Eating patterns and type 2 diabetes risk in men: breakfast omission, eating frequency, and snacking1234

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Background: Little is known about the association between eating patterns and type 2 diabetes (T2D) risk.

Objective: The objective of this study was to prospectively examine associations between breakfast omission, eating frequency, snacking, and T2D risk in men.

Design: Eating patterns were assessed in 1992 in a cohort of 29,206 US men in the Health Professionals Follow-Up Study who were free of T2D, cardiovascular disease, and cancer and were followed for 16 y. We used Cox proportional hazards analysis to evaluate associations with incident T2D.

Results: We documented 1944 T2D cases during follow-up. After adjustment for known risk factors for T2D, including BMI, men who skipped breakfast had 21% higher risk of T2D than did men who consumed breakfast (RR: 1.21; 95% CI: 1.07, 1.35). Compared with men who ate 3 times/d, men who ate 1–2 times/d had a higher risk of T2D (RR: 1.25; 95% CI: 1.08, 1.45). These findings persisted after stratification by BMI or diet quality. Additional snacks beyond the 3 main meals (breakfast, lunch, and dinner) were associated with increased T2D risk, but these associations were attenuated after adjustment for BMI.

Conclusions: Breakfast omission was associated with an increased risk of T2D in men even after adjustment for BMI. A direct association between snacking between meals and T2D risk was mediated by BMI.

Abbreviations:

FFQ
food-frequency questionnaire
MET-h
metabolic equivalent task hours
T2D
type 2 diabetes

Cited by (0)

1

From the Departments of Nutrition (RAM, EG, WCW, RMvD, and FBH) and Epidemiology (EG, WCW, and FBH), Harvard School of Public Health, Boston, MA; the Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (EG, WCW, and FBH); and the Saw Swee Hock School of Public Health, National University of Singapore, Singapore (FBH).

2

Funding sources were not involved in data collection, data analysis, manuscript writing, or publication of the study.

3

Supported by the NIH (grants CA55075, CA95589, P30 DK46200, and DK58845).

4

Address correspondence to FB Hu, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115. E-mail: [email protected].