Marta Guasch-Ferré1,2,3, Nerea Becerra-Tomás2,3, Miguel Ruiz-Canela3,4, Dolores Corella3,5, Helmut Schröder6,7, Ramon Estruch3,8, Emilio Ros3,9, Fernando Arós3,10, Enrique Gómez-Gracia11, Miquel Fiol3,12, Lluís Serra-Majem3,13, José Lapetra3,14, Josep Basora2,3, Nerea Martín-Calvo3,4, Olga Portoles3,5, Montserrat Fitó6,7, Frank B Hu15,16,17, Lluís Forga18, Jordi Salas-Salvadó19,3. 1. Departments of Nutrition and marta.guasch@urv.cat jordi.salas@urv.cat. 2. Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Institute, Rovira i Virgili University, Reus, Spain; Biomedical Research Networking Center for the. 3. Pathophysiology of Obesity and Nutrition and. 4. Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain. 5. Department of Preventive Medicine, University of Valencia, Valencia, Spain. 6. Epidemiology and Public Health, Carlos III Health Institute, Madrid, Spain. 7. Cardiovascular Risk and Nutrition, Hospital del Mar Medical Research Institute, Barcelona, Spain. 8. Department of Internal Medicine and. 9. Lipid Clinic, Endocrinology and Nutrition Service, August Pi i Sunyer Institute of Biomedical Research, Hospital Clinic, University of Barcelona, Barcelona, Spain. 10. Department of Cardiology, Organización Sanitaria Integrada Araba, University Hospital, University of the Basque Country, Universidad del País Vasco/Euskal Herriko Unibertsitatea, Vitoria-Gasteiz, Spain. 11. Department of Preventive Medicine, University of Malaga, Malaga, Spain. 12. Institute of Health Sciences, University of Balearic Islands and Son Espases Hospital, Palma de Mallorca, Spain. 13. Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain. 14. Department of Family Medicine, Research Unit, Primary Care Division of Sevilla, Sevilla, Spain. 15. Departments of Nutrition and. 16. Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA. 17. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and. 18. Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, Navarra Institute of Sanitary Research, Pamplona, Spain. 19. Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Institute, Rovira i Virgili University, Reus, Spain; Biomedical Research Networking Center for the marta.guasch@urv.cat jordi.salas@urv.cat.
Abstract
Background: The associations between dietary fat and cardiovascular disease have been evaluated in several studies, but less is known about their influence on the risk of diabetes.Objective: We examined the associations between total fat, subtypes of dietary fat, and food sources rich in saturated fatty acids and the incidence of type 2 diabetes (T2D).Design: A prospective cohort analysis of 3349 individuals who were free of diabetes at baseline but were at high cardiovascular risk from the PREvención con DIeta MEDiterránea (PREDIMED) study was conducted. Detailed dietary information was assessed at baseline and yearly during the follow-up using a food frequency questionnaire. Multivariable Cox proportional hazards models were used to estimate T2D HRs and 95% CIs according to baseline and yearly updated fat intake. Results: We documented 266 incident cases during 4.3 y of follow-up. Baseline saturated and animal fat intake was not associated with the risk of T2D. After multivariable adjustment, participants in the highest quartile of updated intake of saturated and animal fat had a higher risk of diabetes than the lowest quartile (HR: 2.19; 95% CI: 1.28, 3.73; and P-trend = 0.01 compared with HR: 2.00; 95% CI: 1.29, 3.09; and P-trend < 0.01, respectively). In both the Mediterranean diet and control groups, participants in the highest quartile of updated animal fat intake had an ∼2-fold higher risk of T2D than their counterparts in the lowest quartile. The consumption of 1 serving of butter and cheese was associated with a higher risk of diabetes, whereas whole-fat yogurt intake was associated with a lower risk.Conclusions: In a Mediterranean trial focused on dietary fat interventions, baseline intake of saturated and animal fat was not associated with T2D incidence, but the yearly updated intake of saturated and animal fat was associated with a higher risk of T2D. Cheese and butter intake was associated with a higher risk of T2D, whereas whole-fat yogurt intake was associated with a lower risk of T2D. This trial was registered at www.isrctn.com as ISRCTN35739639.
Background: The associations between dietary fat and cardiovascular disease have been evaluated in several studies, but less is known about their influence on the risk of diabetes.Objective: We examined the associations between total fat, subtypes of dietary fat, and food sources rich in saturated fatty acids and the incidence of type 2 diabetes (T2D).Design: A prospective cohort analysis of 3349 individuals who were free of diabetes at baseline but were at high cardiovascular risk from the PREvención con DIeta MEDiterránea (PREDIMED) study was conducted. Detailed dietary information was assessed at baseline and yearly during the follow-up using a food frequency questionnaire. Multivariable Cox proportional hazards models were used to estimate T2D HRs and 95% CIs according to baseline and yearly updated fat intake. Results: We documented 266 incident cases during 4.3 y of follow-up. Baseline saturated and animal fat intake was not associated with the risk of T2D. After multivariable adjustment, participants in the highest quartile of updated intake of saturated and animal fat had a higher risk of diabetes than the lowest quartile (HR: 2.19; 95% CI: 1.28, 3.73; and P-trend = 0.01 compared with HR: 2.00; 95% CI: 1.29, 3.09; and P-trend < 0.01, respectively). In both the Mediterranean diet and control groups, participants in the highest quartile of updated animal fat intake had an ∼2-fold higher risk of T2D than their counterparts in the lowest quartile. The consumption of 1 serving of butter and cheese was associated with a higher risk of diabetes, whereas whole-fat yogurt intake was associated with a lower risk.Conclusions: In a Mediterranean trial focused on dietary fat interventions, baseline intake of saturated and animal fat was not associated with T2D incidence, but the yearly updated intake of saturated and animal fat was associated with a higher risk of T2D. Cheese and butter intake was associated with a higher risk of T2D, whereas whole-fat yogurt intake was associated with a lower risk of T2D. This trial was registered at www.isrctn.com as ISRCTN35739639.
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