Allie S Carew1, Rania A Mekary2, Susan Kirkland3, Olga Theou4, Ferhan Siddiqi1, Robin Urquhart5, Chris Blanchard1, Ratika Parkash1, Mark Bennett6, Kerry L Ivey7, Kenneth Mukamal8, Frank Hu9, Eric B Rimm9, Leah E Cahill10. 1. Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. 2. School of Pharmacy, Massachusetts College of Pharmacy and Health Sciences University, Boston, Massachusetts, United States. 3. Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada. 4. Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada. 5. QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. 6. Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada. 7. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States; Microbiome and Host Health Programme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Department of Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia. 8. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States; Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, Massachusetts, United States. 9. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States. 10. Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: leah.cahill@dal.ca.
Abstract
BACKGROUND: Skipping meals is an increasingly common practice to lose weight among North American adults. However, the long-term effect of this practice on incident type 2 diabetes mellitus (T2DM) remains unknown. We assessed whether skipping meals to lose weight is associated with T2DM risk and whether this association is modified by cardiometabolic risk factors. METHODS: Skipping meals to lose weight was assessed by questionnaire in 2,288 adults from the 1995 Nova Scotia Health Survey and was linked to administrative health databases to determine T2DM incidence in the following 23 years. Multivariable-adjusted Cox proportional hazards models estimated hazard ratios (aHRs) and 95% confidence intervals (CIs) for T2DM. RESULTS: During follow up, 378 T2DM cases were diagnosed. Compared with participants who did not skip meals to lose weight, those who did (2.2%) had a 125% higher risk of T2DM (aHR, 2.25; 95% CI, 1.31 to 3.86). This association was no longer present after further adjustment for baseline body mass index (BMI) (aHR, 1.66; 95% CI, 0.96 to 2.85). Skipping meals to lose weight was associated with T2DM among participants who were men (n=1,135; aHR, 2.09; 95% CI, 1.09 to 4.02) or had a BMI <30 kg/m2 (n=1,676; aHR, 2.64, 95% CI, 1.15 to 6.06), elevated cholesterol (n=1,146; aHR, 2.11; 95% CI, 1.06 to 4.22), high blood pressure (n=1,133; aHR, 2.10; 95% CI, 1.10 to 4.01) and restless sleep (n=1,186; aHR, 2.19; 95% CI, 1.13 to 4.25), but not among women, those with a BMI of ≥30 kg/m2 and those without elevated cholesterol, high blood pressure or restless sleep. CONCLUSIONS: Skipping meals to lose weight may be a predictive modifiable risk factor for developing T2DM over time, potentially working in connection with other T2DM risk factors.
BACKGROUND: Skipping meals is an increasingly common practice to lose weight among North American adults. However, the long-term effect of this practice on incident type 2 diabetes mellitus (T2DM) remains unknown. We assessed whether skipping meals to lose weight is associated with T2DM risk and whether this association is modified by cardiometabolic risk factors. METHODS: Skipping meals to lose weight was assessed by questionnaire in 2,288 adults from the 1995 Nova Scotia Health Survey and was linked to administrative health databases to determine T2DM incidence in the following 23 years. Multivariable-adjusted Cox proportional hazards models estimated hazard ratios (aHRs) and 95% confidence intervals (CIs) for T2DM. RESULTS: During follow up, 378 T2DM cases were diagnosed. Compared with participants who did not skip meals to lose weight, those who did (2.2%) had a 125% higher risk of T2DM (aHR, 2.25; 95% CI, 1.31 to 3.86). This association was no longer present after further adjustment for baseline body mass index (BMI) (aHR, 1.66; 95% CI, 0.96 to 2.85). Skipping meals to lose weight was associated with T2DM among participants who were men (n=1,135; aHR, 2.09; 95% CI, 1.09 to 4.02) or had a BMI <30 kg/m2 (n=1,676; aHR, 2.64, 95% CI, 1.15 to 6.06), elevated cholesterol (n=1,146; aHR, 2.11; 95% CI, 1.06 to 4.22), high blood pressure (n=1,133; aHR, 2.10; 95% CI, 1.10 to 4.01) and restless sleep (n=1,186; aHR, 2.19; 95% CI, 1.13 to 4.25), but not among women, those with a BMI of ≥30 kg/m2 and those without elevated cholesterol, high blood pressure or restless sleep. CONCLUSIONS: Skipping meals to lose weight may be a predictive modifiable risk factor for developing T2DM over time, potentially working in connection with other T2DM risk factors.
Keywords:
diabète sucré de type 2; epidemiology; nutrition; prevention; prévention; saut de repas en vue de perdre du poids; skipping meals to lose weight; type 2 diabetes mellitus; épidémiologie
Authors: Allie S Carew; Rania A Mekary; Susan Kirkland; Olga Theou; Ferhan Siddiqi; Robin Urquhart; Michelle George; Chris Blanchard; Mary L Biggs; Luc Djoussé; Kenneth J Mukamal; Leah E Cahill Journal: Am J Clin Nutr Date: 2022-08-04 Impact factor: 8.472