InterAct Consortium;
van den Berg, SW;
van der A, DL;
Spijkerman, AM;
van Woudenbergh, GJ;
Tijhuis, MJ;
Amiano, P;
... Wareham, NJ; + view all
(2013)
The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study.
PLoS One
, 8
(5)
, Article e59947. 10.1371/journal.pone.0059947.
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Abstract
Background Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake. Methodology/Principal Findings A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4–1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93–1.13), which was consistent across countries (I2 = 2.9%). Conclusions/Significance In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases.
| Type: | Article |
|---|---|
| Title: | The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1371/journal.pone.0059947 |
| Publisher version: | http://dx.doi.org/10.1371/journal.pone.0059947 |
| Language: | English |
| Additional information: | © 2013 van den Berg et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. PMCID: PMC3655954 |
| UCL classification: | UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1402858 |
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