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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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.