Adherence to a food group-based dietary guideline and incidence of prediabetes and type 2 diabetes

Nicolette R. den Braver*, Femke Rutters, Andrea L.J. Kortlever - van der Spek, Dorina Ibi, Moniek Looman, Anouk Geelen, Petra Elders, Amber A. van der Heijden, Johannes Brug, Jeroen Lakerveld, Sabita S. Soedamah-Muthu, Joline W.J. Beulens

*Corresponding author for this work

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Abstract

Purpose: In this study, we investigated the association between adherence to the Dutch Healthy Diet index 2015 (DHD15-index) and incidence of prediabetes (preT2D) and Type 2 Diabetes (T2D) in a representative sample for the general Dutch population. Methods: Two prospective cohort studies, The Hoorn and The New Hoorn Study, were used for data analyses. In total, data from 2951 participants without diabetes at baseline (mean age 56.5 ± 7.5 years; 49.6% male) were harmonized. Baseline dietary intake was assessed with validated Food Frequency Questionnaires and adherence to the DHD15-index was calculated (range 0–130). PreT2D and T2D were classified according to the WHO criteria 2011. Poisson regression was used to estimate prevalence ratios between participant scores on the DHD15-index and preT2D and T2D, adjusted for follow-up duration, energy intake, socio-demographic, and lifestyle factors. Change in fasting plasma glucose levels (mmol/L) over follow-up was analysed using linear regression analyses, additionally adjusted for baseline value. Results: During a mean follow-up of 6.3 ± 0.7 years, 837 participants developed preT2D and 321 participants developed T2D. The highest adherence to the DHD15-index was significantly associated with lower T2D incidence [model 3, PRT3vsT1: 0.70 (0.53; 0.92), ptrend = 0.01]. The highest adherence to the DHD15-index pointed towards a lower incidence of preT2D [PRT3vsT1: 0.87 (0.74; 1.03), ptrend = 0.11]. Higher adherence to the DHD15-index was not associated with change in fasting plasma glucose levels [β10point: − 0.012 (− 0.034; 0.009)mmol/L]. Conclusion: The present study showed that the highest compared to the lowest adherence to the DHD15-index was associated with a lower T2D incidence, and pointed towards a lower incidence of preT2D. These results support the benefits of adhering to the guidelines in T2D prevention.

Original languageEnglish
Pages (from-to)2159–2169
JournalEuropean Journal of Nutrition
Volume59
Early online date24 Jul 2019
DOIs
Publication statusPublished - Aug 2020

Keywords

  • Dietary pattern
  • Dutch healthy diet index 2015
  • Intermediate hyperglycemia
  • Prediabetes
  • Type 2 diabetes

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    den Braver, N. R., Rutters, F., Kortlever - van der Spek, A. L. J., Ibi, D., Looman, M., Geelen, A., Elders, P., van der Heijden, A. A., Brug, J., Lakerveld, J., Soedamah-Muthu, S. S., & Beulens, J. W. J. (2020). Adherence to a food group-based dietary guideline and incidence of prediabetes and type 2 diabetes. European Journal of Nutrition, 59, 2159–2169. https://doi.org/10.1007/s00394-019-02064-8