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Mozaffari, Hadis

University of British Columbia

Few high-quality studies link dietary diversity to type 2 diabetes (T2D), and no studies examine protein diversity by source. I examined the prospective association of five diversity scores with the 10-year risk of T2D, and assessed differences by sex/gender, obesity, and socioeconomic status (SES). I used the EPIC-InterAct case-cohort study, which included 10,363 incident T2D cases and a representative subcohort of 13,937 individuals, sampled from a cohort of 340,234 participants in 8 European countries (1993-2007). I derived five scores from self-reported diet data (gr/day): diversity between food groups (range: 0—5) and diversity within subtypes of vegetables (0—4), meats/alternatives (0—6), animal protein (0—8) and plant protein (0—5). I estimated country-specific hazard ratios (HRs) and 95% confidence intervals (95% CI) using Prentice-weighted Cox regression and then pooled estimates using mixed-effects models; I also stratified these models based on sex/gender. For obesity and SES subgroups, I used simple Prentice-weighted Cox regression due to smaller sample sizes. Daily intake of five food groups (versus ≤three) was linked to lower T2D incidence (HR 0.86 [95%CI 0.75, 0.98]), particularly in women, and Europeans who were single, married, employed, had technical and primary school education, or were not obese. Daily intake of 3-4 subtypes of vegetables (relative to 0-1 subtype) was inversely associated with T2D among men (0.85 [0.73, 0.99]), and Europeans with primary school education (0.78 [0.65, 0.93]), who were employed (0.82 [0.68, 0.99]), or were single (0.39 [0.20, 0.76]). Greater plant-protein diversity was inversely associated with T2D among women (3 subtypes: 0.75 [0.62, 0.90]), and Europeans without obesity (4-5 subtypes: 0.82 [0.68, 1.00]), or were university-educated (3 subtypes: 0.65 [0.45, 0.95]). By contrast, greater meat/alternatives diversity, and animal-protein diversity, were positively associated with T2D in Europeans without obesity (≥2 subtypes: HR range: 1.29 to 1.39), or had low education (6-8 subtypes: 1.77 [1.10, 2.85]). Diabetes prevention may benefit not only from a diet consisting of five different food groups but also from a diet diverse in vegetables and plant-based protein. However, lower disease incidence associated with greater diet diversity was observed only in specific Europeans subpopulations.

Text

2024-04-02

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/87664

Human Nutrition

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/