Abstract
PurposeInter-individual metabolic differences may be a reason for previously inconsistent results in diet–diabetes associations. We aimed to investigate associations between dietary intake and diabetes for metabolically homogeneous subgroups (‘metabotypes’) in a large cross-sectional study.MethodsWe used data of 1517 adults aged 38–87 years from the German population-based KORA FF4 study (2013/2014). Dietary intake was estimated based on the combination of a food frequency questionnaire and multiple 24-h food lists. Glucose tolerance status was classified based on an oral glucose tolerance test in participants without a previous diabetes diagnosis using American Diabetes Association criteria. Logistic regression was applied to examine the associations between dietary intake and diabetes for two distinct metabotypes, which were identified based on 16 biochemical and anthropometric parameters.ResultsA low intake of fruits and a high intake of total meat, processed meat and sugar-sweetened beverages (SSB) were significantly associated with diabetes in the total study population. Stratified by metabotype, associations with diabetes remained significant for intake of total meat (OR 1.67, 95% CI 1.04–2.67) and processed meat (OR 2.23, 95% CI 1.24–4.04) in the metabotypes with rather favorable metabolic characteristics, and for intake of fruits (OR 0.83, 95% CI 0.68–0.99) and SSB (OR:1.21, 95% CI 1.09–1.35) in the more unfavorable metabotype. However, only the association between SSB intake and diabetes differed significantly by metabotype (p value for interaction = 0.01).ConclusionsOur findings suggest an influence of metabolic characteristics on diet–diabetes associations, which may help to explain inconsistent previous results. The causality of the observed associations needs to be confirmed in prospective and intervention studies.
Highlights
Type 2 diabetes mellitus (T2DM) with its adverse health consequences for individuals and its financial burden on healthcare systems is an important public health issue worldwide [1, 2]
The number of individuals at each stage of our analysis is shown in the flow chart in Supplemental Fig. 1 provided in the Online Resource, leaving a final study population of 1517 individuals for the analysis of diet–diabetes associations
In the KORA FF4 study population, a low intake of fruits and a high intake of total meat, processed meat and sugar-sweetened beverages (SSB) were significantly associated with UDM/prevalent T2DM
Summary
Type 2 diabetes mellitus (T2DM) with its adverse health consequences for individuals and its financial burden on healthcare systems is an important public health issue worldwide [1, 2]. Extended author information available on the last page of the article unhealthy lifestyle [1, 3]. It has to be assumed that the actual prevalence of T2DM is even higher due to a large number of undiagnosed individuals [4, 5]. For example in dietary behavior, may prevent or delay the development of T2DM [6,7,8]. Previous studies investigating the impact of food on the risk of T2DM have shown inconsistent results [9, 10]
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