Eating patterns and type 2 diabetes risk in older women: breakfast consumption and eating frequency
Open accessAbstract
Background Little is known about the association between eating patterns and type 2 diabetes (T2D) risk in women. Objective The objective was to examine prospectively associations between regular breakfast consumption, eating frequency, and T2D risk in women. Design Eating pattern was assessed in 2002 in a cohort of 46,289 US women in the Nurses' Health Study who were free of T2D, cardiovascular disease, or cancer and were followed for 6 y. We used Cox proportional hazards analysis to evaluate associations with incident T2D. Results We documented 1560 T2D cases during follow-up. After adjustment for known risk factors for T2D-except for body mass index (BMI), a potential mediator-women who consumed breakfast irregularly (0-6 times/wk) were at higher risk of T2D than were women who consumed breakfast daily (RR: 1.28; 95% CI: 1.14, 1.44). This association was moderately attenuated after adjustment for BMI (RR: 1.20; 95% CI: 1.07, 1.35). In comparison with women who ate 3 times/d, the RRs were 1.09 (0.84, 1.41) for women who ate 1-2 times/d, 1.13 (1.00, 1.27) for women who ate 4-5 times/d, and 0.99 (0.81, 1.21) for women who ate ≥6 times/d. Among irregular breakfast consumers, women with a higher eating frequency (≥4 times/d) had a significantly greater T2D risk (RR: 1.47; 95% CI: 1.23, 1.75) than did women who consumed breakfast daily and ate 1-3 times/d. Adjustment for BMI attenuated this association (RR: 1.24; 95% CI: 1.04, 1.48). Conclusion Irregular breakfast consumption was associated with a higher T2D risk in women, which was partially but not entirely mediated by BMI.
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The most common measure used to assess overall diet quality was a previously validated and reliability tested a priori diet quality index reflecting adherence to dietary guidelines for the country of the sample population.
“The most common measure used to assess overall diet quality was a previously validated and reliability tested a priori diet quality index which reflects an individual's adherence to the dietary guidelines for the country of the sample population (for example, the Healthy Eating Index (HEI), the Alternative HEI (AHEI) and the Dietary Guidelines Index (DGI))( 23 , 28 , 86 , 88 – 90 , 92 , 94 ).”
From Understanding meal patterns: definitions, methodology and impact on nutrient intake and diet quality (2015) · cites this paper as [86]
Of the nine studies identified that examined associations between skipping breakfast and diet quality, six found a negative association and three found no association.
“Of the nine studies identified that examined associations between skipping breakfast and diet quality, six found a negative association( 22 , 23 , 86 , 87 , 90 , 94 ) and three found no association( 28 , 91 , 93 ).”
From Understanding meal patterns: definitions, methodology and impact on nutrient intake and diet quality (2015) · cites this paper as [86]
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Willett, W. C. (1998) · doi:10.1093/acprof:oso/9780195122978.001.0001 · Cited by 4,541 · see citing works
Self-citationReproducibility and validity of a semiquantitative food frequency questionnaire
WILLETT, W. C., SAMPSON, L., STAMPFER, M. J., ROSNER, B., BAIN, C., WITSCHI, J., HENNEKENS, C. H., & SPEIZER, F. E. (1985) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114086 · Cited by 4,274 · see citing works
Self-citationEconomic Costs of Diabetes in the U.S. in 2002
American Diabetes Association (2003) · Diabetes Care · doi:10.2337/diacare.26.3.917 · Cited by 4,147 · see citing works
Dietary Fiber, Glycemic Load, and Risk of Non—insulin-dependent Diabetes Mellitus in Women
Salmerón, J. (1997) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1997.03540300040031 · Cited by 1,804 · see citing works
Chronic stress at work and the metabolic syndrome: prospective study
Chandola, T., Brunner, E., & Marmot, M. (2006) · BMJ · doi:10.1136/bmj.38693.435301.80 · Cited by 1,075 · see citing works
Reproducibility and validity of a self-administered physical activity questionnaire
WOLF, A. M., HUNTER, D. J., COLDITZ, G. A., MANSON, J. E., STAMPFER, M. J., CORSANO, K. A., ROSNER, B., KRISKA, A., & WILLETT, W. C. (1994) · International Journal of Epidemiology · doi:10.1093/ije/23.5.991 · Cited by 1,038 · cited 1× · see citing works
“Physical activity was expressed as hours per week and converted to metabolic equivalent hours per week by using a validated questionnaire (22).”
MethodSelf-citationPhysical Activity and Television Watching in Relation to Risk for Type 2 Diabetes Mellitus in Men
Hu, F. B., Leitzmann, M. F., Stampfer, M. J., Colditz, G. A., Willett, W. C., & Rimm, E. B. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.12.1542 · Cited by 828 · see citing works
Self-citationRotating Night Shift Work and Risk of Type 2 Diabetes: Two Prospective Cohort Studies in Women
Pan, A., Schernhammer, E. S., Sun, Q., & Hu, F. B. (2011) · PLoS Medicine · doi:10.1371/journal.pmed.1001141 · Cited by 805 · cited 1× · see citing works
“However, there is strong evidence of a direct association between night shift work and T2D (41), partially explained by a higher BMI and disturbed circadian rhythms (42).”
BackgroundSelf-citationde Munter, J. S. L., Hu, F. B., Spiegelman, D., Franz, M., & van Dam, R. M. (2007) · PLoS Medicine · doi:10.1371/journal.pmed.0040261 · Cited by 734 · see citing works
Self-citationAssociation between Eating Patterns and Obesity in a Free-living US Adult Population
Ma, Y. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwg117 · Cited by 725 · see citing works
Nibbling versus gorging: metabolic advantages of increased meal frequency
Jenkins, D. J. A., Wolever, T. M. S., Vuksan, V., Brighenti, F., Cunnane, S. C., Rao, A. V., Jenkins, A. L., Buckley, G., Patten, R., Singer, W., et al. (1989) · New England Journal of Medicine · doi:10.1056/nejm198910053211403 · Cited by 467 · see citing works
Deshmukh-Taskar, P. R., Radcliffe, J. D., Liu, Y., & Nicklas, T. A. (2010) · Journal of the American College of Nutrition · doi:10.1080/07315724.2010.10719858 · Cited by 168 · see citing works
Metabolic effects of alterations in meal frequency in type 2 diabetes
Arnold, L., Mann, J. I., & Ball, M. J. (1997) · Diabetes Care · doi:10.2337/diacare.20.11.1651 · Cited by 58 · cited 1× · see citing works
“Earlier trials showed no effect on glucose metabolism in a comparison of subjects with T2D on low or high eating frequency regimes (13, 14).”
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Sorted by citations
St-Onge, M.-P., Ard, J., Baskin, M. L., Chiuve, S. E., Johnson, H. M., Kris-Etherton, P., & Varady, K. (2017) · Circulation · doi:10.1161/cir.0000000000000476 · Cited by 728 · see citing works
Understanding meal patterns: definitions, methodology and impact on nutrient intake and diet quality
Leech, R. M., Worsley, A., Timperio, A., & McNaughton, S. A. (2015) · Nutrition Research Reviews · doi:10.1017/s0954422414000262 · Cited by 379 · see citing works
Chowdhury, E. A., Richardson, J. D., Holman, G. D., Tsintzas, K., Thompson, D., & Betts, J. A. (2016) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.115.122044 · Cited by 255 · see citing works
Kahleova, H., Belinova, L., Malinska, H., Oliyarnyk, O., Trnovska, J., Skop, V., Kazdova, L., Dezortova, M., Hajek, M., Tura, A., et al. (2014) · Diabetologia · doi:10.1007/s00125-014-3253-5 · Cited by 229 · see citing works
Timing of breakfast, lunch, and dinner. Effects on Obesity and Metabolic Risk
Lopez-Minguez, J., Gómez-Abellán, P., & Garaulet, M. (2019) · Nutrients · doi:10.3390/nu11112624 · Cited by 201 · see citing works
Ardisson Korat, A. V., Willett, W. C., & Hu, F. B. (2014) · Current Nutrition Reports · doi:10.1007/s13668-014-0103-5 · Cited by 162 · see citing works
Self-citationBallon, A., Neuenschwander, M., & Schlesinger, S. (2019) · The Journal of Nutrition · doi:10.1093/jn/nxy194 · Cited by 161 · see citing works
Characterizing eating patterns: a comparison of eating occasion definitions
Leech, R. M., Worsley, A., Timperio, A., & McNaughton, S. A. (2015) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.115.114660 · Cited by 133 · see citing works
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Dashti, H. S., Scheer, F. A. J. L., Saxena, R., & Garaulet, M. (2019) · Advances in Nutrition · doi:10.1093/advances/nmy131 · Cited by 121 · see citing works
Montemayor, S., Bouzas, C., Mascaró, C. M., Casares, M., Llompart, I., Abete, I., Angullo-Martinez, E., Zulet, M. Á., Martínez, J. A., & Tur, J. A. (2022) · Nutrients · doi:10.3390/nu14112223 · Cited by 62 · see citing works
Wennberg, M., Gustafsson, P. E., Wennberg, P., & Hammarström, A. (2016) · Public Health Nutrition · doi:10.1017/s1368980015001445 · Cited by 53 · see citing works
Papakonstantinou, E., Kontogianni, M. D., Mitrou, P., Magriplis, E., Vassiliadi, D., Nomikos, T., Lambadiari, V., Georgousopoulou, E., & Dimitriadis, G. (2018) · Diabetes & Metabolism · doi:10.1016/j.diabet.2018.03.008 · Cited by 39 · see citing works
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- Authors
- Mekary, R. A., Giovannucci, E., Cahill, L., Willett, W. C., van Dam, R. M., & Hu, F. B.
- Affiliations
- Harvard University (US)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2013-08
- Volume
- 98
- Issue
- 2
- Pages
- 436-443
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC3712552
- OpenAlex
- W2143532320
- Cited by
- 180
- References
- 13
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 11 · 2023: 14 · 2022: 17 · 2021: 11 · 2020: 17 · 2019: 17 · 2018: 18 · 2017: 8 · 2016: 19 · 2015: 15 · 2014: 12 · 2013: 3
- FWCI
- 16.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- National University of Singapore (submittedVersion)
- Funders
- National Cancer Institute (R01CA095589, CA95589, CA-55075)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK058845, P30DK046200, P30 DK-46200, DK58845)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- type 2 diabetes, breakfast consumption, meal frequency, dietary habits, older women, body mass index, Nurses' Health Study, diabetes risk
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 2, Dietary Fiber, Feeding Behavior, Female, Follow-Up Studies, Humans, Middle Aged, Prospective Studies, Risk Factors, Nutrition Assessment, Body Mass Index, Proportional Hazards Models, Breakfast
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