Division of Epidemiology and Disease Control, University of Texas Health Sciences Center, Houston, Texas, USA.
Diabetes Care. 2008 Sep;31(9):1777-82. doi: 10.2337/dc08-0760. Epub 2008 Jun 10.
We characterized dietary patterns and their relation to incident type 2 diabetes in 5,011 participants from the Multi-Ethnic Study of Atherosclerosis (MESA).
White, black, Hispanic, and Chinese adults, aged 45-84 years and free of cardiovascular disease and diabetes, completed food frequency questionnaires at baseline (2000-2002). Incident type 2 diabetes was defined at three follow-up exams (2002-2003, 2004-2005, and 2005-2007) as fasting glucose >126 mg/dl, self-reported type 2 diabetes, or use of diabetes medication. Two types of dietary patterns were studied: four empirically derived (principal components analysis) and one author-defined (low-risk food pattern) as the weighted sum of whole grains, vegetables, nuts/seeds, low-fat dairy, coffee (positively weighted), red meat, processed meat, high-fat dairy, and soda (negatively weighted).
The empirically derived dietary pattern characterized by high intake of tomatoes, beans, refined grains, high-fat dairy, and red meat was associated with an 18% greater risk (hazard ratio per 1-score SD 1.18 [95% CI 1.06-1.32]; P(trend) = 0.004), whereas the empirically derived dietary pattern characterized by high intake of whole grains, fruit, nuts/seeds, green leafy vegetables, and low-fat dairy was associated with a 15% lower diabetes risk (0.85 [0.76-0.95]; P(trend) = 0.005). The low-risk food pattern was also inversely associated with diabetes risk (0.87 [0.81-0.99]; P(trend) = 0.04). Individual component food groups were not independently associated with diabetes risk. Associations were not modified by sex or race/ethnicity.
Multiple food groups collectively influence type 2 diabetes risk beyond that of the individual food groups themselves.
我们对动脉粥样硬化多族裔研究（MESA）中5011名参与者的饮食模式及其与2型糖尿病发病的关系进行了特征描述。
年龄在45 - 84岁、无心血管疾病和糖尿病的白人、黑人、西班牙裔和中国成年人在基线期（2000 - 2002年）完成了食物频率问卷。在三次随访检查（2002 - 2003年、2004 - 2005年和2005 - 2007年）中，将空腹血糖>126 mg/dl、自我报告的2型糖尿病或使用糖尿病药物定义为2型糖尿病发病。研究了两种饮食模式：四种通过实证得出的（主成分分析）和一种作者定义的（低风险食物模式），后者是全谷物、蔬菜、坚果/种子、低脂乳制品、咖啡（正加权）、红肉、加工肉类、高脂乳制品和汽水（负加权）的加权总和。
以高摄入番茄、豆类、精制谷物、高脂乳制品和红肉为特征的实证得出的饮食模式与风险高18%相关（每1分标准差的风险比为1.18 [95%可信区间1.06 - 1.32]；P（趋势）= 0.004），而以高摄入全谷物、水果、坚果/种子、绿叶蔬菜和低脂乳制品为特征的实证得出的饮食模式与糖尿病风险低15%相关（0.85 [0.76 - 0.95]；P（趋势）= 0.005）。低风险食物模式也与糖尿病风险呈负相关（0.87 [0.81 - 0.99]；P（趋势）= 0.04）。单个成分食物组与糖尿病风险无独立关联。关联不受性别或种族/族裔的影响。
多种食物组共同影响2型糖尿病风险，其影响程度超过单个食物组本身。
