ADA 2010: Diet can affect type 2 diabetes risk

Dietary choices can have a discernable effect on the risk of developing type 2 diabetes. That conclusion is based on analysis of men in the Health Professionals Follow-Up Study (HPFS), which followed 41,212 men for up to 20 years.

"It is important to replace red and processed meats with other choices, chicken and fish and especially vegetable protein sources," said Lawrence de Koning, PhD, postdoctoral fellow, Harvard School of Public Health, Boston. "The data show us that vegetable-based protein does not elevate the risk of diabetes and may very well be protective."

It has long been recognized that low-carbohydrate diets appear to be protective for cardiovascular and other diseases. Low-carbohydrate diets are also frequently used for weight loss. But the relationship between low-carbohydrate diets and type 2 diabetes risk is less clear, de Koning said.

Researchers analyzed food consumption reports submitted every 4 years by the HPFS participants and the occurrence of type 2 diabetes to assess dietary risk factors. Food questionnaire responses were used to score 3 low-carbohydrate diets: high-total protein/fat, high-animal protein/fat, and high-vegetable protein/fat.

There were 2,761 cases of type 2 disease reported during the follow-up period. Hazard ratios (HRs) were calculated after adjusting for age, smoking, physical activity, body-mass index, coffee and alcohol use, family history of diabetes, and total energy. The high-animal protein/fat diet carried the highest risk for type 2 diabetes (HR, 1.41; PPP

The high-total protein/fat diet lost its type 2 diabetes risk after adjusting for animal protein and fat. The HR associated with the high-animal protein/fat diet was reduced to 1.19 (P

"The risk relationship with red and processed meats is linear,” de Koning said. “At low levels of intake, you might have a low level of risk that can be offset by some other protective factor such as more exercise."

Results of the HPFS analysis suggest that the key to reducing type 2 diabetes risk is to follow a prudent diet that is high in whole grains, moderate in alcohol, and low in red and processed meats, sodium, and sugar-sweetened beverages.