Somayeh Ghiasi Hafezi - Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran.
Naiemeh Varasteh - International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
Moniba Bijari - International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohammad Rashidmayvan - Department of Nutrition, Food Sciences and Clinical Biochemistry, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Science, Gonabad, Iran.
Bahareh Honarmand Rahaghi - Department of Statistics, Faculty of Mathematics and Computer Sciences, Allameh Tabataba’i University, Tehran, Iran.
Nagmeh Azadi - International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
Alireza Ghodsi - Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Elaheh Hasanzadeh - Department of Statistics, Faculty of Mathematics and Computer Sciences, Allameh Tabataba’i University, Tehran, Iran.
Susan Darroudi - International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
Sohrab Effati - Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran.
Mark Ghamsary - Department of Biostatistics and Epidemiology California, Loma Linda University, USA.
Mahmoud Ebrahimi - Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Sara Ghazizade - International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
Iman Alami Arani - International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
Reza Assaran-Darban - Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
Sara Saffar Soflaei - International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
Gordon Ferns - Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, UK.
Majid Ghayour-Mobarhan - International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.

Introduction: The development of type ۲ diabetes mellitus (T۲DM) is associated with lifestyle factors, including dietary patterns. A diet rich in macro- and micronutrients has been reported to reduce the risk of T۲DM. Therefore, this study aimed to identify the dietary factors most closely associated with T۲DM in subjects within the MASHAD cohort using a decision tree algorithm. Methods: This cross-sectional study was conducted on ۹۷۰۴ individuals from the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD), of whom ۵۹۳۶ participants completed a ۲۴h dietary recall questionnaire. Macronutrients and micronutrients were estimated using Diet Plan ۶ software. A decision tree algorithm was utilized to evaluate the most crucial dietary nutrient intakes concerning T۲DM. Results: The algorithm showed a high specificity (۸۱.۳۴%) but low sensitivity (۳۴.۲۱%), which could predict T۲DM with a low-to-moderate diagnostic ability (AUC=۰.۵۸). Based on the decision tree, eight features, including dietary potassium, total sugar, sucrose, riboflavin, thiamin, sodium, total nitrogen, and magnesium, were T۲DM’s most critical dietary components. Conclusion: Based on the results, consuming sugar, salt, and vitamin B was the most critical related dietary intake to T۲DM. Dietary interventions may be a cost-effective strategy for preventing T۲DM.

Diabetes Mellitus, Nutrients, Diet, Cohort Studies