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ORIGINAL RESEARCH COMMUNICATION |
1 From the Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (MBS, KH, CW, and CH); the Division of Preventive Medicine (JEM) and the Channing Laboratory (JEM, WCW, GAC, and FBH), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Departments of Epidemiology (JEM, WCW, GAC, and FBH) and Nutrition (WCW and FBH), Harvard School of Public Health, Boston, MA; and the General Medicine Division, Massachusetts General Hospital, Boston, MA (JBM)
Background: Inflammation is considered a key mechanism leading to type 2 diabetes, but dietary exposures that lead to inflammation and diabetes are largely unknown.
Objective: Our objective was to investigate the relation between a dietary pattern associated with biomarkers of inflammation and the incidence of type 2 diabetes.
Design: We conducted a nested case-control study of 656 cases of type 2 diabetes and 694 controls among women in the Nurses' Health Study and 2 prospective cohort studies of 35 340 women in the Nurses' Health Study and 89 311 women in the Nurses' Health Study II who were followed for incident diabetes.
Results: Through the use of reduced rank regression, we identified a dietary pattern that was strongly related to inflammatory markers in the nested case-control study. This pattern, which was high in sugar-sweetened soft drinks, refined grains, diet soft drinks, and processed meat but low in wine, coffee, cruciferous vegetables, and yellow vegetables, was associated with an increased risk of diabetes (multivariate-adjusted odds ratio comparing extreme quintiles: 3.09; 95% CI: 1.99, 4.79). We identified 1517 incident cases of confirmed type 2 diabetes in the Nurses' Health Study (458 991 person-years) and 724 incident cases in the Nurses' Health Study II (701 155 person-years). After adjustment for body mass index and other potential lifestyle confounders, the relative risks comparing extreme quintiles of the pattern were 2.56 (95% CI: 2.10, 3.12; P for trend < 0.001) in the Nurses' Health Study and 2.93 (95% CI: 2.18, 3.92; P for trend < 0.001) in the Nurses' Health Study II.
Conclusion: The dietary pattern identified may increase chronic inflammation and raise the risk of developing type 2 diabetes.
Key Words: Body mass index • diet pattern • incidence • inflammation • non-insulin-dependent diabetes mellitus • type 2 diabetes • prospective studies • questionnaires • reduced rank regression • risk factors
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