A priori-defined diet quality indexes and risk of type 2 diabetes: the multiethnic cohort
Open accessAbstract
Aims/hypothesis Dietary patterns have been associated with the incidence of type 2 diabetes, but little is known about the impact of ethnicity on this relationship. This study evaluated the association between four a priori dietary quality indexes and risk of type 2 diabetes among white individuals, Japanese-Americans and Native Hawaiians in the Hawaii component of the Multiethnic Cohort.Methods After excluding participants with prevalent diabetes and missing values, the analysis included 89,185 participants (11,217 cases of type 2 diabetes). Dietary intake was assessed at baseline with a quantitative food frequency questionnaire designed for use in the relevant ethnic populations. Sex- and ethnicity-specific HRs were calculated for the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010 (AHEI-2010), the Alternate Mediterranean Diet Score (aMED) and the Dietary Approaches to Stop Hypertension (DASH).Results We observed significant inverse associations between higher DASH index scores and risk of type 2 diabetes in white men and women, as well as in Japanese-American women and Native Hawaiian men, with respective risk reductions of 37%, 31%, 19% and 21% (in the highest compared with the lowest index category). A higher adherence to the AHEI-2010 and aMED diet was related to a 13-28% lower risk of type 2 diabetes in white participants but not in other ethnic groups. No significant associations with risk of type 2 diabetes were observed for the HEI-2010 index.Conclusions/interpretation The small ethnic differences in risk of type 2 diabetes associated with scores of a priori-defined dietary patterns may be due to a different consumption pattern of food components and the fact that the original indexes were not based on diets typical for Asians and Pacific Islanders.
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A multiethnic cohort study including over 89,185 participants failed to indicate any significant association between adherence to the HEI and the risk of type 2 diabetes.
“However, a multiethnic cohort study including over 89,185 participants failed to indicate any significant association between adherence to the HEI and the risk of type 2 diabetes; the authors attributed this issue to the ethnic differences and different consumption patterns of food components [16].”
From Association between healthy eating index-2015 scores and metabolic syndrome among Iranian women: a cross-sectional study (2024) · cites this paper as [16]
The Methods report 89,185 participants, not over 89,185, and the Results report no significant overall association between HEI-2010 and type 2 diabetes risk, with an inverse trend in white men. The Discussion suggests that differences across ethnic groups may reflect food-consumption patterns, among other possibilities; it does not definitively attribute the null HEI-2010 finding to those differences. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn a meta-analysis of 11 cohort studies, low-carbohydrate and high-carbohydrate diets did not differ in diabetes incidence, and low-carbohydrate diets could be harmful if fat comes from red meat.
“In a meta-analysis of 11 cohort studies,715 a low-carbohydrate diet was no different than a high-carbohydrate diet regarding incidence of DM715,834 and could be harmful if fat sources are derived from red meat.835”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [835]
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References 47 · Cited by 121
- Authors
- Jacobs, S., Harmon, B. E., Boushey, C. J., Morimoto, Y., Wilkens, L. R., Le Marchand, L., Kröger, J., Schulze, M. B., Kolonel, L. N., & Maskarinec, G.
- Affiliations
- German Institute of Human Nutrition (DE)
- University of Memphis (US)
- University of Hawaii Cancer Center (US)
- Corresponding author
- Maskarinec, Gertraud
- ORCID
- Venue
- Diabetologia
- Published
- 2014-10-16
- Volume
- 58
- Issue
- 1
- Pages
- 98-112
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- PMC
- PMC4258157
- OpenAlex
- W2075879496
- Cited by
- 121
- References
- 47
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 12 · 2023: 8 · 2022: 17 · 2021: 8 · 2020: 16 · 2019: 13 · 2018: 13 · 2017: 14 · 2016: 8 · 2015: 5
- FWCI
- 8.92
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eSpace (Curtin University) (submittedVersion)
- Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion)
- Funders
- National Cancer Institute (R37 CA 54281, R37CA054281, R01CA054281, UM1CA164973)
- National Institute of Diabetes and Digestive and Kidney Diseases (R21DK073816)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- type 2 diabetes, diet quality index, Healthy Eating Index-2010, Alternative Healthy Eating Index-2010, alternate Mediterranean diet score, DASH diet, dietary habits, ethnicity, Japanese Americans, Native Hawaiians, multi-ethnic cohort
- MeSH terms
- Aged, Asian, Diabetes Mellitus, Type 2, Diet, Feeding Behavior, Female, Humans, Male, Middle Aged, Nutrition Surveys, Risk Factors, Cohort Studies, Nutrition Assessment, Native Hawaiian or Pacific Islander, Food Quality
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