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Quality of overall diet key to lowering type 2 diabetes risk
New research shows that a high-quality diet defined by low intake of animal foods such as red meat, and high intake of plant foods such as vegetables, fruits and whole grains, and reduced inta

Diet is an important risk factor for type 2 diabetes. Studying the impact of individual food items, however, does not account for the synergistic effects of diverse foods consumed together.

Hence, scientists have turned increasing attention to studying the overall dietary patterns in order to capture the combined effect of a variety of food groups.

Researchers from the National University of Singapore’s (NUS) Saw Swee Hock School of Public Health and Duke-NUS Medical School, have shown that a high-quality diet defined by low intake of animal foods such as red meat, and high intake of plant foods such as vegetables, fruits and whole grains, and reduced intake of sweetened beverages could be associated with reduced risk of type 2 diabetes.

Nested in the Singapore Chinese Health Study, the researchers used data from 45,000 middle-aged and elderly participants who did not have diabetes during recruitment (1993 to 1998) and followed them for an average period of 11 years. 5000 cases of diabetes were reported subsequently.

The participants were scored on how similar their diet patterns matched the five high-quality diets originating in Western populations, for instance, the alternative Mediterranean diet (aMED, an international adaptation of the eponymous diet), the Alternate Healthy Eating Index 2010 (AHEI-2010), the Dietary Approaches to Stop Hypertension (DASH) diet, the plant-based diet index (PDI) and the healthful plant-based diet index (hPDI). These dietary patterns are rich in plant-based foods, including whole grains, vegetables and fruits, nuts and legumes, and low in red meat and sugar-sweetened beverages. They are considered high-quality dietary patterns as they are shown to reduce the risk of diabetes and cardiovascular diseases.

The study, published in the American Journal of Epidemiology, found that all five high quality dietary patterns were inversely associated with risk of diabetes. Study participants in the top 20 percent of scores for similarity to these healthy dietary patterns had a significant reduction of 16 to 29 percent in risk of diabetes compared to those who were in the lowest 20 percent.

In a related study also nested in this Singapore Chinese Health Study, published in the European Journal of Nutrition, the investigators have found that although rice consumption was not associated with risk of diabetes, replacing one daily serving of rice with red meat or poultry may increase the risk of diabetes by up to 40 percent. In contrast, the replacement of rice with wholemeal bread could reduce the risk by 18 percent.

Professor Koh Woon Puay, Duke-NUS Medical School, and principal investigator of the Singapore Chinese Health Study said, “Although higher rice intake was not substantially associated with a higher risk of diabetes, eating more rice could lessen the intake of whole grains, which could reduce the risk instead. Hence, it is still advisable to replace rice with whole grains such as wholemeal bread and brown rice.”

This marks the first such local study and, together with related studies published, reinforces the concept of a ‘high-quality’ diet while highlighting the relative increase/decrease in type 2 diabetes risk of potential rice-replacement foods like noodles, bread, red meat and poultry.

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