Abstract
PurposeThe association between dietary saturated fatty acids (SFA) intake and type 2 diabetes (T2D) remains unclear. This study aimed at investigating the association between SFA intake and T2D risk based on (1) individual SFA (differing in carbon chain length), (2) food sources of SFA and (3) the substituting macronutrients.Methods37,421 participants from the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) cohort were included in this study. Baseline dietary intake was assessed by a validated food frequency questionnaire. T2D risks were estimated by Cox regression models adjusted for non-dietary and dietary covariates.Results893 incident T2D cases were documented during 10.1-year follow-up. We observed no association between total SFA and T2D risk. Marginally inverse associations were found for lauric acid (HR per 1 SD of energy%, 95% CI 0.92, 0.85–0.99), myristic acid (0.89, 0.79–0.99), margaric acid (0.84, 0.73–0.97), odd-chain SFA (pentadecylic plus margaric acids; 0.88, 0.79–0.99), and cheese derived SFA (0.90, 0.83–0.98). Soft and liquid fats derived SFA was found related to higher T2D risk (1.08, 1.01–1.17). When substituting SFA by proteins, carbohydrates and polyunsaturated fatty acids, significantly higher risks of T2D were observed (HRs per 1 energy% ranging from 1.05 to 1.15).ConclusionIn this Dutch population, total SFA does not relate to T2D risk. Rather, the association may depend on the types and food sources of SFA. Cheese-derived SFA and individual SFA that are commonly found in cheese, were significantly related to lower T2D risks. We cannot exclude the higher T2D risks found for soft and liquid fats derived SFA and for substituting SFA with other macronutrients are influenced by residual confounding by trans fatty acids or limited intake variation in polyunsaturated fatty acids and vegetable protein.
Highlights
Dietary guidelines recommend that intake of total saturated fatty acids (SFA) should not exceed 10% of energy per day [1, 2]
Associations between non-SFA fatty acids from specific food sources and type 2 diabetes (T2D) risk were fairly similar to associations between SFA from that food sources and T2D risk (Supplemental Table 5). In this large prospective cohort study of 37,421 participants, we found that the association between dietary SFA and risk of T2D is partly depending on the types and food sources of SFA
While no association was found for dietary total SFA, inverse associations with T2D were observed for dietary lauric acid, myristic acid, margaric acid and sum of odd-chains SFA, and cheese derived SFA
Summary
Dietary guidelines recommend that intake of total saturated fatty acids (SFA) should not exceed 10% of energy per day [1, 2]. Evidence is accumulating that the association between SFA and T2D might depend on carbon chain length, food sources and/or the substituting macronutrients, which have not been thoroughly studied yet [7, 8]. Individual SFA that differ in carbon chain length may have different associations with T2D risk. Only three studies have addressed the associations between intakes of individual SFA through self-reported dietary measurements and T2D [7, 9, 10]. These studies investigated a selection of individual SFA, and showed dissimilarities in the associations of individual SFA with T2D risk. Except for palmitic acid, the selection of SFA differed between the studies, which hampers the comparison between the studies
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