Abstract
Aim
To evaluate the relationship of diet to incident diabetes among non-Black and Black
participants in the Adventist Health Study-2.
Methods and Results
Participants were 15,200 men and 26,187 women (17.3% Blacks) across the U.S. and Canada
who were free of diabetes and who provided demographic, anthropometric, lifestyle
and dietary data. Participants were grouped as vegan, lacto ovo vegetarian, pesco
vegetarian, semi-vegetarian or non-vegetarian (reference group). A follow-up questionnaire
after two years elicited information on the development of diabetes. Cases of diabetes
developed in 0.54% of vegans, 1.08% of lacto ovo vegetarians, 1.29% of pesco vegetarians,
0.92% of semi-vegetarians and 2.12% of non-vegetarians. Blacks had an increased risk
compared to non-Blacks (odds ratio [OR] 1.364; 95% confidence interval [CI], 1.093–1.702).
In multiple logistic regression analysis controlling for age, gender, education, income,
television watching, physical activity, sleep, alcohol use, smoking and BMI, vegans
(OR 0.381; 95% CI 0.236–0.617), lacto ovo vegetarians (OR 0.618; 95% CI 0.503–0.760)
and semi-vegetarians (OR 0.486, 95% CI 0.312–0.755) had a lower risk of diabetes than
non-vegetarians. In non-Blacks vegan, lacto ovo and semi-vegetarian diets were protective
against diabetes (OR 0.429, 95% CI 0.249–0.740; OR 0.684, 95% CI 0.542–0.862; OR 0.501,
95% CI 0.303–0.827); among Blacks vegan and lacto ovo vegetarian diets were protective
(OR 0.304, 95% CI 0.110–0.842; OR 0.472, 95% CI 0.270–0.825). These associations were
strengthened when BMI was removed from the analyses.
Conclusion
Vegetarian diets (vegan, lacto ovo, semi-) were associated with a substantial and
independent reduction in diabetes incidence. In Blacks the dimension of the protection
associated with vegetarian diets was as great as the excess risk associated with Black
ethnicity.
Keywords
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Article info
Publication history
Published online: October 10, 2011
Accepted:
July 15,
2011
Received in revised form:
July 13,
2011
Received:
March 1,
2011
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
