Identification of Dietary Patterns Associated with Incidence of Hyperglycemia in Middle-Aged and Older Korean Adults

Little is known about the association between dietary patterns and hyperglycemia incidence among Korean adults. Hence, we aimed to prospectively investigate the major dietary patterns associated with hyperglycemia among middle-aged and older Korean adults. In total, 55,457 adults (18,292 men and 37,165 women) aged 40 to 79 years, who were previously enrolled in the Health Examinee Study of the Korean Genome and Epidemiology Study and had no history of type 2 diabetes mellitus (T2DM) or cancer at baseline, were included. Dietary patterns were identified by a factor analysis based on dietary data, which were assessed at baseline using a validated food-frequency questionnaire. Participants were classified as having hyperglycemia if fasting blood glucose levels were &ge
126 mg/dL or physician diagnosed T2DM during follow-up. Multivariable Cox proportional hazard models were used to examine the associations between each dietary pattern and future hyperglycemia risk after adjusting for potential confounders. After a mean follow-up of 4.9 years, 2574 new cases of hyperglycemia were identified. Using a factor analysis, four distinct dietary patterns were identified: &ldquo
prudent
&rdquo
&ldquo
fatty fish, meat, and flour-based food
coffee and sweets
and &ldquo
whole grain (men)&rdquo
or &ldquo
white rice (women).&rdquo
The &ldquo
prudent&rdquo
pattern was inversely associated with hyperglycemia risk only in women (hazard ratio [HR], 0.75
95% confidence interval [CI], 0.63&ndash
0.89
p for trend = 0.0003). Conversely, women in the highest quintile of the &ldquo
fatty fish, meat, and flour-based food&rdquo
pattern showed an increased risk of hyperglycemia (HR, 1.22
95% CI, 1.03&ndash
1.44
p for trend = 0.0210) compared with those in the lowest quintile. The &ldquo
coffee and sweets&rdquo
white rice&rdquo
patterns were not associated with hyperglycemia risk in women. The dietary patterns observed in men had no associations with hyperglycemia incidence. Our findings suggest that a diet rich in vegetables, mushrooms, seaweeds, fruits, and soy products and low in fatty fish and high-fat meat may potentially play a protective role in T2DM development with sex differences in middle-aged and older Korean adults.