{
  "abstract": "Introduction Diabetes mellitus is involved in the development of various diseases, including microvascular and macrovascular complications, infections, osteoporosis and dementia. This study aimed to evaluate the mediating role of obesity or metabolic abnormalities (hypertension, dyslipidaemia) in causal pathways between dietary habits (fast eating, skipping breakfast) and developing type 2 diabetes.Research design and methods A retrospective cohort study was conducted using health examination data from employees of Panasonic Corporation in Japan. Information on participants’ dietary habits, metabolic factors and the onset of diabetes was collected. Cox regression-based causal mediation analyses were performed to assess associations among dietary habits, metabolic factors and diabetes development.Results Among 155 963 participants, fast eating (HR 1.93, 95% CI 1.73 to 2.14) and skipping breakfast (HR 1.31, 95% CI 1.24 to 1.37) were associated with increased onset of type 2 diabetes within 13 years. Fast eating showed a strong association with diabetes risk mediated through body mass index (BMI) (proportion mediated 0.73, 95% CI 0.65 to 0.85) while skipping breakfast showed a direct association with diabetes risk not mediated through BMI (proportion mediated 0.10, 95% CI 0.07 to 0.14). Both dietary habits exhibited small mediating effects through hypertension or dyslipidaemia.Conclusions Fast eating increases diabetes risk, primarily through BMI, whereas skipping breakfast poses a risk not through BMI. These findings suggest a mechanism by which dietary habits affect glucose metabolism.",
  "authors": [
    {
      "affiliations": [
        "Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine School of Medicine Graduate School of Medical Science, Kyoto, Japan"
      ],
      "name": "Junya Hironaka"
    },
    {
      "affiliations": [
        "Interfaculty Initiative in Information Studies, the University of Tokyo, Tokyo, Japan",
        "Department of Biostatistics, School of Public Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan"
      ],
      "name": "Tomohiro Shinozaki"
    },
    {
      "affiliations": [
        "Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine School of Medicine Graduate School of Medical Science, Kyoto, Japan"
      ],
      "name": "Hiroshi Okada"
    },
    {
      "affiliations": [
        "Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan"
      ],
      "name": "Yoshitaka Hashimoto"
    },
    {
      "affiliations": [
        "Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine School of Medicine Graduate School of Medical Science, Kyoto, Japan"
      ],
      "name": "Ema Toyokuni"
    },
    {
      "affiliations": [
        "Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine School of Medicine Graduate School of Medical Science, Kyoto, Japan"
      ],
      "name": "Masahide Hamaguchi"
    },
    {
      "affiliations": [
        "Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan"
      ],
      "name": "Norihiro Nishioka"
    },
    {
      "affiliations": [
        "Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan"
      ],
      "name": "Yukiko Tateyama"
    },
    {
      "affiliations": [
        "Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan"
      ],
      "name": "Tomonari Shimamoto"
    },
    {
      "affiliations": [
        "Department of Health Care Center, Panasonic Health Insurance Organization, Moriguchi, Osaka, Japan"
      ],
      "name": "Kazushiro Kurogi"
    },
    {
      "affiliations": [
        "Department of Orthopaedic Surgery, Matsushita Memorial Hospital, Moriguchi, Japan"
      ],
      "name": "Hiroaki Murata"
    },
    {
      "affiliations": [
        "Department of Health Care Center, Panasonic Health Insurance Organization, Moriguchi, Osaka, Japan"
      ],
      "name": "Naoki Yoshida"
    },
    {
      "affiliations": [
        "Department of Health Care Center, Panasonic Health Insurance Organization, Moriguchi, Osaka, Japan"
      ],
      "name": "Masato Ito"
    },
    {
      "affiliations": [
        "Department of Biostatistics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan"
      ],
      "name": "Go Horiguchi"
    },
    {
      "affiliations": [
        "Department of Biostatistics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan"
      ],
      "name": "Satoshi Teramukai"
    },
    {
      "affiliations": [
        "Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan"
      ],
      "name": "Taku Iwami"
    },
    {
      "affiliations": [
        "Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine School of Medicine Graduate School of Medical Science, Kyoto, Japan"
      ],
      "name": "Michiaki Fukui"
    }
  ],
  "title": "Mediating role of metabolic factors in the association between dietary habits and the onset of type 2 diabetes: a population-based Panasonic cohort study 19",
  "uid": "1093294a-e1b5-53fc-89a0-2789b40cca97"
}