Plant foods intake and risk of type 2 diabetes:Findings from a registry-based prospective cohort study
[Background]Lifestyle intervention or dietary modification has been the cornerstone of primary prevention and management of type 2 diabetes(T2D).[Objective]To investigate the associations of plant foods intake with the risk of incident T2D.[Methods]Based on a general population cohort,the Shanghai Suburban Adult Cohort and Biobank(SSACB),dietary data were collected for each participant in Songjiang District of Shanghai at enrollment with a validated Food Frequency Questionnaire(FFQ),and plant-based diet index(PDI),healthful plant-based diet index(hPDI),and unhealthful plant-based diet index(uPDI)were calculated.Incident T2D cases were identified according to physician diagnosis(fasting blood glucose≥7.0 mmol·L-1,or 2 h value during a 75-g oral glucose tolerance test≥11.1 mmol·L-1,or glycosylated hemoglobin≥6.5%,or with typical symptoms of hyperglycemia or hyperglycemic crisis,accompanied by a random plasma glucose≥11.1 mmol·L-1)or medication records,obtained from the electronic information system for residents'medical insurance.Multivariable-adjusted Cox proportional hazards models and restricted cubic splines were used to evaluate the associa-tions of foods from different sources with the risk of incident T2D.[Results]A total of 29016 participants[age at baseline(55.3±11.6)years]with a median follow-up duration of 5.688 years until 21 September 2022 were included.Plant foods(unprocessed)intake was associated with a decreased risk of incident T2D[HR(95%CI):0.983(0.969,0.998)].In comparison with participants in the highest quartile(≥859.3 g)of plant foods daily intake,the risk of incident T2D for those in the lowest quartile(<500.9 g)was higher[HR(95%CI):1.250(1.012,1.544)].No significant associations of animal foods[HR(95%CI):1.006(0.987,1.026)]and processed foods[HR(95%CI):0.978(0.944,1.014)]intakes were found with the risk of incident T2D.Replacing 50 g animal foods[HR(95%CI):0.982(0.968,0.996)]or processed foods[HR(95%CI):0.983(0.969,0.998)]with 50 g plant foods was associated with significantly decreased risks of incident T2D.Additionally,non-linear associations of PDI(Pnonlinear=0.023)and hPDI(Pnonlinear=0.016)with the risk of incident T2D were found in the SSACB.[Conclusion]Plant foods intake,especially healthful plant foods intake,is significantly associated with a decreased risk of incident T2D.
plant foodsplant-based diet indextype 2 diabetescohort studyCox proportional hazards model
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