TABLE 4.
Risk of type 2 diabetes by quintile of diet pattern score, Cox proportional hazards analysis, Nurses’ Health Study (NHS) and Nurses’ Health Study II (NHS-II)1
| Quintile of diet pattern score in the NHS (n = 35 367)
|
Quintile of diet pattern score in the NHS-II (n = 89 311)
|
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | P2 | 1 | 2 | 3 | 4 | 5 | P2 | |
| No. of cases | 133 | 227 | 271 | 363 | 523 | – | 57 | 114 | 104 | 156 | 293 | – |
| Person-years | 91 837 | 91 855 | 91 897 | 91 883 | 91 520 | – | 139 949 | 140 312 | 140 471 | 140 435 | 139 988 | – |
| Relative risks (95% CI) | ||||||||||||
| Age-adjusted | 1.00 | 1.74 (1.41, 2.16) | 2.15 (1.75, 2.65) | 2.98 (2.44, 3.64) | 4.66 (3.84, 5.64) | <0.001 | 1.00 | 2.25 (1.64, 3.10) | 2.23 (1.61, 3.08) | 3.52 (2.60, 4.77) | 6.89 (5.18, 9.16) | <0.001 |
| Age- and BMI-adjusted | 1.00 | 1.51 (1.22, 1.87) | 1.65 (1.34, 2.03) | 2.01 (1.64, 2.45) | 2.63 (2.17, 3.20) | <0.001 | 1.00 | 1.95 (1.42, 2.67) | 1.66 (1.20, 2.30) | 2.15 (1.59, 2.92) | 3.05 (2.29, 4.06) | <0.001 |
| Multivariate-adjusted3 | ||||||||||||
| All | 1.00 | 1.50 (1.21, 1.86) | 1.61 (1.31, 1.99) | 1.96 (1.61, 2.40) | 2.56 (2.10, 3.12) | <0.001 | 1.00 | 1.92 (1.39, 2.64) | 1.64 (1.18, 2.26) | 2.10 (1.55, 2.86) | 2.93 (2.18, 3.92) | <0.001 |
| Without family history of diabetes4 | 1.00 | 1.56 (1.21, 2.03) | 1.60 (1.24, 2.07) | 1.98 (1.55, 2.53) | 2.71 (2.13, 3.46) | – | 1.00 | 1.90 (1.26, 2.85) | 1.58 (1.04, 2.39) | 2.10 (1.42, 3.10) | 2.97 (2.04, 4.31) | – |
| With family history of diabetes4 | 1.00 | 1.38 (0.95, 2.02) | 1.66 (1.16, 2.37) | 1.93 (1.36, 2.73) | 2.29 (1.62, 3.23) | – | 1.00 | 1.96 (1.18, 3.27) | 1.74 (1.03, 2.92) | 2.13 (1.30, 3.50) | 2.91 (1.81, 4.67) | – |
| Low physical activity5 | 1.00 | 1.29 (0.92, 1.81) | 1.60 (1.17, 2.21) | 1.88 (1.38, 2.56) | 2.55 (1.89, 3.46) | 1.00 | 1.49 (0.94, 2.37) | 1.80 (1.16, 2.81) | 1.77 (1.15, 2.73) | 2.70 (1.80, 4.07) | ||
| High physical activity5 | 1.00 | 1.69 (1.28, 2.23) | 1.62 (1.23, 2.14) | 2.05 (1.57, 2.67) | 2.61 (2.00, 3.40) | – | 1.00 | 2.45 (1.58, 3.81) | 1.38 (0.84, 2.25) | 2.59 (1.68, 3.99) | 3.19 (2.09, 4.87) | – |
| Low BMI6 | 1.00 | 1.08 (0.60, 1.94) | 1.88 (1.11, 3.21) | 2.51 (1.49, 4.22) | 2.43 (1.40, 4.23) | – | 1.00 | 2.44 (1.34, 4.42) | 1.28 (0.64, 2.54) | 1.63 (0.85, 3.14) | 1.93 (1.00, 3.70) | 0.2 |
| High BMI6 | 1.00 | 1.58 (1.26, 2.00) | 1.59 (1.27, 2.00) | 1.94 (1.56, 2.41) | 2.56 (2.07, 3.18) | – | 1.00 | 1.82 (1.25, 2.65) | 1.80 (1.24, 2.61) | 2.29 (1.61, 3.26) | 3.15 (2.24, 4.41) | <0.001 |
A high diet pattern score reflects a diet high in sugar-sweetened soft drinks, refined grains, diet soft drinks, processed meat, and other vegetables and low in wine, coffee, cruciferous vegetables, and yellow vegetables.
P for linear trends across quintiles of the pattern score on the basis of an ordinal variable containing the median value for each quintile.
Adjusted for age, BMI (9 categories), physical activity (quintiles), family history of diabetes, smoking (never, past, current, or missing), postmenopausal hormone use (never, ever, or missing), and energy intake (quintiles). Stratified analyses were not adjusted for stratifying variable, except BMI strata (adjusted for continuous BMI within each stratum).
P for interaction for family history of diabetes = 0.28 for NHS and 0.20 for NHS-II.
Low baseline activity = lower 2 quintiles of activity level; high activity = upper 3 quintiles of activity level. P for interaction for physical activity = 0.54 for NHS and 0.73 for NHS-II.
Based on baseline population median (NHS: 24; NHS-II: 27). P for interaction for BMI = 0.46 for NHS and 0.017 for NHS-II.