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Abstract
Multiple dietary patterns have been associated with different diseases; however, their comparability to improve overall health has yet to be determined. Here, in 205,852 healthcare professionals from three US cohorts followed for up to 32 years, we prospectively assessed two mechanism-based diets and six diets based on dietary recommendations in relation to major chronic disease, defined as a composite outcome of incident major cardiovascular disease (CVD), type 2 diabetes and cancer. We demonstrated that adherence to a healthy diet was generally associated with a lower risk of major chronic disease (hazard ratio (HR) comparing the 90th with the 10th percentile of dietary pattern scores = 0.58–0.80). Participants with low insulinemic (HR = 0.58, 95% confidence interval (CI) = 0.57, 0.60), low inflammatory (HR = 0.61, 95% CI = 0.60, 0.63) or diabetes risk-reducing (HR = 0.70, 95% CI = 0.69, 0.72) diet had the largest risk reduction for incident major CVD, type 2 diabetes and cancer as a composite and individually. Similar findings were observed across gender and diverse ethnic groups. Our results suggest that dietary patterns associated with markers of hyperinsulinemia and inflammation and diabetes development may inform on future dietary guidelines for chronic disease prevention.

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Troy University doesn’t have access and I would LOVE to read this.

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For those without access to the full text, this is how the studied dietary patterns were defined in terms of food groups to be favoured/reduced (should bypass the paywall). Generally, these dietary patterns gave positive weightings for fruits, vegetables, nuts, legumes, and whole grains, and negative weightings for red and/or processed meat, sugar-sweetened beverages, and ultra-processed foods.

> AHEI-2010, Alternative Healthy Eating Index-2010;

> AMED, Alternate Mediterranean Diet score;

> DASH, Dietary Approaches to Stop Hypertension score;

> DRRD, Diabetes Risk Reduction Diet;

> hPDI, Healthful plant-based diet index;

> rEDIH, reversed Empirical dietary index for hyperinsulinemia;

> rEDIP, reversed Empirical dietary inflammation pattern;

> WCRF/AICR, World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) dietary score.

Results: https://www.nature.com/articles/s41591-023-02235-5/figures/2.