American Diabetes Association
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A Shift Toward a Plant-Centered Diet from Young to Middle Adulthood and Subsequent Risk of Type 2 Diabetes and Weight Gain: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

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posted on 2020-08-26, 16:33 authored by Yuni Choi, Nicole Larson, Daniel D. Gallaher, Andrew O. Odegaard, Jamal S. Rana, James M. Shikany, Lyn M. Steffen, David R. Jacobs, Jr.
OBJECTIVE: To examine the associations between change in plant-centered diet quality and type 2 diabetes risk and change in body size.

RESEARCH DESIGN AND METHODS: A prospective study conducted in the US enrolled adults ages 18–30 years in 1985–1986 (exam year [Y0]) and followed them through 2015–2016. We analyzed the associations between change in plant-centered diet quality over 20 years (Y0–Y20) and diabetes (Y20–30, n=2,534) and change (Y0–Y20 and Y20–30) in body mass index (BMI), waist circumference (WC), and weight (n > 2,434). Plant-centered diet quality was measured using the A Priori Diet Quality Score (APDQS); a higher score favors nutritionally-rich plant foods. Cox regression models were used to assess diabetes risk and linear regression models were used to examine change in body size.

RESULTS: During mean follow-up of 9.3 (±1.7) years, 206 incident diabetes cases occurred. In multivariable analysis, participants with the largest increase in APDQS over 20 years had a 48% (95% CI: 0.31–0.85; P-trend < 0.001) lower risk of diabetes over the subsequent 10–years compared with participants whose score remained stable. Each 1–SD increment in APDQS over 20 years was associated with lower gains in BMI (-0.39 kg/m2, SE: 0.14; P=0.004), WC (-0.90 cm, SE: 0.27; P < 0.001), and weight (-1.14 kg, SE: 0.33; P < 0.001) during the same period, but not with subsequent changes.

CONCLUSIONS: Young adults who increased plant-centered diet quality had a lower diabetes risk and gained less weight by middle adulthood.


The CARDIA is supported by contracts HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, and HHSN268201800007I from the National Heart, Lung, and Blood Institute (NHLBI). The sponsor, NHLBI has a representative on the Steering Committee of CARDIA and participated in study design, data collection, and scientific review of this paper. The sponsor had no role in data analysis, data interpretation, or writing of this report. Yuni Choi is supported by Graduate and Professional Research Grant from the Healthy Food Healthy Lives Institute (HFHL) and from the MnDRIVE Global Food Ventures Professional Development Program, University of Minnesota−Twin Cities.


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