Type 2 diabetes prevention diet and all-cause and cause-specific mortality in the US population: a prospective study

We aimed to examine whether type 2 diabetes prevention diet, a dietary pattern previously developed for reducing type 2 diabetes risk, was associated with mortality in a US population. A population-based cohort of 86633 subjects was identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (study period: 1993 to 2015). Dietary information was collected with a food frequency questionnaire. A dietary diabetes risk reduction score was calculated to reflect adherence to this dietary pattern, with higher scores representing better adherence. Hazard ratios (HRs) and absolute risk differences (ARDs) in mortality rates per 10000 person-years were calculated. After a mean follow-up of 13.6 years, 17532 all-cause deaths were observed. The highest versus the lowest quintiles of dietary diabetes risk reduction score was associated with decreased risks of death from all causes (HRquintile 5 versus 1: 0.76; 95% CI: 0.72, 0.80; ARDquintile 5 versus 1: -81.94; 95% CI: -93.76, -71.12), cardiovascular disease (HRquintile 5 versus 1: 0.73; 95% CI: 0.66, 0.81; ARDquintile 5 versus 1: -17.82; 95% CI: -24.81, -11.30), and cancer (HRquintile 5 versus 1: 0.85; 95% CI: 0.78, 0.94; ARDquintile 5 versus 1: -9.92; 95%CI: -15.86, -3.59), which were modified by sex, smoking status, or alcohol consumption in subgroup analyses (all Pinteraction<0.05). In conclusion, type 2 diabetes prevention diet confers reduced risks of death from all causes, cardiovascular disease, and cancer in this US population.