@article{91263a0726c04c98b6d626cdfab701c8,
title = "The 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) score and diabetes risk in the Diabetes Prevention Program Outcomes Study (DPPOS)",
abstract = "Background: The 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) 3rd expert report highlights up-to-date Cancer Prevention Recommendations that may reduce burdens of many chronic diseases, including diabetes. This study examined if following a lifestyle that aligns with the recommendations – assessed via the 2018 WCRF/AICR Score – was associated with lower risk of type 2 diabetes in high-risk adults participating in the Diabetes Prevention Program Outcomes Study (DPPOS). Methods: The Diabetes Prevention Program (DPP) randomized adults at high risk for diabetes to receive a lifestyle intervention (ILS), metformin (MET) or a placebo (PLB) (mean: 3.2 years), with additional follow-up in DPPOS for 11 years (mean: 15 years total). 2018 WCRF/AICR Scores included seven components: body weight, physical activity, plant-based foods, fast foods, red and processed meat, sugar-sweetened beverages, and alcohol; the optional breastfeeding component was excluded. Scores ranged 0-7 points (with greater scores indicating greater alignment with the recommendations) and were estimated at years 0, 1, 5, 6, 9, and 15 (N=3,147). Fasting glucose and HbA1c were measured every six months and oral glucose tolerance tests were performed annually. Adjusted Cox proportional hazard ratios (HRs) and 95% confidence intervals (CIs) were used to examine the association of both Score changes from years 0-1 and time-dependent Score changes on diabetes risk through DPP and year 15. Results: Scores improved within all groups over 15 years (p<0.001); ILS Scores improved more than MET or PLB Scores after 1 year (p<0.001). For every 1-unit improvement from years 0-1, there was a 31% and 15% lower diabetes risk in ILS (95% CI: 0.56-0.84) and PLB (95% CI: 0.72-0.97) through DPP, and no significant association in MET. Associations were greatest among American Indian participants, followed by non-Hispanic White and Hispanic participants. Score changes from years 0-1 and time-dependent Score changes in ILS and PLB remained associated with lower risk through year 15. Conclusions: Score improvements were associated with long-term, lower diabetes risk among high-risk adults randomized to ILS and PLB, but not MET. Future research should explore impact of the Score on cancer risk.",
keywords = "Alcohol, Diet, Disease prevention, Obesity, Physical activity, Weight",
author = "{DPP Research Group} and Shams-White, {Marissa M.} and Tjaden, {Ashley H.} and Edelstein, {Sharon L.} and Sarah Bassiouni and Kahle, {Lisa L.} and Catherine Kim and Xavier Pi-Sunyer and Temple, {Karla A.} and Venditti, {Elizabeth M.} and Jill Reedy and Heckman-Stoddard, {Brandy M.} and Bray, {George A.} and Gadde, {Kishore M.} and Culbert, {Iris W.} and Jennifer Arceneaux and Annie Chatellier and Amber Dragg and Champagne, {Catherine M.} and Crystal Duncan and Barbara Eberhardt and Frank Greenway and Guillory, {Fonda G.} and Herbert, {April A.} and Jeffirs, {Michael L.} and Kennedy, {Betty M.} and Erma Levy and Monica Lockett and Lovejoy, {Jennifer C.} and Morris, {Laura H.} and Melancon, {Lee E.} and Ryan, {Donna H.} and Sanford, {Deborah A.} and Smith, {Kenneth G.} and Smith, {Lisa L.} and {St. Amant}, {Julia A.} and Tulley, {Richard T.} and Vicknair, {Paula C.} and Donald Williamson and Zachwieja, {Jeffery J.} and Polonsky, {Kenneth S.} and Janet Tobian and Ehrmann, {David A.} and Matulik, {Margaret J.} and Bart Clark and Kirsten Czech and Catherine DeSandre and Ruthanne Hilbrich and Wylie McNabb and Semenske, {Ann R.} and Caro, {Jose F.} and Kevin Furlong and Goldstein, {Barry J.} and Watson, {Pamela G.} and Smith, {Kellie A.} and Jewel Mendoza and Wendi Wildman and Renee Liberoni and John Spandorfer and Constance Pepe and Donahue, {Richard P.} and Goldberg, {Ronald B.} and Ronald Prineas and Jeanette Calles and Juliet Ojito and Patricia Rowe and Paul Cassanova-Romero and Sumaya Castillo-Florez and Florez, {Hermes J.} and Anna Giannella and Lascelles Kirby and Carmen Larreal and Olga Lara and Valerie McLymont and Jadell Mendez and Arlette Perry and Patrice Saab and Beth Veciana and Haffner, {Steven M.} and Hazuda, {Helen P.} and Montez, {Maria G.} and Kathy Hattaway and Carlos Lorenzo and Arlene Martinez and Tatiana Walker and Dana Dabelea and Hamman, {Richard F.} and Nash, {Patricia V.} and Steinke, {Sheila C.} and Lisa Testaverde and Anderson, {Denise R.} and Ballonoff, {Larry B.} and Alexis Bouffard and Brian Bucca and Calonge, {B. Ned} and Lynne Delve and Martha Farago and Hill, {James O.} and Hoyer, {Shelley R.} and Tonya Jenkins and Jortberg, {Bonnie T.} and Dione Lenz and Marsha Miller and Leigh Perreault and Price, {David W.} and Regensteiner, {Judith G.} and Helen Seagle and Smith, {Carissa M.} and Brent VanDorsten and Horton, {Edward S.} and Lawton, {Kathleen E.} and Poirier, {Catherine S.} and Kati Swift and Arky, {Ronald A.} and Marybeth Bryant and Burke, {Jacqueline P.} and Enrique Caballero and Callaphan, {Karen M.} and Barbara Fargnoli and Therese Franklin and Ganda, {Om P.} and Ashley Guidi and Mathew Guido and Jackson, {Sharon D.} and Jacobsen, {Alan M.} and Lori Lambert and Sarah Ledbury and Margaret Kocal and Kula, {Lyn M.} and Malloy, {Maureen A.} and Maryanne Nicosia and Oldmixon, {Cathryn F.} and Jocelyn Pan and Marizel Quitingon and Stacy Rubtchinsky and Jessica Sansoucy and Dana Schweizer and Seely, {Ellen W.} and Donald Simonson and Fannie Smith and Solomon, {Caren G.} and Jeanne Spellman and James Warram and Kahn, {Steven E.} and Montgomery, {Brenda K.} and Wilfred Fujimoto and Knopp, {Robert H.} and Lipkin, {Edward W.} and Michelle Marr and Ivy Morgan-Taggart and Anne Murillo and Dace Trence and Lonnese Taylor and April Thomas and Tsai, {Elaine C.} and Samuel Dagogo-Jack and Kitabchi, {Abbas E.} and Murphy, {Mary E.} and Laura Taylor and Jennifer Dolgoff and Applegate, {William B.} and Michael Bryer-Ash and Debra Clark and Frieson, {Sandra L.} and Uzoma Ibebuogu and Raed Imseis and Helen Lambeth and Lichtermann, {Lynne C.} and Hooman Oktaei and Harriet Ricks and Rutledge, {Lily M.K.} and Sherman, {Amy R.} and Smith, {Clara M.} and Soberman, {Judith E.} and Beverly Williams-Cleaves and Metzger, {Boyd E.} and Molitch, {Mark E.} and Johnson, {Mariana K.} and Adelman, {Daphne T.} and Catherine Behrends and Michelle Cook and Marian Fitzgibbon and Giles, {Mimi M.} and Deloris Heard and Johnson, {Cheryl K.H.} and Diane Larsen and Anne Lowe and Megan Lyman and David McPherson and Penn, {Samsam C.} and Thomas Pitts and Renee Reinhart and Susan Roston and Schinleber, {Pamela A.} and Nathan, {David M.} and Charles McKitrick and Heather Turgeon and Mary Larkin and White, {Neil H.} and Brown, {Angela L.} and Ling Chen",
note = "Publisher Copyright: {\textcopyright} 2022, The Author(s).",
year = "2022",
month = dec,
doi = "10.1186/s40795-022-00596-7",
language = "English",
volume = "8",
journal = "BMC Nutrition",
issn = "2055-0928",
number = "1",
}