Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
Am J Clin Nutr. 2013 Aug;98(2):436-43. doi: 10.3945/ajcn.112.057521. Epub 2013 Jun 12.
Little is known about the association between eating patterns and type 2 diabetes (T2D) risk in women.
The objective was to examine prospectively associations between regular breakfast consumption, eating frequency, and T2D risk in women.
Eating pattern was assessed in 2002 in a cohort of 46,289 US women in the Nurses' Health Study who were free of T2D, cardiovascular disease, or cancer and were followed for 6 y. We used Cox proportional hazards analysis to evaluate associations with incident T2D.
We documented 1560 T2D cases during follow-up. After adjustment for known risk factors for T2D-except for body mass index (BMI), a potential mediator-women who consumed breakfast irregularly (0-6 times/wk) were at higher risk of T2D than were women who consumed breakfast daily (RR: 1.28; 95% CI: 1.14, 1.44). This association was moderately attenuated after adjustment for BMI (RR: 1.20; 95% CI: 1.07, 1.35). In comparison with women who ate 3 times/d, the RRs were 1.09 (0.84, 1.41) for women who ate 1-2 times/d, 1.13 (1.00, 1.27) for women who ate 4-5 times/d, and 0.99 (0.81, 1.21) for women who ate ≥6 times/d. Among irregular breakfast consumers, women with a higher eating frequency (≥4 times/d) had a significantly greater T2D risk (RR: 1.47; 95% CI: 1.23, 1.75) than did women who consumed breakfast daily and ate 1-3 times/d. Adjustment for BMI attenuated this association (RR: 1.24; 95% CI: 1.04, 1.48).
Irregular breakfast consumption was associated with a higher T2D risk in women, which was partially but not entirely mediated by BMI.
关于饮食模式与 2 型糖尿病（T2D）风险之间的关联，我们知之甚少。
本研究旨在前瞻性地研究女性中规律早餐摄入、进食频率与 T2D 风险之间的关联。
在一项于 2002 年开展的、针对美国护士健康研究队列中 46289 名无 T2D、心血管疾病或癌症且随访 6 年的女性中，我们评估了饮食模式。我们使用 Cox 比例风险分析评估了与新发 T2D 的相关性。
在随访期间，我们共记录到 1560 例 T2D 病例。在调整了 T2D 的已知危险因素（除了 BMI，一个潜在的中介因素）后，与每日吃早餐的女性相比，不规律吃早餐（每周 0-6 次）的女性发生 T2D 的风险更高（RR：1.28；95%CI：1.14，1.44）。调整 BMI 后，这种关联适度减弱（RR：1.20；95%CI：1.07，1.35）。与每天吃 3 次相比，每天吃 1-2 次、4-5 次和≥6 次的女性 RR 分别为 1.09（0.84，1.41）、1.13（1.00，1.27）和 0.99（0.81，1.21）。在不规律吃早餐的女性中，进食频率较高（≥4 次/d）的女性 T2D 风险显著更高（RR：1.47；95%CI：1.23，1.75），高于每日吃早餐且每天吃 1-3 次的女性。调整 BMI 后，这种关联减弱（RR：1.24；95%CI：1.04，1.48）。
不规律的早餐摄入与女性 T2D 风险升高相关，该关联部分但并非完全由 BMI 介导。
