Associations Between Dietary Patterns and Incident Type 2 Diabetes: Prospective Cohort Study of 120,343 UK Biobank Participants

<b>OBJECTIVE:</b> To identify dietary patterns (DPs) characterized by a set of nutrients of concern and their association with incident type 2 diabetes (T2D). <p><b>RESEARCH DESIGN AND METHODS: </b>120,343 participants from the UK Biobank study with at least two 24-h dietary assessments were studied. Reduced rank regression was used to derive DPs explaining variability in energy density, free sugars, saturated fat and fiber intakes. We investigated prospective associations with T2D using Cox proportional hazard models. </p> <p><b>RESULTS</b>: 2,878 participants developed T2D over 8.4 years of follow-up from the latest dietary assessment. Two DPs were identified that jointly explained a total of 63% variation in four nutrients. DP1 was characterized by high intakes of chocolate/confectionery, butter, low-fiber bread, sugars/preserves and low intakes of fruit/vegetables. DP1 was linearly associated with T2D in multivariable models without BMI adjustment [hazard ratio(HR) per z-score 1.11, 95%CI (1.08-1.14)] and after BMI adjustment [1.09(1.06-1.12)]. A second DP2 was characterized by high intakes of sugar-sweetened beverages, fruit juice, table sugars/preserves, and low intakes of high fat cheese/butter, but showed no clear association with T2D. There were significant interactions between both DPs and age, with increased risks among younger people in DP1 [1.13(1.09-1.18)] and DP2 [1.10(1.05-1.15)]; as well as with DP1 and BMI, with increased risks among people with obesity [1.11(1.07-1.16)]. </p> <p><b>CONCLUSIONS</b>: A dietary pattern characterized by high intakes of chocolate confectionery, butter, low-fiber bread and added sugars, and low in fresh fruit/vegetables intakes is associated with a higher incidence of T2D, particularly among younger people and those living with obesity.</p>