Association between dietary patterns and prediabetes, undetected diabetes or clinically diagnosed diabetes: results from
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REVIEW
Association between dietary patterns and prediabetes, undetected diabetes or clinically diagnosed diabetes: results from the KORA FF4 study Giulia Pestoni1,2 · Anna Riedl2,3 · Taylor A. Breuninger2,3 · Nina Wawro2,3 · Jean‑Philippe Krieger1 · Christa Meisinger2,3 · Wolfgang Rathmann4,5 · Barbara Thorand5,6 · Carla Harris6,7 · Annette Peters5,6 · Sabine Rohrmann1 · Jakob Linseisen2,3 Received: 25 March 2020 / Accepted: 13 October 2020 © The Author(s) 2020
Abstract Purpose Diet is one of the most important modifiable risk factors for the development of type 2 diabetes. Here, we aim to identify dietary patterns and to investigate their association with prediabetes, undetected diabetes and prevalent diabetes. Methods The present study included 1305 participants of the cross-sectional population-based KORA FF4 study. Oral glucose tolerance test (OGTT) measurements together with a physician-confirmed diagnosis allowed for an accurate categorization of the participants according to their glucose tolerance status into normal glucose tolerance (n = 698), prediabetes (n = 459), undetected diabetes (n = 49), and prevalent diabetes (n = 99). Dietary patterns were identified through principal component analysis followed by hierarchical clustering. The association between dietary patterns and glucose tolerance status was investigated using multinomial logistic regression models. Results A Prudent pattern, characterized by high consumption of vegetables, fruits, wholegrains and dairy products, and a Western pattern, characterized by high consumption of red and processed meat, alcoholic beverages, refined grains and sugar-sweetened beverages, were identified. Participants following the Western pattern had significantly higher chances of having prediabetes (odds ratio [OR] 1.92; 95% confidence interval [CI] 1.35, 2.73), undetected diabetes (OR 10.12; 95% CI 4.19, 24.43) or prevalent diabetes (OR 3.51; 95% CI 1.85, 6.67), compared to participants following the Prudent pattern. Conclusion To our knowledge, the present study is one of the few investigating the association between dietary patterns and prediabetes or undetected diabetes. The use of a reference group exclusively including participants with normal glucose tolerance might explain the strong associations observed in our study. These results suggest a very important role of dietary habits in the prevention of prediabetes and type 2 diabetes. Keywords Dietary patterns · Glucose tolerance status · Prediabetes · Type 2 diabetes · Undetected diabetes · Western pattern Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00394-020-02416-9) contains supplementary material, which is available to authorized users. * Jakob Linseisen j.linseisen@helmholtz‑muenchen.de 1
Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Cen
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