Dietary patterns and the risk of type 2 diabetes in overweight and obese individuals

Florianne Bauer, Joline W.J. Beulens, Daphne L. Van Der A, Cisca Wijmenga, Diederick E. Grobbee, Annemieke M.W. Spijkerman, Yvonne T. Van Der Schouw, N. Charlotte Onland-Moret

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38 Citations (Scopus)


Purpose: Although overweight is an important determinant of diabetes risk, it remains unclear whether food choices can still influence the risk for type 2 diabetes in overweight persons. In this paper, we aim to clarify the role of dietary patterns in the development of type 2 diabetes in overweight and obese individuals. Methods: We studied 20,835 overweight and obese participants in the Dutch part of the European Investigation into Cancer and Nutrition (EPIC-NL) study. Dietary intake was measured using a validated food frequency questionnaire, and dietary patterns were generated using factor analysis. Incident type 2 diabetes was verified against medical records. Cox proportional hazards models were used to assess the association between the dietary patterns (factor scores categorized in quartiles) and incident type 2 diabetes. Results: Scoring on Pattern 1, characterized by fish, wine, chicken, raw vegetables and fruit juices, was not associated with type 2 diabetes risk after confounder adjustment. A high score on Pattern 2, characterized by soft drinks, fries and snacks, was associated with higher risk of type 2 diabetes (HR Q4 vs. Q1 (95 % CI): 1.70 (1.31; 2.20), p trend ≤ 0.0001), particularly among less active individuals [less active: HR Q4 vs. Q1 (95 % CI): 2.14 (1.48; 3.09), p trend = 0.00004, more active: HR Q4 vs. Q1 (95 % CI): 1.35 (0.93; 1.97), p trend = 0.01; p interaction = 0.02]. Conclusions: A high score on a pattern high in soft drinks, fries and snacks and low in fruit and vegetables was associated with higher risk of type 2 diabetes in overweight and obese subjects especially among physically less active individuals.

Original languageEnglish
Pages (from-to)1127-1134
Number of pages8
JournalEuropean Journal of Nutrition
Issue number3
Publication statusPublished - 1 Apr 2013


  • Dietary pattern
  • Epidemiology
  • Obesity
  • Type 2 diabetes

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