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The Association between Dietary Energy Density and Type 2 Diabetes in Europe: Results from the EPIC-InterAct Study

van den Berg, Saskia W. ; van der A, Daphne L. ; Spijkerman, Annemieke M. W. ; van Woudenbergh, Geertruida J. ; Tijhuis, Mariken J. ; Amiano, Pilar ; Ardanaz, Eva ; Beulens, Joline W. J. ; Boeing, Heiner and Clavel-Chapelon, Francoise , et al. (2013) In PLoS ONE 8(5).
Abstract
Background: Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake. Methodology/Principal Findings: A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as... (More)
Background: Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake. Methodology/Principal Findings: A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13), which was consistent across countries (l(2) = 2.9%). Conclusions/Significance: In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases. (Less)
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PLoS ONE
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8
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5
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e59947
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Public Library of Science
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  • wos:000319081900001
  • scopus:84877833999
  • pmid:23696784
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1932-6203
DOI
10.1371/journal.pone.0059947
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English
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@article{d7e7c9ca-beea-487b-85d8-2d8bec5d561c,
  abstract     = {Background: Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake. Methodology/Principal Findings: A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13), which was consistent across countries (l(2) = 2.9%). Conclusions/Significance: In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases.},
  author       = {van den Berg, Saskia W. and van der A, Daphne L. and Spijkerman, Annemieke M. W. and van Woudenbergh, Geertruida J. and Tijhuis, Mariken J. and Amiano, Pilar and Ardanaz, Eva and Beulens, Joline W. J. and Boeing, Heiner and Clavel-Chapelon, Francoise and Crowe, Francesca L. and de Lauzon-Guillain, Blandine and Fagherazzi, Guy and Franks, Paul and Freisling, Heinz and Gonzalez, Carlos and Grioni, Sara and Halkjaer, Jytte and Maria Huerta, Jose and Huybrechts, Inge and Kaaks, Rudolf and Khaw, Kay Tee and Masala, Giovanna and Nilsson, Peter and Overvad, Kim and Panico, Salvatore and Ramon Quiros, J. and Rolandsson, Olov and Sacerdote, Carlotta and Sanchez, Maria-Jose and Schulze, Matthias B. and Slimani, Nadia and Struijk, Ellen A. and Tjonneland, Anne and Tumino, Rosario and Sharp, Stephen J. and Langenberg, Claudia and Forouhi, Nita G. and Feskens, Edith J. M. and Riboli, Elio and Wareham, Nicholas J.},
  issn         = {1932-6203},
  language     = {eng},
  number       = {5},
  publisher    = {Public Library of Science},
  series       = {PLoS ONE},
  title        = {The Association between Dietary Energy Density and Type 2 Diabetes in Europe: Results from the EPIC-InterAct Study},
  url          = {https://lup.lub.lu.se/search/ws/files/3137228/4286382.pdf},
  doi          = {10.1371/journal.pone.0059947},
  volume       = {8},
  year         = {2013},
}