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    Association between Dietary Energy Density and Incident Type 2 Diabetes in the Women's Health Initiative

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    Authors
    Hingle, Melanie
    Wertheim, Betsy C.
    Neuhouser, Marian L.
    Tinker, Lesley
    Howard, Barbara V.
    Johnson, Karen
    Liu, Simin
    Phillips, Lawrence S.
    Qi, Lihong
    Sarto, Gloria E.
    Turner, Tami
    Waring, Molly E.
    Thomson, Cynthia
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    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2017-05-01
    Keywords
    Diabetes prevention
    Dietary behavior
    Dietary energy density
    Postmenopausal women
    Type 2 diabetes
    Dietetics and Clinical Nutrition
    Endocrinology, Diabetes, and Metabolism
    Nutritional and Metabolic Diseases
    Women's Health
    
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    Link to Full Text
    https://doi.org/10.1016/j.jand.2016.11.010
    Abstract
    BACKGROUND: Dietary energy density, or energy available in relation to gram intake, can inform disease risk. OBJECTIVE: The objective of this study was to investigate the association between baseline dietary energy density and risk of incident type 2 diabetes in postmenopausal women. DESIGN: Dietary energy density, weight status, and type 2 diabetes incidence were prospectively characterized in a large cohort of postmenopausal women participating in one or more clinical trials or an observational study. PARTICIPANTS/SETTING: The study involved 161,808 postmenopausal women recruited to the Women's Health Initiative observational study or clinical trials at 40 centers across the United States between 1993 and 1998. MAIN OUTCOME MEASURES: The primary outcome was incident type 2 diabetes. STATISTICAL ANALYSES PERFORMED: The association between dietary energy density quintiles and incident diabetes was tested using Cox proportional hazards regression. RESULTS: A total of 143,204 participants without self-reported diabetes at enrollment completed baseline dietary assessment and were followed for 12.7+/-4.6 years. Risk of diabetes developing was 24% greater for women in the highest dietary energy density quintile compared with the lowest after adjusting for confounders (95% CI 1.17 to 1.32). Body mass index (calculated as kg/m2) and waist circumference mediated the relationship between dietary energy density and diabetes. In waist circumference-stratified analysis, women in dietary energy density quintiles 2 to 5 with waist circumferences > 88 cm were at 9% to 12% greater risk of diabetes developing compared with women with waist circumference CONCLUSIONS: In this prospective study, a higher baseline dietary energy density was associated with higher incidence of type 2 diabetes among postmenopausal women, both overall, and in women with elevated waist circumference.
    Source
    J Acad Nutr Diet. 2017 May;117(5):778-785.e1. doi: 10.1016/j.jand.2016.11.010. Epub 2017 Jan 5. Link to article on publisher's site
    DOI
    10.1016/j.jand.2016.11.010
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29071
    PubMed ID
    28065634
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jand.2016.11.010
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