Associations Between Dietary Patterns and Incident Type 2 Diabetes: Prospective Cohort Study of 120,343 UK Biobank Participants
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Abstract
OBJECTIVE: To identify dietary patterns (DPs) characterized by a set of nutrients of concern and their association with incident type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS: A total of 120,343 participants from the U.K. Biobank study with at least two 24 h dietary assessments were studied. Reduced rank regression was used to derive DPs explaining variability in energy density, free sugars, saturated fat, and fiber intakes. We investigated prospective associations with T2D using Cox proportional hazard models. RESULTS: Over 8.4 years of follow-up from the latest dietary assessment, 2,878 participants developed T2D. Two DPs were identified that jointly explained a total of 63% variation in four nutrients. DP1 was characterized by high intakes of chocolate and confectionery, butter, low-fiber bread, and sugars and preserves, and low intakes of fruits and vegetables. DP1 was linearly associated with T2D in multivariable models without BMI adjustment (per z score, hazard ratio [HR] 1.11 [95% CI 1.08–1.14]) and after BMI adjustment (HR 1.09 [95% CI 1.06–1.12]). DP2 was characterized by high intakes of sugar-sweetened beverages, fruit juice, table sugars and preserves, and low intakes of high-fat cheese and butter, but showed no clear association with T2D. There were significant interactions between both DPs and age, with increased risks among younger people in DP1 (HR 1.13 [95% CI 1.09–1.18]) and DP2 (HR 1.10 [95% CI 1.05–1.15]), as well as with DP1 and BMI, with increased risks among people with obesity (HR 1.11 [95% CI 1.07–1.16]). CONCLUSIONS: A DP characterized by high intakes of chocolate and confectionery, butter, low-fiber bread, and added sugars, and low in fresh fruits and vegetables intake is associated with a higher incidence of T2D, particularly among younger people and those with obesity.
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In a prospective cohort study of 120 343 UK participants followed for 8.4 years, a dietary pattern high in added sugars was associated with a higher incidence of type 2 diabetes mellitus (hazard ratio 1.09, 1.06 to 1.12) after adjustment for confounders.
“A dietary pattern high in added sugars was associated with a higher incidence of type 2 diabetes mellitus (hazard ratio 1.09, 1.06 to 1.12) after adjustment for confounders.148”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [148]
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Dietary sugar consumption and health: umbrella review
Huang, Y., Chen, Z., Chen, B., Li, J., Yuan, X., Li, J., Wang, W., Dai, T., Chen, H., Wang, Y., et al. (2023) · BMJ · doi:10.1136/bmj-2022-071609 · Cited by 348 · see citing works
- Authors
- Gao, M., Jebb, S. A., Aveyard, P., Ambrosini, G. L., Perez-Cornago, A., Papier, K., Carter, J., & Piernas, C.
- Affiliations
- University of Oxford (GB)
- The University of Western Australia (AU)
- 4Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, U.K
- Corresponding author
- Piernas, Carmen
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2022-03-17
- Volume
- 45
- Issue
- 6
- Pages
- 1315-1325
- ISSN
- 0149-5992 (ISSN-L)
- OpenAlex
- W4220855290
- Cited by
- 46
- References
- 50
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 9 · 2023: 11 · 2022: 2
- FWCI
- 7.52
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, other-oa)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Funders
- National Institute for Health and Care Research (NIHR203808)
- British Heart Foundation (CH/1996001/9454)
- Department of Health and Social Care
- British Nutrition Foundation
- Medical Research Council (CH/1996001/9454)
- NIHR Oxford Biomedical Research Centre
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- dietary habits, type 2 diabetes, new-onset diabetes, free sugars, saturated fat, dietary fiber, energy density, butter, sugar-sweetened beverages, fruit juice, fruit and vegetable intake, obesity, age interaction, UK Biobank
- MeSH terms
- Sugars, Butter, Diabetes Mellitus, Type 2, Diet, Dietary Fiber, United Kingdom, Humans, Obesity, Prospective Studies, Biological Specimen Banks
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