Abstract P392: Eating Frequency and Snacking and Risk of Incident Type 2 Diabetes among French Women
Background—Increased eating frequency has been suggested to improve the metabolic profile among individuals with and without diabetes. However, a recent study found that both a decreased and an increased eating frequency increased the risk of diabetes.
Methods and Results— We evaluated the relation of eating frequency and snacking to type 2 diabetes in a prospective cohort study among 66,043 disease-free French women in the E3N cohort, a component of the EPIC cohort. In 1993, participants responded to a validated diet history questionnaire. This dietary assessment tool evaluates habitual food consumption over 8 possible eating occasions including meals, pre-meal apperatifs and snacks. Women were categorized according to the number of calorie-containing eating occasions and the number of snacks per day. Between 1993 and 2005, 1,358 cases of incident diabetes were identified and validated using a drug reimbursement dataset and a supplementary questionnaire. In multivariate analyses we adjusted for age, education, family history of diabetes, smoking, physical activity, menopausal status, hormone use, alcohol, prudent and Western dietary pattern and dietary fiber. Increased meal frequency was associated with lower diabetes risk. The HR comparing 8 meals a day to 4 or fewer was 0.69 (95%CI 0.55-0.86; p-trend 0.0002 across classes of meal frequency). More snacks were also associated with a lower risk of diabetes. As compared to having at least one snack a day, no snacking was associated with an increased risk of diabetes [HR=1.42 (95% CI 1.15-1.75); p-trend 0.003]. Results remained the same after further adjustment for BMI. After stratification by the median BMI (22.3 kg/m2), this inverse association appeared to be stronger in women with a higher BMI [HR8vs. ≤4 meals/day = 0.64 (95%CI 0.50-0.81; p-trend <0.0001 p-heterogeneity=0.04].
Conclusion—In this large prospective cohort of French women, more frequent meals or snacks were associated with a lower risk for type 2 diabetes, even after adjustment for BMI. This association appeared to be stronger among women with increased adiposity.
- © 2013 by American Heart Association, Inc.