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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):3961-70DC

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.

Authors+Show Affiliations

Corresponding author: Nita G. Forouhi, nita.forouhi@mrc-epid.cam.ac.uk.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

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 -