(P13-080-24) Life Course Dietary Insulinemic and Inflammatory Potential and Risk of Type 2 Diabetes

Objectives: Timing of exposure to diet across the lifespan may be a critical issue in the development of type 2 diabetes (T2D). This study aims to investigate the associations of lifetime, adolescent, premenopausal adulthood, postmenopausal adulthood, and changes in lifetime dietary insulinemic and inflammatory potential with incident T2D risk from a life course perspective.

Methods: We analyzed 37,905 eligible participants in the Nurses’ Health Study II prospective cohort. Empirical dietary index for hyperinsulinemia (EDIH) and empirical dietary inflammatory pattern (EDIP) scores were derived from validated adulthood food frequency questionnaires (FFQ) administered every 4 years and validated high school FFQ. Multivariable-adjusted Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI).

Results: In fully-adjusted analyses (controlled for a wide range of T2D risk factors, and with mutual adjustments of EDIH/EDIP across different life course periods where applicable), we detected increased risk of T2D associated with higher lifetime average EDIH and EDIP (HR, 95% CI: 2.55, 2.23-2.91 and 2.08, 1.83-2.35, respectively; highest vs. lowest quintile), and higher EDIH and EDIP during adolescence (1.06, 0.94-1.19 and 1.17, 1.04-1.32), premenopausal adulthood (2.78, 2.22-3.48 and 2.04, 1.68-2.48), and postmenopausal adulthood (2.38, 1.91-2.96 and 1.73, 1.42-2.11). The HR, 95%CI associated with higher lifetime averages for both EDIH and EDIP (vs. low lifetime averages for both, based on tertiles) was 2.53 (2.21-2.89). Individuals with high adulthood EDIH/EDIP had similar magnitudes of risk elevation, regardless of their adolescent EDIH/EDIP status. Reducing adulthood EDIH was associated with a decreased T2D risk among individuals with low/intermediate adolescent EDIH, whereas reducing adulthood EDIP benefited especially those who had high adolescent EDIP. A substantially higher multivariable-adjusted cumulative incidence of T2D were associated with lifetime consistently high (vs. low) EDIH and EDIP (19.10% vs. 7.56% and 20.25% vs. 9.19%, respectively, at age 70).

Conclusions: Over the life course, higher dietary insulinemic and inflammatory potential were associated with an increased risk of T2D, and the magnitude of risk was especially high for diet during adulthood.

Funding Sources: NIH