OBJECTIVE To examine the associations between change in plant-centered diet quality and type 2 diabetes risk and change in body size. RESEARCH DESIGN AND METHODS A prospective study conducted in the U.S. enrolled adults ages 18–30 years in 1985– 1986 (examination 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 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 a mean follow-up of 9.3 (± 1.7) years, 206 case subjects with incident diabetes were observed. In multivariable analysis, participants with the largest increase in APDQS over 20 years had a 48% (95% CI 0.31–0.85; Ptrend < 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.
Bibliographical noteFunding Information:
The CARDIA study is supported by National Heart,Lung, and Blood Institute contracts HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, and HHSN268201800007I. Y.C. is supported by a Graduate and Professional Research Grant from the Healthy Food, Healthy Lives Institute and the MnDRIVE Global Food Ventures Professional Development Program, University of Minnesota Twin Cities. The sponsor, the National Heart, Lung, and Blood Institute, has a representative on the Steering Committee of CARDIA and participated in study design, data collection, and scientific review of this article. The sponsor had no role in data analysis, data interpretation, or writing of this report.
© 2020 by the American Diabetes Association.