Insulinemic and Inflammatory Dietary Patterns Show Enhanced Predictive Potential for Type 2 Diabetes Risk in Postmenopausal Women
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 (HR) and 95% confidence intervals (95%CI) 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 type 2 diabetes cases 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),Ptrend<.0001; EDIP: 1.45 (1.29-1.63),Ptrend<.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),Ptrend=0.46; GL: 1.01 (0.89, 1.16),Ptrend=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.