Dietary Patterns and Incident Type 2 Diabetes in Chinese Men and Women: The Singapore Chinese Health Study

OBJECTIVE: To empirically derive dietary patterns and examine their association with incident type 2 diabetes. RESEARCH DESIGN AND METHODS: We used data from the Singapore Chinese Health Study, including 43,176 Chinese men and women (aged 45–74 years), free of diabetes, cardiovascular disease, and cancer at baseline (1993–1998) and followed up through 2004. Two major dietary patterns were identified using principal components analysis: a vegetable, fruit, and soy-rich pattern (VFS) and a dim sum and meat-rich pattern (DSM). Pattern scores for each participant were calculated and examined with type 2 diabetes risk using Cox regression. RESULTS: The associations of the two dietary patterns with diabetes risk were modified by smoking status. Neither pattern was associated with risk of diabetes in ever smokers. In never smokers, the VFS dietary pattern was inversely associated with risk of type 2 diabetes. Compared with the lowest quintile of the VFS dietary pattern score, the hazard ratios (HRs) for quintiles 2–5 were 0.91, 0.82, 0.73, and 0.75 (P = 0.0005 for trend). The DSM dietary pattern was positively associated with risk of type 2 diabetes in never smokers, with HRs for quintiles 2–5 of 1.07, 1.25, 1.18, and 1.47 (P < 0.0001 for trend). CONCLUSIONS: A dietary pattern with higher intake of vegetables, fruits, and soy foods was inversely associated with risk of incident type 2 diabetes, and a pattern with higher intake of dim sum, meat and processed meat, sweetened foods and beverages, and fried foods was associated with a significantly increased risk of type 2 diabetes in Chinese men and women in Singapore.