We examined links among dietary patterns (DPs) , insulin resistance (IR) , and diabetes risk by heritage (Cuban, Dominican, Mexican, Puerto Rican, and Central and South American) in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) . HCHS/SOL is a population-based cohort of 16,415 Hispanics/Latinos aged 18-74 y living in 4 US cities. At both visits, questionnaires and clinical examinations were administered, including two 24-hr diet recalls conducted at baseline only (2008-11) . Among 7,774 participants with 2nd-visit data (2014-17) and without diabetes at baseline, we performed heritage-specific principal factor analyses and characterized overarching DPs based on high-loading foods shared by ≥ 2 heritage groups. We classified 6-yr IR status (improved, unchanged, worsened) using a SD-change in fasting insulin. We defined incident diabetes using self-report, self-reported diabetes medication, or labs (fasting glucose (≥126 mg/dL) , post-OGTT (≥200 mg/dL) , or HbA1C (≥6.5%)) . We identified 5 overarching DPs: Burger, Fries, & Soft Drinks; White Rice, Beans, & Red Meats; Fish & Whole Grains; Cheese & Sweets; and Stew & Corn. Comparing highest to lowest quintiles, the Burger, Fries, & Soft Drinks DP in Dominicans (log-odds: 2.35, 95% CI: 1.02, 3.68, Ptrend=0.037) and White Rice, Beans, & Red Meats DP in Cubans (log-odds: 1.27, 95% CI: 0.49, 2.06, Ptrend =0.009) were associated with worsened (vs. unchanged) 6-year IR status. The Burger, Fries, & Soft Drinks DP in Puerto Ricans (OR: 3.00, 95% CI:1.50, 5.99, Ptrend=0.003) and the White Rice, Beans, & Red Meats DP in Central Americans (OR: 2.41, 95% CI: 1.05, 5.50, Ptrend=0.032) were associated with greater diabetes risk. In sum, dietary interventions for diabetes prevention should be tailored by Hispanic/Latino heritage.


L.E.Maldonado: None. L.Gallo: None. S.Albrecht: None. D.Sotres-alvarez: None. J.Mattei: None. M.L.Daviglus: None. G.A.Talavera: None. K.M.Perreira: None. L.Van horn: None. Y.Mossavar-rahmani: None. M.N.Lecroy: None.


The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233) , University of Miami (N01-HC65234) , Albert Einstein College of Medicine (N01-HC65235) , Northwestern University (N01-HC65236) , and San Diego State University (N01-HC65237) . The following Institutes/Centers/Offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Center on Minority Health and Health Disparities, the National Institute of Deafness and Other Communications Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements. This research received support from the National Heart, Lung, and Blood Institute Global Cardiometabolic Disease Training Grant (1T32HL129969-01A1) , the National Institute of Diabetes and Digestive and Kidney Diseases (K01DK107791) ,and from the Population Research Infrastructure Program (R24 HD050924) awarded to the Carolina Population Center at The University of North Carolina at Chapel Hill by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

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