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The Association Between Dietary Flavonoid and Lignan Intakes and Incident Type 2 Diabetes in European Populations The EPIC-InterAct study

Zamora-Ros, Raul; Forouhi, Nita G.; Sharp, Stephen J.; Gonzalez, Carlos A.; Buijsse, Brian; Guevara, Marcela; van der Schouw, Yvonne T.; Amiano, Pilar; Boeing, Heiner and Bredsdorff, Lea, et al. (2013) In Diabetes Care 36(12). p.3961-3970
Abstract
OBJECTIVETo study the association between dietary flavonoid and lignan intakes, and the risk of development of type 2 diabetes among European populations.RESEARCH DESIGN AND METHODSThe 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... (More)
OBJECTIVETo study the association between dietary flavonoid and lignan intakes, and the risk of development of type 2 diabetes among European populations.RESEARCH DESIGN AND METHODSThe 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.RESULTSIn 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.CONCLUSIONSProspective 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. (Less)
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Diabetes Care
volume
36
issue
12
pages
3961 - 3970
publisher
American Diabetes Association
external identifiers
  • wos:000327211500044
  • scopus:84891873486
ISSN
1935-5548
DOI
10.2337/dc13-0877
language
English
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yes
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64b9c182-1a48-4703-b4d0-907aaf398b03 (old id 4273300)
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2014-02-10 12:25:40
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2019-03-05 02:41:09
@article{64b9c182-1a48-4703-b4d0-907aaf398b03,
  abstract     = {OBJECTIVETo study the association between dietary flavonoid and lignan intakes, and the risk of development of type 2 diabetes among European populations.RESEARCH DESIGN AND METHODSThe 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.RESULTSIn 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.CONCLUSIONSProspective 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.},
  author       = {Zamora-Ros, Raul and Forouhi, Nita G. and Sharp, Stephen J. and Gonzalez, Carlos A. and Buijsse, Brian and Guevara, Marcela and van der Schouw, Yvonne T. and Amiano, Pilar and Boeing, Heiner and Bredsdorff, Lea and Clavel-Chapelon, Francoise and Fagherazzi, Guy and Feskens, Edith J. and Franks, Paul and Grioni, Sara and Katzke, Verena and Key, Timothy J. and Khaw, Kay-Tee and Kuehn, Tilman and Masala, Giovanna and Mattiello, Amalia and Molina-Montes, Esther and Nilsson, Peter and Overvad, Kim and Perquier, Florence and Ramon Quiros, J. and Romieu, Isabelle and Sacerdote, Carlotta and Scalbert, Augustin and Schulze, Matthias and Slimani, Nadia and Spijkerman, Annemieke M. W. and Tjonneland, Anne and Jose Tormo, Maria and Tumino, Rosario and van der A, Daphne L. and Langenberg, Claudia and Riboli, Elio and Wareham, Nicholas J.},
  issn         = {1935-5548},
  language     = {eng},
  number       = {12},
  pages        = {3961--3970},
  publisher    = {American Diabetes Association},
  series       = {Diabetes Care},
  title        = {The Association Between Dietary Flavonoid and Lignan Intakes and Incident Type 2 Diabetes in European Populations The EPIC-InterAct study},
  url          = {http://dx.doi.org/10.2337/dc13-0877},
  volume       = {36},
  year         = {2013},
}