Dairy fat intake and risk of type 2 diabetes in 3 cohorts of US men and women

ABSTRACT Background Previous studies have examined dairy products with various fat contents in relation to type 2 diabetes (T2D) risk, although data regarding dairy fat intake per se are sparse. Objectives We aimed to evaluate the association between dairy fat intake and risk of T2D in 3 prospective cohorts. We also examined associations for isocalorically replacing dairy fat with other macronutrients. Methods We prospectively followed 41,808 men in the Health Professionals Follow-Up Study (HPFS; 1986–2012), 65,929 women in the Nurses’ Health Study (NHS; 1984–2012), and 89,565 women in the NHS II (1991–2013). Diet was assessed quadrennially using validated FFQs. Fat intake from dairy products and other relevant sources was expressed as percentage of total energy. Self-reported incident T2D cases were confirmed using validated supplementary questionnaires. Time-dependent Cox proportional hazards regression was used to estimate the HR for dairy fat intake and T2D risk. Results During 4,219,457 person-years of follow-up, we documented 16,511 incident T2D cases. Dairy fat was not associated with risk of T2D when compared with calories from carbohydrates (HR for extreme quintiles: 0.98; 95% CI: 0.95, 1.02). Replacing 5% of calories from dairy fat with other sources of animal fat or carbohydrate from refined grains was associated with a 17% (HR: 1.17; 95% CI: 1.13, 1.21) and a 4% (HR: 1.04; 95% CI: 1.00, 1.08) higher risk of T2D, respectively. Conversely, a 5% calorie replacement with carbohydrate from whole grains was associated with a 7% lower risk of T2D (HR: 0.93; 95% CI: 0.88, 0.98). Conclusions Dairy fat intake was not associated with T2D risk in these cohort studies of US men and women when compared with calories from carbohydrate. Replacing dairy fat with carbohydrates from whole grains was associated with lower risk of T2D. Replacement with other animal fats or refined carbohydrates was associated with higher risk.

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Abstract P234: Dairy Fat Intake and Risk of Type 2 Diabetes in 3 Cohorts of US Adults

Circulation ◽

10.1161/circ.137.suppl_1.p234 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Andres Ardisson Korat ◽

Frank B Hu ◽

Qi Sun

Keyword(s):

Type 2 Diabetes ◽

Dairy Products ◽

Whole Grains ◽

Fat Intake ◽

Food Items ◽

Animal Fat ◽

Dairy Fat ◽

Increased Risk

Background: Previous studies have examined the association between dairy fat intake and incident Type 2 Diabetes (T2D) by conducting analyses of dairy products stratified by fat content, although data linking dairy fat intake and incident T2D and their substitution for other nutrients are sparse. Objective: The aim of this study is to evaluate the association between dairy fat intake and risk of T2D. We assessed the hypothesis that replacing calories from dairy fat for other animal fat or refined carbohydrates will result in modest increases in T2D risk. Methods: We followed up 41,670 men in the Health Professionals Follow-Up Study (1986-2010), 84, 685 women in the Nurses’ Health Study (NHS; 1980-2012), and 90,325 women in the NHSII (1991-2011). Diet was assessed every 4 years with the use of validated food-frequency questionnaires, and other health and lifestyle covariates were collected biennially. Dairy fat contents were determined for dairy products and food items that contain dairy. Dairy fat intake from all relevant food items was summed to calculate total intake, which was expressed as percent of total energy. Incident T2D cases were identified by self-reports during follow-up and confirmed by a validated supplementary questionnaire. A time-dependent Cox proportional hazards regression was used to estimate the hazard ratio for dairy fat intake and T2D risk. Results: During 4,661,518 years of follow-up, we documented 18,298 incident T2D cases. In multivariate models, a 5% increase in energy dairy fat was associated with a 2% risk increase in T2D (RR: 1.02; 95% CI: 1.00, 1.05). In isocaloric substitution models, the replacement of 5% of calories from dairy fat with the equivalent energy from other sources of animal fat or carbohydrate from refined grains was associated with an 7% [RR: 1.07; 95% CI: 1.04, 1.09], and a 7% [RR: 1.07; 95% CI: 1.04, 1.11] increased risk of T2D, respectively. Conversely, a 5% calorie substitution of carbohydrate from whole grains was associated with 7% lower risk of T2D [RR: 0.93; 95% CI: 0.89, 0.97]. Conclusions: In conclusion, dairy fat intake was modestly associated with a higher T2D risk. The replacement of dairy fat with carbohydrates from whole grains may decrease incident T2D risk. Further research is warranted to elucidate the role of other components in dairy products that may contribute to previously reported null associations with T2D.

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Abstract MP94: Consumption of Specific Fruits and Incidence of Type 2 Diabetes in Men and Women

Circulation ◽

10.1161/circ.127.suppl_12.amp94 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Isao Muraki ◽

Fumiaki Imamura ◽

Frank B Hu ◽

Walter C Willett ◽

Rob van Dam ◽

...

Keyword(s):

Type 2 Diabetes ◽

Lower Risk ◽

Fruit Juice ◽

Dietary Factors ◽

Health Study ◽

Significant Heterogeneity ◽

Men And Women ◽

Increased Risk

Background: Consumption of whole fruits, but not fruit juice, has been associated with lower risk of type 2 diabetes. However, individual fruits have different compositions of carbohydrate, phytochemicals and other nutrients, and may thus have different effects on diabetes risk. We examined whether consumption of specific fruits was prospectively associated with risk of type 2 diabetes in US men and women. In addition, we evaluated whether the associations of fruits with diabetes were determined by the glycemic load (GL) of fruits consumption. Methods: After excluding participants with chronic diseases at baseline, we evaluated 66,720 women from the Nurses' Health Study (1984-2008); 85,961 women from the Nurses’ Health Study II (1991-2009); and 26,149 men from the Health Professionals Follow-up Study (1986-2008). Validated semi-quantitative food frequency questionnaires were administered to assess habitual consumption of fruits and other foods every two to four years. Incidences of type 2 diabetes were identified using biennial self-reported questionnaires and confirmed using supplementary questionnaires. The associations were prospectively assessed in each cohort, using Cox proportional hazard regression. Sociodemographics, lifestyle, caloric intakes, intakes of other fruits, and other dietary factors were adjusted for to control for confounding. Cohort-specific estimates were pooled by a random-effects meta-analysis. Results: During 3,447,866 person-years of follow-up, 11,521 participants were newly diagnosed with type 2 diabetes. The pooled multivariable-adjusted hazard ratios (HRs) for type 2 diabetes (for every 3 servings/week increase of fruit intake) were 0.74 [95% confidence interval (CI): 0.66, 0.83] for blueberries; 0.86 (0.80, 0.93) for grapes or raisins; 0.86 (0.75, 0.99) for prunes; 0.91 (0.81, 1.03) for bananas; 0.93 (0.88, 0.97) for apples or pears; 0.95 (0.91, 1.00) for grapefruits; 0.96 (0.90, 1.02) for peaches, plums or apricots; 1.01 (0.97, 1.05) for oranges; 1.06 (0.96, 1.19) for strawberries; and 1.11 (1.03, 1.20) for cantaloupe. No significant heterogeneity was found among the three cohorts, except associations with banana consumption. In contrast, each drink per day of fruit juice was associated with a HR (95% CI) of 1.07 (1.00, 1.14). The HRs for type 2 diabetes were 0.81 (0.69, 0.96) per 1 serving/day of high GL fruits, 0.96 (0.86, 1.07) for moderate GL fruits, and 1.05 (0.92, 1.19) for low GL fruits. Conclusion: Our data suggest that intakes of certain whole fruits, including grapes or raisins, prunes, apples or pears, grapefruits, and blueberries, are associated with lower risk of type 2 diabetes, whereas high consumption of fruit juice may lead to increased risk. Future research is needed to confirm our findings and elucidate mechanism underlying the associations for individual fruits.

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Intake of whole grain foods and risk of type 2 diabetes: results from three prospective cohort studies

BMJ ◽

10.1136/bmj.m2206 ◽

2020 ◽

pp. m2206 ◽

Cited By ~ 3

Author(s):

Yang Hu ◽

Ming Ding ◽

Laura Sampson ◽

Walter C Willett ◽

JoAnn E Manson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Brown Rice ◽

Whole Grains ◽

Health Study ◽

Whole Grain ◽

Breakfast Cereal ◽

Hazard Ratios ◽

Grain Foods

Abstract Objective To examine the associations between the intake of total and individual whole grain foods and the risk of type 2 diabetes. Design Prospective cohort studies. Setting Nurses’ Health Study (1984-2014), Nurses’ Health Study II (1991-2017), and Health Professionals Follow-Up Study (1986-2016), United States. Participants 158 259 women and 36 525 men who did not have type 2 diabetes, cardiovascular disease, or cancer at baseline. Main outcome measures Self-reports of incident type 2 diabetes by participants identified through follow-up questionnaires and confirmed by a validated supplementary questionnaire. Results During 4 618 796 person years of follow-up, 18 629 participants with type 2 diabetes were identified. Total whole grain consumption was categorized into five equal groups of servings a day for the three cohorts. After adjusting for lifestyle and dietary risk factors for diabetes, participants in the highest category for total whole grain consumption had a 29% (95% confidence interval 26% to 33%) lower rate of type 2 diabetes compared with those in the lowest category. For individual whole grain foods, pooled hazard ratios (95% confidence intervals) for type 2 diabetes in participants consuming one or more servings a day compared with those consuming less than one serving a month were 0.81 (0.77 to 0.86) for whole grain cold breakfast cereal, 0.79 (0.75 to 0.83) for dark bread, and 1.08 (1.00 to 1.17) for popcorn. For other individual whole grains with lower average intake levels, comparing consumption of two or more servings a week with less than one serving a month, the pooled hazard ratios (95% confidence intervals) were 0.79 (0.75 to 0.83) for oatmeal, 0.88 (0.82 to 0.94) for brown rice, 0.85 (0.80 to 0.90) for added bran, and 0.88 (0.78 to 0.98) for wheat germ. Spline regression showed a non-linear dose-response association between total whole grain intake and the risk of type 2 diabetes where the rate reduction slightly plateaued at more than two servings a day (P<0.001 for curvature). For whole grain cold breakfast cereal and dark bread, the rate reduction plateaued at about 0.5 servings a day. For consumption of popcorn, a J shaped association was found where the rate of type 2 diabetes was not significantly raised until consumption exceeded about one serving a day. The association between higher total whole grain intake and lower risk of type 2 diabetes was stronger in individuals who were lean than in those who were overweight or obese (P=0.003 for interaction), and the associations did not vary significantly across levels of physical activity, family history of diabetes, or smoking status. Conclusion Higher consumption of total whole grains and several commonly eaten whole grain foods, including whole grain breakfast cereal, oatmeal, dark bread, brown rice, added bran, and wheat germ, was significantly associated with a lower risk of type 2 diabetes. These findings provide further support for the current recommendations of increasing whole grain consumption as part of a healthy diet for the prevention of type 2 diabetes.

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Consumption of Total Olive Oil and Risk of Total and Cause-Specific Mortality in US Adults

Current Developments in Nutrition ◽

10.1093/cdn/nzab053_029 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1036-1036

Author(s):

Marta Guasch-Ferre ◽

Yanping Li ◽

Walter Willett ◽

Qi Sun ◽

Laura Sampson ◽

...

Keyword(s):

Olive Oil ◽

Lower Risk ◽

Total Mortality ◽

Cox Proportional Hazards ◽

Health Study ◽

Men And Women ◽

Dairy Fat ◽

Risk Of Mortality ◽

Specific Mortality

Abstract Objectives The association between olive oil intake and the risk of mortality has not been evaluated before in the US population. Our objective was to examine whether olive oil intake is associated with total and cause-specific mortality in two prospective cohorts of US men and women. We hypothesize that higher olive oil consumption is associated with lower risk of total and cause-specific mortality. Methods We followed 61,096 women (Nurses’ Health Study, 1990–2016) and 31,936 men (Health Professionals Follow-up Study, 1990–2016) who were free of diabetes, cardiovascular disease and cancer at baseline. Diet was assessed by a semi quantitative food frequency questionnaire at baseline and then every 4 years. Cox proportional hazards regressions were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results During 26 years of follow-up, 32,868 deaths occurred. Compared with those participants who never consumed olive oil, those with higher olive oil intake (>1/2 tablespoon/d or >8g/d) had 15% lower risk of total mortality [pooled hazard ratio (95% confidence interval): 0.85 (0.81, 0.88)] after adjustment for potential confounders. Higher olive oil intake was associated with 15% lower risk of CVD death [0.85 (0.78, 0.92)], 38% lower risk of neurodegenerative disease death [0.62 (0.54, 0.71)], and 12% lower risk of respiratory death [0.88 (0.77, 1.00)]. Replacing 10 g of margarine, mayonnaise, and dairy fat with the equivalent amount of olive oil was associated with 7–20% lower risk of total mortality, and death from CVD, cancer, neurodegenerative, and respiratory diseases. No significant associations were observed when olive oil was replacing other vegetable oils combined (corn, safflower, soybean and canola oil). Conclusions We observed that higher olive oil intake was associated with a lower risk of total mortality and cause-specific mortality in a large prospective cohort of U.S. men and women. The substitution of margarine, mayonnaise, and dairy fat with olive oil was associated with a reduced risk of mortality. Funding Sources This work was supported by grants from the National Institutes of Health.

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Carbohydrate Quantity and Quality and Risk of Type 2 Diabetes: Results from Three Large Prospective US Cohorts

Current Developments in Nutrition ◽

10.1093/cdn/nzaa061_008 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1380-1380

Author(s):

Kim Braun ◽

Marta Liu Guasch-Ferré ◽

Vasanti Malik ◽

Hala Alessa ◽

Walter Willett ◽

...

Keyword(s):

Type 2 Diabetes ◽

Saturated Fat ◽

Whole Grains ◽

Health Study ◽

Monounsaturated Fat ◽

Funding Sources ◽

Cox Proportional Hazard Regression ◽

Time Varying Covariates

Abstract Objectives Carbohydrate intake has been reported to be associated with higher type 2 diabetes (T2D) risk, but high and low quality of carbohydrate may have different effects. Furthermore, these effects may differ depending on overall macronutrient composition. We aimed to examine associations of isocalorically substituting high quality carbohydrates (HQC) and low quality carbohydrates (LQC) with other macronutrients on T2D risk. Methods We included 69,949 women from the Nurses’ Health Study, 90,239 women from the Nurses’ Health Study 2, and 40,539 men from the Health Professionals Follow-up Study. Dietary data were collected every 2–4 years using a semi-quantitative food frequency questionnaire, from which dietary intake of LQC and HQC were calculated. LQC was defined as the percentage of energy (E%) from carbohydrates from refined grains, sugary foods, and potatoes, and HQC as E% from carbohydrate from whole grains. Hazard ratios were estimated using Cox proportional hazard regression analyses with time-varying covariates. Results During 4389,996 years of follow-up, we documented 11,872 T2D cases. In pooled multivariable-adjusted analyses, substituting 5E% from saturated fat with 5E% from LQC was associated with a higher T2D (HR[95% CI] = 1.05[1.00–1.09]) while substitution with HQC was associated with a lower T2D risk (HR[95% CI] = 0.93[0.87–0.99]). Isocaloric substitution of other macronutrients with LQC was not associated with T2D risk. On the other hand, isocaloric substitution of HQC was associated with lower T2D risk when the replacement nutrient was monounsaturated fat (HR[95% CI] = 0.88[0.83–0.94]), polyunsaturated fat (HR[95% CI] = 0.92[0.86–0.98]), trans fat (HR[95% CI] = 0.90[0.85–0.97]), animal protein (HR[95% CI] = 0.88[0.83–0.93]), and vegetable protein (HR[95% CI] = 0.90[0.84–0.96]). Conclusions Our study suggests that higher intake of HQC, especially from whole grains, is associated with a lower T2D risk, irrespective of the macronutrient it replaces. In contrast, a higher intake of LQC is associated with a higher risk of type 2 diabetes, but only when it replaces saturated fat. Our findings highlight the importance of making a distinction between carbohydrate from high and low quality sources and taking into account different substitutions when examining macronutrients. Funding Sources National Institutes of Health.

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Abstract MP21: Circulating Biomarkers of Dairy Fat and Incident Type 2 Diabetes in Two US Prospective Cohorts

Circulation ◽

10.1161/circ.129.suppl_1.mp21 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Mohammad Y Yakoob ◽

Peilin Shi ◽

Frank B Hu ◽

Hannia Campos ◽

Kathryn M Rexrode ◽

...

Keyword(s):

Type 2 Diabetes ◽

Lower Incidence ◽

Lower Risk ◽

Circulating Biomarkers ◽

Dairy Fat ◽

Fat Consumption ◽

Increased Risk ◽

Prospective Cohorts

Background: Prior observational studies suggest that self-reported consumption of dairy foods is associated with lower risk of type 2 diabetes (DM). Few studies have used circulating biomarkers that provide objective measures of dairy fat consumption. Aim: To test the hypothesis that plasma fatty acid biomarkers of dairy fat, 15:0, 17:0, 16:1 n-7t and 14:0, are associated with lower incidence of DM. Methods: We used gas-liquid chromatography to measure plasma 15:0, 17:0, 16:1 n-7t and 14:0 biomarkers in 3,347 adults aged 30-75 years and free of prevalent DM at baseline in two separate U.S. prospective cohorts, Nurses’ Health Study (NHS) and Health Professionals’ Follow Up Study (HPFS). Incident DM was identified through 2008 and confirmed by validated supplementary questionnaire using symptoms, diagnostic tests, and medical therapy. Cox proportional hazards regression was used and cohort findings pooled by fixed-effects meta-analysis. Results: During mean ± SD follow-up of 14.0 ± 4.9 years, 254 new cases of DM were diagnosed. Correlations with self-reported dairy fat consumption were modest for 17:0 (r=0.19), 16:1 n-7t (r=0.21) and 15:0 (r=0.27), and weaker for 14:0 (r=0.12). In pooled multivariate analyses, comparing highest to lowest quartiles, lower risk of DM was seen for 17:0 [HR=0.57 (95% CI: 0.39 - 0.82), P-trend=0.001] and 16:1 n-7t [HR=0.60 (0.42 - 0.87), P-trend=0.007], while 14:0 was positively associated [HR=1.98 (1.35 - 2.91), P-trend <0.0001] and 15:0 was not associated [HR=1.11 (0.75 - 1.63), P-trend=0.80] ( Table ). Conclusion: In separate prospective cohorts, two biomarkers of dairy fat (17:0 and 16:1 n-7t) were associated with lower incidence of DM. 14:0, which is also obtained from beef, and is a marker of de novo lipogenesis, was associated with increased risk. Further research is needed on plausible biological and mechanistic pathways.

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Abstract 17285: Frequent Consumption of Meals Prepared at Home and Risk of Type 2 Diabetes Among American Men and Women

Circulation ◽

10.1161/circ.132.suppl_3.17285 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Geng Zong ◽

David M Eisenberg ◽

Frank B Hu ◽

Qi Sun

Keyword(s):

Type 2 Diabetes ◽

Weight Gain ◽

Lower Risk ◽

Fruits And Vegetables ◽

Hazard Ratio ◽

Health Study ◽

Sugar Sweetened Beverage ◽

At Home

Introduction: The frequency of eating meals prepared at home (MPAH) decreased among Americans over the last 50 years. Eating out has been associated with poor diet quality and weight gain in adolescents and adult. Few studies have examined MPAH frequency in relation to diabetes risk. Hypothesis: Having MPAH is associated with lower risk of Type 2 Diabetes (T2D). Methods: We followed 57,994 women in the Nurses’ Health Study and 41,679 men in the Health Professionals Follow-up Study from 1986 to 2012. Participants were free of diabetes, cardiovascular disease, and cancer at baseline. Weekly frequencies of consuming MPAH were collected at baseline, and summed up as overall MPAH. Results: Participants with more MPAH had higher intake of whole grains, total and low-fat dairy products, fruits, and vegetables, and lower sugar sweetened beverage (SSB) at baseline. However, MPAH turned to be associated with more red meat and low coffee intakes. MPAH was moderately associated with less weight gain during follow-up. Compared to those with 0-6 overall MPAH/week, women with 11-14 MPAH/week had 0.45±0.08kg less weight gain over 8 years, whereas men had 0.41±0.07 kg less weight gain (P<0.001) for the same comparison. During 2.3 million person-years of follow-up, 8959 T2D cases were identified and confirmed in both cohorts. After multivariate adjustment of demographic and lifestyle factors, pooled hazard ratio (95% confidence interval) of T2D were 0.96 (0.90, 1.01), 0.96 (0.87, 1.06), 0.88 (0.83, 0.94) for participants who had 7-8, 9-10, and 11-14 MPAH/week (P for trend<0.001), comparing with those eating 0-6 MPAH/week. Each additional MPAH for lunch was associated with 2% lower risk of T2D, whereas the corresponding value was 4% for dinner (P<0.001 for both). These findings were attenuated when BMI or SSB were further adjusted: the hazard ratio comparing participants with 11-14 MPAH/week to those with 0-6 MPAH/week were 0.95 (0.90, 1.01; P for trend=0.13) with adjusting of BMI, and 0.94 (0.89, 1.00; P for trend=0.09) with adjustment of SSB. Conclusions: These findings suggest that eating more MPAH is associated with a lower risk of T2D overtime, and this relationship may be partly ascribed to less weight gain and lower SSB intake by those who prepare their own meals at home more often.

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Restricted AccessChanges in Plant-Based Diet Indices and Subsequent Risk of Type 2 Diabetes in Women and Men: Three U.S. Prospective Cohorts

10.2337/figshare.13312577.v1 ◽

2021 ◽

Author(s):

Zhangling Chen ◽

Jean-Philippe Drouin-Chartier ◽

Yanping Li ◽

Megu Y. Baden ◽

JoAnn E. Manson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Lower Risk ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Diabetes Risk ◽

Health Study ◽

Weight Changes ◽

Subsequent Risk

Objective We evaluated the associations between changes in plant-based diets and subsequent risk of type 2 diabetes. Methods We prospectively followed 76,530 women in the Nurses’ Health Study (NHS, 1986-2012), 81,569 women in NHS II (1991-2017), and 34,468 men in the Health Professionals’ Follow-up Study (1986-2016). Adherence to plant-based diets was assessed every 4 years using the overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI). We used multivariable Cox proportional hazards models to estimate hazard ratios (HRs). Results of the three cohorts were pooled using meta-analysis. Results We documented 12,627 cases of type 2 diabetes during 2,955,350 person-years of follow-up. <a>After adjustment for initial BMI, initial and 4-year changes in alcohol intake, smoking, physical activity, and other factors, </a><a>compared with participants whose indices remained relatively stable (±3%), </a><a>participants with the largest decrease (>10%) in PDI and hPDI over 4 years had a 12%-23% higher diabetes risk in the subsequent 4 years (pooled HR: PDI, 1.12 (95% CI 1.05, 1.20), hPDI, 1.23 (1.16, 1.31)). </a>Each 10% increment in PDI and hPDI over 4 years was associated with a 7%-9% lower risk (PDI, 0.93 (0.91, 0.95), hPDI, 0.91 (0.87, 0.95)). Changes in uPDI were not associated with diabetes risk. Weight changes accounted for 6.0%-35.6% of the associations between changes in PDI and hPDI and diabetes risk. Conclusions Improving adherence to overall and healthful plant-based diets was associated with a lower risk of type 2 diabetes, whereas decreased adherence to such diets was associated with a higher risk.

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Abstract P074: Caffeine Intake May be Associated with a Lower Risk of Type 2 Diabetes in the Physicians’ Health Study and Meta-Analysis

Circulation ◽

10.1161/circ.129.suppl_1.p074 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Chisa Matsumoto ◽

Howard D Sesso ◽

J. Michael Gaziano ◽

Luc Djoussé

Keyword(s):

Type 2 Diabetes ◽

Lower Risk ◽

Linear Trend ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Health Study ◽

Caffeine Intake

Objectives: Short-term metabolic studies have shown that caffeine improves insulin-sensitivity. However, epidemiological studies evaluating the relationship of caffeine intake with risk of type 2 diabetes (DM) have shown inconsistent results. We examined whether caffeine intake is associated with the risk of DM in the Physicians’ Health Study and supplemented the results with a meta-analysis. Methods: We prospectively analyzed data on 18,432 PHS participants that were free of DM at baseline (1997-2001). Caffeine intake was assessed using a food-frequency questionnaire. Incident DM was ascertained via annual follow-up questionnaires and validated in a subsample by review of medical records. We used Cox proportional hazards models to estimate the HR and 95% CI of DM. Meta-analysis was conducted through a systematic literature search using PubMed and EMBASE. A random-effect model was used and between-studies heterogeneity was estimated with I 2 . Results: In the PHS, mean age at baseline was 66.4 ± 9.3 years, and 1,137 men (6.2%) developed DM during mean follow up of 9.2 years. In a multivariable model adjusted for conventional risk factors of DM, HRs (95% CI) for DM were 1.0 (ref), 1.08 (0.90-1.29), 1.03 (0.85-1.24), 0.98 (0.81-1.18), and 0.86 (0.70-1.04) across consecutive quintiles of caffeine intake (p for linear trend= 0.69). Meta-analysis included 6 studies consisted of 7 separate cohorts comprising 275,971 individuals and 10,048 cases of incident DM. The pooled odds ratio (95% CI) for DM was 0.79 (0.68-0.93) when the highest caffeine intake was compared to the lowest group in random effects model (I 2 =75%). Conclusion: While only the highest category of caffeine intake was associated with a modest and non-significant association with DM in the PHS, results from the meta-analysis were consistent with a lower risk of DM.

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Replacing the consumption of red meat with other major dietary protein sources and risk of type 2 diabetes mellitus: a prospective cohort study

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa284 ◽

2020 ◽

Author(s):

Anne Mette L Würtz ◽

Marianne U Jakobsen ◽

Monica L Bertoia ◽

Tao Hou ◽

Erik B Schmidt ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Dietary Protein ◽

Lower Risk ◽

Red Meat ◽

Health Study ◽

Protein Sources ◽

Processed Red Meat

ABSTRACT Background Greater consumption of red meat has been associated with a higher risk of type 2 diabetes mellitus (T2DM). A decreased intake of red meat and simultaneous increased intake of other high-protein foods may be associated with a lower risk of T2DM. These analyses of specific food replacements for red meat may provide more accurate dietary advice. Objective We examined the association between a decrease in intake of red meat accompanied by an increase in other major dietary protein sources and risk of T2DM. Methods We prospectively followed 27,634 males in the Health Professionals Follow-up Study, 46,023 females in the Nurses’ Health Study, and 75,196 females in the Nurses’ Health Study II. Diet was assessed by a validated FFQ and updated every 4 y. Cox proportional hazards models adjusted for T2DM risk factors were used to model the food replacements. We calculated HRs and 95% CIs for the T2DM risk associated with replacements of 1 daily serving of red meat with another protein source. Results During 2,113,245 person-years of follow-up, we identified 8763 incident T2DM cases from 1990 to 2013. In the pooled analyses, a decrease in total red meat intake during a 4-y period replaced with another common protein food was associated with a lower risk of T2DM in the subsequent 4-y period. The HR (95% CI) per 1 serving/d was 0.82 (0.75, 0.90) for poultry, 0.87 (0.77, 0.98) for seafood, 0.82 (0.78, 0.86) for low-fat dairy, 0.82 (0.77, 0.86) for high-fat dairy, 0.90 (0.81, 0.99) for eggs, 0.89 (0.82, 0.98) for legumes, and 0.83 (0.78, 0.89) for nuts. The associations were present for both unprocessed and processed red meat, although stronger for the replacement of processed red meat. Conclusions Replacing red meat consumption with other protein sources was associated with a lower risk of T2DM.

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