Dietary pattern trajectories from youth to adulthood and adult risk of impaired fasting glucose: a 31-year cohort study.

Context The influence of dietary pattern trajectories from youth to adulthood on adult glucose metabolism is unknown. Objectives To identify dietary pattern trajectories from youth to adulthood and examine their associations with adult impaired fasting glucose (IFG). Design, setting, and participants 31-year population-based cohort study among 1,007 youths aged 3-18 years at baseline in Finland. Exposures Diet intake was assessed in 1980, 1986, 2001, 2007 and 2011. Group-based trajectory modelling was used to identify dietary pattern (identified by factor analysis) trajectories. Main outcome measures Adult IFG was measured by the latest available data from 2001, 2007 and 2011. Results Among 1,007 participants, 202 (20.1%) developed IFG and 27 (2.7%) developed T2D in adulthood (mean follow-up of 30.7 years; mean (SD) age=40.5 (5.0) years). Three dietary patterns were identified at baseline and were retained in 1986 and 2001: 'Traditional Finnish', 'High-carbohydrate' and 'Vegetables and dairy products'. Three different patterns were identified in 2007, which remained similar in 2011: 'Traditional Finnish and high-carbohydrate', 'Red meat', and 'Healthy'. Trajectories of increased or stably medium 'red meat' pattern scores from youth to adulthood were detrimentally associated with IFG (relative risk=1.46, 95% confidence interval: 1.12-1.90 for M-stable/M-large increase vs. Low-stable trajectory) after adjusting for confounders. This association was slightly reduced after further adjusting for long-term dietary fibre intake. Conclusions Trajectories of an increased or stably moderate adherence to a 'red meat' dietary pattern from youth to adulthood are associated with higher risk of adult IFG. This association is partly explained by low dietary fibre intake.