Food-based healthy diet metrics, type 2 diabetes and insulin resistance in Brazilian Longitudinal Study of Adults Health (ELSA-Brasil): a prospective study of over 12 000 Brazilians

Résumé fourni par la source

Abstract The Global Diet Quality Score (GDQS), the Global Dietary Recommendations score (GDR), Nova ultra-processed foods score and Minimum Diet Diversity for Women were listed by the UN as promising food-based metrics to track dietary quality. The aim was to evaluate those diet metrics performances for monitoring diet-related type 2 diabetes risk and insulin resistance in comparison with the Alternative Healthy Eating Index (AHEI). The study included 12 254 participants (56 % women; 35–74 years) of the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil) with available dietary, biochemical, socio-demographic and lifestyle data. Diet quality scores were derived from a validated FFQ covering the previous 12 months. Incident diabetes and changes in insulin resistance (HOMA-IR) over time were evaluated, and mediation by BMI was assessed. After an average 8·2 years follow-up period (17 % attrition; n 10 191), with 1-standard deviation increase in GDQS, GDR and AHEI, a 5 %, 6 % and 7 % decrease in incident diabetes was observed with BMI mediation effect of 39·6 %, 74·8 % and 59·4 %, respectively ( P < 0·001 for all the analysis). HOMA-IR increase rate over time was higher in the lower quintile of GDQS ( P = 0·002) and GDR ( P < 0·001), compared with the upper quintile. As AHEI, GDR and GDQS had similar performances in monitoring diet-related type 2 diabetes risk, food-based metrics, such as the GDR and the GDQS, can be advantageous in lower resources settings and in nations where there is no food composition data availability.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.