A Low-Fat Dietary Pattern and Diabetes: A Secondary Analysis From the Women's Health Initiative Dietary Modification Trial.

Diabetes Care 2018 04 27;41(4):680-687. Epub 2017 Dec 27.

Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.

Objective: We performed a secondary analysis to evaluate the effect of the Women's Health Initiative dietary intervention on incident diabetes and diabetes treatment in postmenopausal women.

Research Design And Methods: A total of 48,835 women were randomized to a comparison group or an intervention group that underwent a behavioral/nutritional modification program to decrease fat and increase vegetable, fruit, and grain intake for an average of 8.1 years. Ninety-three percent of participants completed the intervention, and 71% participated in active follow-up through 30 September 2015 (median 17.3 years). We measured time to development of treated diabetes and progression from oral antihyperglycemic agents to insulin. Serum glucose and insulin were measured in a subsample of women ( = 2,324) at baseline and years 1, 3, and 6.

Results: During the trial, intervention group women had lower rates of initiation of insulin therapy (hazard ratio [HR] 0.74 [95% CI 0.59, 0.94]; = 0.01). Moreover, women with baseline waist circumference ≥88 cm ( interaction = 0.01) and worse metabolic syndrome scores ( interaction = 0.02) had the greatest reduction in risk of initiating insulin therapy. The decreased risk from the intervention was present during the cumulative follow-up (HR 0.88 [95% CI 0.78, 0.99]; = 0.04). In participants with measured biomarkers (5.8% subsample) who had baseline glucose <100 mg/dL, the intervention reduced the risk of developing glucose ≥100 mg/dL by 25% (odds ratio 0.75 [95% CI 0.61, 0.93]; = 0.008). Adjustment for weight change did not alter the results.

Conclusions: In this secondary analysis, a dietary intervention in postmenopausal women aimed at reducing fat and increasing intake of vegetables, fruits, and grains did not increase risk of diabetes and may have slowed progression.

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Source
http://dx.doi.org/10.2337/dc17-0534DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5860839PMC
April 2018
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