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PubMed2003

Genetic susceptibility and dietary patterns in lung cancer.

Cigarette smoking is the dominant risk factor for lung cancer, but only a minority of smokers ever develops tumors. Though genetic susceptibility is likely to explain some of the variability in risk, results from previous studies of genetic polymorphisms have been inconclusive. As diet may also affect the risk of lung cancer, it is possible that the degree of risk produced by smoking and genetic susceptibility varies, depending on diet. To assess this hypothesis, we conducted a case-control study to examine the effect of cigarette smoking, dietary patterns and variation in genes involved in phase II metabolism. A total of 254 individuals with lung cancer and 184 healthy controls were recruited for the study. To identify persons with similar dietary patterns, cluster analysis was performed using nutrient densities of four major dietary constituents: protein, carbohydrate, animal fat, and dietary fiber. Two groups of individuals were identified with distinct dietary patterns: (1) a group (n=241) with a high intake of animal fat and protein and a low intake of carbohydrates and dietary fiber (the 'unhealthy' pattern) and (2) a group (n=197) with a high intake of fiber and carbohydrate and a low intake of protein and animal fat (the 'healthy' pattern) [corrected]. On stratified analysis, several genotype/dietary pattern combinations were found to affect risk of lung cancer. Smokers who were not homozygous for the most common GSTP1 allele and had a healthy dietary pattern were at significantly lower risk than smokers who were homozygous for the GSTP1 common allele and who had an unhealthy dietary pattern (OR=0.16, 95%CI: 0.04-0.57). Among smokers who were GSTM1 null, persons with a healthy dietary pattern were at lower risk than persons with an unhealthy dietary pattern (OR: 0.46, 95%CI: 0.21-1.01). Among smokers with an unhealthy dietary patterns, persons with a His/His genotype in the exon 3 polymorphism of EPHX1 were at significantly lower risk that persons who were not homozygous. These data suggest that dietary factors may affect the risk imposed by genetic susceptibility at detoxification loci. Adjustments using dietary pattern may be useful in elucidating the effects of polymorphisms in genes responsible for carcinogen metabolism.

Adult↗
PubMed2005

Dietary patterns and colorectal adenomas in Japanese men: the Self-Defense Forces Health Study.

The role of dietary patterns in colorectal carcinogenesis remains unclear in Asian populations. Using 1999-2002 data, the authors investigated the association between dietary patterns and colorectal adenomas in 1,341 Japanese men who underwent total colonoscopy. Information about diet was obtained using a 74-item food frequency questionnaire prior to the colonoscopy. Three dietary patterns were generated by factor analysis: 1) a high-dairy, high-fruit and -vegetable, high-starch, low-alcohol pattern; 2) an "animal food" pattern; and 3) a Japanese pattern. Logistic regression analysis was used to estimate the odds ratio of having colorectal adenomas with the adjustment for potential confounding variables including body mass index, smoking, alcohol, and leisure-time physical activities. A significant inverse association was found for the high-dairy, high-fruit and -vegetable, high-starch, low-alcohol pattern; the odds ratios for the second, third, and fourth quartiles were 0.97 (95% confidence interval: 0.70, 1.36), 0.71 (95% confidence interval: 0.50, 1.01), and 0.62 (95% confidence interval: 0.43, 0.90), respectively, compared with the lowest (p(trend) = 0.003). Similar associations were observed for larger adenomas or for each subsite of the colorectum. The Japanese and "animal food" patterns were not clearly associated with colorectal adenomas. A dietary pattern including greater consumption of dairy products and fruits and vegetables with low alcohol consumption may be associated with decreased risk of colorectal adenomas.

Adenoma↗
PubMed2005

Dietary patterns and the risk of breast cancer.

PURPOSE: Ecologic, migrant, and secular trend studies suggest an association between the Western diet and the risk of breast cancer. We examined data from the Nurses Health Study II to evaluate the association between major dietary patterns and the risk of breast cancer among pre-menopausal women. METHODS: We derived "Western" and "prudent" dietary patterns from the responses of 90,638 premenopausal women, aged 26 to 46 years at baseline in 1991, who completed validated food frequency questionnaires in 1991 and 1995. These patterns were then evaluated for their associations with risk of breast cancer. RESULTS: During 8 years of follow-up, we documented 710 cases of invasive breast cancer. The multivariate RR (95% CI) comparing highest to lowest quintiles of cumulative average score were 0.90 (0.68-1.18, p-value, test for trend = 0.54) for the prudent dietary pattern and 0.97 (0.71-1.33, p-value, test for trend = 0.97) for the Western dietary pattern. CONCLUSIONS: Our findings suggest that there is no overall association between dietary patterns and risk of breast cancer. However, we found an inverse association between the prudent dietary pattern and breast cancer risk among ever smokers, but the test for interaction was not significant. We suggest that this finding merits further evaluation.

Adult↗
PubMed2004

Dietary patterns of rural older adults are associated with weight and nutritional status.

OBJECTIVES: To characterize dietary patterns of rural older adults and relate patterns to weight and nutritional status. DESIGN: Cross-sectional. SETTING: Rural Pennsylvania. PARTICIPANTS: One hundred seventy-nine community-dwelling adults aged 66 to 87 years. MEASUREMENTS: A home visit was conducted to collect demographic, health behavior, and anthropometric data and a blood sample. Five 24-hour dietary recall were administered. Cluster analysis classified participants into dietary patterns using food subgroup servings. Chi-square, analysis of covariance, and logistic regression were used to assess differences across clusters. RESULTS: A low-nutrient-dense cluster (n=107), with higher intake of breads, sweet breads/desserts, dairy desserts, processed meats, eggs, and fats/oils, and a high-nutrient-dense cluster (n=72) with higher intake of cereals, dark green/yellow vegetables, other vegetables, citrus/melons/berries, fruit juices, other fruits, milks, poultry, fish, and beans, were identified. Those in the high-nutrient-dense cluster had lower energy intake; higher energy-adjusted intake of fiber, iron, zinc, folate, and vitamins B(6), B(12), and D; higher Healthy Eating Index scores; higher plasma vitamin B(12) levels; and a lower waist circumference. Those with a low-nutrient-dense dietary pattern were twice as likely to be obese, twice as likely to have low plasma vitamin B(12) levels, and three to 17 times more likely to have low nutrient intake. CONCLUSION: This study provides support for recommending a high-nutrient-dense dietary pattern for older adults. Behavioral interventions encouraging diets characterized by high-nutrient-dense foods may improve weight and nutritional status of older adults.

Aged↗
PubMed2002

Changes in dietary patterns and certain nutrition-related diseases in urban and rural residents of Jiangsu Province, China, during the 1990s.

OBJECTIVE: To investigate into the changes of dietary patterns and their impacts on health of urban and rural residents in Jiangsu Province, China during the 1990s. METHODS: On the basis of the results of food consumption survey, the calorie intake was calculated according to the balanced diet method and the quality of diet was assessed by scores of desirable dietary pattern (DDP). RESULTS: It was found that food consumption and dietary patterns changed remarkably during the 1990s. Grain consumption was decreasing year by year, but the consumption of animal food was markedly increasing. Although the score of desirable dietary pattern (DDP) in urban residents was more than 90, the deducted score due to over-consumption of animal food increased. The mortality from infectious diseases evidently decreased in the whole province, while the death rates of some chronic diseases, such as diabetes, hypertension, colorectal cancer and breast cancer, were increasing rapidly in urban areas. CONCLUSIONS: Sufficient attention should be paid to the negative effects of change in dietary patterns on people's health, especially in the urban residents.

China↗
PubMedDate not supplied

Dietary patterns and stomach cancer among middle-aged male workers in Tokyo.

Many epidemiological studies have examined the associations of nutrients and foods with risk of stomach cancer. Few studies have addressed the dietary patterns that reflect various components of food consumption and their interactions. We identified major four dietary patterns; "vegetable and fruit", "Western breakfast", "meat", and "rice/snack" with principal component analysis using food consumption questionnaire in a prospective study of 5,765 middle-aged male workers in Tokyo. After 10 years of follow-up between September 1988 and August 1998, 84 incident cases of stomach cancer were documented. Using proportional hazards regression to estimate risk ratios, we found no clear association between each of dietary pattern and stomach cancer risk. After adjustment for age and other potential confounding factors and after exclusion of the cases diagnosed in first follow-up year, the risk ratio (RR) associated with high tertile compared to low tertile was 0.78(95%CI 0.42-1.44) for "vegetable and fruit" pattern and 0.71(95%CI 0.40-1.24) for "Western breakfast" pattern. The V-shaped associations between dietary patterns and stomach cancer risk were appeared in the "meat" (RR=1.00, 0.55, and 1.10) and the "rice/snack" (RR=1.00, 0.52, and 1.19) patterns, while the linear trend of these associations was statistically on borderline. The roll of overall dietary patterns in predicting stomach cancer risk requires further investigation.

Adult↗
PubMed2003

Major dietary patterns and the risk of colorectal cancer in women.

BACKGROUND: Several foods and nutrients have been implicated in the development of colon and rectal cancers. In this study, we prospectively assessed the associations between major dietary patterns and the risks of these 2 cancers in women. METHODS: Using dietary information collected in 1984, 1986, 1990, and 1994 from 76 402 women aged 38 to 63 years without a history of cancer in 1984, we conducted factor analysis and identified 2 major dietary patterns: "prudent" and "Western." We calculated factor scores for each participant and examined prospectively the associations between dietary patterns and colon and rectal cancer risks. RESULTS: The prudent pattern was characterized by higher intakes of fruits, vegetables, legumes, fish, poultry, and whole grains, while the Western pattern, by higher intakes of red and processed meats, sweets and desserts, french fries, and refined grains. During 12 years of follow-up, we identified 445 cases of colon cancer and 101 cases of rectal cancer. After adjusting for potential confounders, we observed a relative risk for colon cancer of 1.46 (95% confidence interval, 0.97-2.19) when comparing the highest with the lowest quintiles of the Western pattern (P value for trend across quintiles, .02). The prudent pattern had a nonsignificant inverse association with colon cancer (relative risk for fifth quintile compared with the first, 0.71; 95% confidence interval, 0.50-1.00; P for trend across quintiles, .31). We did not observe any significant association between dietary patterns and rectal cancer. CONCLUSION: We found a significant positive association between the Western dietary pattern and the risk of colon cancer.

Adult↗
PubMed2002

A controlled evaluation of staging dietary patterns to reduce the risk of diabetes in African-American women.

OBJECTIVE: This study evaluated the 3-month follow-up data of the Eat Well, Live Well Nutrition Program, a culturally specific, peer-led dietary change program designed to reduce the risk of type 2 diabetes in low-income African-American women. This peer-led program was delivered in the community and was tailored to the participants' stage of change for individual dietary patterns. We report the results of the 3-month intervention and the extent to which dietary changes and other key outcomes were maintained at a 3-month follow-up assessment. RESEARCH DESIGN AND METHODS: Using an experimental control group design, 294 overweight African-American women (ages 25-55 years), recruited in collaboration with a neighborhood organization, completed pre- and posttest and 3-month follow-up interviews of dietary behaviors, knowledge, attitudes, fat intake, and weight. RESULTS: Significant reductions were found in fat intake among women in the treatment condition when compared with women in the control group; these reductions were maintained at 3-month follow-up assessment. Likewise, significant changes in dietary patterns were reported after the study and were maintained, except for one dietary pattern (replacement). CONCLUSIONS: This model of health promotion, which individually tailors dietary patterns through staging and use of peer educators, has the potential for decreasing fat intake and increasing and maintaining specific low-fat dietary patterns among overweight African-American women at risk for diabetes.

Adult↗
PubMed2006

[Impact of childhood abuses on the psychology and behaviors regarding harmful dietary pattern in adolescents].

OBJECTIVE: To examine the effect of childhood abuses on adolescents' psychology and behaviors related to harmful dietary pattern. METHODS: Anonymous questionnaire study on childhood abuses, adolescents' psychology and behaviors regarding their dietary patterns was conducted among 5141 students in 9 middle schools in 2 areas of Anhui province. RESULTS: Among 5141 students, 29.9% reported having severe childhood physical abuse, 64.8% having intermediate childhood physical abuse, 51.4% having mental abuse, 5.3% having physical contact sexual abuse and 24.5% having non-physical contact sexual abuse. In junior, senior middle schools and vocational schools, the incidence rate of severe childhood physical abuse, physical contact sexual abuse and non-physical contact sexual abuse among male students was higher than that among female students. In total, the incidence rate of childhood mental abuse among female students (53.1%) was higher than that among male students (49.8%) and with significant difference (chi2 = 5.484, P < 0.05). The incidence rate of 5 kinds of childhood abuses among junior middle school students was relatively low, and the incidence rate of intermediate childhood physical abuse and mental abuse was higher among senior middle school students. The incidence rate of 9 among the 11 kinds of psychology and behaviors related to harmful dietary pattern among female students in the middle schools and vocational schools was higher than that among male students. By unconditional multivariate logistic regression model, results showed that the childhood abuses was among the 11 kinds of psychological and behavioral risk factors related to harmful dietary pattern. CONCLUSION: Childhood abuses had negative effects on dietary behaviors in adolescents.

Adolescent↗
PubMed2001

Validation of a dietary pattern approach for evaluating nutritional risk: the Framingham Nutrition Studies.

OBJECTIVE: To validate the use of cluster analysis for characterizing population dietary patterns. DESIGN: Cluster analysis was applied to a food frequency questionnaire to define dietary patterns. Independent estimates of nutrient intake were derived from 3-day food records. Heart disease risk factors were assessed using standardized protocols in a clinic setting. SETTING: Adult women (n = 1,828) participating in the Framingham Offspring-Spouse study. STATISTICAL ANALYSES: Age-adjusted mean nutrient intakes were determined for each cluster. Analysis of covariance was used to evaluate pairwise differences in intake across clusters. Compliance with published recommendations was determined for selected heart disease risk factors. Differences in age-adjusted compliance across clusters were evaluated using logistic regression. RESULTS: Cluster analysis identified 5 distinct dietary patterns characterized by unique food behaviors and significantly different nutrient intake profiles. Patterns rich in fruits, vegetables, grains, low-fat dairy, and lean protein foods resulted in higher nutrient density. Patterns rich in fatty foods, added fats, desserts, and sweets were less nutrient-dense. Women who consumed an Empty Calorie pattern were less likely to achieve compliance with clinical risk factor guidelines in contrast to most other groups of women. CONCLUSIONS: Cluster analysis is a valid tool for evaluating nutrition risk by considering overall patterns and food behaviors. This is important because dietary patterns appear to be linked with other health-related behaviors that confer risk for chronic disease. Therefore, insight into dietary behaviors of distinct clusters within a population can help to design intervention strategies for prevention and management of chronic health conditions including obesity and cardiovascular disease.

Aged↗
PubMed2003

Common and country-specific dietary patterns in four European cohort studies.

The association between diet and cancer, predominantly investigated univariately, has often been inconsistent, possibly because of the large number of candidate risk factors and their high intercorrelations. Analysis of dietary patterns is expected to give more insight than analysis of single nutrients or foods. This study aimed to develop and apply a common methodological approach to determine dietary patterns in four cohort studies originating in Finland, the Netherlands, Sweden and Italy. Food items on each of the food frequency questionnaires were aggregated into 51 food groups, defined on the basis of their position in the diet pattern and possible relevance to cancer etiology. Exploratory factor analysis was used to analyze dietary patterns. Using a standardized approach, 3-5 stable dietary patterns were identified, explaining 20-29% of total variance in consumption of the food groups. Two dietary patterns, which explained most of the variance, were consistent across the studies. The first pattern was characterized by high consumption of (salad) vegetables, the second by high consumption of pork, processed meat and potatoes. In addition, a few specifically national food patterns were identified. Sensitivity analyses showed that the identified patterns were robust for number of factors extracted, distribution of input variables and energy adjustment. Our findings suggest that some important eating patterns are shared by the four populations under study, whereas other eating patterns are population specific.

Adult↗
PubMed2006

Methodological approaches to study dietary patterns in relation to risk of coronary heart disease and stroke.

Dietary pattern analysis, which reflects the complexity of dietary intake, has received considerable attention by nutritional epidemiology. For a long time, two general approaches have been used to define these summary variables in observational studies. The exploratory approach is based only on the data of the study, whereas the hypothesis-oriented approach constructs pattern variables based on scientific evidence available before the study. Recently, a new statistical method, reduced rank regression, was applied to nutritional epidemiology that is exploratory by nature, but can use scientific evidence by focusing on disease-related dietary components or biomarkers. Several studies, both observational and clinical, suggest that dietary patterns may predict the risk of CHD and stroke. In the present review, we describe the results of these studies and the available evidence regarding the relationships between dietary patterns and risk of CVD and we discuss limitations and strengths of the statistical methods used to extract dietary patterns.

Coronary Disease↗
PubMed2006

Dietary patterns and risk of colorectal tumors: a cohort of French women of the National Education System (E3N).

Little is known about the dietary patterns associated with colorectal tumors along the adenoma-carcinoma sequence. Scores for dietary patterns were obtained by factor analysis in women from the French cohort of the European Prospective Investigation into Cancer and Nutrition (1993-2000). Their association with colorectal tumors was investigated in 516 adenoma cases (175 high-risk adenomas) and 4,804 polyp-free women and in 172 colorectal cancer cases and 67,312 cancer-free women. The authors identified four dietary patterns: "healthy" (vegetables, fruit, yogurt, sea products, and olive oil); "Western" (potatoes, pizzas and pies, sandwiches, sweets, cakes, cheese, cereal products, processed meat, eggs, and butter); "drinker" (sandwiches, snacks, processed meat, and alcoholic beverages); and "meat eaters" (meat, poultry, and margarine). For quartile 4 versus quartile 1, an increased risk of adenoma was observed with high scores of the Western pattern (multivariate relative risk (RR) = 1.39, 95% confidence interval: 1.00, 1.94; p(trend) = 0.03) and the drinker pattern (RR = 1.42, 95% confidence interval: 1.10, 1.83; p(trend) = 0.01). The meat-eaters pattern was positively associated with colorectal cancer risk (for quartile 4 vs. quartile 1: RR = 1.58, 95% confidence interval: 0.98, 2.53; p(trend) = 0.02). Dietary patterns that reflect a Western way of life are associated with a higher risk of colorectal tumors.

Adenoma↗
PubMed2006

Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA).

BACKGROUND: Dietary patterns may influence cardiovascular disease risk through effects on inflammation and endothelial activation. OBJECTIVE: We examined relations between dietary patterns and markers of inflammation and endothelial activation. DESIGN: At baseline, diet (food-frequency questionnaire) and concentrations of C-reactive protein (CRP), interleukin 6 (IL-6), homocysteine, soluble intercellular adhesion molecule-1 (sICAM-1), and soluble E selectin were assessed in 5089 nondiabetic participants in the Multi-Ethnic Study of Atherosclerosis. RESULTS: Four dietary patterns were derived by using factor analysis. The fats and processed meats pattern (fats, oils, processed meats, fried potatoes, salty snacks, and desserts) was positively associated with CRP (P for trend < 0.001), IL-6 (P for trend < 0.001), and homocysteine (P for trend = 0.002). The beans, tomatoes, and refined grains pattern (beans, tomatoes, refined grains, and high-fat dairy products) was positively related to sICAM-1 (P for trend = 0.007). In contrast, the whole grains and fruit pattern (whole grains, fruit, nuts, and green leafy vegetables) was inversely associated with CRP, IL-6, homocysteine (P for trend < or = 0.001), and sICAM-1 (P for trend = 0.034), and the vegetables and fish pattern (fish and dark-yellow, cruciferous, and other vegetables) was inversely related to IL-6 (P for trend = 0.009). CRP, IL-6, and homocysteine relations across the fats and processed meats and whole grains and fruit patterns were independent of demographics and lifestyle factors and were not modified by race-ethnicity. CRP and homocysteine relations were independent of waist circumference. CONCLUSIONS: These results corroborate previous findings that empirically derived dietary patterns are associated with inflammation and show that these relations in an ethnically diverse population with unique dietary habits are similar to findings in more homogeneous populations.

Aged↗
PubMed2006

Dietary patterns are associated with sexual maturation in Korean children.

The purpose of this study was to investigate the association between dietary patterns and sexual maturation among Korean children. A cross-sectional study was conducted in 422 boys and 365 girls aged 9-12 years living in Seoul, Korea. Three-day food records were obtained, and pubertal stages were determined with a questionnaire using Tanner stages. Body fat was measured by bioelectrical impedance analysis, and bone mass content at the right calcaneus was measured by portable dual-emission X-ray absorptiometry. Exploratory factor analysis with a Varimax rotation was applied to identify dietary patterns using twenty-four food groups. Four distinct dietary patterns--"rice and Kimchi", "shellfish and processed meat", "pizza and drinks" and "milk and cereal"--were obtained. Twenty-six per cent (24 % stage 2, 2 % stage 3) of boys had genital development, and 79 % (63 % stage 2, 16 % stage 3) of girls showed breast development. In boys, genital development was weakly positively associated with "shellfish and processed meat" dietary factor scores (odds ratio 1.65, CI 0.95, 2.89, P for trend 0.07) after adjusting for confounders. In girls, breast development was significantly positively associated with the factor score of "shellfish and processed meat" (odds ratio 1.88, CI 1.08, 3.26, P for trend 0.05). These results suggest that dietary patterns were related to body composition and sexual maturation among the Korean children. Further investigations are needed to identify components of the foods consumed in high amounts in these patterns and how they are related to sexual maturation.

Anthropometry↗
PubMed2006

Associations between dietary pattern and lifestyle, anthropometry and other health indicators in the elderly participants of the EPIC-Italy cohort.

INTRODUCTION: Epidemiological studies have shown that dietary behaviour is an important aetiological factor in various chronic diseases. We used principal component factor analysis to identify dietary patterns and to examine the associations of these patterns with health-related variables in a sample of elderly (> or =60 years) Italians participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS AND RESULTS: Exploratory factor analysis was applied to the intake of food groups as estimated by semi-quantitative food questionnaires. Individual participants were assigned factor scores, indicating the extent to which their diet conformed to each of the four dietary patterns identified: prudent (cooked vegetables, pulses, cabbage, seed oil and fish); pasta & meat (pasta, tomato sauce, red meat, processed meat, bread and wine); olive oil & salad (raw vegetables, olive oil, soup and chicken); and sweet & dairy (sugar, cakes, ice cream, coffee and dairy). Highly educated people had high scores on prudent and low scores on pasta & meat. The pasta & meat and prudent patterns were strongly positively associated with body mass index (BMI) and waist-to-hip ratio (WHR) in men and women. Hyperlipidaemic men and women consumed more of the prudent and olive oil & salad patterns and less of the sweet & dairy pattern than those with normal lipids. The olive oil & salad was significantly higher and the pasta & meat and sweet & dairy patterns significantly lower in men and women who had dieted over the previous year, suggesting awareness of the health consequences of these patterns. CONCLUSIONS: Dietary pattern analysis provides a characterization of recurrent dietary behaviour in elderly people, and can be used to provide tangible dietary advice to elderly people.

Anthropometry↗
PubMed2004

Dietary patterns and risk of breast cancer in the ORDET cohort.

The aim of this study was to evaluate the association between dietary patterns and risk of developing breast cancer in an Italian cohort. Women volunteers were recruited from 1987 to 1992 from residents in Varese province, northern Italy, an area covered by a cancer registry. Participants completed a semiquantitative food frequency questionnaire, and anthropometric and other data were collected systematically. Using nutritional data from 8984 women with an average follow up of 9.5 years and 207 incident cases of breast cancer, we conducted an exploratory factor analysis to identify major dietary patterns. Four dietary patterns, which explained 30% of the variance, emerged: salad vegetables (mainly consisting of raw vegetables and olive oil); western (mainly consisting of potatoes, red meat, eggs and butter); canteen (pasta and tomato sauce); and prudent (cooked vegetables, pulses, and fish, with negative loading on wines and spirits). After adjustment for potential confounders, only the salad vegetables pattern was associated with significantly lower (34-35%) breast cancer incidence (RR = 0.66, CI(95%) = 0.47+/-0.95 comparing highest with lowest tertile) with a significant linear trend (P = 0.016). Women with body mass index <25 had an even greater risk reduction in the highest tertile of the salad vegetables pattern (>50% less risk than the lowest tertile, RR = 0.39, CI(95%) = 0.22-0.69) with a significant trend (P = 0.001); whereas women with body mass index > or =25 had no protective effect for the consumption of salad vegetables. These findings suggest that a diet rich in raw vegetables and olive oil protects against breast cancer.

Adult↗
PubMed2005

A dietary pattern protective against type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)--Potsdam Study cohort.

AIMS/HYPOTHESIS: The aim of this study was to identify a dietary pattern associated with diabetes-related biomarkers and to investigate whether this pattern is associated with the incidence of type 2 diabetes. METHODS: A nested case-control study of 192 cases of incident type 2 diabetes and 382 control subjects matched for sex and age was conducted. All subjects were participants in the population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Dietary pattern score was derived using intake data on 48 food groups as exposure variables and the biomarkers HbA1c, HDL cholesterol, C-reactive protein and adiponectin as response variables in reduced rank regression. The association of the score with diabetes risk was estimated by conditional logistic regression analysis. RESULTS: A high score for the identified dietary pattern was characterised by a high intake of fresh fruit and a low intake of high-caloric soft drinks, beer, red meat, poultry, processed meat, legumes and bread (excluding wholegrain bread). Subjects with high scores had high plasma concentrations of HDL cholesterol and adiponectin and low plasma concentrations of HbA1c and C-reactive protein. After multivariate adjustment, the odds ratios for type 2 diabetes across increasing quintiles of the dietary pattern score were 1.0, 0.59, 0.51, 0.26 and 0.27, respectively (p = 0.0006 for trend). CONCLUSIONS/INTERPRETATION: A high score for the identified dietary pattern is associated with a more favourable biomarker profile and a substantially reduced incidence of type 2 diabetes.

Adiponectin↗