Table 2.
HRs of type 2 diabetes according to updated 4-year changes in dietary quality (categories in AHEI scores)
| Decrease |
No change or stable(±<3%) | Increase |
P for trend | HR per 10% score increase | |||
|---|---|---|---|---|---|---|---|
| Moderate to large (>10%) | Small to moderate(3–10%) | Small to moderate(3–10%) | Moderate to large (>10%) | ||||
| NHS (1986–2010) | |||||||
| Cases/person-years | 358/61,075 | 870/176,310 | 1,477/300,169 | 1,074/226,534 | 529/109,284 | ||
| Model 1* | 1.33 (1.18–1.50) | 1.06 (0.97–1.15) | 1.00 | 0.93 (0.85–1.00) | 0.87 (0.78–0.96) | <0.0001 | 0.86 (0.83–0.90) |
| Model 2† | 1.27 (1.13–1.43) | 1.04 (0.95–1.13) | 1.00 | 0.95 (0.88–1.03) | 0.89 (0.80–0.99) | <0.0001 | 0.89 (0.85–0.93) |
| NHS II (1991–2011) | |||||||
| Cases/person-years | 258/47,760 | 539/127,070 | 1,143/265,994 | 705/189,609 | 491/129,739 | ||
| Model 1* | 1.45 (1.25–1.67) | 1.09 (0.97–1.21) | 1.00 | 0.85 (0.77–0.94) | 0.76 (0.67–0.85) | <0.0001 | 0.81 (0.78–0.85) |
| Model 2† | 1.31 (1.13–1.51) | 1.03 (0.93–1.15) | 1.00 | 0.88 (0.80–0.98) | 0.77 (0.69–0.87) | <0.0001 | 0.85 (0.81–0.89) |
| HPFS (1986–2010) | |||||||
| Cases/person-years | 118/27,668 | 340/83,582 | 734/176,678 | 470/116,985 | 255/54,959 | ||
| Model 1* | 1.15 (0.93–1.41) | 1.02 (0.89–1.17) | 1.00 | 0.92 (0.81–1.04) | 0.99 (0.85–1.16) | 0.14 | 0.94 (0.87–1.00) |
| Model 2† | 1.05 (0.86–1.30) | 0.98 (0.86–1.13) | 1.00 | 0.94 (0.83–1.07) | 1.01 (0.86–1.18) | 0.67 | 0.97 (0.91–1.04) |
| Pooled | |||||||
| Model 1* | 1.34 (1.23–1.46) | 1.06 (1.00–1.13) | 1.00 | 0.90 (0.85–0.94) | 0.84 (0.78–0.90) | <0.0001 | 0.85 (0.83–0.88) |
| Model 2† | 1.25 (1.15–1.36) | 1.03 (0.97–1.09) | 1.00 | 0.93 (0.88–0.98) | 0.86 (0.81–0.93) | <0.0001 | 0.89 (0.86–0.91) |
Values are reported as HR (95% CI), unless otherwise indicated.
*Model 1 was adjusted for age; ethnicity (white/nonwhite); family history of diabetes (yes/no); baseline AHEI score, physical activity, and total energy intake at the beginning of each 4-year period (all in quintiles); 4-year changes in smoking status (never to never, never to current, past to past, past to current, current to past, current to current, or missing indicator), physical activity, and total energy intake (all in quintiles); and a medical history of hypertension (yes/no) and hypercholesterolemia (yes/no). In the NHS and NHS II, postmenopausal status and postmenopausal hormone use (never use, current use, past use, or missing) were also included.
†Model 2 was adjusted for model 1 variables in addition to baseline BMI values at the beginning of each 4-year period (<21, 21–22.9, 23–24.9, 25–29.9, ≥30 kg/m2).