Top

Diabetologia

Published in:

Open Access 01-02-2014 | Article

Adherence to predefined dietary patterns and incident type 2 diabetes in European populations: EPIC-InterAct Study

Author: The InterAct Consortium

Published in: Diabetologia | Issue 2/2014

Abstract

Aims/hypothesis

Few studies have investigated the relationship between predefined dietary patterns and type 2 diabetes incidence; little is known about the generalisability of these associations. We aimed to assess the association between predefined dietary patterns and type 2 diabetes risk in European populations.

Methods

From among a case-cohort of 12,403 incident diabetes cases and 16,154 subcohort members nested within the prospective European Prospective Investigation into Cancer and Nutrition study, we used data on 9,682 cases and 12,595 subcohort participants from seven countries. Habitual dietary intake was assessed at baseline with country-specific dietary questionnaires. Two diet-quality scores (alternative Healthy Eating Index [aHEI], Dietary Approaches to Stop Hypertension [DASH] score) and three reduced rank regression (RRR)-derived dietary-pattern scores were constructed. Country-specific HRs were calculated and combined using a random-effects meta-analysis.

Results

After multivariable adjustment, including body size, the aHEI and DASH scores were not significantly associated with diabetes, although for the aHEI there was a tendency towards an inverse association in countries with higher mean age. We observed inverse associations of the three RRR-derived dietary-pattern scores with diabetes: HRs (95% CIs) for a 1-SD difference were 0.91 (0.86, 0.96), 0.92 (0.84, 1.01) and 0.87 (0.82, 0.92). Random-effects meta-analyses revealed heterogeneity between countries that was explainable by differences in the age of participants or the distribution of dietary intake.

Conclusions/interpretation

Adherence to specific RRR-derived dietary patterns, commonly characterised by high intake of fruits or vegetables and low intake of processed meat, sugar-sweetened beverages and refined grains, may lower type 2 diabetes risk.

Available only for authorised users

Gillies CL, Abrams KR, Lambert PC et al (2007) Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ 334:299PubMedCrossRef

Schulze MB, Hoffmann K (2006) Methodological approaches to study dietary patterns in relation to risk of coronary heart disease and stroke. Br J Nutr 95:860–869PubMedCrossRef

Kennedy ET, Ohls J, Carlson S, Fleming K (1995) The Healthy Eating Index: design and applications. J Am Diet Assoc 95:1103–1108PubMedCrossRef

Haines PS, Siega-Riz AM, Popkin BM (1999) The Diet Quality Index revised: a measurement instrument for populations. J Am Diet Assoc 99:697–704PubMedCrossRef

McCullough ML, Feskanich D, Stampfer MJ et al (2002) Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance. Am J Clin Nutr 76:1261–1271PubMed

Hoffmann K, Schulze MB, Schienkiewitz A, Nothlings U, Boeing H (2004) Application of a new statistical method to derive dietary patterns in nutritional epidemiology. Am J Epidemiol 159:935–944PubMedCrossRef

Martinez-Gonzalez MA, de la Fuente-Arrillaga C, Nunez-Cordoba JM et al (2008) Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. BMJ 336:1348–1351PubMedCrossRef

Salas-Salvado J, Bullo M, Babio N et al (2011) Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care 34:14–19PubMedCrossRef

Romaguera D, Guevara M, Norat T et al (2011) Mediterranean diet and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study: the InterAct project. Diabetes Care 34:1913–1918PubMedCrossRef

10.

Abiemo EE, Alonso A, Nettleton JA et al (2012) Relationships of the Mediterranean dietary pattern with insulin resistance and diabetes incidence in the Multi-Ethnic Study of Atherosclerosis (MESA). Br J Nutr 109:1490–1497PubMedCrossRef

11.

Chiuve SE, Fung TT, Rimm EB et al (2012) Alternative dietary indices both strongly predict risk of chronic disease. J Nutr 142:1009–1018PubMedCrossRef

12.

de Koning L, Chiuve SE, Fung TT, Willett WC, Rimm EB, Hu FB (2011) Diet-quality scores and the risk of type 2 diabetes in men. Diabetes Care 34:1150–1156PubMedCrossRef

13.

Liese AD, Nichols M, Sun X, D'Agostino RB Jr, Haffner SM (2009) Adherence to the DASH Diet is inversely associated with incidence of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes Care 32:1434–1436PubMedCrossRef

14.

Chiuve SE, Sampson L, Willett WC (2011) The association between a nutritional quality index and risk of chronic disease. Am J Prev Med 40:505–513PubMedCentralPubMedCrossRef

15.

Zamora D, Gordon-Larsen P, He K, Jacobs DR Jr, Shikany JM, Popkin BM (2011) Are the 2005 Dietary Guidelines for Americans Associated With reduced risk of type 2 diabetes and cardiometabolic risk factors? Twenty-year findings from the CARDIA study. Diabetes Care 34:1183–1185PubMedCrossRef

16.

von Ruesten A, Illner AK, Buijsse B, Heidemann C, Boeing H (2010) Adherence to recommendations of the German food pyramid and risk of chronic diseases: results from the EPIC-Potsdam study. Eur J Clin Nutr 64:1251–1259CrossRef

17.

Gopinath B, Rochtchina E, Flood VM, Mitchell P (2013) Diet quality is prospectively associated with incident impaired fasting glucose in older adults. Diabet Med 30:557–562PubMedCrossRef

18.

Heidemann C, Hoffmann K, Spranger J et al (2005) A dietary pattern protective against type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam Study cohort. Diabetologia 48:1126–1134PubMedCrossRef

19.

McNaughton SA, Mishra GD, Brunner EJ (2008) Dietary patterns, insulin resistance, and incidence of type 2 diabetes in the Whitehall II Study. Diabetes Care 31:1343–1348PubMedCrossRef

20.

Schulze MB, Hoffmann K, Manson JE et al (2005) Dietary pattern, inflammation, and incidence of type 2 diabetes in women. Am J Clin Nutr 82:675–684

21.

Imamura F, Lichtenstein AH, Dallal GE, Meigs JB, Jacques PF (2009) Generalizability of dietary patterns associated with incidence of type 2 diabetes mellitus. Am J Clin Nutr 90:1075–1083PubMedCrossRef

22.

Langenberg C, Sharp S, Forouhi NG et al (2011) Design and cohort description of the InterAct Project: an examination of the interaction of genetic and lifestyle factors on the incidence of type 2 diabetes in the EPIC Study. Diabetologia 54:2272–2282PubMedCrossRef

23.

Bingham S, Riboli E (2004) Diet and cancer–the European Prospective Investigation into Cancer and Nutrition. Nat Rev Cancer 4:206–215PubMedCrossRef

24.

Riboli E, Hunt KJ, Slimani N et al (2002) European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection. Public Health Nutr 5:1113–1124PubMedCrossRef

25.

Riboli E, Kaaks R (1997) The EPIC Project: rationale and study design. European Prospective Investigation into Cancer and Nutrition. Int J Epidemiol 26(Suppl 1):S6–S14PubMedCrossRef

26.

Rolandsson O, Norberg M, Nystrom L et al (2012) How to diagnose and classify diabetes in primary health care: lessons learned from the Diabetes Register in Northern Sweden (DiabNorth). Scand J Prim Health Care 30:81–87PubMedCentralPubMedCrossRef

27.

Kaaks R, Riboli E (1997) Validation and calibration of dietary intake measurements in the EPIC project: methodological considerations. European Prospective Investigation into Cancer and Nutrition. Int J Epidemiol 26(Suppl 1):S15–S25PubMedCrossRef

28.

Kaaks R, Slimani N, Riboli E (1997) Pilot phase studies on the accuracy of dietary intake measurements in the EPIC project: overall evaluation of results. European Prospective Investigation into Cancer and Nutrition. Int J Epidemiol 26(Suppl 1):S26–S36PubMedCrossRef

29.

Margetts BM, Pietinen P (1997) European Prospective Investigation into Cancer and Nutrition: validity studies on dietary assessment methods. Int J Epidemiol 26(Suppl 1):S1–S5PubMedCrossRef

30.

Slimani N, Deharveng G, Unwin I et al (2007) The EPIC nutrient database project (ENDB): a first attempt to standardize nutrient databases across the 10 European countries participating in the EPIC study. Eur J Clin Nutr 61:1037–1056PubMedCrossRef

31.

Appel LJ, Moore TJ, Obarzanek E et al (1997) A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 336:1117–1124PubMedCrossRef

32.

Sacks FM, Obarzanek E, Windhauser MM et al (1995) Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). A multicenter controlled-feeding study of dietary patterns to lower blood pressure. Ann Epidemiol 5:108–118PubMedCrossRef

33.

Haftenberger M, Schuit AJ, Tormo MJ et al (2002) Physical activity of subjects aged 50–64 years involved in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr 5:1163–1176PubMedCrossRef

34.

Barlow WE, Ichikawa L, Rosner D, Izumi S (1999) Analysis of case-cohort designs. J Clin Epidemiol 52:1165–1172PubMedCrossRef

35.

Wareham NJ, Jakes RW, Rennie KL et al (2003) Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Public Health Nutr 6:407–413PubMedCrossRef

36.

Thompson SG, Higgins JP (2002) How should meta-regression analyses be undertaken and interpreted? Stat Med 21:1559–1573PubMedCrossRef

37.

Pan A, Sun Q, Bernstein AM et al (2011) Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. Am J Clin Nutr 94:1088–1096PubMedCrossRef

38.

Malik VS, Popkin BM, Bray GA, Despres JP, Willett WC, Hu FB (2010) Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care 33:2477–2483PubMedCrossRef

39.

Fung TT, McCullough M, van Dam RM, Hu FB (2007) A prospective study of overall diet quality and risk of type 2 diabetes in women. Diabetes Care 30:1753–1757PubMedCrossRef

40.

Kroger J, Zietemann V, Enzenbach C et al (2011) Erythrocyte membrane phospholipid fatty acids, desaturase activity, and dietary fatty acids in relation to risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam Study. Am J Clin Nutr 93:127–142PubMedCrossRef

41.

Patel PS, Sharp SJ, Jansen E et al (2010) Fatty acids measured in plasma and erythrocyte-membrane phospholipids and derived by food-frequency questionnaire and the risk of new-onset type 2 diabetes: a pilot study in the European Prospective Investigation into Cancer and Nutrition (EPIC)–Norfolk cohort. Am J Clin Nutr 92:1214–1222PubMedCrossRef

42.

Hodge AM, English DR, O'Dea K et al (2007) Plasma phospholipid and dietary fatty acids as predictors of type 2 diabetes: interpreting the role of linoleic acid. Am J Clin Nutr 86:189–197PubMed

43.

Mozaffarian D, Cao H, King IB et al (2010) Trans-palmitoleic acid, metabolic risk factors, and new-onset diabetes in U.S. adults: a cohort study. Ann Intern Med 153:790–799PubMedCentralPubMedCrossRef

44.

Freedman LS, Schatzkin A, Midthune D, Kipnis V (2011) Dealing with dietary measurement error in nutritional cohort studies. J Natl Cancer Inst 103:1086–1092PubMedCrossRef

45.

Shirani F, Salehi-Abargouei A, Azadbakht L (2013) Effects of Dietary Approaches to Stop Hypertension (DASH) diet on some risk for developing type 2 diabetes: a systematic review and meta-analysis on controlled clinical trials. Nutrition 29:939–947

46.

Beulens JW, van der Schouw YT, Bergmann MM et al (2012) Alcohol consumption and risk of type 2 diabetes in European men and women: influence of beverage type and body size. The EPIC-InterAct study. J Intern Med 272:358–370

47.

Cooper AJ, Forouhi NG, Ye Z et al (2012) Fruit and vegetable intake and type 2 diabetes: EPIC-InterAct prospective study and meta-analysis. Eur J Clin Nutr 66:1082–1092PubMedCentralPubMedCrossRef

Title: Adherence to predefined dietary patterns and incident type 2 diabetes in European populations: EPIC-InterAct Study
Author: The InterAct Consortium
Publication date: 01-02-2014
Publisher: Springer Berlin Heidelberg
Published in: Diabetologia / Issue 2/2014
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-013-3092-9

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Adherence to predefined dietary patterns and incident type 2 diabetes in European populations: EPIC-InterAct Study

Abstract

Aims/hypothesis

Methods

Results

Conclusions/interpretation

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Aims/hypothesis

Methods

Results

Conclusions/interpretation

Please log in to get access to this content

Other articles of this Issue 2/2014

Plasma concentrations of soluble IL-2 receptor α (CD25) are increased in type 1 diabetes and associated with reduced C-peptide levels in young patients

Thioredoxin-interacting protein is required for endothelial NLRP3 inflammasome activation and cell death in a rat model of high-fat diet

Evaluation of the fidelity of immunolabelling obtained with clone 5D8/1, a monoclonal antibody directed against the enteroviral capsid protein, VP1, in human pancreas

Thrombomodulin domain 1 ameliorates diabetic nephropathy in mice via anti-NF-κB/NLRP3 inflammasome-mediated inflammation, enhancement of NRF2 antioxidant activity and inhibition of apoptosis

Good news for the ageing beta cell

Liver X receptors preserve renal glomerular integrity under normoglycaemia and in diabetes in mice

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page