Introduction and Objective: Diet plays a critical role in the prevention and management of type 2 diabetes, yet the optimal dietary pattern for reducing diabetes risk remains unclear. The EAT-Lancet diet was designed to promote both human health and global environmental sustainability. The association of this dietary pattern and risk of developing diabetes is unknown. Methods: Atherosclerosis Risk in Communities (ARIC) study participants without diabetes at baseline (1987-1989) who completed a food-frequency questionnaire (n= 12,730) were included in the analysis. The Planetary Health Diet Index (PHDI) was scored to assess adherence to the EAT-Lancet diet for planetary health and human health based on the consumption of adequacy food components (whole grain, vegetables, fruits, fish/shellfish, nuts, legumes, and unsaturated fat) and moderation components (poultry, red/processed meat, dairy, tubers, saturated fat, and added sugar). Cox regression was used to estimate hazard ratios (HRs) for the association between PHDI and incident diabetes, defined by self-reported diagnosis, elevated fasting or non-fasting glucose, and medication use, through December 31, 2022. Results: Among 12,730 participants, mean age was 54 years, 77% were white, 55% were women, and mean BMI was 27 kg/m2. Average PHDI score was 76.04 of 130. During a median follow-up of 21 years, 4,316 study participants 33.9% developed diabetes. Participants with higher PHDI scores had a lower risk of developing diabetes (quintile 5 vs. quintile 1 HR 0.89, 95% CI: 0.81, 0.98, p = 0.01) after adjusting for socioeconomic factors. Higher intake of non-soy legumes, nuts, tubers, and dairy were associated with lower risk of incident diabetes, while higher intake of red and processed meat, chicken and other poultry, and eggs were associated with higher risk of incident diabetes after adjusting for socioeconomic factors and health behaviors. Conclusion: A diet designed primarily for both environmental and human health also translates to meaningful reductions in diabetes risk, with varied associations for component food groups with diabetes. Disclosure R. Osman: None. C. Rebholz: None. Funding National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Department of Health and Human Services, under contract numbers (75N92022D00001, 75N92022D00002, 75N92022D00003, 75N92022D00004, 75N92022D00005). NHLBI (R01 HL153178)
OSMAN et al. (Fri,) studied this question.