Dietary patterns and risk for diabetes: the multiethnic cohort.
Dietary patterns and risk for diabetes: the multiethnic cohort.
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DOI：
10.2337/dc09-1621
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发表时间：
2010-03
期刊：
影响因子：
16.2
通讯作者：
Maskarinec G
中科院分区：
文献类型：
--
作者：
Erber E;Hopping BN;Grandinetti A;Park SY;Kolonel LN;Maskarinec G
日裔美国人和夏威夷原住民的高糖尿病发病率不能用BMI来解释。因此，我们研究了“脂肪和肉”、“蔬菜”和“水果和牛奶”三种饮食模式对夏威夷多种族队列中29,759名白种人、35,244名日裔美国人和10,509名夏威夷原住民糖尿病风险的影响。年龄在45-75岁之间的受试者完成了一份基线食物频率问卷。经过14年的随访，通过自我报告或健康计划联系确定了8587名糖尿病患者。使用Cox回归按年龄分层评估风险，并根据种族、BMI、体育活动、教育程度、总能量、吸烟、饮酒、婚姻状况和高血压进行调整。当比较极端五分位数时，脂肪和肉类与男性糖尿病风险显著相关（风险比1.40 [95% CI 1.23-1.60]， p趋势< 0.0001），女性（风险比1.22 [1.06-1.40]，p趋势= 0.004）。除了夏威夷女性外，不同种族的女性患乳腺癌的风险程度相似，尽管并不总是显著的。在BMI分层后，脂肪和肉类仍然是主要在超重男性和超重日本女性中疾病的预测因子。蔬菜降低了男性患糖尿病的风险（0.86 [0.77-0.95]，p趋势= 0.004），但对女性没有作用，而水果和牛奶似乎对女性更有益（0.85 [0.76-0.96]，p趋势= 0.005），而对男性更有益（0.92 [0.83-1.02]，p趋势= 0.04）。在所有种族中，高肉和高脂肪的食物似乎都赋予了更高的糖尿病风险，而其他饮食模式的影响则因性别和种族而异。
The high diabetes incidence among Japanese Americans and Native Hawaiians cannot be explained by BMI. Therefore, we examined the influence of three dietary patterns of “fat and meat,” “vegetables,” and “fruit and milk” on diabetes risk in the Hawaii component of the Multiethnic Cohort with 29,759 Caucasians, 35,244 Japanese Americans, and 10,509 Native Hawaiians. Subjects aged 45–75 years completed a baseline food frequency questionnaire. After 14 years of follow-up, 8,587 subjects with incident diabetes were identified through self-reports or health plan linkages. Risk was assessed using Cox regression stratified by age and adjusted for ethnicity, BMI, physical activity, education, total energy, smoking, alcohol intake, marital status, and hypertension. Fat and meat was significantly associated with diabetes risk in men (hazard ratio 1.40 [95% CI 1.23–1.60], Ptrend < 0.0001) and women (1.22 [1.06–1.40], Ptrend = 0.004) when extreme quintiles were compared. Except in Hawaiian women, the magnitude of the risk was similar across ethnic groups although not always significant. After stratification by BMI, fat and meat remained a predictor of disease primarily among overweight men and among overweight Japanese women. Vegetables lowered diabetes risk in men (0.86 [0.77–0.95], Ptrend = 0.004) but not in women, whereas fruit and milk seemed to be more beneficial in women (0.85 [0.76–0.96], Ptrend = 0.005) than in men (0.92 [0.83–1.02], Ptrend = 0.04). Foods high in meat and fat appear to confer a higher diabetes risk in all ethnic groups, whereas the effects of other dietary patterns vary by sex and ethnicity.
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