TABLE 4.
RRs (95% CIs) for type 2 diabetes according to quintile of energy-adjusted glycemic load with diet no longer updated after incident cardiovascular disease or cancer1
| Quintile of glycemic load |
||||||
| 1 | 2 | 3 | 4 | 5 | P-trend | |
| Nurses’ Health Study | ||||||
| Median | 81.4 | 94.5 | 102.8 | 111.0 | 123.5 | |
| No. of cases/person-years | 1486/312,181 | 1588/312,959 | 1472/315,849 | 1459/310,499 | 1395/314,964 | |
| Model 1 | 1.00 | 1.07 (1.00, 1.15) | 0.99 (0.92, 1.06) | 0.99 (0.92, 1.06) | 0.93 (0.87, 1.00) | 0.01 |
| Model 2 | 1.00 | 0.99 (0.92, 1.06) | 0.94 (0.88, 1.02) | 1.00 (0.92, 1.07) | 1.05 (0.97, 1.13) | 0.27 |
| Model 3 | 1.00 | 1.02 (0.95, 1.11) | 1.00 (0.92, 1.09) | 1.08 (0.99, 1.19) | 1.18 (1.06, 1.31) | 0.003 |
| Nurses’ Health Study II | ||||||
| Median | 98.8 | 112.5 | 121.7 | 131.2 | 146.5 | |
| No. of cases/person-years | 1164/300,470 | 1040/300,655 | 810/301,083 | 776/301,073 | 725/300,445 | |
| Model 1 | 1.00 | 0.93 (0.85, 1.01) | 0.73 (0.67, 0.80) | 0.71 (0.65, 0.77) | 0.66 (0.61, 0.73) | <0.0001 |
| Model 2 | 1.00 | 1.00 (0.92, 1.09) | 0.87 (0.79, 0.95) | 0.94 (0.86, 1.03) | 1.02 (0.93, 1.12) | 0.66 |
| Model 3 | 1.00 | 1.05 (0.96, 1.15) | 0.93 (0.83, 1.03) | 1.01 (0.89, 1.14) | 1.05 (0.92, 1.21) | 0.67 |
| Health Professionals Follow-Up Study | ||||||
| Median | 99.0 | 116.5 | 128.0 | 140.0 | 157.2 | |
| No. of cases/person-years | 760/145,549 | 686/144,995 | 631/146,062 | 573/147,446 | 462/146,387 | |
| Model 1 | 1.00 | 0.93 (0.84, 1.03) | 0.85 (0.76, 0.94) | 0.77 (0.69, 0.86) | 0.63 (0.56, 0.70) | <0.0001 |
| Model 2 | 1.00 | 0.96 (0.86, 1.06) | 0.92 (0.83, 1.03) | 0.90 (0.80, 1.01) | 0.83 (0.73, 0.94) | 0.003 |
| Model 3 | 1.00 | 0.99 (0.88, 1.11) | 0.99 (0.87, 1.13) | 0.98 (0.85, 1.14) | 0.96 (0.81, 1.15) | 0.71 |
| Pooled analysis2 | ||||||
| Model 1 | 1.00 | 0.99 (0.94, 1.04) | 0.87 (0.83, 0.92) | 0.85 (0.80, 0.89) | 0.78 (0.74, 0.82) | <0.0001 |
| Model 2 | 1.00 | 0.98 (0.94, 1.03) | 0.91 (0.87, 0.96) | 0.96 (0.91, 1.01) | 0.99 (0.94, 1.05) | 0.50 |
| Model 3 | 1.00 | 1.02 (0.97, 1.08) | 0.98 (0.92, 1.04) | 1.04 (0.97, 1.11) | 1.10 (1.02, 1.18) | 0.02 |
Median values of glycemic load for each category were used to test for a linear trend across categories. Model 1 adjusted for age (y); model 2 adjusted as for model 1 + race (white or nonwhite), smoking (never; past; current: 1–14, 15–24, or >24 cigarettes/d), alcohol intake (0, 0.1–4.9, 5–9.9, 10–14.9, or ≥15 g/d), postmenopausal hormone use (women only; premenopausal, postmenopausal current user, or postmenopausal never/past user), oral contraceptive use (women only; never, past, or current), physical activity (<3, 3–8.9, 9–17.9, 18–26.9, or ≥27 metabolic equivalent task hours/wk), family history of diabetes (yes or no), BMI (in kg/m2; <21, 21–22.9, 23–24.9, 25–26.9, 27–29.9, 30–34.9, 35–39.9, or ≥40), and total energy intake (quintiles); model 3 adjusted as for model 2 + intakes of total coffee (quintiles), energy-adjusted cereal fiber (quintiles), energy-adjusted PUFAs (quintiles), energy-adjusted trans fatty acids (quintiles), and SFAs (quintiles). All statistical tests were conducted by using Cox proportional hazards regression models.
Results were combined with the use of a fixed-effects model.