Healthy Diet Lowers Diabetes Risk in All Ethnic Groups

Jinnie J. Rhee Department of Epidemiology, Harvard School of Public Health, Boston, Interview with:
Jinnie J. Rhee MSc, ScD
Department of Medicine, Stanford University School of Medicine Palo Alto, CA

Medical Research: What is the background for this study? What are the main findings?

Response: The goal of this study was to see if the dietary determinants of type 2 diabetes observed in predominantly white populations were similar to those in other racial and ethnic groups.  We created a dietary diabetes risk reduction score using eight different dietary factors found to be associated with risk of type 2 diabetes, where a higher score indicates a healthier overall diet (A higher score included low intakes trans fat, sugar-sweetened beverages, and red and processed meats; lower glycemic index; and higher intakes of cereal fiber, nuts, and coffee; and higher polyunsaturated to saturated fat ratio).  We found a protective association of similar magnitude between a healthy overall diet and type 2 diabetes risk in all racial and ethnic groups.  However, in terms of the actual number of preventable cases, a healthier diet conferred even greater benefit for minority women because they were initially at higher risk than white women.

This study is significant because diabetes is a rapidly growing epidemic in most parts of the world, but most previous studies of diet and diabetes have been conducted in populations of European origin.  This analysis was very powerful because it combined two large populations with a total of 156,030 women who were followed for up to 28 years with many repeated assessments of diet.  This allowed us to conduct detailed analyses within specific racial and ethnic groups.

Medical Research: What should clinicians and patients take away from your report?

Response: These findings suggest that a healthy overall diet can play an important role in the prevention of type 2 diabetes, particularly in high-risk groups.  The take-home message is that regardless of one’s race and ethnicity, a healthy diet can play an important role in preventing diabetes, and in fact, the benefit may be greater for minority women who already have elevated risks of diabetes.  A healthier diet, especially that of lower glycemic foods and lower intakes of sugar sweetened beverages and red and processed meats, and higher intakes of cereal fiber and coffee should be encouraged.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: This study marks a big step forward in diabetes research because it shows that a dietary pattern found to be beneficial in a population mainly European origin can be applicable to most of the world’s population of women.  Future research should focus on how this knowledge can be applied into practice.  This includes finding ways to address health disparities that are influenced by race, income, and other socioeconomic factors


Jinnie J. Rhee, Josiemer Mattei, Michael D. Hughes, Frank B. Hu, and Walter C. Willett

Dietary Diabetes Risk Reduction Score, Race and Ethnicity, and Risk of Type 2 Diabetes in Women Diabetes Care published ahead of print January 15, 2015, doi:10.2337/dc14-1986