Optimal dietary patterns for prevention of chronic disease

Abstract

Multiple dietary patterns have been associated with different diseases; however, their comparability to improve overall health is yet to be determined. In 205,852 healthcare professionals from three US cohorts followed for up to 32 years, we prospectively assessed two mechanism-based diets and six diets based on dietary recommendations in relation to major chronic disease, defined as a composite outcome of incident major cardiovascular disease, type 2 diabetes, and cancer. We demonstrated that adherence to a healthy diet was generally associated with a lower risk of major chronic disease (hazard ratio [HR] comparing the 90th to 10th percentile of dietary pattern scores: 0.58–0.80). Participants with low insulinemic (HR 0.58, 95% CI 0.57, 0.60), low inflammatory (HR 0.61, 95% CI 0.60, 0.63), or diabetes risk-reducing diet (HR 0.70, 95% CI 0.69, 0.72) had the largest risk reduction for incident major cardiovascular disease, type 2 diabetes, and cancer in composite and individually. Similar findings were observed across sex, and diverse ethnic groups. Our results suggest that dietary patterns that are associated with markers of hyperinsulinemia and inflammation and diabetes development may inform on future dietary guidelines for chronic disease prevention.