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Dietary vitamin D intake and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition: the EPIC-InterAct study.
Eur J Clin Nutr 2014; 68(2):196-202EJ

Abstract

BACKGROUND/OBJECTIVES

Prospective cohort studies have indicated that serum vitamin D levels are inversely related to risk of type 2 diabetes. However, such studies cannot determine the source of vitamin D. Therefore, we examined the association of dietary vitamin D intake with incident type 2 diabetes within the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study in a heterogeneous European population including eight countries with large geographical variation.

SUBJECTS/METHODS

Using a case-cohort design, 11,245 incident cases of type 2 diabetes and a representative subcohort (N=15,798) were included in the analyses. Hazard ratios (HR) and 95% confidence intervals (CIs) for type 2 diabetes were calculated using a Prentice-weighted Cox regression adjusted for potential confounders. Twenty-four-hour diet-recall data from a subsample (N=2347) were used to calibrate habitual intake data derived from dietary questionnaires.

RESULTS

Median follow-up time was 10.8 years. Dietary vitamin D intake was not significantly associated with the risk of type 2 diabetes. HR and 95% CIs for the highest compared to the lowest quintile of uncalibrated vitamin D intake was 1.09 (0.97-1.22) (Ptrend=0.17). No associations were observed in a sex-specific analysis. The overall pooled effect (HR (95% CI)) using the continuous calibrated variable was 1.00 (0.97-1.03) per increase of 1 μg/day dietary vitamin D.

CONCLUSIONS

This observational study does not support an association between higher dietary vitamin D intake and type 2 diabetes incidence. This result has to be interpreted in light of the limited contribution of dietary vitamin D on the overall vitamin D status of a person.

Authors+Show Affiliations

1] German Cancer Research Centre (DKFZ), Heidelberg, Germany [2] Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.1] German Cancer Research Centre (DKFZ), Heidelberg, Germany [2] Helmholtz Centre Munich (HMGU), Neuherberg, Germany.1] German Cancer Research Centre (DKFZ), Heidelberg, Germany [2] Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland.University Medical Center Utrecht, Utrecht, The Netherlands.German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam-Rehbruecke, Germany.1] Public Health Division of Gipuzkoa, San Sebastian, Spain [2] Instituto BIO-Donostia, Basque Government, San Sebastian, Spain [3] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Navarre Public Health Institute (ISPN), Pamplona, Spain.1] Inserm, CESP, U1018, Villejuif, France [2] Université Paris-Sud, UMRS 1018, Villejuif, France.German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam-Rehbruecke, Germany.1] Inserm, CESP, U1018, Villejuif, France [2] Université Paris-Sud, UMRS 1018, Villejuif, France.1] Inserm, CESP, U1018, Villejuif, France [2] Université Paris-Sud, UMRS 1018, Villejuif, France.1] Lund University, Malmö, Sweden [2] Umeå University, Umeå, Sweden.1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.Epidemiology and Prevention Unit, Milan, Italy.German Cancer Research Centre (DKFZ), Heidelberg, Germany.University of Oxford, Oxford, UK.University of Cambridge, Cambridge, UK.German Cancer Research Centre (DKFZ), Heidelberg, Germany.Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Andalusian School of Public Health, Granada, Spain.Lund University, Malmö, Sweden.Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.Public Health Directorate, Asturias, Spain.Umeå University, Umeå, Sweden.1] Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital, University of Turin and Center for Cancer Prevention (CPO), Torino, Italy [2] Human Genetics Foundation (HuGeF), Torino, Italy.Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy.International Agency for Research on Cancer, Lyon, France.University Medical Center Utrecht, Utrecht, The Netherlands.National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.Danish Cancer Society Research Center, Copenhagen, Denmark.1] ASP Ragusa, Ragusa, Italy [2] Aire Onlus, Ragusa, Italy.National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.School of Public Health, Imperial College, London, UK.MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.

Pub Type(s)

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

Language

eng

PubMed ID

24253760

Citation

Abbas, S, et al. "Dietary Vitamin D Intake and Risk of Type 2 Diabetes in the European Prospective Investigation Into Cancer and Nutrition: the EPIC-InterAct Study." European Journal of Clinical Nutrition, vol. 68, no. 2, 2014, pp. 196-202.
Abbas S, Linseisen J, Rohrmann S, et al. Dietary vitamin D intake and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition: the EPIC-InterAct study. Eur J Clin Nutr. 2014;68(2):196-202.
Abbas, S., Linseisen, J., Rohrmann, S., Beulens, J. W., Buijsse, B., Amiano, P., ... Wareham, N. J. (2014). Dietary vitamin D intake and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition: the EPIC-InterAct study. European Journal of Clinical Nutrition, 68(2), pp. 196-202. doi:10.1038/ejcn.2013.235.
Abbas S, et al. Dietary Vitamin D Intake and Risk of Type 2 Diabetes in the European Prospective Investigation Into Cancer and Nutrition: the EPIC-InterAct Study. Eur J Clin Nutr. 2014;68(2):196-202. PubMed PMID: 24253760.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary vitamin D intake and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition: the EPIC-InterAct study. AU - Abbas,S, AU - Linseisen,J, AU - Rohrmann,S, AU - Beulens,J W J, AU - Buijsse,B, AU - Amiano,P, AU - Ardanaz,E, AU - Balkau,B, AU - Boeing,H, AU - Clavel-Chapelon,F, AU - Fagherazzi,G, AU - Franks,P W, AU - Gavrila,D, AU - Grioni,S, AU - Kaaks,R, AU - Key,T J, AU - Khaw,K T, AU - Kühn,T, AU - Mattiello,A, AU - Molina-Montes,E, AU - Nilsson,P M, AU - Overvad,K, AU - Quirós,J R, AU - Rolandsson,O, AU - Sacerdote,C, AU - Saieva,C, AU - Slimani,N, AU - Sluijs,I, AU - Spijkerman,A M W, AU - Tjonneland,A, AU - Tumino,R, AU - van der A,D L, AU - Zamora-Ros,R, AU - Sharp,S J, AU - Langenberg,C, AU - Forouhi,N G, AU - Riboli,E, AU - Wareham,N J, Y1 - 2013/11/20/ PY - 2013/06/21/received PY - 2013/10/02/revised PY - 2013/10/10/accepted PY - 2013/11/21/entrez PY - 2013/11/21/pubmed PY - 2014/9/30/medline SP - 196 EP - 202 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 68 IS - 2 N2 - BACKGROUND/OBJECTIVES: Prospective cohort studies have indicated that serum vitamin D levels are inversely related to risk of type 2 diabetes. However, such studies cannot determine the source of vitamin D. Therefore, we examined the association of dietary vitamin D intake with incident type 2 diabetes within the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study in a heterogeneous European population including eight countries with large geographical variation. SUBJECTS/METHODS: Using a case-cohort design, 11,245 incident cases of type 2 diabetes and a representative subcohort (N=15,798) were included in the analyses. Hazard ratios (HR) and 95% confidence intervals (CIs) for type 2 diabetes were calculated using a Prentice-weighted Cox regression adjusted for potential confounders. Twenty-four-hour diet-recall data from a subsample (N=2347) were used to calibrate habitual intake data derived from dietary questionnaires. RESULTS: Median follow-up time was 10.8 years. Dietary vitamin D intake was not significantly associated with the risk of type 2 diabetes. HR and 95% CIs for the highest compared to the lowest quintile of uncalibrated vitamin D intake was 1.09 (0.97-1.22) (Ptrend=0.17). No associations were observed in a sex-specific analysis. The overall pooled effect (HR (95% CI)) using the continuous calibrated variable was 1.00 (0.97-1.03) per increase of 1 μg/day dietary vitamin D. CONCLUSIONS: This observational study does not support an association between higher dietary vitamin D intake and type 2 diabetes incidence. This result has to be interpreted in light of the limited contribution of dietary vitamin D on the overall vitamin D status of a person. SN - 1476-5640 UR - https://www.unboundmedicine.com/medline/citation/24253760/Dietary_vitamin_D_intake_and_risk_of_type_2_diabetes_in_the_European_Prospective_Investigation_into_Cancer_and_Nutrition:_the_EPIC_InterAct_study_ L2 - http://dx.doi.org/10.1038/ejcn.2013.235 DB - PRIME DP - Unbound Medicine ER -