Choosing to Avoid Diabetes

The USDA 2005 Dietary Guidelines for Americans (DGA) provide recommendations about calorie and nutrient intake (Table 1) to maintain ideal body weight and to reduce risk for chronic disease.

When followed, are these guidelines actually effective at reducing risk? Approximately 1600 women and 1400 men in the Framingham Offspring Cohort completed a food frequency questionnaire during the preceding year. Researchers assessed whether diets were consistent with the 2005 DGA using a standardized tool, the 2005 Dietary Guidelines Adherence Index (DGAI). The index includes items such as food-intake patterns, calorie intake, and calorie expenditure. Higher DGAI scores reflect stricter adherence to the guidelines. Height, weight, waist circumference, and fasting plasma glucose and insulin were measured for calculations of BMI and insulin resistance. Participants also provided information about age, smoking, multivitamin use, physical activity, and sleep habits.

Mean age and BMI were 54.2 years and 26.5 for women and 54.0 years and 27.3 for men. Participants in the highest DGAI quintile were about three times more likely to be women than men. A higher DGAI score was significantly inversely related to insulin resistance in women; no association was noted for men. Adjustment for BMI, smoking, multivitamin use, waist circumference, physical activity, and energy intake did not affect the results.