Clusters of carbohydrate-rich foods and associations with type 2 diabetes incidence: a prospective cohort study
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Clusters of carbohydrate-rich foods and associations with type 2 diabetes incidence: a prospective cohort study. / Olsson, Kjell; González-Padilla, Esther; Janzi, Suzanne; Stubbendorff, Anna; Borné, Yan; Ramne, Stina; Ericson, Ulrika; Sonestedt, Emily.
In: Nutrition Journal, Vol. 22, No. 1, 18.12.2023, p. 71.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Clusters of carbohydrate-rich foods and associations with type 2 diabetes incidence: a prospective cohort study
AU - Olsson, Kjell
AU - González-Padilla, Esther
AU - Janzi, Suzanne
AU - Stubbendorff, Anna
AU - Borné, Yan
AU - Ramne, Stina
AU - Ericson, Ulrika
AU - Sonestedt, Emily
N1 - © 2023. The Author(s).
PY - 2023/12/18
Y1 - 2023/12/18
N2 - BACKGROUND: About one in ten adults are living with diabetes worldwide. Intake of carbohydrates and carbohydrate-rich foods are often identified as modifiable risk factors for incident type 2 diabetes. However, strong correlation between food variables can make it difficult to identify true associations. The purpose of this study was to identify clusters of carbohydrate-rich foods and analyse their associations with type 2 diabetes incidence in the Malmö Diet and Cancer Study cohort in southern Sweden.METHODS: Dietary intake of 26 622 participants was assessed using a validated three-part diet history method: a 7-day food diary, a 168-item food frequency questionnaire, and a 60-minute interview. K-means clustering analysis identified five clusters from 21 food variables. The Cox proportional hazard regression model was applied to calculate hazard ratios (HR) and 95% confidence intervals (CI) of the association between clusters and incident type 2 diabetes.RESULTS: The cluster analysis resulted in five clusters; high vegetables/low added sugar, high sugar-sweetened beverages, high juice, high fruit, and high refined carbohydrates/low fruit & vegetables (reference). During mean follow-up of 18 years, 4046 type 2 diabetes cases were identified. After adjustment for potential confounding (including lifestyle, body mass index, and diet), a high fruit cluster (HR 0.86; 95% CI 0.78, 0.94) was inversely associated with type 2 diabetes compared to the reference cluster. No other significant associations were identified.CONCLUSIONS: A dietary pattern defined by a high intake of fruits was associated with a lower incidence of type 2 diabetes. The findings provide additional evidence of a potential protective effect from fruit intake in reducing type 2 diabetes risk. Future studies are needed to explore this association further.
AB - BACKGROUND: About one in ten adults are living with diabetes worldwide. Intake of carbohydrates and carbohydrate-rich foods are often identified as modifiable risk factors for incident type 2 diabetes. However, strong correlation between food variables can make it difficult to identify true associations. The purpose of this study was to identify clusters of carbohydrate-rich foods and analyse their associations with type 2 diabetes incidence in the Malmö Diet and Cancer Study cohort in southern Sweden.METHODS: Dietary intake of 26 622 participants was assessed using a validated three-part diet history method: a 7-day food diary, a 168-item food frequency questionnaire, and a 60-minute interview. K-means clustering analysis identified five clusters from 21 food variables. The Cox proportional hazard regression model was applied to calculate hazard ratios (HR) and 95% confidence intervals (CI) of the association between clusters and incident type 2 diabetes.RESULTS: The cluster analysis resulted in five clusters; high vegetables/low added sugar, high sugar-sweetened beverages, high juice, high fruit, and high refined carbohydrates/low fruit & vegetables (reference). During mean follow-up of 18 years, 4046 type 2 diabetes cases were identified. After adjustment for potential confounding (including lifestyle, body mass index, and diet), a high fruit cluster (HR 0.86; 95% CI 0.78, 0.94) was inversely associated with type 2 diabetes compared to the reference cluster. No other significant associations were identified.CONCLUSIONS: A dietary pattern defined by a high intake of fruits was associated with a lower incidence of type 2 diabetes. The findings provide additional evidence of a potential protective effect from fruit intake in reducing type 2 diabetes risk. Future studies are needed to explore this association further.
KW - Adult
KW - Humans
KW - Diabetes Mellitus, Type 2/epidemiology
KW - Prospective Studies
KW - Diet/adverse effects
KW - Risk Factors
KW - Fruit
KW - Vegetables
KW - Incidence
KW - Carbohydrates
U2 - 10.1186/s12937-023-00906-0
DO - 10.1186/s12937-023-00906-0
M3 - Journal article
C2 - 38111004
VL - 22
SP - 71
JO - Nutrition Journal
JF - Nutrition Journal
SN - 1475-2891
IS - 1
ER -
ID: 396726701