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Eur J Nutr. 2013 Apr;52(3):1127-34. doi: 10.1007/s00394-012-0423-4. Epub 2012 Jul 28.
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.
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.
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].
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.
尽管超重是糖尿病风险的一个重要决定因素，但目前尚不清楚食物选择是否仍会影响超重人群患 2 型糖尿病的风险。本文旨在阐明饮食模式在超重和肥胖个体 2 型糖尿病发展中的作用。
我们研究了荷兰欧洲癌症与营养前瞻性调查（EPIC-NL）研究中的 20835 名超重和肥胖参与者。膳食摄入量通过验证过的食物频率问卷进行测量，使用因子分析生成饮食模式。使用医疗记录验证 2 型糖尿病的发病情况。使用 Cox 比例风险模型评估饮食模式（因子得分按四分位数分类）与 2 型糖尿病发病之间的关系。
Pattern 1 评分特征为鱼类、葡萄酒、鸡肉、生蔬菜和果汁，在调整混杂因素后与 2 型糖尿病风险无关。Pattern 2 评分较高，特征为软饮料、薯条和零食，与 2 型糖尿病风险升高相关（HR Q4 vs. Q1 (95%CI)：1.70 (1.31; 2.20)，P(trend) ≤ 0.0001），尤其是在活动量较少的个体中[活动量较少：HR Q4 vs. Q1 (95%CI)：2.14 (1.48; 3.09)，P(trend) = 0.00004，活动量较多：HR Q4 vs. Q1 (95%CI)：1.35 (0.93; 1.97)，P(trend) = 0.01；P(交互) = 0.02]。
高得分的 Pattern 饮食模式中富含软饮料、薯条和零食，而水果和蔬菜含量较低，与超重和肥胖人群 2 型糖尿病风险升高相关，尤其是在身体活动量较少的个体中。
