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Dietary Protein Intake and Incidence of Type 2 Diabetes in Europe: The EPIC-InterAct Case-Cohort Study

van Nielen, Monique; Feskens, Edith J. M.; Mensink, Marco; Sluijs, Ivonne; Molina, Esther; Amiano, Pilar; Ardanaz, Eva; Balkau, Beverly; Beulens, Joline W. J. and Boeing, Heiner, et al. (2014) In Diabetes Care 37(7). p.1854-1862
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... (More)
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. (Less)
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type
Contribution to journal
publication status
published
subject
in
Diabetes Care
volume
37
issue
7
pages
1854 - 1862
publisher
American Diabetes Association
external identifiers
  • wos:000338020400018
  • scopus:84903537108
ISSN
1935-5548
DOI
10.2337/dc13-2627
language
English
LU publication?
yes
id
02d46730-7d69-4b71-89cd-b2a3793fc25e (old id 4609334)
date added to LUP
2014-09-01 07:41:18
date last changed
2017-10-22 04:21:15
@article{02d46730-7d69-4b71-89cd-b2a3793fc25e,
  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 &lt; 0.001) and animal protein (per 10 g: 1.05 [1.02-1.08], P-trend = 0.001). Effect modification by sex (P &lt; 0.001) and BMI among women (P &lt; 0.001) was observed. Compared with the overall analyses, associations were stronger in women, more specifically obese women with a BMI &gt; 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.},
  author       = {van Nielen, Monique and Feskens, Edith J. M. and Mensink, Marco and Sluijs, Ivonne and Molina, Esther and Amiano, Pilar and Ardanaz, Eva and Balkau, Beverly and Beulens, Joline W. J. and Boeing, Heiner and Clavel-Chapelon, Francoise and Fagherazzi, Guy and Franks, Paul and Halkjaer, Jytte and Maria Huerta, Jose and Katzke, Verena and Key, Timothy J. and Khaw, Kay Tee and Krogh, Vittorio and Kuhn, Tilman and Menendez, Virginia V. M. and Nilsson, Peter and Overvad, Kim and Palli, Domenico and Panico, Salvatore and Rolandsson, Olov and Romieu, Isabelle and Sacerdote, Carlotta and Sanchez, Maria-Jose and Schulze, Matthias B. and Spijkerman, Annemieke M. W. and Tjonneland, Anne and Tumino, Rosario and Daphne, L. van der A. and Wurtz, Anne M. L. and Zamora-Ros, Raul and Langenberg, Claudia and Sharp, Stephen J. and Forouhi, Nita G. and Riboli, Elio and Wareham, Nicholas J.},
  issn         = {1935-5548},
  language     = {eng},
  number       = {7},
  pages        = {1854--1862},
  publisher    = {American Diabetes Association},
  series       = {Diabetes Care},
  title        = {Dietary Protein Intake and Incidence of Type 2 Diabetes in Europe: The EPIC-InterAct Case-Cohort Study},
  url          = {http://dx.doi.org/10.2337/dc13-2627},
  volume       = {37},
  year         = {2014},
}