Eating patterns and type 2 diabetes risk in older women: breakfast consumption and eating frequency.

BACKGROUND Little is known about the association between eating patterns and type 2 diabetes (T2D) risk in women. OBJECTIVE The objective was to examine prospectively associations between regular breakfast consumption, eating frequency, and T2D risk in women. DESIGN Eating pattern was assessed in 2002 in a cohort of 46,289 US women in the Nurses' Health Study who were free of T2D, cardiovascular disease, or cancer and were followed for 6 y. We used Cox proportional hazards analysis to evaluate associations with incident T2D. RESULTS We documented 1560 T2D cases during follow-up. After adjustment for known risk factors for T2D-except for body mass index (BMI), a potential mediator-women who consumed breakfast irregularly (0-6 times/wk) were at higher risk of T2D than were women who consumed breakfast daily (RR: 1.28; 95% CI: 1.14, 1.44). This association was moderately attenuated after adjustment for BMI (RR: 1.20; 95% CI: 1.07, 1.35). In comparison with women who ate 3 times/d, the RRs were 1.09 (0.84, 1.41) for women who ate 1-2 times/d, 1.13 (1.00, 1.27) for women who ate 4-5 times/d, and 0.99 (0.81, 1.21) for women who ate ≥6 times/d. Among irregular breakfast consumers, women with a higher eating frequency (≥4 times/d) had a significantly greater T2D risk (RR: 1.47; 95% CI: 1.23, 1.75) than did women who consumed breakfast daily and ate 1-3 times/d. Adjustment for BMI attenuated this association (RR: 1.24; 95% CI: 1.04, 1.48). CONCLUSION Irregular breakfast consumption was associated with a higher T2D risk in women, which was partially but not entirely mediated by BMI.