Association of Dietary Patterns with Incident Type 2 Diabetes Among Migrant and Nonmigrant Ghanaian Populations in the Prospective Research on Obesity and Diabetes in African Migrants (RODAM-Pros) Study.

Egg consumption and risk of incident type 2 diabetes in men: the Kuopio Ischaemic Heart Disease Risk Factor Study

BackgroundAlthough potatoes are considered a dietary staple in some cultures, evidence suggests that their impact on type 2 diabetes (T2D) risk is nuanced, with preparation methods and dietary patterns playing crucial roles. Investigating the substitution effects of replacing potatoes with other foods is required to inform dietary recommendations for lowering T2D risk. ObjectiveThe objective of this was to investigate associations between the substitution of potatoes (excluding fries/chips) with other food groups (vegetables, whole grains, refined grains, red meat, processed meat, poultry, fish, and dairy) and the risk of T2D. MethodsThe diet of participants from the prospective Danish Diet, Cancer, and Health study (DCH) was measured at baseline (1993–1997) by a food frequency questionnaire. Participants were followed up for incident T2D from baseline until 2012. Associations between the substitution of potatoes (total, boiled, and mashed) with other food groups and incident T2D was assessed by multivariable Cox proportional hazards model. ResultsIn 54,793 DCH study participants, during a median follow-up of 16.3 y, 7693 incident T2D cases were recorded. A 26% lower risk of T2D was observed when 50 g/d of potatoes were substituted with the same amount of whole grains [hazard ratio and 95% confidence interval (CI): 0.74 (0.70, 0.79)]. Similarly, a lower risk of T2D was observed upon substituting 25 g/d of potatoes with an equivalent amount of green leafy [HR (95% CI): 0.79 (0.74, 0.83)], cruciferous [HR (95% CI): 0.87 (0.83, 0.92)], and yellow/orange/red vegetables [HR (95% CI): 0.97 (0.96, 0.99)]. Conversely, a higher risk of T2D was observed when potatoes were substituted with poultry [HR (95% CI): 1.08 (1.02, 1.15)], red meat [HR (95% CI): 1.06 (1.02, 1.10)], and processed meat [HR (95% CI): 1.17 (1.11, 1.23)]. Replacing boiled potatoes with red meat or poultry was associated with a higher risk of T2D compared with replacing mashed potatoes. ConclusionsSubstituting potatoes with whole grains and most types of vegetables was associated with a lower risk of T2D, whereas substituting potatoes with poultry, red meat, and processed meat was associated with a higher risk.

Introduction: Higher coffee consumption has been consistently associated with lower type 2 diabetes (T2D) risk but the underlying mechanisms are largely unknown. Our prior study showed higher coffee intake was associated with improved post-load glucose clarence and insulin sensitivity, and lower visceral adiposity. Hypothesis: We hypothesized that coffee consumption was associated with decreased T2D risk, by lowering genetic susceptibility of T2D in pathophysiological pathways related to insulin sensitivity, insulin production, and central adiposity. Methods: We analyzed data from 333,053 UK Biobank participants who were free of baseline chronic diseases. Coffee intake was assessed by a dietary questionnaire at baseline. We calculated seven partitioned polygenic scores (pPS) denoting 7 distinct physiological mechanisms underlying hyperinsulinemia, ranging from proinsulin, insulin secretion, to visceral adiposity. We examined the association of coffee intake, the pPS, and their interactions, with incident T2D, using Cox regression model. Results: We identified 10,707 incident T2D cases during 13.3 years of follow-up. Higher coffee intake, as expected, was associated with lower risk of T2D; compared to participants who did not regularly drink coffee, those consuming 4-5 cups/day had a 21% lower risk of incident T2D (95% confidence interval, 0.74-0.85) after adjusting for known risk factors including BMI. Of all pPS, 5 significantly predicted T2D risk ( P <0.05/7) but 2 pPS related to proinsulin and insulin secretion, did not ( P >0.05). In multivariable adjusted analyses, we identified a significant multiplicative interaction between coffee intake and proinsulin pPS; this pPS, which was in a genetic cluster linked to lower visceral fat and higher post-load insulin response (Fig. A), was associated with lower T2D risk only among participants who were high coffee consumers ( P interaction = 0.004; Fig. B). Furthermore, the positive associations between pPS for adiposity and pPS for visceral adiposity with T2D risk were attenuated among participants who consumed coffee daily vs. who did not ( P interaction = 0.088 and 0.093, respectively). Conclusions: Our data, coupled with our prior study, suggest that coffee consumption may be associated with lower T2D risk through its interactions with genetic pathways related to insulin secretion, post-load insulin sensitivity, and visceral adiposity. These results may inform tailored dietary recommendations to enhance T2D prevention.

Background: Plasma metabolites have been associated with type 2 diabetes (T2D) risk and may reflect metabolic homeostasis as a result of the interplay among diet, genetics, and the gut microbiome. Hypothesis: We hypothesized that specific multi-metabolite signatures can characterize the adherence and metabolic response to various dietary patterns and are associated with incident T2D. Methods: We analyzed 20578 participants in the Nurses’ Health studies and Health Professional Follow-up Study (NHS/HPFS), Hispanic Community Health Study/Study of Latinos, and Women’s Health Initiative, whose blood metabolome were profiled by liquid chromatography-mass spectrometry. We applied elastic net regression to develop (n=1206 in a NHS/HPFS lifestyle sub-study) and validate (in the remaining samples) metabolic signatures for 3 dietary recommendation-based diets (a Mediterranean diet - AMED, a healthy eating index - AHEI, and an anti-hypertensive diet - DASH), 3 plant-based diets (PDIs), and 2 mechanism-based diets (proinflammatory [EDIP] and insulinemic [EDIH] diets). We tested associations between the dietary metabolic signatures and incident T2D in 14060 initially T2D-free participants (1832 cases in up to 22 years of follow-up). In sub-samples, we further examined genetic and microbial factors (shotgun sequencing) associated with metabolic signatures. Results: We identified 8 metabolic signatures, each consisted of 37-66 metabolites and was robustly correlated with the corresponding dietary pattern index in all validation cohorts ( r =0.11-0.38; P < 8.06 х10 -9 ). We noted shared and distinct metabolites cross metabolic signatures of various dietary patterns. In multivariable-analyses, metabolic signatures of healthful diets (i.e., AMED, AHEI, DASH, healthful PDI) were associated with a lower T2D risk (hazard ratio [HR]: 0.82-0.90; P < 3х10 -6 ), whereas metabolic signatures of unhealthful diets (e.g., EDIP and EDIH) were associated with a higher T2D risk (HR: 1.23-1.26; P < 2х10 -15 ). The metabolic signatures mediated 26%-56% of the associations between their corresponding dietary patterns and T2D risk ( P < 0.01). Further, a proportion of variation in the dietary metabolic signatures was explained by genetic variants (9.9% for EDIP to 34.5% for PDI) and gut microbial diversity (0.2% for PDI to 14.9% for EDIP). Dietary metabolic signatures were associated with 7 genetic loci including those involved in fatty acid and energy metabolism (e.g., FADS1/2 and CERS4 , P < 5х10 -8 ), and the abundance of 39 gut bacterial species (FDR <0.05). Conclusions: We identified metabolic signatures that characterized the adherence and metabolic responses (related to genetics and gut microbiome) to various dietary patterns, and were associated with T2D risk, in ethnically diverse populations. Metabolomic profiling may facilitate personalized nutritional interventions for T2D prevention.

Dietary Fat Quality and Genetic Risk of Type 2 Diabetes

PurposeIn several studies, exploratory dietary patterns (DP), derived by principal component analysis, were inversely or positively associated with incident type 2 diabetes (T2D). However, findings remained study-specific, inconsistent and rarely replicated. This study aimed to investigate the associations between DPs and T2D in multiple cohorts across the world.MethodsThis federated meta-analysis of individual participant data was based on 25 prospective cohort studies from 5 continents including a total of 390,664 participants with a follow-up for T2D (3.8–25.0 years). After data harmonization across cohorts we evaluated 15 previously identified T2D-related DPs for association with incident T2D estimating pooled incidence rate ratios (IRR) and confidence intervals (CI) by Piecewise Poisson regression and random-effects meta-analysis.Results29,386 participants developed T2D during follow-up. Five DPs, characterized by higher intake of red meat, processed meat, French fries and refined grains, were associated with higher incidence of T2D. The strongest association was observed for a DP comprising these food groups besides others (IRRpooled per 1 SD = 1.104, 95% CI 1.059–1.151). Although heterogeneity was present (I2 = 85%), IRR exceeded 1 in 18 of the 20 meta-analyzed studies. Original DPs associated with lower T2D risk were not confirmed. Instead, a healthy DP (HDP1) was associated with higher T2D risk (IRRpooled per 1 SD = 1.057, 95% CI 1.027–1.088).ConclusionOur findings from various cohorts revealed positive associations for several DPs, characterized by higher intake of red meat, processed meat, French fries and refined grains, adding to the evidence-base that links DPs to higher T2D risk. However, no inverse DP–T2D associations were confirmed.

Background/objectivesWe aimed to study the associations of dietary patterns (DPs) with type 2 diabetes (T2D) among Ghanaian adults.Subjects/methodsIn the multi-centre, cross-sectional RODAM (Research on Obesity and Diabetes among African Migrants) study (n = 4543), three overall DPs (“mixed”, “rice, pasta, meat and fish,” and “roots, tubers and plantain”) and two site-specific DPs per study site (rural Ghana, urban Ghana and Europe) were identified by principal component analysis. The DPs–T2D associations were calculated by logistic regression models.ResultsHigher adherence to the “rice, pasta, meat and fish” DP (characterized by legumes, rice/pasta, meat, fish, cakes/sweets, condiments) was associated with decreased odds of T2D, adjusted for socio-demographic factors, total energy intake and adiposity measures (odds ratio (OR)per 1 SD = 0.80; 95% confidence interval (CI) = 0.70–0.92). Similar DPs and T2D associations were discernible in urban Ghana and Europe. In the total study population, neither the “mixed” DP (whole grain cereals, sweet spreads, dairy products, potatoes, vegetables, poultry, coffee/tea, sodas/juices, olive oil) nor the “roots, tubers and plantain” DP (refined cereals, fruits, nuts/seeds, roots/tubers/plantain, fermented maize products, legumes, palm oil, condiments) was associated with T2D. Yet, after the exclusion of individuals with self-reported T2D, the “roots, tubers and plantain” DP was inversely associated with T2D (ORper 1 SD = 0.88; 95% CI = 0.69–1.12).ConclusionIn this Ghanaian population, DPs characterized by the intake of legumes, fish, meat and confectionery were inversely associated with T2D. The effect of a traditional-oriented diet (typical staples, vegetables and legumes) remains unclear.

BackgroundHigher consumption of sugary beverages (SB) has been associated with type 2 diabetes (T2D), but whether these associations are modified by physical activity remains unclear. This study aimed to examine the associations of SB intake, including sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB), and natural juices (NJ) with the risk of incident T2D, and the potential role of physical activity.MethodsWe included 153,862 diabetes-free participants in the UK Biobank who completed both the International Physical Activity Questionnaire at recruitment (2006–2010) and at least one 24-h dietary recall questionnaire in 2009–2012. We assessed the associations of each SB with the risk of incident T2D using Cox proportional hazard models, and explored the interactions between each SB and physical activity.ResultsDuring a median follow-up of 11.8 years, 6631 participants developed incident T2D. Participants consuming more SSB and ASB (comparing > 2 to 0 unit/d) had a higher hazard of T2D (hazard ratio [HR]: 1.17, 95% confidence interval [CI]: 1.05–1.31 for SSB; 1.54, 1.37–1.74 for ASB), while medium intake of NJ showed an inverse association (HR> 0–1 vs. 0 unit/d: 0.87, 95% CI: 0.82–0.92; HR> 1–2 vs. 0 unit/d: 0.88, 95% CI: 0.81–0.97) with incident T2D. No significant interactions between physical activity and SSB/ASB were found (P-interaction=0.204 for SSB, 0.926 for ASB), but the protective association of medium NJ intake with T2D was stronger among participants with higher level of physical activity (P-interaction = 0.043).ConclusionsHigher intake of SSB and ASB was related to higher risks of T2D. Medium NJ intake was associated with a lower risk of T2D, particularly among individuals with higher physical activity level. These findings emphasized the importance of healthy beverage intake and adequate physical activity in diabetes prevention.

Background: Diet is a pivotal modifable risk factor for type 2 diabetes (T2D), while lifestyle and dietary modifcations are ostensible measures considering the disease association. The present study was endeavored to identify dietary patterns in Bangladesh and to evaluate the association between dietary patterns and the risk of T2D.Methods: The investigation population (n=108) was a part of the population-based nutrition study conducted in Chattogram, Bangladesh. Dietary intake was obtained using a validated food frequency questionnaire (FFQ). Demographic, anthropometric, socioeconomic characteristics, and other covariates were collected using structured lifestyle questionnaires. Associations between dietary patterns and the risk of T2D were estimated by multivariate logistic regression analyses.Two major dietary patterns including traditional Bangladeshi and Western were identifed using factor analysis. Odds ratios were calculated for the risk of T2D across quartiles of dietary pattern scores.Results: Subsequent adjusting for the possible confounders, the highest quartile of the Western dietary pattern score had greater odds of T2D (OR=1.16; 95% CI: 1.102-1.136; P=0.02) than those did in the lowest quartile. Compared with those in the lowest quartile, subjects in the highest quartile of the traditional Bangladeshi dietary pattern score had lower odds of the T2D (OR=0.69; 95% CI: 0.562-0.874; P=0.04) than those did in the lowest quartile.Conclusion: Traditional Bangladeshi dietary patterns had no association with the incidence of T2D and Western dietary patterns were associated with an increased risk of T2D.

Background: Recently, a dietary index reflecting adherence to the 2017 French food-based dietary guidelines, the Programme National Nutrition Santé - guidelines score 2 (PNNS-GS2), has been developed, but evidence on its level of adherence and incident type 2 diabetes (T2D) risk is limited. Objective: We aimed to investigate the association between adherence to the simplified PNNS-GS2 (sPNNS-GS2) and the risk of incident T2D in a French cohort of women. Methods: Between 1993 and 2014, 71,450 women aged over 18 years were examined, and thereafter followed up for the occurrence of T2D within the E3N-EPIC prospective cohort. Dietary data were collected at baseline via a food frequency questionnaire, and the sPNNS-GS2 was derived for each participant. Multivariable Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of T2D for continuous and quintile groups of the sPNNS-GS2. Effect modification by body mass index (BMI) and mediation by BMI and waist-hip ratio (WHR) were explored. Results: The mean age was 52.9 years (SD 6.7). During a mean follow-up of 19 years, 3679 incident T2D cases were identified and validated. There was a linear association between adherence to sPNNS-GS2 and T2D risk (P non-linear = 0.85). In the fully adjusted model, each 1-SD increase in the sPNNS-GS2 was associated with a 8% decrease risk of T2D [HR (95% CI), 0.92 (0.89, 0.95)]. Compared to those with the lowest adherence (first quintile), the third [HR (95% CI), 0.91 (0.82, 1.00)] up to the fifth quintile group [HR (95% CI), 0.79 (0.71, 0.88)] had a lower T2D risk. There was a sPNNS-GS2 x BMI interaction on T2D risk (P interaction < 0.01) but not with WHR. The overall association was partly mediated by BMI (18%) and WHR (59%). Conclusion: Higher adherence to the 2017 French food-based dietary guidelines was associated with a lower risk of T2D in women. Furthermore, our mediation analysis suggests that the lower risk of T2D in women associated with adherence to the sPNNS-GS2 is partly mediated by obesity measured by BMI or WHR.

The Association Between Circulating Lipoprotein(a) and Type 2 Diabetes: Is It Causal?

Background and aims: Previous studies of primarily Western populations have consistently documented a lower risk of type 2 diabetes (T2D) among people with a higher yogurt intake, but an inconsistent association with milk intake. However, little is known about the association between dairy intake and risk of T2D among Chinese adults who consume considerably less dairy (mainly milk and yogurt) compared with Western populations. The aim is to investigate the associations of dairy intake with the risk of incident T2D in the general adult population in China. Methods: This cohort study consisted of 22 843 participants without prevalent cardiovascular disease, cancer, or diabetes at the baseline. Dietary data were collected using a validated food frequency questionnaire at the baseline (2013-2018); dairy intake was categorized into tertiles after zero consumers were taken as the reference. Incident T2D was ascertained by medical examinations and self-report of physician-diagnosed diabetes during follow-up visits. Cox proportional hazards models were performed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Results: In total, 735 incident T2D cases were recorded over a median follow-up of 4.0 years. Relative to zero consumers, the HRs (95% CIs) for incident T2D among participants in the highest tertiles were 0.70 (0.57, 0.87) for total dairy, 0.73 (0.60, 0.90) for milk, and 0.81 (0.66, 1.00) for yogurt. Such associations were slightly attenuated by additional adjustment for the body mass index. In addition, such inverse associations were robust in sensitivity analyses and consistent in most of the subgroups defined by baseline characteristics. Conclusion: Higher intakes of total dairy, milk, and yogurt were all associated with a lower risk of T2D among Chinese adults.

ObjectiveTo prospectively investigate the associations between dark, milk, and total chocolate consumption and risk of type 2 diabetes (T2D) in three US cohorts.DesignProspective cohort studies.SettingNurses’ Health Study (NHS; 1986-2018), Nurses’...

Dietary Copper-Zinc Ratio and Type 2 Diabetes Risk in Women: The E3N Cohort Study

Evidence of the association between income fluctuation and risk of type 2 diabetes (T2D) is scarce. To investigate whether sustained low or high income and income changes are associated with incidence of T2D. In this population-based cohort study, more than 7.8 million adults without T2D aged 30 to 64 years from a nationally representative sample from the Korean Health Insurance Service database were enrolled in 2012 and followed up to 2019 (median follow-up, 6.3 years [IQR, 6.1-6.6 years]). Twenty quantiles of monthly health insurance premiums determined income levels. Income quartiles were annually analyzed from 2008 to 2012. Beneficiaries of the Medical Aid Program were regarded as those with very low income. A decrease in income was indicated as a reduction of 25% or more in income compared with income in the previous year. The primary outcome was incident T2D based on the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes E11 to E14, 1 or more claims of antidiabetic medication, or a fasting glucose level of 126 mg/dL or higher. Multivariable Cox proportional hazards models were used to assess the association of low- or high-income status and income changes with incidence of T2D. Of 7 821 227 participants (mean [SD] age, 46.4 [9.3] years; 54.9% men), 359 931 (4.6%) developed T2D at least 1 year after enrollment. Individuals who repeatedly experienced low and very low income for 5 years showed 22% (hazard ratio [HR], 1.22 [95% CI, 1.21-1.23]) and 57% (1.57 [95% CI, 1.53-1.62]) higher T2D risk compared with those who never experienced low and very low income, respectively. In contrast, individuals who were repeatedly in high-income quartiles showed lower T2D risk compared with those who never experienced high income (HR, 0.86 [95% CI, 0.85-0.86]). The number of income decreases was associated with elevated T2D risk (≥2 vs 0 income decreases: HR, 1.08 [95% CI, 1.06-1.11]; P < .001 for trend). When income quartile status was compared between 2008 and 2012, individuals who experienced an income increase had lowered T2D risk, while those who experienced an income decrease had elevated T2D risk in each income quartile group. This cohort study found that individuals who experienced sustained low-income status or an income decrease had elevated T2D risk, while those who had sustained high-income status or an income increase had lowered T2D risk.