Original Contribution

European Journal of Nutrition

, Volume 52, Issue 3, pp 1127-1134

Dietary patterns and the risk of type 2 diabetes in overweight and obese individuals

  • Florianne BauerAffiliated withJulius Center for Health Sciences and Primary Care, University Medical Center UtrechtComplex Genetics Section, Department of Medical Genetics-DBG, University Medical Center Utrecht
  • , Joline W. J. BeulensAffiliated withJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht
  • , Daphne L. van der AAffiliated withCenter for Nutrition and Health, National Institute for Public Health and the Environment
  • , Cisca WijmengaAffiliated withUniversity of Groningen, University Medical Center Groningen, Department of Genetics
  • , Diederick E. GrobbeeAffiliated withJulius Center for Health Sciences and Primary Care, University Medical Center UtrechtJulius Center, University of Malaya Medical Center
  • , Annemieke M. W. SpijkermanAffiliated withCenter for Prevention and Health Services Research, National Institute for Public Health and the Environment
  • , Yvonne T. van der SchouwAffiliated withJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht
  • , N. Charlotte Onland-MoretAffiliated withJulius Center for Health Sciences and Primary Care, University Medical Center UtrechtComplex Genetics Section, Department of Medical Genetics-DBG, University Medical Center Utrecht Email author 

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Abstract

Purpose

Although overweight is an important determinant of diabetes risk, it remains unclear whether food choices can still influence the risk for type 2 diabetes in overweight persons. In this paper, we aim to clarify the role of dietary patterns in the development of type 2 diabetes in overweight and obese individuals.

Methods

We studied 20,835 overweight and obese participants in the Dutch part of the European Investigation into Cancer and Nutrition (EPIC-NL) study. Dietary intake was measured using a validated food frequency questionnaire, and dietary patterns were generated using factor analysis. Incident type 2 diabetes was verified against medical records. Cox proportional hazards models were used to assess the association between the dietary patterns (factor scores categorized in quartiles) and incident type 2 diabetes.

Results

Scoring on Pattern 1, characterized by fish, wine, chicken, raw vegetables and fruit juices, was not associated with type 2 diabetes risk after confounder adjustment. A high score on Pattern 2, characterized by soft drinks, fries and snacks, was associated with higher risk of type 2 diabetes (HR Q4 vs. Q1 (95 % CI): 1.70 (1.31; 2.20), p trend ≤ 0.0001), particularly among less active individuals [less active: HR Q4 vs. Q1 (95 % CI): 2.14 (1.48; 3.09), p trend = 0.00004, more active: HR Q4 vs. Q1 (95 % CI): 1.35 (0.93; 1.97), p trend = 0.01; p interaction = 0.02].

Conclusions

A high score on a pattern high in soft drinks, fries and snacks and low in fruit and vegetables was associated with higher risk of type 2 diabetes in overweight and obese subjects especially among physically less active individuals.

Keywords

Dietary pattern Type 2 diabetes Obesity Epidemiology