Associations of nutrient intakes with obesity and diabetes mellitus in the longitudinal medical surveys of Japanese Americans

AIMS/INTRODUCTION: Our previous survey of two Japanese populations, with different lifestyles but identical genetic dispositions, showed that Japanese Americans had different dietary intakes and higher prevalences of obesity and diabetes mellitus, compared with the native Japanese population. The present study examined whether Westernized dietary habits could affect the development of obesity or diabetes. MATERIALS AND METHODS: This study included 765 individuals with normal glucose tolerance at baseline medical examinations (1986 or 1989 in Los Angeles and in 1988 or 1992 in Hawaii) who subsequently completed follow‐up medical examinations several years later. The participants were categorized at baseline as “lean” (576 individuals, body mass index of <25 kg/m(2)) or “obese” (189 individuals, body mass index of ≥25 kg/m(2)). Nutrient intakes were analyzed for associations with the development of obesity or diabetes using Cox's proportional hazard model. RESULTS: A total of 41 lean participants developed diabetes, which was not associated with any nutrient intakes (mean follow up 10.8 ± 6.6 years). A total of 36 obese participants developed diabetes, which was positively associated with intakes of animal protein, animal fat and saturated fatty acid (mean follow up 10.7 ± 6.3 years). A total of 85 lean participants became obese, which was positively associated with intakes of simple carbohydrates, sugar and fructose, as well as inversely associated with intakes of vegetable protein and complex carbohydrates (mean follow up 10.4 ± 6.5 years). CONCLUSIONS: In the Japanese Americans, different nutrient intakes affected the development of obesity and diabetes. Furthermore, the associations of nutrient intakes with diabetes development varied according to the presence or absence of obesity.