TY - JOUR
T1 - Dietary patterns and 10-year (2002-2012) incidence of type 2 diabetes
T2 - Results from the ATTICA cohort study
AU - ATTICA Study Group
AU - Koloverou, Efi
AU - Panagiotakos, Demosthenes B.
AU - Georgousopoulou, Ekavi N.
AU - Grekas, Athanasios
AU - Christou, Aimilia
AU - Chatzigeorgiou, Michail
AU - Chrysohoou, Christina
AU - Tousoulis, Dimitrios
AU - Stefanadis, Christodoulos
AU - Pitsavos, Christos
N1 - Funding Information:
Funding: The ATTICA study was funded by research grants from the Hellenic Cardiology Society (HCS/2002), and the Hellenic Atherosclerosis Society (HAS/2004/2015). Demosthenes Panagiotakos and Ekavi Georgousopoulou received research grants from Coca-Cola SA (10.9.2013).
Publisher Copyright:
© by Lab & Life Press/SBDR.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - AIM: To identify dietary patterns among apparently healthy individuals and to determine their long-term effect on diabetes incidence. METHODS: During 2001-2002, a random sample of 3,042 men and women (18-89 years old), living in greater Athens, was randomly selected to participate in the study. During 2011-2012, the 10-year follow-up was performed in 2,583 participants (15% drop-out rate). After excluding participants with diabetes at baseline and those for whom no information on diabetes status was available at follow- up, the working sample consisted of 1,485 participants. Dietary habits were assessed by means of a validated semiquantitative, food frequency questionnaire. Factor analysis was performed to extract dietary patterns from 18 food groups. RESULTS: Diabetes diagnosis at follow-up was made in 191 participants, yielding an incidence rate of 12.9%. Six factors (i.e. dietary patterns) were identified that explained 54% of the variation in consumption. After adjusting for major confounders, and stratification by age-group, logistic regression revealed that the most healthful pattern consisted of the consumption of fruits, vegetables, legumes, bread, rusk, and pasta which reduced the 10-year diabetes risk by 40%, among participants aged 45-55 years. The association reached marginal statistical significance (95% CI: 0.34, 1.07), while no significant association was observed for the other age-groups. When the analysis was additionally adjusted for carbohydrate percentage, statistical significance was lost completely, suggesting a possibly mediating effect of this macronutrient. CONCLUSIONS: The results confirm the potentially protective effect of a plant-based dietary pattern in the primary prevention of diabetes, in particular among middle-aged people. Carbohydrate content may be a specific factor in this relationship; other micronutrients found in plant-based food groups may also play a role.
AB - AIM: To identify dietary patterns among apparently healthy individuals and to determine their long-term effect on diabetes incidence. METHODS: During 2001-2002, a random sample of 3,042 men and women (18-89 years old), living in greater Athens, was randomly selected to participate in the study. During 2011-2012, the 10-year follow-up was performed in 2,583 participants (15% drop-out rate). After excluding participants with diabetes at baseline and those for whom no information on diabetes status was available at follow- up, the working sample consisted of 1,485 participants. Dietary habits were assessed by means of a validated semiquantitative, food frequency questionnaire. Factor analysis was performed to extract dietary patterns from 18 food groups. RESULTS: Diabetes diagnosis at follow-up was made in 191 participants, yielding an incidence rate of 12.9%. Six factors (i.e. dietary patterns) were identified that explained 54% of the variation in consumption. After adjusting for major confounders, and stratification by age-group, logistic regression revealed that the most healthful pattern consisted of the consumption of fruits, vegetables, legumes, bread, rusk, and pasta which reduced the 10-year diabetes risk by 40%, among participants aged 45-55 years. The association reached marginal statistical significance (95% CI: 0.34, 1.07), while no significant association was observed for the other age-groups. When the analysis was additionally adjusted for carbohydrate percentage, statistical significance was lost completely, suggesting a possibly mediating effect of this macronutrient. CONCLUSIONS: The results confirm the potentially protective effect of a plant-based dietary pattern in the primary prevention of diabetes, in particular among middle-aged people. Carbohydrate content may be a specific factor in this relationship; other micronutrients found in plant-based food groups may also play a role.
KW - Diabetes incidence
KW - Dietary pattern
KW - Factor analysis
KW - Mediterranean diet
KW - Prediabetes
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85031043940&partnerID=8YFLogxK
U2 - 10.1900/RDS.2016.13.246
DO - 10.1900/RDS.2016.13.246
M3 - Review article
C2 - 28394951
AN - SCOPUS:85031043940
SN - 1613-6071
VL - 13
SP - 246
EP - 256
JO - Review of Diabetic Studies
JF - Review of Diabetic Studies
IS - 4
ER -