Nasser Laouali1,2, Francesca Romana Mancini1,2, Mariem Hajji-Louati1,2, Douae El Fatouhi1,2, Beverley Balkau1,2, Marie-Christine Boutron-Ruault1,2, Fabrice Bonnet3, Guy Fagherazzi4,5,6. 1. Centre for Research in Epidemiology and Population Health (CESP), Inserm (Institut National de la Santé et de la Recherche Médicale) U1018, Generations and Health Across Generations, Gustave Roussy Institute, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France. 2. Faculte de Medecine, UPS-UVSQ-Paris-Saclay University, Le Kremlin-Bicêtre, France. 3. Service d'Endocrinologie, Groupe Hospitalier Paris St-Joseph, Paris, France. 4. Centre for Research in Epidemiology and Population Health (CESP), Inserm (Institut National de la Santé et de la Recherche Médicale) U1018, Generations and Health Across Generations, Gustave Roussy Institute, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France. guy.fagherazzi@gustaveroussy.fr. 5. Faculte de Medecine, UPS-UVSQ-Paris-Saclay University, Le Kremlin-Bicêtre, France. guy.fagherazzi@gustaveroussy.fr. 6. Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg. guy.fagherazzi@gustaveroussy.fr.
Abstract
AIMS/HYPOTHESIS: Diet is one of the main lifestyle-related factors that can modulate the inflammatory process. Surprisingly the dietary inflammatory index (DII) has been little investigated in relation to type 2 diabetes, and the role of BMI in this relationship is not well established. We studied this association and the role of BMI in the inflammatory process in a large population-based observational study. METHODS: A total of 70,991 women from the E3N (Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale) cohort study were followed for 20 years. Incident type 2 diabetes cases were identified using diabetes-specific questionnaires and drug reimbursement insurance databases, and 3292 incident cases were validated. The DII was derived from a validated food frequency questionnaire. Multivariable Cox regression models estimated HRs and 95% CIs between DII and incident type 2 diabetes. Interactions were tested between DII and BMI on incident type 2 diabetes and a mediation analysis of BMI was performed. RESULTS: Higher DII scores, corresponding to a higher anti-inflammatory potential of the diet, were associated with a lower risk of type 2 diabetes. Compared with the 1st quintile group, women from the 2nd quintile group (HR 0.85 [95% CI 0.77, 0.94]) up to the 5th quintile group (HR 0.77 [95% CI 0.69, 0.85]) had a lower risk of type 2 diabetes before adjustment for BMI. There was an interaction between DII and BMI on type 2 diabetes risk (pInteraction < 0.0001). The overall association was partly mediated by BMI (58%). CONCLUSIONS/ INTERPRETATION: Our findings suggest that a higher anti-inflammatory potential of the diet is associated with a lower risk of type 2 diabetes, and the association may be mediated by BMI. These results may improve our understanding of the mechanisms underlying the role of diet-related anti-inflammation in the pathogenesis of type 2 diabetes in women. Further studies are warranted to validate our results and evaluate whether the results are similar in men.
AIMS/HYPOTHESIS: Diet is one of the main lifestyle-related factors that can modulate the inflammatory process. Surprisingly the dietary inflammatory index (DII) has been little investigated in relation to type 2 diabetes, and the role of BMI in this relationship is not well established. We studied this association and the role of BMI in the inflammatory process in a large population-based observational study. METHODS: A total of 70,991 women from the E3N (Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale) cohort study were followed for 20 years. Incident type 2 diabetes cases were identified using diabetes-specific questionnaires and drug reimbursement insurance databases, and 3292 incident cases were validated. The DII was derived from a validated food frequency questionnaire. Multivariable Cox regression models estimated HRs and 95% CIs between DII and incident type 2 diabetes. Interactions were tested between DII and BMI on incident type 2 diabetes and a mediation analysis of BMI was performed. RESULTS: Higher DII scores, corresponding to a higher anti-inflammatory potential of the diet, were associated with a lower risk of type 2 diabetes. Compared with the 1st quintile group, women from the 2nd quintile group (HR 0.85 [95% CI 0.77, 0.94]) up to the 5th quintile group (HR 0.77 [95% CI 0.69, 0.85]) had a lower risk of type 2 diabetes before adjustment for BMI. There was an interaction between DII and BMI on type 2 diabetes risk (pInteraction < 0.0001). The overall association was partly mediated by BMI (58%). CONCLUSIONS/ INTERPRETATION: Our findings suggest that a higher anti-inflammatory potential of the diet is associated with a lower risk of type 2 diabetes, and the association may be mediated by BMI. These results may improve our understanding of the mechanisms underlying the role of diet-related anti-inflammation in the pathogenesis of type 2 diabetes in women. Further studies are warranted to validate our results and evaluate whether the results are similar in men.
Entities:
Keywords:
BMI, Body mass index; Cohort; Diet inflammation; Mediation analysis; Prevention; Risk; Type 2 diabetes
Authors: Francesca Romana Mancini; Kalina Rajaobelina; Delphine Praud; Courtney Dow; Jean Philippe Antignac; Marina Kvaskoff; Gianluca Severi; Fabrice Bonnet; Marie-Christine Boutron-Ruault; Guy Fagherazzi Journal: Int J Hyg Environ Health Date: 2018-07-25 Impact factor: 5.840