Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
Am J Clin Nutr. 2012 May;95(5):1182-9. doi: 10.3945/ajcn.111.028209. Epub 2012 Mar 28.
Little is known about the association between eating patterns and type 2 diabetes (T2D) risk.
The objective of this study was to prospectively examine associations between breakfast omission, eating frequency, snacking, and T2D risk in men.
Eating patterns were assessed in 1992 in a cohort of 29,206 US men in the Health Professionals Follow-Up Study who were free of T2D, cardiovascular disease, and cancer and were followed for 16 y. We used Cox proportional hazards analysis to evaluate associations with incident T2D.
We documented 1944 T2D cases during follow-up. After adjustment for known risk factors for T2D, including BMI, men who skipped breakfast had 21% higher risk of T2D than did men who consumed breakfast (RR: 1.21; 95% CI: 1.07, 1.35). Compared with men who ate 3 times/d, men who ate 1-2 times/d had a higher risk of T2D (RR: 1.25; 95% CI: 1.08, 1.45). These findings persisted after stratification by BMI or diet quality. Additional snacks beyond the 3 main meals (breakfast, lunch, and dinner) were associated with increased T2D risk, but these associations were attenuated after adjustment for BMI.
Breakfast omission was associated with an increased risk of T2D in men even after adjustment for BMI. A direct association between snacking between meals and T2D risk was mediated by BMI.
关于饮食模式与 2 型糖尿病（T2D）风险之间的关系知之甚少。
本研究旨在前瞻性研究男性中不吃早餐、进食频率、吃零食与 T2D 风险之间的关系。
1992 年，在一项由 29206 名美国男性组成的队列研究中评估了饮食模式，这些男性在参加研究时无 T2D、心血管疾病和癌症，随访时间为 16 年。我们使用 Cox 比例风险分析评估与新发 T2D 的相关性。
在随访期间，我们记录了 1944 例 T2D 病例。在校正了 T2D 的已知危险因素（包括 BMI）后，与吃早餐的男性相比，不吃早餐的男性发生 T2D 的风险高 21%（RR：1.21；95%CI：1.07，1.35）。与每天进食 3 次的男性相比，每天进食 1-2 次的男性发生 T2D 的风险更高（RR：1.25；95%CI：1.08，1.45）。这些发现在按 BMI 或饮食质量分层后仍然存在。除了 3 顿主要餐（早餐、午餐和晚餐）之外，额外的零食与 T2D 风险增加有关，但这些关联在调整 BMI 后减弱。
即使在校正 BMI 后，男性不吃早餐与 T2D 风险增加相关。两餐之间吃零食与 T2D 风险之间的直接关联是通过 BMI 介导的。
