STROBE Statementchecklist of items that should be included in reports of observational studies

Ite Pag
m Recommendati e
No. on No.
Title and 1 (a) Indicate the 1 A specically designed questionnaire was used to collect information on possible risk factors of type 2 diabetes
abstract studys design
with a
commonly used
term in the title
or the abstract
(b) Provide in 1 Subjects and methods: A case-control study included 234 cases with newly diagnosed type 2 diabetes and 468 non diabetic controls. A specica
the abstract an they were eating at the same table. The odds ratios (OR), and 95% condence intervals (95% CI) for type 2 diabetes were calculated by a condi
informative and were retained in multivariate logistic regression models as confounders because their inclusion changed the value of the OR by more than 5% in
balanced subjects eating slower.
summary of
what was done
and what was
found
Introduction
Background/ratio 2 Explain the 1 The estimate diabetes prevalence for 2011has risen to 366 million,representing8.5%oftheworldsadult population, with a prediction that by 203
nale scientific
background and
rationale for the
investigation
being reported
Objectives 3 State specific Therefore the aim of the study was to assess the relationship between eating speed and the risk of type 2 diabetes mellitus.
objectives,
including any
prespecified
hypotheses

1
Methods
Study design 4 Present key 1 A case-control study has been carried out at outpatient clinic in Kaunas, Lithuania. The study included 234 cases aged 35e86 years with newly c
elements of
study design
early in the
paper
Setting 5 Describe the 2 In Lithuania, state located on thesoutheastcoastoftheBalticSeawithanareaof65,200km2 and population of 3,349,872 estimated in the beginning o
setting,
locations, and
relevant dates,
including
periods of
recruitment,
exposure,
follow-up, and
data collection
Participants 6 (a) Cohort 1 The study included 234 cases aged 35e86 years with newly conrmed diagnose of type 2 diabetes mellitus according to the criteria of World He
studyGive recruited from the patients of the same clinic
the eligibility
criteria, and the
sources and
methods of
selection of
participants.
Describe
methods of
follow-up
Case-control
studyGive
the eligibility
criteria, and the

2
sources and
methods of case
ascertainment
and control
selection. Give
the rationale for
the choice of
cases and
controls
Cross-sectional
studyGive
the eligibility
criteria, and the
sources and
methods of
selection of
participants
(b)Cohort 2 . They were individually statistically matched to the diabetic patients by gender and age (5 years.). Ratio of cases and controls was 1:2.
studyFor
matched
studies, give
matching
criteria and
number of
exposed and
unexposed
Case-control
studyFor
matched
studies, give
matching
criteria and the

3
 number of
controls per
case
Variables 7 Clearly define 2 Variables such as a family history on diabetes, body mass index, waist circumference, educational level, morning exercise, cigarette smoking an
all outcomes, category.
exposures,
predictors,
potential
confounders,
and effect
modifiers. Give
diagnostic
criteria, if
applicable
Data 8* For each Laboratory blood tests included fasting blood samples drawn from subjects elbow vein and venous plasma samples analyzed for glucose and tri
sources/measurem variable of tolerance tests for the assessing carbohydrate disorders were performed and evaluated in the study subjects. TG was estimated by the GPOePAP
ent interest, give Participants were asked to fast for 12 h and to avoid smoking and heavy physical activityforat least 2 h beforethe examinations. Anthropometric
sources of data light clothing in kilogrammes (0.5 kg accuracy). Body mass index (BMI) calculated as weight (kg)/height (metres) squared.8 Waistcircumferenc
and details of level of great femur trochanter in centimetres (0.1 cm accuracy).
methods of
assessment
(measurement).
Describe
comparability
of assessment
methods if
there is more
than one group
Bias 9 Describe any BMI was grouped according to those who were 18.5e24.9 kg/ m2, 25e29.9 kg/m2, and 30 kg/m2.9 WC grou
efforts to cm for males.10,11 Family history on diabetes mellitus divided into categories of rst-degree relatives with family history on diabetes and of r
address Levelofeducation(numberofyears)dividedintocategories

4
 potential
sources of bias 10 years,11e13 years, 14 years. Smoking was assessed according to smoking habits: nonsmoker, ex-smoker
grouped as <1.7 (mmol/L) and 1.7 (mmol/L).
Study size 10 Explain how
the study size
was arrived at
Continued on next page

5
Quantitative 11 Explain how quantitative variables were handled in the analyses. If
variables applicable, describe which groupings were chosen and why
Statistical 12 (a) Describe all statistical methods, including those used to control for 2 All reported trend test signicance levels (P values) were twosided.12
methods confounding Thedifferencesbetweenproportionswerecalculatedusing the X2 test.
The level of signicance was set at 5%. All the
calculationswereperformedwiththestandardSTATA7softwareprogram.
(b) Describe any methods used to examine subgroups and interactions X2 test
(c) Explain how missing data were addressed
(d) Cohort studyIf applicable, explain how loss to follow-up was
addressed
Case-control studyIf applicable, explain how matching of cases and
controls was addressed
Cross-sectional studyIf applicable, describe analytical methods taking
account of sampling strategy
(e) Describe any sensitivity analyses
Results
Participants 13* (a) Report numbers of individuals at each stage of studyeg numbers In our study there were 28.21% men and 71.79% women.
potentially eligible, examined for eligibility, confirmed eligible, included
in the study, completing follow-up, and analysed
(b) Give reasons for non-participation at each stage
(c) Consider use of a flow diagram
Descriptive 14* (a) Give characteristics of study participants (eg demographic, clinical, The cases e type 2 diabetic patients had signicantly lower education
data social) and information on exposures and potential confounders level, compared to controls. Their body mass index was higher than
in controls. There were more controls without a family history of a
rst degree relative with diabetes than cases.
(b) Indicate number of participants with missing data for each variable of
interest
(c) Cohort studySummarise follow-up time (eg, average and total
amount)
Outcome data 15* Cohort studyReport numbers of outcome events or summary measures
over time

6
 Case-control studyReport numbers in each exposure category, or
summary measures of exposure
Cross-sectional studyReport numbers of outcome events or summary
measures
Main results 16 (a) Give unadjusted estimates and, if applicable, confounder-adjusted After further controlling for a family history on diabetes, BMI, WC,
estimates and their precision (eg, 95% confidence interval). Make clear educational level,morningexercise,
which confounders were adjusted for and why they were included cigarettesmokingandplasmatriglycerides levelwefoundmorethantwo-
foldincreasedriskoftype2diabetes mellitus for subjects eating faster
(OR2.52; 95% CI 1.56e4.06) vs. subjects eating slower.
(b) Report category boundaries when continuous variables were
categorized
(c) If relevant, consider translating estimates of relative risk into absolute
risk for a meaningful time period
Continued on next page

7
Other analyses 17 Report other analyses doneeg analyses of subgroups and interactions, and
sensitivity analyses
Discussion
Key results 18 Summarise key results with reference to study objectives The present study has demonstrated that subjects who were
eating faster compare to those eating slower were associated
with the higher risk of type 2 diabetes mellitus. Gorging and
eating quickly have been associated with total energy intake,
and eating quickly and binge eating have been associated
with satiety and insulin resistance
Limitations 19 Discuss limitations of the study, taking into account sources of potential bias or Our work has certain limitations that need to be
imprecision. Discuss both direction and magnitude of any potential bias acknowledged. First weakness of the study is that the
validity of self-reported speed of eating was not evaluated
by quantied measurement of eating speed using objective
methods, neither by comparison with
speedofeatingasreportedbyfriends.Second,theeatingspeedwas
subjectively by determinable and self-reported by study
subjects and we cannot exclude reporting bias in the present
study. Selfreporting measurement may potentially lead to
under-estimation of eating speed as a separate risk factor for
type 2 diabetes mellitus We used only 2 categories of eating
speed (i.e. slowly and relatively slower and relatively
faster and very fast) due to small sample size. Another
limitation is that analyses did not control
energyintake.Validationstudiesofself-reportedspeed
ofeatingin comparison with careful quantied measurements
of eating rate would be useful.
Interpretation 20 Give a cautious overall interpretation of results considering objectives, limitations, Our data support a possible relationship between faster
multiplicity of analyses, results from similar studies, and other relevant evidence eating speed and the increased risk of type 2 diabetes
mellitus.
Generalisability 21 Discuss the generalisability (external validity) of the study results
Other information

8
Funding 22 Give the source of funding and the role of the funders for the present study and, if This research received no specic grant from any funding
applicable, for the original study on which the present article is based agency in the public, commercial or not-for-prot sectors.

*Give information separately for cases and controls in case-control studies and, if applicable, for exposed and unexposed groups in cohort and cross-sectional studies.

Note: An Explanation and Elaboration article discusses each checklist item and gives methodological background and published examples of transparent reporting. The STROBE
checklist is best used in conjunction with this article (freely available on the Web sites of PLoS Medicine at http://www.plosmedicine.org/, Annals of Internal Medicine at
http://www.annals.org/, and Epidemiology at http://www.epidem.com/). Information on the STROBE Initiative is available at www.strobe-statement.org.