Journal article
A Low-Fat Dietary Pattern and Diabetes: A Secondary Analysis From the Women's Health Initiative Dietary Modification Trial
Diabetes care, Vol.41(4), pp.680-687
04/2018
DOI: 10.2337/dc17-0534
PMCID: PMC5860839
PMID: 29282203
Abstract
We performed a secondary analysis to evaluate the effect of the Women's Health Initiative dietary intervention on incident diabetes and diabetes treatment in postmenopausal women.
A total of 48,835 women were randomized to a comparison group or an intervention group that underwent a behavioral/nutritional modification program to decrease fat and increase vegetable, fruit, and grain intake for an average of 8.1 years. Ninety-three percent of participants completed the intervention, and 71% participated in active follow-up through 30 September 2015 (median 17.3 years). We measured time to development of treated diabetes and progression from oral antihyperglycemic agents to insulin. Serum glucose and insulin were measured in a subsample of women (
= 2,324) at baseline and years 1, 3, and 6.
During the trial, intervention group women had lower rates of initiation of insulin therapy (hazard ratio [HR] 0.74 [95% CI 0.59, 0.94];
= 0.01). Moreover, women with baseline waist circumference ≥88 cm (
interaction = 0.01) and worse metabolic syndrome scores (
interaction = 0.02) had the greatest reduction in risk of initiating insulin therapy. The decreased risk from the intervention was present during the cumulative follow-up (HR 0.88 [95% CI 0.78, 0.99];
= 0.04). In participants with measured biomarkers (5.8% subsample) who had baseline glucose <100 mg/dL, the intervention reduced the risk of developing glucose ≥100 mg/dL by 25% (odds ratio 0.75 [95% CI 0.61, 0.93];
= 0.008). Adjustment for weight change did not alter the results.
In this secondary analysis, a dietary intervention in postmenopausal women aimed at reducing fat and increasing intake of vegetables, fruits, and grains did not increase risk of diabetes and may have slowed progression.
Details
- Title: Subtitle
- A Low-Fat Dietary Pattern and Diabetes: A Secondary Analysis From the Women's Health Initiative Dietary Modification Trial
- Creators
- Barbara V Howard - Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DCAaron K Aragaki - Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WALesley F Tinker - Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WAMatthew Allison - Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CAMelanie D Hingle - Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZKaren C Johnson - University of Tennessee Health Science Center, Memphis, TNJoAnn E Manson - Brigham and Women's Hospital, Harvard Medical School, Boston, MAAladdin H Shadyab - Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CAJames M Shikany - University of Alabama at Birmingham, Birmingham, ALLinda G Snetselaar - University of Iowa, Iowa City, IACynthia A Thomson - Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZOleg Zaslavsky - University of Washington, Seattle, WARoss L Prentice - Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
- Resource Type
- Journal article
- Publication Details
- Diabetes care, Vol.41(4), pp.680-687
- Publisher
- United States
- DOI
- 10.2337/dc17-0534
- PMID
- 29282203
- PMCID
- PMC5860839
- ISSN
- 0149-5992
- eISSN
- 1935-5548
- Grant note
- HHSN268201600018C / NHLBI NIH HHS P30 DK017047 / NIDDK NIH HHS R01 CA210921 / NCI NIH HHS HHSN268201600003C / NHLBI NIH HHS HHSN268201600004C / NHLBI NIH HHS HHSN268201600002C / NHLBI NIH HHS HHSN268201600001C / NHLBI NIH HHS UL1 TR001409 / NCATS NIH HHS P01 CA053996 / NCI NIH HHS
- Language
- English
- Date published
- 04/2018
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983996066502771
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