Journal article
The Association Between Dietary Flavonoid and Lignan Intakes and Incident Type 2 Diabetes in European Populations: The EPIC-InterAct study : The EPIC-InterAct study
Medical Research Council1
Wageningen University & Research2
Lund University3
Istituto Nazionale dei Tumori4
German Cancer Research Center5
University of Oxford6
University of Cambridge7
Cancer Research and Prevention Institute8
University of Naples Federico II9
Aarhus University10
Ministry of Health, Consumption and Social Welfare11
Catalan Institute of Oncology12
International Agency for Research on Cancer13
Human Genetic Foundation14
National Institute of Public Health and the Environment15
Danish Cancer Society16
University of Murcia17
'Civic MP Arezzo' Hospital18
Murcia Regional Health Council19
Imperial College London20
German Institute of Human Nutrition Potsdam-Rehbruecke21
Public University of Navarre22
University Medical Centre Utrecht23
CIBER Epidemiología y Salud Pública24
National Food Institute, Technical University of Denmark25
Division of Toxicology and Risk Assessment, National Food Institute, Technical University of Denmark26
Centre for Research in Epidemiology and Population Health27
...and 17 moreOBJECTIVE To study the association between dietary flavonoid and lignan intakes, and the risk of development of type 2 diabetes among European populations.RESEARCH DESIGN AND METHODS The 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.RESULTS In 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.CONCLUSIONS Prospective 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.
Language: | English |
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Publisher: | American Diabetes Association |
Year: | 2013 |
Pages: | 3961-3970 |
ISSN: | 19355548 , 01495992 and 10649131 |
Types: | Journal article |
DOI: | 10.2337/dc13-0877 |
ORCIDs: | Bredsdorff, Lea and 0000-0001-6429-7921 |