Association between Dietary Energy Density and Incident Type 2 Diabetes in the Women's Health Initiative. 

 -  2017 
<br/><br/> BACKGROUND: Dietary energy density, or energy available in relation to gram intake, can inform disease risk.  CONCLUSIONS: In this prospective study, a higher baseline dietary energy density was associated with higher incidence of type 2 diabetes among postmenopausal women, both overall, and in women with elevated waist circumference. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.  DESIGN: Dietary energy density, weight status, and type 2 diabetes incidence were prospectively characterized in a large cohort of postmenopausal women participating in one or more clinical trials or an observational study.  MAIN OUTCOME MEASURES: The primary outcome was incident type 2 diabetes.  OBJECTIVE: The objective of this study was to investigate the association between baseline dietary energy density and risk of incident type 2 diabetes in postmenopausal women.  PARTICIPANTS/SETTING: The study involved 161,808 postmenopausal women recruited to the Women's Health Initiative observational study or clinical trials at 40 centers across the United States between 1993 and 1998.  RESULTS: A total of 143,204 participants without self-reported diabetes at enrollment completed baseline dietary assessment and were followed for 12.7+/-4.6 years. Risk of diabetes developing was 24% greater for women in the highest dietary energy density quintile compared with the lowest after adjusting for confounders (95% CI 1.17 to 1.32). Body mass index (calculated as kg/m<sup>2</sup>) and waist circumference mediated the relationship between dietary energy density and diabetes. In waist circumference-stratified analysis, women in dietary energy density quintiles 2 to 5 with waist circumferences >88 cm were at 9% to 12% greater risk of diabetes developing compared with women with waist circumference <=88 cm.  STATISTICAL ANALYSES PERFORMED: The association between dietary energy density quintiles and incident diabetes was tested using Cox proportional hazards regression. 
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<br/><br/><label>Subjects--Topical Terms: </label><br/>*Diabetes Mellitus, Type 2/ep [Epidemiology]<br/>*Diet<br/>*Energy Intake<br/>*Women's Health<br/>Aged<br/>Body Mass Index<br/>Female<br/>Humans<br/>Middle Aged<br/>Nutrition Assessment<br/>Postmenopause<br/>Prospective Studies<br/>Risk Factors<br/>Surveys and Questionnaires<br/>United States<br/>Waist Circumference
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Health Research Institute
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article