1. There was a lower risk of developing type 2 diabetes in patients with high fruit consumption compared to patients with high refined carbohydrates/low fruit & vegetable consumption.
2. There were no significant differences between males and females.
Evidence Rating Level: 2 (Good)
Diabetes affects a large population worldwide, with dietary intake identified as one of the most common modifiable risk factors for type 2 diabetes (T2DM). Multiple studies have identified associations between different dietary patterns and incidence of T2DM. However, most studies have established dietary patterns a priori and compared the incidence of T2DM in patients with such dietary patterns versus a pre-established control diet. This study aimed to look at the association between computationally determined clusters of carbohydrate intake patterns with T2DM incidences.
This was a prospective cohort study of 26,662 adult participants living in Sweden. Participants with limited Swedish proficiency, mental disability, or diabetes at baseline were excluded. The primary exposure was carbohydrate intake, determined by a 3-part dietary history method: a 7-day food diary, a 168-item food frequency questionnaire, and a 60-minute interview. The incidence of T2DM was determined through a diabetes diagnosis by a physician or at least two HbA1c values >6.0% during the study follow-up period from 1996 -2016.
There were 5 distinct clusters of carbohydrate consumption identified within the analysis: 1) high vegetables/low added sugar, 2) high sugar-sweetened beverages, 3) high juices, 4) high fruit, and 5) high refined carbohydrates/low fruit & vegetables. The results demonstrated that there was a significantly lower risk of developing T2DM in patients in the high fruit cluster compared to the high refined carbohydrates/low fruit & vegetables cluster. Interestingly, the high fruit cluster had the highest mean age and lowest proportion of current smokers, which may have confounded the results given the known correlation between increased risk of T2DM and. Lastly, there was no interaction with sex identified for the clusters, suggesting that the associations were similar between genders. This study was limited by possible measurement error due to self-reported dietary data as well as generalizability to a non-Swedish population. Nonetheless, these results suggest more nuanced dietary recommendations in patients with T2DM may be beneficial.
Click here to read the study in BMC Nutrition Journal
Image: PD
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