Quantity and variety of food groups consumption and the risk of diabetes in adults: A prospective cohort study

Background: Evidence remains inconsistent regarding the association between quantity of food groups and diabetes, and remains scarce regarding the relation of dietary diversity with diabetes. Objective: We aimed to evaluate the prospective relation of variety and quantity of 12 major food groups with new-onset diabetes. Methods: A total of 16,117 participants who were free of diabetes at baseline from China Health and Nutrition Survey were included. Dietary intake and variety score were measured by three consecutive 24-h dietary recalls combined with a household food inventory in each survey round. The study outcome was new-onset diabetes, defined as self-reported physician-diagnosed diabetes during the follow-up period. Cox proportional hazards models and restricted cubic spline analysis were used to estimate hazard ratios (HR) and dose-response relation, respectively. Results: During a median follow-up duration of 9.0 years, a total of 1088 (6.7%) participants developed new-onset diabetes. Overall, there was a significant inverse association between dietary variety score and the risk of new-onset diabetes (per one point increment; HR, 0.85; 95% CI, 0.80-0.90). In addition, there were U-shaped associations of refined grains, whole grains, nuts, red meat, poultry, processed meat, dairy products, and aquatic products intake with diabetes, and L-shaped associations of legumes, vegetables, fruits, and eggs intake with diabetes (all P values for nonlinearity <0.001). Conclusion: Our results suggested that greater variety of food groups consumption was associated with significantly lower risk of new-onset diabetes. Furthermore, when the quantity of food groups intakes was relatively low, there was a negative correlation between the quantity of each different food group consumption and diabetes risk; however, when intake exceeded certain thresholds, the risks of newonset diabetes increased or reached a plateau. 0 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Automated summary

The study found that greater dietary variety was associated with a lower risk of new-onset diabetes. There were different associations between intake of various food groups and diabetes risk, with some showing U-shaped relationships and others showing L-shaped relationships.