Inflammatory, Insulinemic, and Plant-Based Dietary Patterns and Diabetes Among Patients with Acute Pancreatitis: A Cross-Sectional Analysis of the DREAM Study

Background/Objectives: Plant-based diets are widely recommended for lowering the risk of type 2 diabetes, with the caveat that their health benefits depend on the quality of the foods consumed. This analysis examined associations between five dietary patterns and pre-existing diabetes among patients with acute pancreatitis (AP), a population in which the relationship between diet and diabetes has not been well characterized. Methods: Participants were drawn from the Diabetes RElated to Acute Pancreatitis and its Mechanisms (DREAM) study, an ongoing multicenter study of adults aged 18 to 75 years with AP in the U.S. This cross-sectional analysis evaluated five dietary patterns using food frequency questionnaires (FFQ): the reverse Empirical Dietary Index for Hyperinsulinemia (rEDIH), the reverse Empirical Dietary Inflammatory Pattern (rEDIP), the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI). We used multivariable logistic regression models to estimate odds ratios (ORs) for pre-existing diabetes (i.e., prior to the AP episode). Results: A total of 647 participants (mean age 49.1 ± 14.5 years) were included. In multivariable-adjusted analyses, participants in the highest versus lowest tertile of PDI had 55% lower odds of pre-existing diabetes (adjusted OR: 0.45; 95% CI: 0.25–0.80; p-trend = 0.005). No statistically significant associations were detected for rEDIP, rEDIH, hPDI, or uPDI. Conclusions: Higher overall PDI scores were associated with lower odds of prevalent diabetes. Among patients with AP, further studies are needed to evaluate dietary contributions to future diabetes development following AP and identify potential dietary strategies for diabetes prevention.

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Journal
Nutrients
Published
2026-11-06
DOI
https://doi.org/10.3390/nu18213676
Primary Topic
Nutritional Studies and Diet
Type
article
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article

Inflammatory, Insulinemic, and Plant-Based Dietary Patterns and Diabetes Among Patients with Acute Pancreatitis: A Cross-Sectional Analysis of the DREAM Study

Daisy Duan, Kristen M. Roberts, Tian Qiu, Melena D. Bellin et al.
2 links
Nutrients
Nutritional Studies and Diet
article

Inflammatory, Insulinemic, and Plant-Based Dietary Patterns and Diabetes Among Patients with Acute Pancreatitis: A Cross-Sectional Analysis of the DREAM Study

Daisy Duan, Kristen M. Roberts, Tian Qiu, Melena D. Bellin, Rajesh N. Keswani, Kathleen Marie Dungan, Vernon M. Chinchilli, Marina Basina, Phil A. Hart, Sandra M. Lord, Brian Thomas Layden, Mark O. Goodarzi, Djibril M. Ba, Anna Casu, Evan L. Fogel, Nazia T. Raja-Khan, Georgios I. Papachristou, Stephen Jacob Pandol, Frederico G. S. Toledo, Richard E. Pratley, Anna Evans Phillips, Carmella Evans‐Molina, Fred K. Tabung, Temel Tirkes, Cate Speake, Walter G. Park, Vikesh K. Singh, Cemal Yazıcı, Guru Trikudanathan, Ni Shi, James Leonard Buxbaum, Chris E. Forsmark, Qi Sun, Dhiraj Yadav, Steven Hughes
article en

Abstract

Background/Objectives: Plant-based diets are widely recommended for lowering the risk of type 2 diabetes, with the caveat that their health benefits depend on the quality of the foods consumed. This analysis examined associations between five dietary patterns and pre-existing diabetes among patients with acute pancreatitis (AP), a population in which the relationship between diet and diabetes has not been well characterized. Methods: Participants were drawn from the Diabetes RElated to Acute Pancreatitis and its Mechanisms (DREAM) study, an ongoing multicenter study of adults aged 18 to 75 years with AP in the U.S. This cross-sectional analysis evaluated five dietary patterns using food frequency questionnaires (FFQ): the reverse Empirical Dietary Index for Hyperinsulinemia (rEDIH), the reverse Empirical Dietary Inflammatory Pattern (rEDIP), the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI). We used multivariable logistic regression models to estimate odds ratios (ORs) for pre-existing diabetes (i.e., prior to the AP episode). Results: A total of 647 participants (mean age 49.1 ± 14.5 years) were included. In multivariable-adjusted analyses, participants in the highest versus lowest tertile of PDI had 55% lower odds of pre-existing diabetes (adjusted OR: 0.45; 95% CI: 0.25–0.80; p-trend = 0.005). No statistically significant associations were detected for rEDIP, rEDIH, hPDI, or uPDI. Conclusions: Higher overall PDI scores were associated with lower odds of prevalent diabetes. Among patients with AP, further studies are needed to evaluate dietary contributions to future diabetes development following AP and identify potential dietary strategies for diabetes prevention.

NutrientsVol. 18(21)
Northwestern University (US), University of Southern California (US), Cedars-Sinai Medical Center (US), Brigham and Women's Hospital (US), University of Minnesota (US), Pennsylvania State University (US), Harvard University (US), Johns Hopkins University (US), University of Pittsburgh (US), AdventHealth Orlando (US), Johns Hopkins Medicine (US), University of Florida Health (US), The Ohio State University Wexner Medical Center (US), University of Florida (US), University of Illinois Chicago (US), University of Pittsburgh Medical Center (US), University of Minnesota Medical Center (US), Jesse Brown VA Medical Center (US), Stanford Medicine (US), Indiana University Indianapolis (US), Benaroya Research Institute (US), Indiana University School of Medicine (US), AdventHealth (US), The Ohio State University (US), Penn State Milton S. Hershey Medical Center (US), Stanford University (US)
Good health and well-being
Openalex Percentile: Top 12%
Nutritional Studies and Diet
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