OBJECTIVE Plant-based dietary patterns emphasize plant foods and minimize animal-derived foods. We investigated the association between plant-based dietary patterns and diabetes in a community-based U.S. sample of Black and White adults. RESEARCH DESIGN AND METHODS We included middle-aged adults from the Atherosclerosis Risk in Communities (ARIC) study without diabetes at baseline who completed a food-frequency questionnaire (n = 11,965). We scored plant-based diet adherence according to three indices: overall, healthy, and unhealthy plant-based diet indices. Higher overall plant-based diet index (PDI) scores represent greater intakes of all plant foods and lower intakes of animal-derived foods. Higher healthy plant-based diet index (hPDI) scores represent greater healthy plant food intake and lower intakes of animal-derived and unhealthy plant foods. Higher unhealthy plant-based diet index (uPDI) scores represent greater unhealthy plant food intake and lower intakes of animal-derived and healthy plant foods. We used Cox regression to estimate hazard ratios (HRs) for incident diabetes (defined according to self-reported diagnosis, medication use, or elevated blood glucose) associated with each index. RESULTS Over a median follow-up of 22 years, we identified 4,208 cases of diabetes among subjects. Higher PDI scores were associated with a lower risk of diabetes (quintile 5 vs. 1 HR 0.89 [95% CI 0.80, 0.98]; Ptrend = 0.01). hPDI scores were also inversely associated with diabetes risk (quintile 5 vs. 1 HR 0.85 [95% CI 0.77, 0.94]; Ptrend < 0.001). uPDI scores were not associated with diabetes risk. CONCLUSIONS A dietary pattern that minimizes animal-derived foods and emphasizes plant foods may reduce diabetes risk.

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社区动脉粥样硬化风险 (ARIC) 研究中的植物性饮食模式和糖尿病事件

目标 以植物为基础的饮食模式强调植物性食品并尽量减少动物性食品。我们在美国社区的黑人和白人成年人样本中调查了植物性饮食模式与糖尿病之间的关联。研究设计和方法 我们纳入了来自社区动脉粥样硬化风险 (ARIC) 研究的基线时没有糖尿病的中年成年人，他们完成了食物频率调查问卷 (n = 11,965)。我们根据三个指数对植物性饮食的依从性进行评分：总体、健康和不健康的植物性饮食指数。植物性饮食总体指数 (PDI) 得分越高，代表植物性食品的摄入量越高，动物源性食品的摄入量越低。健康植物性饮食指数 (hPDI) 分数越高，代表健康植物性食物摄入量越高，动物源性和不健康植物性食物摄入量越低。不健康植物性饮食指数 (uPDI) 分数越高，代表不健康植物性食品摄入量越高，动物源性和健康植物性食品摄入量越低。我们使用 Cox 回归来估计与每个指标相关的糖尿病发病风险比 (HR)（根据自我报告的诊断、药物使用或血糖升高定义）。结果 在中位随访 22 年中，我们在受试者中发现了 4,208 例糖尿病病例。较高的 PDI 评分与较低的糖尿病风险相关（五分位数 5 vs. 1 HR 0.89 [95% CI 0.80, 0.98]；Ptrend = 0.01）。 hPDI 评分也与糖尿病风险呈负相关（五分位数 5 vs. 1 HR 0.85 [95% CI 0.77, 0.94]；Ptrend < 0.001）。 uPDI 评分与糖尿病风险无关。结论 尽量减少动物性食品并强调植物性食品的饮食模式可能会降低患糖尿病的风险。