Abstract
Most studies on dietary polyphenol intake and type 2 diabetes (T2D) risk have focused on total or specific subclasses of polyphenols. Since polyphenols are often consumed simultaneously, the joint effect of an intake of multiple subclasses should be explored. We aimed to identify profiles of the dietary polyphenol subclasses intake associated with T2D. A total of 60,586 women from the Etude Epidémiologique auprès de femmes de l’Education Nationale (E3N) cohort study were followed for 20 years between 1993 and 2014. T2D cases were identified and validated. The individual energy-adjusted daily intakes of 15 subclasses of polyphenols were estimated at baseline using a food frequency questionnaire and the PhenolExplorer database. We used Bayesian profile regression to perform the clustering of the covariates by identifying exposure profiles of polyphenol intakes and, simultaneously, link these to T2D risk by using multivariable Cox regression models. We validated 2740 incident T2D cases during follow-up, and identified 15 distinct clusters with different intake profiles and T2D risk. When compared to the largest cluster (n = 6298 women), higher risks of T2D were observed in three of those clusters, which were composed of women with low or medium intakes of anthocyanins, dihydroflavonols, catechins, flavonols, hydroxybenzoic acids, lignans, and stilbenes. One cluster (n = 4243), characterized by higher intakes of these polyphenol subclasses, exhibited lower T2D risk when compared to the reference cluster. These results highlight the importance of a varied diet of polyphenol-rich foods such as nuts, fruits, and vegetables to prevent T2D risk.
Highlights
Type 2 diabetes (T2D) is a lifelong disabling disease and its global prevalence continues to increase rapidly
Prior studies on dietary polyphenol intake and type 2 diabetes (T2D) risk reported a lower risk for higher total polyphenol intake, while mixed results were found in other studies that focused on specific subclasses of polyphenols [10]
Since polyphenols are ubiquitous in plant foods and beverages and are often consumed simultaneously, clustering approaches that account for highly correlated intakes are of interest to better clarify the associations between polyphenol intake and diabetes risk
Summary
Type 2 diabetes (T2D) is a lifelong disabling disease and its global prevalence continues to increase rapidly. Diet is one of the main lifestyle-related factors which can modulate the inflammatory process [3,4], and it is well known that the consumption of certain foods and nutrients. Polyphenols, bioactive compounds found in fruits and vegetables, have biological activities [7] which include modulation of the inflammatory signaling cascades and improved vascular function [7,8,9]. The role of polyphenol intake in the etiology of T2D has been widely investigated. Since polyphenols are ubiquitous in plant foods and beverages and are often consumed simultaneously, clustering approaches that account for highly correlated intakes are of interest to better clarify the associations between polyphenol intake and diabetes risk. We aimed to identify profiles of the polyphenol intake associated with
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