B Buijsse1, H Boeing1, D Drogan1, M B Schulze2, E J Feskens3, P Amiano4, A Barricarte5, F Clavel-Chapelon6, B de Lauzon-Guillain6, G Fagherazzi6, A Fonseca-Nunes7, P W Franks8, J M Huerta9, M U Jakobsen10, R Kaaks11, T J Key12, K T Khaw13, G Masala14, A Moskal15, P M Nilsson16, K Overvad17, V Pala18, S Panico19, M L Redondo20, F Ricceri21, O Rolandsson22, M-J Sánchez23, I Sluijs24, A M Spijkerman25, A Tjonneland26, R Tumino27, D L van der A25, Y T van der Schouw24, C Langenberg28, S J Sharp28, N G Forouhi28, E Riboli29, N J Wareham28. 1. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. 2. Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. 3. Division of Human Nutrition-Section Nutrition and Epidemiology, University of Wageningen, Wageningen, The Netherlands. 4. 1] Public Health Division of Gipuzkoa, San Sebastian, Spain [2] Instituto BIO-Donostia, San Sebastian, Spain [3] Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain. 5. 1] Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain [2] Navarre Public Health Institute, Pamplona, Spain. 6. 1] INSERM, Centre for Research in Epidemiology and Population Health, Villejuif, France [2] Paris South University, Villejuif, France. 7. Unit Nutrition, Environment and Cancer, Department of Epidemiology, Catalan Institute of Oncology, Barcelona, Spain. 8. 1] Department of Clinical Sciences, Clinical Research Center, Skåne University Hospital, Lund University, Malmö, Sweden [2] Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. 9. 1] Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain [2] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. 10. Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. 11. Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany. 12. Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. 13. Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. 14. Cancer Research and Prevention Institute, Florence, Italy. 15. International Agency for Research on Cancer, Lyon, France. 16. Department of Clinical Sciences, Clinical Research Center, Skåne University Hospital, Lund University, Malmö, Sweden. 17. 1] Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark [2] Department of Cardiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. 18. Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 19. Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy. 20. Consejería de Sanidad, Public Health Directorate, Oviedo-Asturias, Spain. 21. Human Genetics Foundation, Turin, Italy. 22. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. 23. 1] Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain [2] Andalusian School of Public Health, Instituto de Investigación Biosanitaria (IBS GRANADA) and Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. 24. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. 25. National Institute for Public Health and the Environment, Bilthoven, The Netherlands. 26. Danish Cancer Society Research Center, Copenhagen, Denmark. 27. 1] Histopathology Unit, 'Civic MP Arezzo' Hospital, ASP Ragusa, Italy [2] Associazone Iblea per la Ricerca Epidemiologica-Onlus, Ragusa, Italy. 28. MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. 29. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.
Abstract
BACKGROUND/ OBJECTIVES: Diets high in saturated and trans fat and low in unsaturated fat may increase type 2 diabetes (T2D) risk, but studies on foods high in fat per unit weight are sparse. We assessed whether the intake of vegetable oil, butter, margarine, nuts and seeds and cakes and cookies is related to incident T2D. SUBJECTS/ METHODS: A case-cohort study was conducted, nested within eight countries of the European Prospective Investigation into Cancer (EPIC), with 12,403 incident T2D cases and a subcohort of 16,835 people, identified from a cohort of 340,234 people. Diet was assessed at baseline (1991-1999) by country-specific questionnaires. Country-specific hazard ratios (HRs) across four categories of fatty foods (nonconsumers and tertiles among consumers) were combined with random-effects meta-analysis. RESULTS: After adjustment not including body mass index (BMI), nonconsumers of butter, nuts and seeds and cakes and cookies were at higher T2D risk compared with the middle tertile of consumption. Among consumers, cakes and cookies were inversely related to T2D (HRs across increasing tertiles 1.14, 1.00 and 0.92, respectively; P-trend <0.0001). All these associations attenuated upon adjustment for BMI, except the higher risk of nonconsumers of cakes and cookies (HR 1.57). Higher consumption of margarine became positively associated after BMI adjustment (HRs across increasing consumption tertiles: 0.93, 1.00 and 1.12; P-trend 0.03). Within consumers, vegetable oil, butter and nuts and seeds were unrelated to T2D. CONCLUSIONS: Fatty foods were generally not associated with T2D, apart from weak positive association for margarine. The higher risk among nonconsumers of cakes and cookies needs further explanation.
BACKGROUND/ OBJECTIVES: Diets high in saturated and trans fat and low in unsaturated fat may increase type 2 diabetes (T2D) risk, but studies on foods high in fat per unit weight are sparse. We assessed whether the intake of vegetable oil, butter, margarine, nuts and seeds and cakes and cookies is related to incident T2D. SUBJECTS/ METHODS: A case-cohort study was conducted, nested within eight countries of the European Prospective Investigation into Cancer (EPIC), with 12,403 incident T2D cases and a subcohort of 16,835 people, identified from a cohort of 340,234 people. Diet was assessed at baseline (1991-1999) by country-specific questionnaires. Country-specific hazard ratios (HRs) across four categories of fatty foods (nonconsumers and tertiles among consumers) were combined with random-effects meta-analysis. RESULTS: After adjustment not including body mass index (BMI), nonconsumers of butter, nuts and seeds and cakes and cookies were at higher T2D risk compared with the middle tertile of consumption. Among consumers, cakes and cookies were inversely related to T2D (HRs across increasing tertiles 1.14, 1.00 and 0.92, respectively; P-trend <0.0001). All these associations attenuated upon adjustment for BMI, except the higher risk of nonconsumers of cakes and cookies (HR 1.57). Higher consumption of margarine became positively associated after BMI adjustment (HRs across increasing consumption tertiles: 0.93, 1.00 and 1.12; P-trend 0.03). Within consumers, vegetable oil, butter and nuts and seeds were unrelated to T2D. CONCLUSIONS: Fatty foods were generally not associated with T2D, apart from weak positive association for margarine. The higher risk among nonconsumers of cakes and cookies needs further explanation.
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