Eating patterns and type 2 diabetes risk in older women: breakfast consumption and eating frequency

Am J Clin Nutr. 2013 Aug;98(2):436-43. doi: 10.3945/ajcn.112.057521. Epub 2013 Jun 12.


Background: Little is known about the association between eating patterns and type 2 diabetes (T2D) risk in women.

Objective: The objective was to examine prospectively associations between regular breakfast consumption, eating frequency, and T2D risk in women.

Design: Eating pattern was assessed in 2002 in a cohort of 46,289 US women in the Nurses' Health Study who were free of T2D, cardiovascular disease, or cancer and were followed for 6 y. We used Cox proportional hazards analysis to evaluate associations with incident T2D.

Results: We documented 1560 T2D cases during follow-up. After adjustment for known risk factors for T2D-except for body mass index (BMI), a potential mediator-women who consumed breakfast irregularly (0-6 times/wk) were at higher risk of T2D than were women who consumed breakfast daily (RR: 1.28; 95% CI: 1.14, 1.44). This association was moderately attenuated after adjustment for BMI (RR: 1.20; 95% CI: 1.07, 1.35). In comparison with women who ate 3 times/d, the RRs were 1.09 (0.84, 1.41) for women who ate 1-2 times/d, 1.13 (1.00, 1.27) for women who ate 4-5 times/d, and 0.99 (0.81, 1.21) for women who ate ≥6 times/d. Among irregular breakfast consumers, women with a higher eating frequency (≥4 times/d) had a significantly greater T2D risk (RR: 1.47; 95% CI: 1.23, 1.75) than did women who consumed breakfast daily and ate 1-3 times/d. Adjustment for BMI attenuated this association (RR: 1.24; 95% CI: 1.04, 1.48).

Conclusion: Irregular breakfast consumption was associated with a higher T2D risk in women, which was partially but not entirely mediated by BMI.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Body Mass Index
  • Breakfast*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Dietary Fiber / administration & dosage
  • Feeding Behavior*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Nutrition Assessment
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors


  • Blood Glucose
  • Dietary Fiber