Insulin response is related to overall health. Diet modulates insulin response. We investigated whether insulinemic potential of diet is associated with risk of all-cause and cause-specific mortality.

We prospectively followed 63,464 women from the Nurses' Health Study (1986–2016) and 42,880 men from the Health Professionals Follow-up Study (1986–2016). Diet was assessed by food frequency questionnaires every 4 years. The insulinemic potential of diet was evaluated using a food-based empirical dietary index for hyperinsulinemia (EDIH), which was predefined based on predicting circulating C-peptide concentrations.

During 2,792,550 person-years of follow-up, 38,329 deaths occurred. In the pooled multivariable-adjusted analyses, a higher dietary insulinemic potential was associated with an increased risk of mortality from all-cause (hazard ratio [HR] comparing extreme quintiles: 1.33; 95% CI 1.29, 1.38; P-trend <0.001), cardiovascular disease (CVD) (HR 1.37; 95% CI 1.27, 1.46; P-trend <0.001), and cancers (HR 1.20; 95% CI 1.13, 1.28; P-trend<0.001). These associations were independent of BMI and remained significant after further adjustment for other well-known dietary indices. Furthermore, compared with participants whose EDIH scores were stable over an 8-year period, those with the greatest increases had a higher subsequent risk of all-cause (HR 1.13; 95% CI 1.09, 1.18; P-trend<0.001) and CVD (HR 1.10; 95% CI 1.01, 1.21; P-trend = 0.006) mortality.

Higher insulinemic potential of diet was associated with increased risk of all-cause, CVD, and cancer mortality. Adopting a diet with low insulinemic potential might be an effective approach to improve overall health and prevent premature death.

胰岛素反应与整体健康有关。饮食调节胰岛素反应。我们调查了饮食的潜在胰岛素血症是否与全因和特定原因死亡率的风险相关。

我们前瞻性地跟踪了来自护士健康研究（1986-2016）的 63,464 名女性和来自卫生专业人员随访研究（1986-2016）的 42,880 名男性。每 4 年通过食物频率问卷评估饮食。使用基于食物的高胰岛素血症经验饮食指数 (EDIH) 评估饮食的胰岛素血症潜力，该指数基于预测循环 C 肽浓度而预先定义。

在 2,792,550 人年的随访中，有 38,329 人死亡。在汇总的多变量调整分析中，较高的膳食胰岛素潜在性与全因死亡风险增加相关（风险比 [HR] 比较极端五分位数：1.33；95% CI 1.29, 1.38；P趋势 <0.001） , 心血管疾病 (CVD) (HR 1.37; 95% CI 1.27, 1.46; P趋势 <0.001) 和癌症 (HR 1.20; 95% CI 1.13, 1.28; P-趋势<0.001）。这些关联与 BMI 无关，并且在进一步调整其他众所周知的饮食指数后仍然显着。此外，与 EDIH 评分在 8 年内保持稳定的参与者相比，增幅最大的参与者随后的全因风险（HR 1.13；95% CI 1.09, 1.18；P趋势<0.001）和 CVD风险更高（HR 1.10；95% CI 1.01, 1.21；P趋势 = 0.006）死亡率。

饮食中较高的胰岛素生成潜能与全因、心血管疾病和癌症死亡率的风险增加有关。采用低胰岛素血症的饮食可能是改善整体健康和防止过早死亡的有效方法。