scholarly journals Pure Fruit Juice and Fruit Consumption Are Not Associated with Incidence of Type 2 Diabetes after Adjustment for Overall Dietary Quality in the European Prospective Investigation into Cancer and Nutrition–Netherlands (EPIC-NL) Study

2020 ◽  
Vol 150 (6) ◽  
pp. 1470-1477 ◽  
Author(s):  
Floor R Scheffers ◽  
Alet H Wijga ◽  
W M Monique Verschuren ◽  
Yvonne T van der Schouw ◽  
Ivonne Sluijs ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Fruit Juice ◽  
Cox Regression ◽  
Diabetes Risk ◽  
Dietary Guidelines ◽  
Dietary Quality ◽  
Fruit Consumption ◽  
Incident Cases ◽  
Prospective Investigation

ABSTRACT Background Dietary guidelines on pure fruit juice consumption vary from country to country regarding the inclusion of pure fruit juice in the recommendations as an acceptable alternative for fruit. Current epidemiological evidence on the association between pure fruit juice consumption and diabetes risk is scarce. Objective We studied the association of both pure fruit juice and fruit consumption with diabetes risk and investigated the differences between low and high fruit consumers in the association of pure fruit juice consumption with diabetes risk. Methods This prospective cohort study included 36,147 participants in the European Prospective Investigation into Cancer and Nutrition–Netherlands (EPIC-NL) Study aged 20–69 y at baseline. Fruit juice and fruit consumption were assessed using a validated food-frequency questionnaire; amounts of consumption were divided into 5 categories and quintiles, respectively. Incident type 2 diabetes cases were mainly self-reported and verified against medical records. Cox regression was used to estimate adjusted HRs and 95% CIs. Results After an average follow-up of 14.6 y, 1477 verified incident cases of type 2 diabetes were documented. Compared with no consumption, pure fruit juice consumption was not significantly associated with type 2 diabetes, with adjusted HRs ranging from 0.92 (95% CI: 0.79, 1.09) to 1.03 (95% CI: 0.83, 1.26). The associations did not differ between participants with low and high fruit consumption. None of the categories of fruit consumption were associated with type 2 diabetes (lowest quintile as reference). Adjusted HRs ranged between 0.93 (95% CI: 0.78, 1.10) and 1.00 (95% CI: 0.84, 1.19). Adjustment for the Dutch Healthy Diet Index, as an overall measure of dietary quality, strongly attenuated the observed associations of type 2 diabetes with both fruit juice and fruit consumption. Conclusions We found no evidence for associations between pure fruit juice and fruit consumption and diabetes risk after adjustment for overall dietary quality for participants in the EPIC-NL study. This trial was registered at https://www.trialregister.nl/trial/6939 as NL6939.

scholarly journals Pure fruit juice and fruit consumption and the risk of CVD: the European Prospective Investigation into Cancer and Nutrition–Netherlands (EPIC-NL) study

2018 ◽  
Vol 121 (3) ◽  
pp. 351-359 ◽  
Author(s):  
Floor R. Scheffers ◽  
Jolanda M. A. Boer ◽  
W. M. Monique Verschuren ◽  
Martijn Verheus ◽  
Yvonne T. van der Schouw ◽  
...  
Keyword(s):  
Fruit Juice ◽  
Cox Regression ◽  
Dietary Guidelines ◽  
Fruit Consumption ◽  
Acceptable Alternative ◽  
Hazard Ratios ◽  
No Consumption ◽  
Reduced Risk ◽  
Prospective Investigation

AbstractDietary guidelines for pure fruit juice consumption differ between countries, regarding the question whether pure fruit juice is an acceptable alternative for fruit. Currently, little is known about pure fruit juice consumption and the risk of CVD. In this prospective cohort study, we studied the association of pure fruit juice and fruit consumption with the incidence of fatal and non-fatal CVD, CHD and stroke and investigated the differences in association with pure fruit juice consumption between low and high fruit consumers. A validated FFQ was used to estimate dietary intake of 34 560 participants (26·0 % men and 74·0 % women) aged 20–69 years from the European Prospective Investigation into Cancer and Nutrition–Netherlands study. Adjusted hazard ratios (HR) were estimated using Cox regression after average follow-up of 14·6 years. Compared with no consumption, pure fruit juice consumption up to 7 glasses/week – but not consumption of ≥8 glasses – was significantly associated with reduced risk of CVD and CHD, with HR from 0·83 (95 % CI 0·73, 0·95) to 0·88 (95 % CI 0·80, 0·97). Consumption of 1–4 and 4–8 glasses/week was significantly associated with lower risk of stroke with HR of 0·80 (95 % CI 0·64, 0·99) and 0·76 (95 % CI 0·61, 0·94), respectively. Associations did not differ considerably between low and high fruit consumers. The highest three quintiles of fruit consumption (≥121 g/d) were significantly associated with lower incidence of CVD, with HR of 0·87 (95 % CI 0·78, 0·97) and 0·88 (95 % CI 0·80, 0·98). In conclusion, although we observed favourable associations of moderate pure fruit juice consumption with CVD, for now consumption of whole fruit should be preferred because the evidence of the health benefits of fruit is more conclusive.

scholarly journals Diet quality score is a predictor of type 2 diabetes risk in women: The Australian Longitudinal Study on Women's Health

2014 ◽  
Vol 112 (6) ◽  
pp. 945-951 ◽  
Author(s):  
Amani Alhazmi ◽  
Elizabeth Stojanovski ◽  
Mark McEvoy ◽  
Wendy Brown ◽  
Manohar L. Garg
Keyword(s):  
Type 2 Diabetes ◽  
Longitudinal Study ◽  
Women’S Health ◽  
Women's Health ◽  
Diet Quality ◽  
Diabetes Risk ◽  
Dietary Guidelines ◽  
Australian Longitudinal Study ◽  
Incident Cases

The present study aimed to determine the ability of two diet quality scores to predict the incidence of type 2 diabetes in women. The study population comprised a nationally representative sample of 8370 Australian middle-aged (45–50 years) women participating in the ALSWH (Australian Longitudinal Study on Women's Health), who were free of diabetes and completed FFQ at baseline. The associations between the Australian Recommended Food Score (ARFS) and Dietary Guideline Index (DGI) with type 2 diabetes risk were assessed using multiple logistic regression models, adjusting for sociodemographic characteristics, lifestyle factors and energy intake. During 6 years of follow-up, 311 incident cases of type 2 diabetes were reported. The DGI score was inversely associated with type 2 diabetes risk (OR comparing the highest with the lowest quintile of DGI was 0·51; 95 % CI 0·35, 0·76; P for trend = 0·01). There was no statistically significant association between the ARFS and type 2 diabetes risk (OR comparing the highest with the lowest quintile of ARFS was 0·99; 95 % CI 0·68, 1·43; P for trend = 0·42). The results of the present prospective study indicate that the DGI score, which assesses compliance with established dietary guidelines, is predictive of type 2 diabetes risk in Australian women. The risk of type 2 diabetes among women in the highest quintile of DGI was approximately 50 % lower than that in women in the lowest quintile. The ARFS was not significantly predictive of type 2 diabetes.

scholarly journals Circulating metabolites and the risk of type 2 diabetes: a prospective study of 11,896 young adults from four Finnish cohorts

Diabetologia ◽  
2019 ◽  
Vol 62 (12) ◽  
pp. 2298-2309 ◽  
Author(s):  
Ari V. Ahola-Olli ◽  
Linda Mustelin ◽  
Maria Kalimeri ◽  
Johannes Kettunen ◽  
Jari Jokelainen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Adults ◽  
Fasting Glucose ◽  
Diabetes Risk ◽  
Increased Risk ◽  
Metabolic Biomarkers ◽  
Incident Cases ◽  
Future Diabetes

Abstract Aims/hypothesis Metabolomics technologies have identified numerous blood biomarkers for type 2 diabetes risk in case−control studies of middle-aged and older individuals. We aimed to validate existing and identify novel metabolic biomarkers predictive of future diabetes in large cohorts of young adults. Methods NMR metabolomics was used to quantify 229 circulating metabolic measures in 11,896 individuals from four Finnish observational cohorts (baseline age 24–45 years). Associations between baseline metabolites and risk of developing diabetes during 8–15 years of follow-up (392 incident cases) were adjusted for sex, age, BMI and fasting glucose. Prospective metabolite associations were also tested with fasting glucose, 2 h glucose and HOMA-IR at follow-up. Results Out of 229 metabolic measures, 113 were associated with incident type 2 diabetes in meta-analysis of the four cohorts (ORs per 1 SD: 0.59–1.50; p< 0.0009). Among the strongest biomarkers of diabetes risk were branched-chain and aromatic amino acids (OR 1.31–1.33) and triacylglycerol within VLDL particles (OR 1.33–1.50), as well as linoleic n-6 fatty acid (OR 0.75) and non-esterified cholesterol in large HDL particles (OR 0.59). The metabolic biomarkers were more strongly associated with deterioration in post-load glucose and insulin resistance than with future fasting hyperglycaemia. A multi-metabolite score comprised of phenylalanine, non-esterified cholesterol in large HDL and the ratio of cholesteryl ester to total lipid in large VLDL was associated with future diabetes risk (OR 10.1 comparing individuals in upper vs lower fifth of the multi-metabolite score) in one of the cohorts (mean age 31 years). Conclusions/interpretation Metabolic biomarkers across multiple molecular pathways are already predictive of the long-term risk of diabetes in young adults. Comprehensive metabolic profiling may help to target preventive interventions for young asymptomatic individuals at increased risk.

scholarly journals Fatty acid consumption and incident type 2 diabetes: an 18-year follow-up in the female E3N (Etude Epidémiologique auprès des femmes de la Mutuelle Générale de l’Education Nationale) prospective cohort study

2016 ◽  
Vol 116 (10) ◽  
pp. 1807-1815 ◽  
Author(s):  
Courtney Dow ◽  
Marie Mangin ◽  
Beverley Balkau ◽  
Aurélie Affret ◽  
Marie-Christine Boutron-Ruault ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Fatty Acid ◽  
Cox Regression ◽  
Positive Association ◽  
Incident Type ◽  
Overweight Women ◽  
Hazard Ratios ◽  
Acid Consumption ◽  
Incident Cases

AbstractWe evaluated the association between dietary estimates of fatty acid (FA) consumption and type 2 diabetes (T2D) risk in the French E3N (Etude Epidémiologique auprès des femmes de la Mutuelle Générale de l’Education Nationale) cohort. In total, 71 334 women without diabetes at baseline were followed up from 1993 to 2011. Diabetes was identified using questionnaires and drug-reimbursement claims, and incident cases were validated. FA consumption in 1993 was estimated from a validated dietary questionnaire. Cox regression estimated hazard ratios (HR) and 95 % CI of diabetes risk, comparing the upper tertile group with the lowest. High n-3 PUFA consumption was associated with T2D even after adjustment for confounders, including other FA and BMI (HR 1·26; 95 % CI 1·13, 1·41; upper tertile compared with lowest). Upon stratification by overweight (BMI≥25 kg/m2)/non-overweight, a positive association between total PUFA consumption and T2D was observed, but it was restricted to non-overweight women (HR 1·22; 95 % CI 1·05, 1·42), whereas n-3 PUFA consumption was associated with increased T2D risk in both BMI strata (BMI<25 kg/m2: HR 1·19; 95 % CI 1·01, 1·40 and BMI≥25 kg/m2: HR 1·38; 95 % CI 1·20, 1·59). Within the n-3 PUFA, high DPA (HR 1·41; 95 % CI 1·23, 1·63) and α-linolenic acid (ALA) intakes were associated with increased T2D risk, but the effects of ALA were restricted to overweight women (HR 1·17; 95 % CI 1·01, 1·36). Within the n-6 PUFA, only arachidonic acid (AA) intake was associated with T2D risk (HR 1·49; 95 % CI 1·33, 1·66). The associations with DPA and AA persisted even after adjustment of their principal source in this cohort, the consumption of meat. The effects of PUFA are heterogeneous within the FA group. Intake of DPA and AA may contribute to T2D development.

scholarly journals Mentally tiring work and type 2 diabetes in women: a 22-year follow-up study

2019 ◽  
Vol 180 (4) ◽  
pp. 257-263
Author(s):  
Guy Fagherazzi ◽  
Gaelle Gusto ◽  
Douae El Fatouhi ◽  
Francesca Romana Mancini ◽  
Beverley Balkau ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Job Demands ◽  
Diabetes Risk ◽  
Work Related Stress ◽  
Overweight Women ◽  
Work Related ◽  
Increased Risk ◽  
Related Stress ◽  
Incident Cases

Hypothesis Previous work suggested no or inconsistent associations between components of work-related stress and type 2 diabetes risk, but suggested sex-specific differences should be further investigated, as women potentially had higher risks. Methods We analyzed data from 73 517 women, mostly teachers, from the E3N cohort study followed for 22 years (1992–2014), to study the association between mentally tiring work, used as a proxy of job demands, and type 2 diabetes risk. Univariate and multivariable Cox regression models were used to estimate hazard ratios and 95% confidence intervals. Results A total of 4187 incident cases of type 2 diabetes cases were observed. There was a higher type 2 diabetes risk for women with a ‘Very mentally tiring work’ when compared to women with ‘Little or not mentally tiring work’ (HR = 1.21 (1.09–1.35)). This association was independent of unhealthy lifestyle and traditional metabolic factors. An interaction between mentally tiring work and BMI was detected (P < 0.0001), with a stronger association being observed in non-overweight women, HR = 1.26 (1.08–1.47) vs HR = 1.14 (0.98, 1.32), in overweight women. Conclusions We observed an increased risk of type 2 diabetes associated with mentally tiring work, used as a proxy of job demands. These observational results suggest the importance of taking into consideration the potential long-term metabolic impact of work-related stress for women working in a demanding environment. Increased support for such women should be investigated in intervention studies.

scholarly journals A Shift Toward a Plant-Centered Diet from Young to Middle Adulthood and Subsequent Risk of Type 2 Diabetes and Weight Gain: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

2020 ◽  
Author(s):  
Yuni Choi ◽  
Nicole Larson ◽  
Daniel D. Gallaher ◽  
Andrew O. Odegaard ◽  
Jamal S. Rana ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Adults ◽  
Body Size ◽  
Diet Quality ◽  
Regression Models ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Diabetes Risk ◽  
Middle Adulthood

<b>OBJECTIVE: </b>To examine the associations between change in plant-centered diet quality and type 2 diabetes risk and change in body size. <p><b>RESEARCH DESIGN AND METHODS: </b>A<b> </b>prospective study conducted in the US enrolled adults ages 18–30 years in 1985–1986 (exam year [Y0]) and followed them through 2015–2016. <a>We analyzed the associations between change in plant-centered diet quality over 20 years (Y0–Y20) and diabetes (Y20–30, n=2,534) and change (Y0–Y20 and Y20–30) in body mass index (BMI), waist circumference (WC), and weight (n > 2,434). </a>Plant-centered diet quality was measured using the A Priori Diet Quality Score (APDQS); a higher score favors nutritionally-rich plant foods. Cox regression models were used to assess diabetes risk and linear regression models were used to examine change in body size.</p> <p><b>RESULTS: </b>During mean follow-up of 9.3 (±1.7) years, 206 incident diabetes cases occurred. In multivariable analysis, participants with the largest increase in APDQS over 20 years had a 48% (95% CI: 0.31–0.85; P-trend < 0.001) lower risk of diabetes over the subsequent 10–years compared with participants whose score remained stable. <a>Each 1–SD increment in APDQS over 20 years was associated with lower gains in BMI (-0.39 kg/m<sup>2</sup>, SE: 0.14; P=0.004), WC (-0.90 cm, SE: 0.27; P < 0.001), and weight (-1.14 kg, SE: 0.33; P < 0.001) during the same period, but not with subsequent changes.</a></p> <p><b>CONCLUSIONS: </b>Young adults who increased plant-centered diet quality had a lower diabetes risk and gained less weight by middle adulthood.<b></b></p>

scholarly journals Self-rated health and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition-InterAct study: a case-cohort study

BMJ Open ◽  
2013 ◽  
Vol 3 (3) ◽  
pp. e002436 ◽  
Author(s):  
Patrik Wennberg ◽  
Olov Rolandsson ◽  
Daphne L van der A ◽  
Annemieke M W Spijkerman ◽  
Rudolf Kaaks ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Diabetes Risk ◽  
Self Rated Health ◽  
Prospective Investigation

scholarly journals Opposing associations of NT-proBNP with risks of diabetes and diabetes-related complications

2020 ◽  
Author(s):  
Anna Birukov ◽  
Fabian Eichelmann ◽  
Olga Kuxhaus ◽  
Elli Polemiti ◽  
Andreas Fritsche ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vascular Complications ◽  
Diabetes Risk ◽  
Macrovascular Complications ◽  
Incident Type ◽  
Incident Type 2 Diabetes ◽  
Design And Methods ◽  
Incident Cases ◽  
Healthy Participants

<b>Objective:</b> Circulating N-terminal pro b-type natriuretic peptide (NT-proBNP) is a classic diagnostic and prognostic marker for heart failure. However, it is inversely associated with diabetes risk. We aimed to investigate relationships of NT-proBNP with risk of diabetes-related complications in initially healthy individuals. <p><b>Research Design and Methods:</b> <a>We performed a case-cohort study within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort including a random subcohort (n=1294) and incident cases of type 2 diabetes (n=649) and cardiovascular diseases (CVD, n=478). Incident cases of type 2 diabetes (n=545) were followed up for micro- (n=133) and macrovascular (n=50) complications. Plasma NT-proBNP was measured at baseline in initially healthy participants.</a></p> <p><b>Results: </b><a></a><a>In multivariable models, NT-proBNP was linearly inversely associated with incident type 2 diabetes, HR (95% CI) per doubling in NT-proBNP: 0.91 (0.86; 0.98). The association was only observable in women, HR (95%CI): 0.80 (0.72; 0.90), compared to 0.98 (0.91; 1.07) in men. Among persons with incident diabetes, NT-proBNP was positively associated with diabetes complications, HR (95% CI): 1.31 (1.13; 1.53) for overall, 1.20 (1.01; 1.43) for micro- and 1.37 (1.03; 1.83) for macrovascular complications. </a></p> <b>Conclusions: </b><a>Although higher NT-proBNP levels are associated with lower diabetes risk, in persons who develop diabetes NT-proBNP is a biomarker for vascular complications independent of potential confounders. </a><a>Thus, NT-proBNP might be informative to monitor risk for diabetes-related micro- and macrovascular complications, which should be further explored in future prospective studies.</a>

scholarly journals Dietary intake of carbohydrates and risk of type 2 diabetes: the European Prospective Investigation into Cancer-Norfolk study

2013 ◽  
Vol 111 (2) ◽  
pp. 342-352 ◽  
Author(s):  
Sara Ahmadi-Abhari ◽  
Robert N. Luben ◽  
Natasha Powell ◽  
Amit Bhaniani ◽  
Rajiv Chowdhury ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Dietary Intake ◽  
Energy Intake ◽  
Cox Proportional Hazards ◽  
Diabetes Risk ◽  
Dietary Intakes ◽  
Residual Method ◽  
Nutrient Density ◽  
Incident Cases

In the present study, we investigated the association between dietary intake of carbohydrates and the risk of type 2 diabetes. Incident cases of diabetes (n 749) were identified and compared with a randomly selected subcohort of 3496 participants aged 40–79 years. For dietary assessment, we used 7 d food diaries administered at baseline. We carried out modified Cox proportional hazards regression analyses and compared results obtained from the different methods of adjustment for total energy intake. Dietary intakes of total carbohydrates, starch, sucrose, lactose or maltose were not significantly related to diabetes risk after adjustment for confounders. However, in the residual method for energy adjustment, intakes of fructose and glucose were inversely related to diabetes risk. The multivariable-adjusted hazard ratios (HR) of diabetes comparing the extreme quintiles of intake were 0·79 (95 % CI 0·59, 1·07; P for trend = 0·03) for glucose and 0·62 (95 % CI 0·46, 0·83; P for trend = 0·01) for fructose. In the nutrient density method, only fructose was inversely related to diabetes risk (HR 0·65, 95 % CI 0·48, 0·88). The replacement of 5 % energy intake from SFA with an isoenergetic amount of fructose was associated with a 30 % lower diabetes risk (HR 0·69, 95 % CI 0·50, 0·96). Results of the standard and energy partition methods were similar to those of the residual method. These prospective findings suggest that the intakes of starch and sucrose are not associated, but that those of fructose and glucose are inversely associated with diabetes risk. Whether the inverse associations with fructose and glucose reflect the effect of substitution of these carbohydrate subtypes with other nutrients (i.e. SFA), their net higher intake or other nutrients associated with their intake remains to be established through further investigation.

scholarly journals Lysine pathway metabolites and the risk of type 2 diabetes and cardiovascular disease in the PREDIMED study: results from two case-cohort studies

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Cristina Razquin ◽  
Miguel Ruiz-Canela ◽  
Clary B. Clish ◽  
Jun Li ◽  
Estefania Toledo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Dietary Intervention ◽  
Cox Regression ◽  
Lifestyle Changes ◽  
Pipecolic Acid ◽  
Study Results ◽  
Incident Cases

Abstract Background The pandemic of cardiovascular disease (CVD) and type 2 diabetes (T2D) requires the identification of new predictor biomarkers. Biomarkers potentially modifiable with lifestyle changes deserve a special interest. Our aims were to analyze: (a) The associations of lysine, 2-aminoadipic acid (2-AAA) or pipecolic acid with the risk of T2D or CVD in the PREDIMED trial; (b) the effect of the dietary intervention on 1-year changes in these metabolites, and (c) whether the Mediterranean diet (MedDiet) interventions can modify the effects of these metabolites on CVD or T2D risk. Methods Two unstratified case-cohort studies nested within the PREDIMED trial were used. For CVD analyses, we selected 696 non-cases and 221 incident CVD cases; for T2D, we included 610 non-cases and 243 type 2 diabetes incident cases. Metabolites were quantified using liquid chromatography–tandem mass spectrometry, at baseline and after 1-year of intervention. Results In weighted Cox regression models, we found that baseline lysine (HR+1 SD increase = 1.26; 95% CI 1.06–1.51) and 2-AAA (HR+1 SD increase = 1.28; 95% CI 1.05–1.55) were both associated with a higher risk of T2D, but not with CVD. A significant interaction (p = 0.032) between baseline lysine and T2D on the risk of CVD was observed: subjects with prevalent T2D and high levels of lysine exhibited the highest risk of CVD. The intervention with MedDiet did not have a significant effect on 1-year changes of the metabolites. Conclusions Our results provide an independent prospective replication of the association of 2-AAA with future risk of T2D. We show an association of lysine with subsequent CVD risk, which is apparently diabetes-dependent. No evidence of effects of MedDiet intervention on lysine, 2-AAA or pipecolic acid changes was found. Trial registration ISRCTN35739639; registration date: 05/10/2005; recruitment start date 01/10/2003

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