Positive association between breakfast skipping and incidence of type 2 diabetes mellitus: evidence from a Japanese worksite-based cohort

Uemura, Mayu

Positive association between breakfast skipping and incidence of type 2 diabetes mellitus: evidence from a Japanese worksite-based cohort

Tuesday, 19 August 2014

Exhibit hall (Dena'ina Center)

Mayu Uemura, MS , Nagoya University Graduate School of Medicine, Nagoya, Japan

Hiroshi Yatsuya, PhD , Nagoya University Graduate School of Medicine, Nagoya, Japan

Yuanying Li, PhD , Nagoya University Graduate School of Medicine, Nagoya, Japan

Chaochen Wang, MS , Nagoya University Graduate School of Medicine, Nagoya, Japan

Esayas Haregot Hilawe, MPH , Nagoya University Graduate School of Medicine, Nagoya, Japan

Chifa Chiang, PhD , Nagoya University Graduate School of Medicine, Nagoya, Japan

Hideaki Toyoshima, PhD , Anjo Kosei Hospital, Anjo-shi, Aichi-prefecture, Japan

Koji Tamakoshi, PhD , Nagoya University School of Health Science, Nagoya, Japan

Yan Zhang, MS , Nagoya University Graduate School of Medicine, Nagoya, Japan

Atsuko Aoyama, PhD , Nagoya University Graduate School of Medicine, Nagoya, Japan

INTRODUCTION: 　We examined the association between breakfast skipping and type 2 diabetes mellitus (T2DM) incidence. We explored whether the association would be independent of baseline body mass index (BMI) and fasting blood glucose (FBG) levels, as these could influence subjects’ dietary habits including breakfast eating behavior.

METHODS: 　Between 2002 and 2011, we followed 4,672 subjects (3,626 men, 1,046 women) aged 35-66 years enrolled in the Aichi workers’ cohort study. According to self-reported information, subjects were classified into five categories of breakfast-eating frequency: everyday, almost everyday with occasional skips, 3-5 days, 1-2 days, and never, per week. Using multivariable adjusted Cox proportional hazards models, we examined the association between breakfast-eating frequency and T2DM incidence. Possible effect modifications by sex, and baseline values of BMI (<25 kg/m², 25 kg/m²or more) and FBG (<110 mg/dL, 110 mg/dL or more) were assessed by adding multiplicative interaction terms to the models.

RESULTS: 　In comparison to that of those who eat breakfast ‘everyday’, hazard ratios (HRs) and respective 95% confidence intervals (95% CIs) for the risk of T2DM among subjects who eat ‘almost everyday with occasional skips’, ‘3-5 days’, ‘1-2 days’ , and ‘never’ were 1.10 (0.76-1.60), 2.20 (1.26-3.83), 1.51 (0.89-2.55) and 2.15 (1.20-3.87), respectively, in a maximally adjusted model (P for linear trend <0.001). The association was attenuated to a level of insignificance after further inclusion of insulin concentrations in the model. Nonetheless, the association was not modified by sex, and baseline values of BMI and FBG (P for interaction >0.05 for all).

CONCLUSIONS: 　We found a positive association of breakfast skipping with T2DM incidence independent of dietary intake, lifestyle factors, baseline levels of BMI and FBG, and other confounding factors in middle-aged Japanese workers. However, the association was not independent of baseline serum insulin levels.