Insulinemic and Inflammatory Dietary Patterns Show Enhanced Predictive Potential for Type 2 Diabetes Risk in Postmenopausal Women

Qi Jin; Ni Shi; Desmond Aroke; Dong Hoon Lee; Joshua J. Joseph; Macarius Donneyong; Darwin L. Conwell; Phil A. Hart; Xuehong Zhang; Steven K. Clinton; Zobeida Cruz-Monserrate; Theodore M. Brasky; Rebecca Jackson; Lesley F. Tinker; Simin Liu; Lawrence S. Phillips; Aladdin H. Shadyab; Rami Nassir; Wei Bao; Fred K. Tabung

doi:10.2337/dc20-2216

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Insulinemic and Inflammatory Dietary Patterns Show Enhanced Predictive Potential for Type 2 Diabetes Risk in Postmenopausal Women

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Insulinemic and Inflammatory Dietary Patterns Show Enhanced Predictive Potential for Type 2 Diabetes Risk in Postmenopausal Women

Qi Jin, Ni Shi, Desmond Aroke, Dong Hoon Lee, Joshua J. Joseph, Macarius Donneyong, Darwin L. Conwell, Phil A. Hart, Xuehong Zhang, Steven K. Clinton, …

Diabetes care, Vol.44(3), pp.707-714

03/01/2021

DOI: 10.2337/dc20-2216

PMCID: PMC7896263

PMID: 33419931

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Abstract

OBJECTIVE The empirical dietary index for hyperinsulinemia (EDIH) and empirical dietary inflammatory pattern (EDIP) scores assess the insulinemic and inflammatory potentials of habitual dietary patterns, irrespective of the macronutrient content, and are based on plasma insulin response or inflammatory biomarkers, respectively. The glycemic index (GI) and glycemic load (GL) assess postprandial glycemic potential based on dietary carbohydrate content. We tested the hypothesis that dietary patterns promoting hyperinsulinemia, chronic inflammation, or hyperglycemia may influence type 2 diabetes risk. RESEARCH DESIGN AND METHODS We calculated dietary scores from baseline (1993-1998) food frequency questionnaires among 73,495 postmenopausal women in the Women's Health Initiative, followed through March 2019. We used multivariable-adjusted Cox regression to estimate hazard ratios (HRs) and 95% CIs for type 2 diabetes risk. We also estimated multivariable-adjusted absolute risk of type 2 diabetes. RESULTS During a median 13.3 years of follow-up, 11,009 incident cases of type 2 diabetes were diagnosed. Participants consuming the most hyperinsulinemic or proinflammatory dietary patterns experienced greater risk of type 2 diabetes; HRs (95% CI) comparing highest to lowest dietary index quintiles were EDIH 1.49 (1.32-1.68; P-trend < 0.0001) and EDIP 1.45 (1.29-1.63; P-trend < 0.0001). The absolute excess incidence for the same comparison was 220 (EDIH) and 271 (EDIP) cases per 100,000 person-years. GI and GL were not associated with type 2 diabetes risk: GI 0.99 (0.88-1.12; P-trend = 0.46) and GL 1.01 (0.89-1.16; P-trend = 0.30). CONCLUSIONS Our findings in this diverse cohort of postmenopausal women suggest that lowering the insulinemic and inflammatory potentials of the diet may be more effective in preventing type 2 diabetes than focusing on glycemic foods.

Endocrinology & Metabolism

Life Sciences & Biomedicine

Science & Technology

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Title: Subtitle: Insulinemic and Inflammatory Dietary Patterns Show Enhanced Predictive Potential for Type 2 Diabetes Risk in Postmenopausal Women
Creators: Qi Jin - The Ohio State University
Ni Shi - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
Desmond Aroke - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
Dong Hoon Lee - Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA
Joshua J. Joseph - The Ohio State University Wexner Medical Center
Macarius Donneyong - The Ohio State University
Darwin L. Conwell - The Ohio State University Wexner Medical Center
Phil A. Hart - The Ohio State University Wexner Medical Center
Xuehong Zhang - Harvard University
Steven K. Clinton - The Ohio State University Wexner Medical Center
Zobeida Cruz-Monserrate - The Ohio State University Wexner Medical Center
Theodore M. Brasky - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
Rebecca Jackson - The Ohio State University Wexner Medical Center
Lesley F. Tinker - Fred Hutch Cancer Center
Simin Liu - Brown University
Lawrence S. Phillips - Atlanta VA Health Care System
Aladdin H. Shadyab - University of California San Diego
Rami Nassir - Umm al-Qura University
Wei Bao - University of Iowa
Fred K. Tabung - The Ohio State University
Resource Type: Journal article
Publication Details: Diabetes care, Vol.44(3), pp.707-714
DOI: 10.2337/dc20-2216
PMID: 33419931
PMCID: PMC7896263
NLM abbreviation: Diabetes Care
ISSN: 0149-5992
eISSN: 1935-5548
Publisher: Amer Diabetes Assoc
Number of pages: 8
Grant note: HHSN268201600018C; HHSN268201600001C; HHSN268201600002C; HHSN268201600003C; HHSN268201600004C / National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
Language: English
Date published: 03/01/2021
Academic Unit: Epidemiology
Record Identifier: 9984364518202771

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