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Carbohydrate quantity and quality and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) study.
Am J Clin Nutr 2010; 92(4):905-11AJ

Abstract

BACKGROUND

Carbohydrate quantity and quality may play an important role in the development of type 2 diabetes.

OBJECTIVE

We investigated the associations of dietary glycemic load (GL), glycemic index (GI), carbohydrate, and fiber intake with the incidence of type 2 diabetes.

DESIGN

A prospective cohort study was conducted in 37,846 participants of the EPIC-NL (European Prospective Investigation into Cancer and Nutrition-Netherlands) study, aged 21-70 y at baseline and free of diabetes. Dietary intake was assessed with the use of a validated food-frequency questionnaire. Incident diabetes cases were mainly self-reported and verified against general practitioner records.

RESULTS

During a mean follow-up of 10 y, 915 incident diabetes cases were documented. Dietary GL was associated with an increased diabetes risk after adjustment for age, sex, established diabetes risk factors, and dietary factors [hazard ratio (HR) per SD increase: 1.27; 95% CI: 1.11, 1.44; P < 0.001] [corrected]. GI tended to increase diabetes risk (HR: 1.08; 95% CI: 1.00, 1.17; P = 0.05). Dietary fiber was inversely associated with diabetes risk (HR: 0.92; 95% CI: 0.85, 0.99; P < 0.05), whereas carbohydrate intake was associated with increased diabetes risk (HR: 1.15; 95% CI: 1.01, 1.32; P < 0.05). Of the carbohydrate subtypes, only starch was related to increased diabetes risk [HR: 1.25 (1.07, 1.46), P < 0.05]. All associations became slightly stronger after exclusion of energy misreporters.

CONCLUSIONS

Diets high in GL, GI, and starch and low in fiber were associated with an increased diabetes risk. Both carbohydrate quantity and quality seem to be important factors in diabetes prevention. Energy misreporting contributed to a slight attenuation of associations.

Authors+Show Affiliations

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands. i.sluijs-2@umcutrecht.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20685945

Citation

Sluijs, Ivonne, et al. "Carbohydrate Quantity and Quality and Risk of Type 2 Diabetes in the European Prospective Investigation Into Cancer and Nutrition-Netherlands (EPIC-NL) Study." The American Journal of Clinical Nutrition, vol. 92, no. 4, 2010, pp. 905-11.
Sluijs I, van der Schouw YT, van der A DL, et al. Carbohydrate quantity and quality and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) study. Am J Clin Nutr. 2010;92(4):905-11.
Sluijs, I., van der Schouw, Y. T., van der A, D. L., Spijkerman, A. M., Hu, F. B., Grobbee, D. E., & Beulens, J. W. (2010). Carbohydrate quantity and quality and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) study. The American Journal of Clinical Nutrition, 92(4), pp. 905-11. doi:10.3945/ajcn.2010.29620.
Sluijs I, et al. Carbohydrate Quantity and Quality and Risk of Type 2 Diabetes in the European Prospective Investigation Into Cancer and Nutrition-Netherlands (EPIC-NL) Study. Am J Clin Nutr. 2010;92(4):905-11. PubMed PMID: 20685945.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Carbohydrate quantity and quality and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) study. AU - Sluijs,Ivonne, AU - van der Schouw,Yvonne T, AU - van der A,Daphne L, AU - Spijkerman,Annemieke M, AU - Hu,Frank B, AU - Grobbee,Diederick E, AU - Beulens,Joline W, Y1 - 2010/08/04/ PY - 2010/8/6/entrez PY - 2010/8/6/pubmed PY - 2010/10/28/medline SP - 905 EP - 11 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 92 IS - 4 N2 - BACKGROUND: Carbohydrate quantity and quality may play an important role in the development of type 2 diabetes. OBJECTIVE: We investigated the associations of dietary glycemic load (GL), glycemic index (GI), carbohydrate, and fiber intake with the incidence of type 2 diabetes. DESIGN: A prospective cohort study was conducted in 37,846 participants of the EPIC-NL (European Prospective Investigation into Cancer and Nutrition-Netherlands) study, aged 21-70 y at baseline and free of diabetes. Dietary intake was assessed with the use of a validated food-frequency questionnaire. Incident diabetes cases were mainly self-reported and verified against general practitioner records. RESULTS: During a mean follow-up of 10 y, 915 incident diabetes cases were documented. Dietary GL was associated with an increased diabetes risk after adjustment for age, sex, established diabetes risk factors, and dietary factors [hazard ratio (HR) per SD increase: 1.27; 95% CI: 1.11, 1.44; P < 0.001] [corrected]. GI tended to increase diabetes risk (HR: 1.08; 95% CI: 1.00, 1.17; P = 0.05). Dietary fiber was inversely associated with diabetes risk (HR: 0.92; 95% CI: 0.85, 0.99; P < 0.05), whereas carbohydrate intake was associated with increased diabetes risk (HR: 1.15; 95% CI: 1.01, 1.32; P < 0.05). Of the carbohydrate subtypes, only starch was related to increased diabetes risk [HR: 1.25 (1.07, 1.46), P < 0.05]. All associations became slightly stronger after exclusion of energy misreporters. CONCLUSIONS: Diets high in GL, GI, and starch and low in fiber were associated with an increased diabetes risk. Both carbohydrate quantity and quality seem to be important factors in diabetes prevention. Energy misreporting contributed to a slight attenuation of associations. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/20685945/Carbohydrate_quantity_and_quality_and_risk_of_type_2_diabetes_in_the_European_Prospective_Investigation_into_Cancer_and_Nutrition_Netherlands__EPIC_NL__study_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2010.29620 DB - PRIME DP - Unbound Medicine ER -