TY - JOUR
T1 - The Association Between Dietary Flavonoid and Lignan Intakes and Incident Type 2 Diabetes in European Populations The EPIC-InterAct study
AU - Zamora-Ros, Raul
AU - Forouhi, Nita G.
AU - Sharp, Stephen J.
AU - Gonzalez, Carlos A.
AU - Buijsse, Brian
AU - Guevara, Marcela
AU - van der Schouw, Yvonne T.
AU - Amiano, Pilar
AU - Boeing, Heiner
AU - Bredsdorff, Lea
AU - Clavel-Chapelon, Francoise
AU - Fagherazzi, Guy
AU - Feskens, Edith J.
AU - Franks, Paul
AU - Grioni, Sara
AU - Katzke, Verena
AU - Key, Timothy J.
AU - Khaw, Kay-Tee
AU - Kuehn, Tilman
AU - Masala, Giovanna
AU - Mattiello, Amalia
AU - Molina-Montes, Esther
AU - Nilsson, Peter
AU - Overvad, Kim
AU - Perquier, Florence
AU - Ramon Quiros, J.
AU - Romieu, Isabelle
AU - Sacerdote, Carlotta
AU - Scalbert, Augustin
AU - Schulze, Matthias
AU - Slimani, Nadia
AU - Spijkerman, Annemieke M. W.
AU - Tjonneland, Anne
AU - Jose Tormo, Maria
AU - Tumino, Rosario
AU - van der A, Daphne L.
AU - Langenberg, Claudia
AU - Riboli, Elio
AU - Wareham, Nicholas J.
PY - 2013
Y1 - 2013
N2 - OBJECTIVETo study the association between dietary flavonoid and lignan intakes, and the risk of development of type 2 diabetes among European populations.RESEARCH DESIGN AND METHODSThe European Prospective Investigation into Cancer and Nutrition-InterAct case-cohort study included 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants from among 340,234 participants with 3.99 million person-years of follow-up in eight European countries. At baseline, country-specific validated dietary questionnaires were used. A flavonoid and lignan food composition database was developed from the Phenol-Explorer, the U.K. Food Standards Agency, and the U.S. Department of Agriculture databases. Hazard ratios (HRs) from country-specific Prentice-weighted Cox regression models were pooled using random-effects meta-analysis.RESULTSIn multivariable models, a trend for an inverse association between total flavonoid intake and type 2 diabetes was observed (HR for the highest vs. the lowest quintile, 0.90 [95% CI 0.77-1.04]; P value trend = 0.040), but not with lignans (HR 0.88 [95% CI 0.72-1.07]; P value trend = 0.119). Among flavonoid subclasses, flavonols (HR 0.81 [95% CI 0.69-0.95]; P value trend = 0.020) and flavanols (HR 0.82 [95% CI 0.68-0.99]; P value trend = 0.012), including flavan-3-ol monomers (HR 0.73 [95% CI 0.57-0.93]; P value trend = 0.029), were associated with a significantly reduced hazard of diabetes.CONCLUSIONSProspective findings in this large European cohort demonstrate inverse associations between flavonoids, particularly flavanols and flavonols, and incident type 2 diabetes. This suggests a potential protective role of eating a diet rich in flavonoids, a dietary pattern based on plant-based foods, in the prevention of type 2 diabetes.
AB - OBJECTIVETo study the association between dietary flavonoid and lignan intakes, and the risk of development of type 2 diabetes among European populations.RESEARCH DESIGN AND METHODSThe European Prospective Investigation into Cancer and Nutrition-InterAct case-cohort study included 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants from among 340,234 participants with 3.99 million person-years of follow-up in eight European countries. At baseline, country-specific validated dietary questionnaires were used. A flavonoid and lignan food composition database was developed from the Phenol-Explorer, the U.K. Food Standards Agency, and the U.S. Department of Agriculture databases. Hazard ratios (HRs) from country-specific Prentice-weighted Cox regression models were pooled using random-effects meta-analysis.RESULTSIn multivariable models, a trend for an inverse association between total flavonoid intake and type 2 diabetes was observed (HR for the highest vs. the lowest quintile, 0.90 [95% CI 0.77-1.04]; P value trend = 0.040), but not with lignans (HR 0.88 [95% CI 0.72-1.07]; P value trend = 0.119). Among flavonoid subclasses, flavonols (HR 0.81 [95% CI 0.69-0.95]; P value trend = 0.020) and flavanols (HR 0.82 [95% CI 0.68-0.99]; P value trend = 0.012), including flavan-3-ol monomers (HR 0.73 [95% CI 0.57-0.93]; P value trend = 0.029), were associated with a significantly reduced hazard of diabetes.CONCLUSIONSProspective findings in this large European cohort demonstrate inverse associations between flavonoids, particularly flavanols and flavonols, and incident type 2 diabetes. This suggests a potential protective role of eating a diet rich in flavonoids, a dietary pattern based on plant-based foods, in the prevention of type 2 diabetes.
U2 - 10.2337/dc13-0877
DO - 10.2337/dc13-0877
M3 - Article
C2 - 24130345
SN - 1935-5548
VL - 36
SP - 3961
EP - 3970
JO - Diabetes Care
JF - Diabetes Care
IS - 12
ER -
