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Eating Wisely Deters Diabetes

Women with healthy diets as indicated by high Alternate Healthy Eating Index scores had reduced risk for type 2 diabetes.

In addition to its other proven benefits, healthful eating may lower risk for type 2 diabetes. Investigators assessed prospectively the dietary habits of 80,000 participants in the Nurses’ Health Study (NHS) using the Alternate Healthy Eating Index (AHEI), which measures intake frequency and portion size of nine dietary components: fruits, vegetables, ratio of white (seafood and poultry) to red meat, trans fat, ratio of polyunsaturated to saturated fat, cereal fiber, nuts and soy, alcohol, and supplemental multivitamins. Higher AHEI scores indicate healthier diets. Study participants completed food frequency questionnaires in 1984, 1986, 1990, and 1998; new diagnoses of diabetes were identified through self-reports and confirmed with standardized diagnostic criteria.

During the 18-year follow-up, 5183 incident cases of diabetes occurred. When adjusted for BMI and other confounders, AHEI scores in the highest quintile versus the lowest quintile were associated with a relative risk of 0.64 for type 2 diabetes (P for trend <0.0001). Additional adjustment for waist-to-hip ratio attenuated the association (RR, 0.76; P for trend <0.0001). Higher AHEI scores seemed to be protective only for nonsmokers (RR, 0.74; P for trend <0.0001). Women who initially scored high and later reported lower scores had no risk reduction compared with women having consistently low scores, but those whose scores increased (even during the preceding 4 years) reduced their diabetes risk.

Comment: Although obesity is a major risk factor for type 2 diabetes, these findings from the methodologically sound NHS suggest that, regardless of adiposity, women can lower their diabetes risk by following, or changing to, a healthful diet. In practice, most clinicians have little time to assess patients’ eating habits and to provide advice about how to improve them. Options include referral to nutrition specialists (if available) and use of printed materials, online resources (e.g., the USDA Web site), and interactive computer software.

— Diane E. Judge, APN/CNP

Published in Journal Watch Women's Health September 6, 2007

Citation(s):

Fung TT et al. A prospective study of overall diet quality and risk of type 2 diabetes in women. Diabetes Care 2007 Jul; 30:1753-7.

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