Low-Fat Dietary Pattern and Risk of Treated Diabetes Mellitus in Postmenopausal Women
(2008)
Journal - Archives of Internal Medicine
Abstract :
Methods A randomized controlled trial was conducted at40 US clinical centers from 1993 to 2005, including 48 835postmenopausal women aged 50 to 79 years. Women were randomlyassigned to a usual-diet comparison group (n = 29 294[60.0%]) or an intervention group with a 20% low-fat dietarypattern with increased vegetables, fruits, and grains (n = 19 541[40.0%]). Self-reported incident diabetes treated with oralagents or insulin was assessed.Results Incident treated diabetes was reported by 1303intervention participants (7.1%) and 2039 comparison participants(7.4%) (hazard ratio, 0.96; 95% confidence interval, 0.90-1.03;P = .25). Weight loss occurred in the interventiongroup, with a difference between intervention and comparisongroups of 1.9 kg after 7.5 years (P < .001). Subgroupanalysis suggested that greater decreases in percentage of energyfrom total fat reduced diabetes risk (P for trend = .04),which was not statistically significant after adjusting forweight loss.Conclusions A low-fat dietary pattern among generallyhealthy postmenopausal women showed no evidence of reducingdiabetes risk after 8.1 years. Trends toward reduced incidencewere greater with greater decreases in total fat intake andweight loss. Weight loss, rather than macronutrient composition,may be the dominant predictor of reduced risk of diabetes.Trial Registration clinicaltrials.gov Identifier: NCT00000611