Relationship between dietary intake and the development of type 2 diabetes in a Chinese population: the Hong Kong Dietary Survey.

OBJECTIVE To study the relationship between dietary intake and the development of type 2 diabetes among Chinese adults. DESIGN A prospective cohort study. Dietary assessment was carried out using a validated FFQ. Principal component analysis was used to identify dietary patterns. Dietary glycaemic load and variety of snacks were also calculated. SETTING A hospital-based centre at the Queen Mary Hospital in Hong Kong SAR, China. SUBJECTS A total of 1010 Chinese adults aged 25-74 years who participated in a territory-wide dietary and cardiovascular risk factor prevalence survey in 1995-1996 were followed up for 9-14 years for the development of diabetes. RESULTS A total of 690 (68·3 %) individuals completed follow-up during 2005-2008 and seventy-four cases of diabetes were identified over the follow-up period. Four dietary patterns were identified ('more snacks and drinks', 'more vegetables, fruits and fish', 'more meat and milk products' and 'more refined grains'). After adjustment for age, sex, BMI, waist-to-hip ratio, smoking, alcohol intake, participation in exercise/sports and family history of diabetes, the more vegetables, fruits and fish pattern was associated with a 14 % lower risk (OR per 1 sd increase in score = 0·76; 95 % CI 0·58, 0·99), whereas the more meat and milk products pattern was associated with a 39 % greater risk of diabetes (OR per 1 sd increase in score = 1·39; 95 % CI 1·04, 1·84). Dietary glycaemic load, rice intake, snack intake and variety of snacks were not independently associated with diabetes. CONCLUSIONS The more vegetables, fruits and fish pattern was associated with reduced risk and the more meat and milk products pattern was associated with an increased risk of diabetes.