Changes in Overall Diet Quality and Subsequent Type 2 Diabetes Risk: Three US Prospective Cohorts
Changes in Overall Diet Quality and Subsequent Type 2 Diabetes Risk: Three US Prospective Cohorts
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DOI：
10.2337/dc16-0574
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发表时间：
2016-11-01
期刊：
影响因子：
16.2
通讯作者：
Hu, Frank B.
中科院分区：
文献类型：
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作者：
Ley, Sylvia H.;Pan, An;Hu, Frank B.
最近的公共卫生建议强调采取健康的饮食模式，但缺乏证据表明增加饮食质量的变化是否对长期糖尿病预防有影响。我们的目标是评估4年期间的饮食质量变化以及随后4年的2型糖尿病发病率。研究设计和方法前瞻性队列、护士健康研究（NHS）、NHS II和卫生专业人员随访研究的参与者，基线时没有糖尿病（n = 124，607），观察时间>= 20年。每4年评估一次饮食质量，通过替代健康饮食指数（AHEI）评分来反映，以计算变化。4年内AHEI评分下降>10%与随后糖尿病风险较高相关（合并风险比1.34 [95%CI 1.23-1.46]），多重校正，而AHEI评分增加>10%与风险较低相关（0.84 [0.78-0.90]）。在基线饮食质量状态下，饮食质量的改善与糖尿病风险的降低相关（P趋势
OBJECTIVERecent public health recommendations emphasize adopting a healthful dietary pattern, but evidence is scarce on whether incremental diet quality changes have an impact on long-term diabetes prevention. We aim to evaluate diet quality changes during a 4-year period and subsequent 4-year type 2 diabetes incidence.RESEARCH DESIGN AND METHODSParticipants of prospective cohorts, the Nurses' Health Study (NHS), NHS II, and the Health Professionals Follow-up Study, who were free of diabetes at baseline (n = 124,607), were observed for >= 20 years. Diet quality, reflected by the Alternate Healthy Eating Index (AHEI) score, was assessed every 4 years to calculate changes.RESULTSWe documented 9,361 cases of type 2 diabetes during 2,093,416 person-years of follow-up. A >10% decrease in AHEI score over 4 years was associated with a higher subsequent diabetes risk (pooled hazard ratio 1.34 [95% CI 1.23-1.46]) with multiple adjustment, whereas a >10% increase in AHEI score was associated with a lower risk (0.84 [0.78-0.90]). Greater improvement in diet quality was associated with lower diabetes risk across baseline diet quality status (P for trend