Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA.
Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA.
Diabetes Care. 2024 Sep 1;47(9):1673-1681. doi: 10.2337/dc24-0564.
To evaluate the association between meal timing and type 2 diabetes risk in U.S. Hispanic/Latino adults.
The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multicenter, community-based, prospective cohort study. This study included 8,868 HCHS/SOL adults without diabetes at baseline (2008-2011) and attending the visit 2 examination (2014-2017). Energy intake and glycemic load (GL) in each meal timing were assessed at baseline using two 24-h dietary recalls. Incident diabetes was identified through annual follow-up calls or at visit 2. Hazard ratios (HRs) for incident diabetes were estimated using Cox models, accounting for the complex survey design.
The study population (50.9% female) had a baseline mean age of 39.0 (95% CI, 38.4-39.5) years. Over a median (range) follow-up of 5.8 (0.8-9.6) years, 1,262 incident diabetes cases were documented. Greater energy intake and GL in late morning (9:00-11:59 a.m.) were associated with a lower diabetes risk, whereas greater energy intake and GL in other meal timings were not. After accounting for diet quantity and quality, sociodemographic characteristics, lifestyle factors, and chronic conditions, the HRs were 0.94 (95% CI, 0.91-0.97) per 100-kcal energy intake increment and 0.93 (0.89-0.97) per 10-unit GL increment in late morning. Replacing energy intake or GL from early morning (6:00-8:59 a.m.), afternoon (12:00-5:59 p.m.), or evening (6:00-11:59 p.m.) with late-morning equivalents was associated with a comparably lower diabetes risk.
This study identified late morning as a favorable meal timing in Hispanic/Latino adults, providing a novel perspective on type 2 diabetes prevention that warrants confirmation.
评估美国西班牙裔/拉丁裔成年人的进餐时间与 2 型糖尿病风险之间的关联。
西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）是一项多中心、社区为基础、前瞻性队列研究。这项研究纳入了 8868 名基线时无糖尿病（2008-2011 年）且参加访视 2 检查（2014-2017 年）的 HCHS/SOL 成年人。使用两次 24 小时膳食回忆法，在基线时评估每种进餐时间的能量摄入和血糖负荷（GL）。通过年度随访或访视 2 确定新发糖尿病。使用 Cox 模型估计新发糖尿病的风险比（HRs），并考虑到复杂的调查设计。
研究人群（50.9%为女性）的基线平均年龄为 39.0 岁（95%CI，38.4-39.5）。在中位（范围）随访 5.8 年（0.8-9.6 年）期间，记录到 1262 例新发糖尿病病例。上午晚些时候（9：00-11：59）的能量摄入和 GL 较高与较低的糖尿病风险相关，而其他进餐时间的能量摄入和 GL 较高则与较低的糖尿病风险无关。在考虑饮食数量和质量、社会人口统计学特征、生活方式因素和慢性疾病后，上午晚些时候每增加 100 千卡能量摄入的 HR 为 0.94（95%CI，0.91-0.97），每增加 10 个单位 GL 的 HR 为 0.93（0.89-0.97）。用上午晚些时候的能量摄入或 GL 替代清晨（6：00-8：59）、下午（12：00-5：59）或晚上（6：00-11：59）的能量摄入或 GL 与糖尿病风险的降低程度相当。
本研究确定上午晚些时候是西班牙裔/拉丁裔成年人的一个有利进餐时间，为 2 型糖尿病预防提供了新的视角，值得进一步确认。
