Food-based healthy diet metrics, type 2 diabetes, and insulin resistance in ELSA-Brasil: A prospective study of over 12,000 Brazilians
Issued Date
2026-01-01
Resource Type
ISSN
00071145
eISSN
14752662
Scopus ID
2-s2.0-105034209435
Journal Title
British Journal of Nutrition
Rights Holder(s)
SCOPUS
Bibliographic Citation
British Journal of Nutrition (2026)
Suggested Citation
Norde M.M., Benseñor I.M., Cacau L.T., Deitchler M., Bromage S., Vasques A.C.J., De Carvalho A.M., Marchioni D.M.L., Velloso L., Giovannucci E., Lotufo P.A., Geloneze B. Food-based healthy diet metrics, type 2 diabetes, and insulin resistance in ELSA-Brasil: A prospective study of over 12,000 Brazilians. British Journal of Nutrition (2026). doi:10.1017/S0007114526106886 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/115970
Title
Food-based healthy diet metrics, type 2 diabetes, and insulin resistance in ELSA-Brasil: A prospective study of over 12,000 Brazilians
Corresponding Author(s)
Other Contributor(s)
Abstract
The Global Diet Quality Score (GDQS), the Global Dietary Recommendations score (GDR), Nova-UPF score, and Minimum Diet Diversity for Women (MDD-W) were listed by the United Nations as promising food-based metrics to track dietary quality. The aim was to evaluate those diet metrics performances for monitoring diet-related type 2 diabetes risk and insulin resistance in comparison with the Alternative Healthy Eating Index (AHEI). The study included 12,254 participants (56% women; 35-74 years) of the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil) with available dietary, biochemical, sociodemographic and lifestyle data. Diet quality scores were derived from a validated food-frequency questionnaire covering the previous 12 months. Incident diabetes and changes in insulin resistance (HOMA-IR) over time were evaluated, and mediation by body mass index (BMI) was assessed. After an average 8.2y follow-up period (17% attrition; n=10,191), with 1-standard deviation increase in GDQS, GDR, and AHEI, a 5%, 6%, and 7% decrease in incident diabetes was observed with BMI mediation effect of 39.6%, 74.8%, and 59.4%, respectively (p<0.001 for all the analysis). HOMA-IR increase rate over time was higher in the lower quintile of GDQS (p=0.002) and GDR (p<0.001), compared to the upper quintile. As AHEI, GDR, and GDQS had similar performances in monitoring diet-related type 2 diabetes risk, food-based metrics, such as the GDR and the GDQS can be advantageous in lower resources settings and in nations where there is no food composition data availability.