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The association between dietary flavonoid and lignan intakes and incident type 2 diabetes in European populations: the EPIC-InterAct study.

Abstract

OBJECTIVE

To study the association between dietary flavonoid and lignan intakes, and the risk of development of type 2 diabetes among European populations.

RESEARCH DESIGN AND METHODS

The 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.

RESULTS

In 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.

CONCLUSIONS

Prospective 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.

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    Corresponding author: Nita G. Forouhi, nita.forouhi@mrc-epid.cam.ac.uk.

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    Source

    Diabetes care 36:12 2013 Dec pg 3961-70

    MeSH

    Diabetes Mellitus, Type 2
    Europe
    Feeding Behavior
    Female
    Flavonoids
    Follow-Up Studies
    Humans
    Incidence
    Lignans
    Male
    Middle Aged
    Nutritional Status
    Population Surveillance
    Prospective Studies

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    24130345

    Citation

    Zamora-Ros, Raul, et al. "The Association Between Dietary Flavonoid and Lignan Intakes and Incident Type 2 Diabetes in European Populations: the EPIC-InterAct Study." Diabetes Care, vol. 36, no. 12, 2013, pp. 3961-70.
    Zamora-Ros R, Forouhi NG, Sharp SJ, et al. The association between dietary flavonoid and lignan intakes and incident type 2 diabetes in European populations: the EPIC-InterAct study. Diabetes Care. 2013;36(12):3961-70.
    Zamora-Ros, R., Forouhi, N. G., Sharp, S. J., González, C. A., Buijsse, B., Guevara, M., ... Wareham, N. J. (2013). The association between dietary flavonoid and lignan intakes and incident type 2 diabetes in European populations: the EPIC-InterAct study. Diabetes Care, 36(12), pp. 3961-70. doi:10.2337/dc13-0877.
    Zamora-Ros R, et al. The Association Between Dietary Flavonoid and Lignan Intakes and Incident Type 2 Diabetes in European Populations: the EPIC-InterAct Study. Diabetes Care. 2013;36(12):3961-70. PubMed PMID: 24130345.
    * Article titles in AMA citation format should be in sentence-case
    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 - González,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,Françoise, AU - Fagherazzi,Guy, AU - Feskens,Edith J, AU - Franks,Paul W, AU - Grioni,Sara, AU - Katzke,Verena, AU - Key,Timothy J, AU - Khaw,Kay-Tee, AU - Kühn,Tilman, AU - Masala,Giovanna, AU - Mattiello,Amalia, AU - Molina-Montes,Esther, AU - Nilsson,Peter M, AU - Overvad,Kim, AU - Perquier,Florence, AU - Quirós,J Ramón, AU - Romieu,Isabelle, AU - Sacerdote,Carlotta, AU - Scalbert,Augustin, AU - Schulze,Matthias, AU - Slimani,Nadia, AU - Spijkerman,Annemieke M W, AU - Tjonneland,Anne, AU - Tormo,Maria Jose, AU - Tumino,Rosario, AU - van der A,Daphne L, AU - Langenberg,Claudia, AU - Riboli,Elio, AU - Wareham,Nicholas J, Y1 - 2013/10/15/ PY - 2013/10/17/entrez PY - 2013/10/17/pubmed PY - 2014/12/17/medline SP - 3961 EP - 70 JF - Diabetes care JO - Diabetes Care VL - 36 IS - 12 N2 - OBJECTIVE: To study the association between dietary flavonoid and lignan intakes, and the risk of development of type 2 diabetes among European populations. RESEARCH DESIGN AND METHODS: The 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. RESULTS: In 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. CONCLUSIONS: Prospective 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. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/24130345/The_association_between_dietary_flavonoid_and_lignan_intakes_and_incident_type_2_diabetes_in_European_populations:_the_EPIC_InterAct_study_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=24130345 DB - PRIME DP - Unbound Medicine ER -