Energy Intake and Dietary Glycemic Load in Late Morning and Risk of Type 2 Diabetes: the Hispanic Community Health Study/Study of Latinos, a Multicenter Prospective Cohort Study

Objective: To evaluate the association between meal timing and type 2 diabetes risk in U.S. Hispanic/Latino adults.Research Design and Methods: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multicenter, community-based, prospective cohort study. This study included 8,868 HCHS/SOL adults without diabetes at baseline (2008-2011) and attending visit 2 examination (2014-2017). Energy intake and glycemic load (GL) in each meal timing were assessed at baseline using two 24-hour dietary recalls. Incident diabetes was identified through annual follow-up calls or at visit 2. Hazard ratios (HRs) for incident diabetes were estimated using Cox models, accounting for complex survey design.Results: The study population (50.9% female) had a baseline mean age of 39.0 (95% CI, 38.4-39.5) years. Over a median (range) follow-up of 5.8 (0.8-9.6) years, 1,262 incident diabetes cases were documented. Greater energy intake and GL in late morning (9:00-11:59 AM) were associated with lower diabetes risk, whereas greater energy intake and GL in other meal timings were not. After accounting for diet quantity and quality, sociodemographic characteristics, lifestyle factors, and chronic conditions, the HRs were 0.94 (95% CI, 0.91¬-0.97) per 100-kcal energy intake increment and 0.93 (0.89-¬¬0.97) per 10-unit GL increment in late morning. Replacing energy intake or GL, from early morning (6:00-8:59 AM), afternoon (12:00-5:59 PM), or evening (6:00-11:59 PM) with late morning equivalents was associated with comparably lower diabetes risk. Conclusions: This study identified late morning as a favorable meal timing in Hispanic/Latino adults, providing a novel perspective on type 2 diabetes prevention that warrants confirmation.