Wang YY, Chen B, Zhang JW, Li HR, Zeng XF, Zhang Z, Zhu Y, Li XD, Hu AL, Zhao QH, Yang WS. Diets with Higher Insulinemic Potential are Associated with Increased Risk of Overall and Cardiovascular Disease-specific Mortality. British Journal of Nutrition, 2021,1-26. 



  • The present prospective cohort study examined the associations between hyperinsulinemic diets and the risk of total and cause-specific mortality in a large nationally representative US population.
  • During a median follow-up of 7.8 years, 4,904 deaths were documented among 40,074 participants.
  • They found that for empirical dietary indices for hyperinsulinemia, the multivariable-adjusted hazard ratios (comparing extreme quintiles) were 1.20 (95% CI: 1.09-1.32, P-trend <0.001) for overall mortality, and 1.41(95% CI:1.15-1.74, P-trend=0.002) for cardiovascular disease (CVD) mortality.
  • Besides, they also observed similar associations for empirical dietary indices for insulin resistance with hazard ratios of 1.18 (95% CI:1.07-1.29, P-trend<0.005) for CVD mortality.
  • Although these positive associations were somewhat attenuated after further adjustments for body mass index and diabetes, most remained statistically significant.
  • They concluded that diets with higher insulinemic potential (insulin resistance and hyperinsulinemia) may be associated with increased risk of overall and CVD-specific mortality, and suggested avoiding hyperinsulinemic dietary patterns may potentially promote health and longevity.


  1. Diet information assessed by 24-hour recalls might lead to measurement errors.
  2. It might be controversial to use dietary information from 24-hour recalls representing the dietary habits as the dietary habits could change during the median follow-up and lead to misclassification of dietary habits.
  3. Measurement of biomarkers only contains one, which might lead to underestimating the validity of empirical dietary indices for insulin resistance and hyperinsulinemia.

Question to members

 How can higher insulin diet patterns differ in different regions?

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