Diet-Wide Association Study for the Incidence of Type 2 Diabetes in Three Population-Based Cohorts

Dietary factors are well-known modifiable risk factors for type 2 diabetes (T2D), but many studies overlook the interrelationships between these factors, even though foods are often consumed together and contain a variety of nutrients.

In this study, we employed a diet-wide association study approach to investigate the links between various dietary factors and T2D onset, taking into account complex dietary patterns.

We analyzed 16,666 participants without T2D from three Korean population-based cohorts: the Multi-Rural Communities Cohort (n = 8302), the Atherosclerosis Risk of a Rural Area Korean General Population cohort (n = 4990), and the Kanghwa cohort (n = 3374). A two-step approach was employed. In the first step, robust Poisson regression analysis was used for the initial screening (false discovery rate-adjusted p-values < 0.05). In the second step, a hierarchical cluster analysis was conducted of all dietary factors, followed by mutual adjustment of the screened factors within each cluster to account for interrelationships.

The 11 food clusters screened were cooked rice with beans, rice cakes, breads/spreads, bread products, cheese and pizza/hamburger, grain powder, snack/confections, nuts and roasted beans, soy milk, traditional beverages, and non-native fruit. These factors were similarly distributed across three of the seven clusters in each cohort. After mutual adjustment, cooked rice with beans (p-value ≤ 2.00 × 10^-7 in all three cohorts) and non-native fruits (p-value ≤ 5.91 × 10^-3 in two cohorts) remained significantly associated with lower T2D risk in more than one cohort.

The inverse association of cooked rice with beans, not observed with other types of cooked rice, and that of non-native fruits, suggest that incorporating beans into rice and eating various fruits may be an effective strategy for preventing diabetes.