Tags

Type your tag names separated by a space and hit enter

Dietary protein intake and incidence of type 2 diabetes in Europe: the EPIC-InterAct Case-Cohort Study.

Abstract

OBJECTIVE

The long-term association between dietary protein and type 2 diabetes incidence is uncertain. We aimed to investigate the association between total, animal, and plant protein intake and the incidence of type 2 diabetes.

RESEARCH DESIGN AND METHODS

The prospective European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from eight European countries, with an average follow-up time of 12.0 years. Pooled country-specific hazard ratios (HRs) and 95% CI of prentice-weighted Cox regression analyses were used to estimate type 2 diabetes incidence according to protein intake.

RESULTS

After adjustment for important diabetes risk factors and dietary factors, the incidence of type 2 diabetes was higher in those with high intake of total protein (per 10 g: HR 1.06 [95% CI 1.02-1.09], P(trend) < 0.001) and animal protein (per 10 g: 1.05 [1.02-1.08], P(trend) = 0.001). Effect modification by sex (P < 0.001) and BMI among women (P < 0.001) was observed. Compared with the overall analyses, associations were stronger in women, more specifically obese women with a BMI >30 kg/m(2) (per 10 g animal protein: 1.19 [1.09-1.32]), and nonsignificant in men. Plant protein intake was not associated with type 2 diabetes (per 10 g: 1.04 [0.93-1.16], P(trend) = 0.098).

CONCLUSIONS

High total and animal protein intake was associated with a modest elevated risk of type 2 diabetes in a large cohort of European adults. In view of the rapidly increasing prevalence of type 2 diabetes, limiting iso-energetic diets high in dietary proteins, particularly from animal sources, should be considered.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands monique.vannielen@wur.nl.

    ,

    Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands.

    ,

    Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands.

    ,

    Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.

    ,

    Andalusian School of Public Health, Granada, Spain.

    ,

    Public Health Division of Gipuzkoa, San Sebastian, SpainCIBER Epidemiología y Salud Pública, Madrid, Spain.

    ,

    CIBER Epidemiología y Salud Pública, Madrid, SpainNavarre Public Health Institute, Pamplona, Spain.

    ,

    Inserm, Centre for Research in Epidemiology and Population Health, Villejuif, France.

    ,

    Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.

    ,

    German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany.

    ,

    Inserm, Centre for Research in Epidemiology and Population Health, Villejuif, FranceUniversité Paris-Sud, France.

    ,

    Inserm, Centre for Research in Epidemiology and Population Health, Villejuif, FranceUniversité Paris-Sud, France.

    ,

    Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.

    ,

    Danish Cancer Society Research Center, Copenhagen, Denmark.

    ,

    CIBER Epidemiología y Salud Pública, Madrid, SpainDepartment of Epidemiology, Murcia Regional Health Council, Murcia, Spain.

    ,

    German Cancer Research Center, Heidelberg, Germany.

    ,

    Cancer Epidemiology Unit, University of Oxford, Oxford, U.K.

    ,

    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.

    ,

    National Cancer Institute, Milan, Italy.

    ,

    German Cancer Research Center, Heidelberg, Germany.

    ,

    Public Health Directorate, Asturias, Spain.

    ,

    Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.

    ,

    School of Public Health, Aarhus University, Denmark.

    ,

    Cancer Research and Prevention Institute, Florence, Italy.

    ,

    Dipartimento di medicina clinica e chirurgia, federico ii University, Naples, Italy.

    ,

    Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

    ,

    International Agency for Research on Cancer, Lyon, France.

    ,

    Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza-University of Turin and Center for Cancer Prevention, Turin, ItalyHuman Genetics Foundation, Turin, Italy.

    ,

    Andalusian School of Public Health, Granada, SpainCIBER Epidemiología y Salud Pública, Madrid, Spain.

    ,

    German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany.

    ,

    National Institute for Public Health and the Environment, Bilthoven, the Netherlands.

    ,

    Danish Cancer Society Research Center, Copenhagen, Denmark.

    ,

    Cancer Registry and Histopathology Unit, Ragusa, Italy.

    ,

    National Institute for Public Health and the Environment, Bilthoven, the Netherlands.

    ,

    School of Public Health, Aarhus University, Denmark.

    ,

    Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, Barcelona, SpainBellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain.

    ,

    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.

    ,

    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.

    ,

    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.

    ,

    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K.

    ,

    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.

    Source

    Diabetes care 37:7 2014 Jul pg 1854-62

    MeSH

    Adult
    Animals
    Cohort Studies
    Diabetes Mellitus, Type 2
    Diet
    Dietary Proteins
    Europe
    Female
    Follow-Up Studies
    Humans
    Incidence
    Male
    Meat
    Middle Aged
    Obesity
    Prospective Studies
    Risk
    Risk Factors

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    24722499

    Citation

    van Nielen, Monique, et al. "Dietary Protein Intake and Incidence of Type 2 Diabetes in Europe: the EPIC-InterAct Case-Cohort Study." Diabetes Care, vol. 37, no. 7, 2014, pp. 1854-62.
    van Nielen M, Feskens EJ, Mensink M, et al. Dietary protein intake and incidence of type 2 diabetes in Europe: the EPIC-InterAct Case-Cohort Study. Diabetes Care. 2014;37(7):1854-62.
    van Nielen, M., Feskens, E. J., Mensink, M., Sluijs, I., Molina, E., Amiano, P., ... Wareham, N. J. (2014). Dietary protein intake and incidence of type 2 diabetes in Europe: the EPIC-InterAct Case-Cohort Study. Diabetes Care, 37(7), pp. 1854-62. doi:10.2337/dc13-2627.
    van Nielen M, et al. Dietary Protein Intake and Incidence of Type 2 Diabetes in Europe: the EPIC-InterAct Case-Cohort Study. Diabetes Care. 2014;37(7):1854-62. PubMed PMID: 24722499.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary protein intake and incidence of type 2 diabetes in Europe: the EPIC-InterAct Case-Cohort Study. AU - van Nielen,Monique, AU - Feskens,Edith J M, AU - Mensink,Marco, AU - Sluijs,Ivonne, AU - Molina,Esther, AU - Amiano,Pilar, AU - Ardanaz,Eva, AU - Balkau,Beverly, AU - Beulens,Joline W J, AU - Boeing,Heiner, AU - Clavel-Chapelon,Françoise, AU - Fagherazzi,Guy, AU - Franks,Paul W, AU - Halkjaer,Jytte, AU - Huerta,José Maria, AU - Katzke,Verena, AU - Key,Timothy J, AU - Khaw,Kay Tee, AU - Krogh,Vittorio, AU - Kühn,Tilman, AU - Menéndez,Virginia V M, AU - Nilsson,Peter, AU - Overvad,Kim, AU - Palli,Domenico, AU - Panico,Salvatore, AU - Rolandsson,Olov, AU - Romieu,Isabelle, AU - Sacerdote,Carlotta, AU - Sánchez,Maria-José, AU - Schulze,Matthias B, AU - Spijkerman,Annemieke M W, AU - Tjonneland,Anne, AU - Tumino,Rosario, AU - van der A,Daphne L, AU - Würtz,Anne M L, AU - Zamora-Ros,Raul, AU - Langenberg,Claudia, AU - Sharp,Stephen J, AU - Forouhi,Nita G, AU - Riboli,Elio, AU - Wareham,Nicholas J, AU - ,, Y1 - 2014/04/10/ PY - 2014/4/12/entrez PY - 2014/4/12/pubmed PY - 2014/12/15/medline SP - 1854 EP - 62 JF - Diabetes care JO - Diabetes Care VL - 37 IS - 7 N2 - OBJECTIVE: The long-term association between dietary protein and type 2 diabetes incidence is uncertain. We aimed to investigate the association between total, animal, and plant protein intake and the incidence of type 2 diabetes. RESEARCH DESIGN AND METHODS: The prospective European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from eight European countries, with an average follow-up time of 12.0 years. Pooled country-specific hazard ratios (HRs) and 95% CI of prentice-weighted Cox regression analyses were used to estimate type 2 diabetes incidence according to protein intake. RESULTS: After adjustment for important diabetes risk factors and dietary factors, the incidence of type 2 diabetes was higher in those with high intake of total protein (per 10 g: HR 1.06 [95% CI 1.02-1.09], P(trend) < 0.001) and animal protein (per 10 g: 1.05 [1.02-1.08], P(trend) = 0.001). Effect modification by sex (P < 0.001) and BMI among women (P < 0.001) was observed. Compared with the overall analyses, associations were stronger in women, more specifically obese women with a BMI >30 kg/m(2) (per 10 g animal protein: 1.19 [1.09-1.32]), and nonsignificant in men. Plant protein intake was not associated with type 2 diabetes (per 10 g: 1.04 [0.93-1.16], P(trend) = 0.098). CONCLUSIONS: High total and animal protein intake was associated with a modest elevated risk of type 2 diabetes in a large cohort of European adults. In view of the rapidly increasing prevalence of type 2 diabetes, limiting iso-energetic diets high in dietary proteins, particularly from animal sources, should be considered. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/24722499/full_citation L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=24722499 DB - PRIME DP - Unbound Medicine ER -