Associations between dietary patterns and diabetes in patients with acute pancreatitis: a cross-sectional analysis from the DREAM study

Background: Dietary patterns have been associated with altered risk of diabetes mellitus (DM) in the general population. These patterns can estimate habitual intake of food groups associated with decreased or increased (e.g., greater intake of red meats) risk of DM. Objective: This analysis aimed to examine the underexplored associations of four dietary patterns in patients presenting with an acute pancreatitis (AP) diagnosis based on the presence of pre-existing DM. Methods: Study participants were selected from the Diabetes RElated to Acute Pancreatitis and its Mechanisms (DREAM) study, an ongoing, multicenter study of adults (18–75 years) with AP in the US. This is a cross-sectional analysis of baseline data collected using the VioScreen computer-administered Food Frequency Questionnaire. We examined four dietary patterns: the Alternate Mediterranean Diet (AMED), the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND), the Healthy Eating Index-2020 (HEI-2020), and the Alternate Healthy Eating Index-2010 (AHEI-2010). Multivariable logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Results: The study population included 647 individuals with AP (mean (SD) baseline age, 49.1 (14.5) years). Participants in the highest tertile of dietary index scores were more likely to be older, female, non-Hispanic White, and to have higher educational attainment. In multivariable analyses, greater adherence to the AMED and the MIND dietary patterns was associated with lower odds of pre-existing DM. Multivariable ORs for the odds of pre-existing DM comparing the highest to lowest tertile of diet scores were 0.44 (95% CI: 0.23, 0.84; P-trend = 0.01) for AMED, 0.46 (95% CI: 0.26, 0.82; P-trend = 0.01) for MIND, indicating lower odds for participants with a healthier dietary pattern. Conclusions: In this analysis, greater adherence to selected healthy dietary patterns was associated with lower odds of pre-existing DM at the time of AP presentation.