The Association Between Dietary Flavonoid and Lignan Intakes and Incident Type 2 Diabetes in European Populations

  • Raul Zamora-Ros
    Medical Research Council, Epidemiology Unit, Cambridge, U.K.
  • Nita G. Forouhi
    Medical Research Council, Epidemiology Unit, Cambridge, U.K.
  • Stephen J. Sharp
    Medical Research Council, Epidemiology Unit, Cambridge, U.K.
  • Carlos A. González
    Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, Barcelona, Spain
  • Brian Buijsse
    Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
  • Marcela Guevara
    Navarre Public Health Institute, Pamplona, Spain
  • Yvonne T. van der Schouw
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
  • Pilar Amiano
    CIBER Epidemiología y Salud Pública, Madrid, Spain
  • Heiner Boeing
    Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
  • Lea Bredsdorff
    National Food Institute, Technical University of Denmark, Moerkhoej, Denmark
  • Françoise Clavel-Chapelon
    INSERM, Centre for Research in Epidemiology and Population Health, U1018, Nutrition, Hormones and Women's Health, Villejuif, France
  • Guy Fagherazzi
    INSERM, Centre for Research in Epidemiology and Population Health, U1018, Nutrition, Hormones and Women's Health, Villejuif, France
  • Edith J. Feskens
    Division of Human Nutrition, Section of Nutrition and Epidemiology, University of Wageningen, Wageningen, the Netherlands
  • Paul W. Franks
    Genetic and Molecular Epidemiology Unit, Clinical Research Center, Skåne University Hospital, Lund University, Malmö, Sweden
  • Sara Grioni
    Nutritional Epidemiology Unit, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan, Italy
  • Verena Katzke
    Department of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
  • Timothy J. Key
    Cancer Epidemiology Unit, University of Oxford, Oxford, U.K.
  • Kay-Tee Khaw
    Department of Public Health and Primary Care, University of Cambridge, Cambridge, U.K.
  • Tilman Kühn
    Department of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
  • Giovanna Masala
    Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute, Florence, Italy
  • Amalia Mattiello
    Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
  • Esther Molina-Montes
    CIBER Epidemiología y Salud Pública, Madrid, Spain
  • Peter M. Nilsson
    Department of Clinical Sciences, Lund University, Malmö, Sweden
  • Kim Overvad
    Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
  • Florence Perquier
    INSERM, Centre for Research in Epidemiology and Population Health, U1018, Nutrition, Hormones and Women's Health, Villejuif, France
  • J. Ramón Quirós
    Public Health Directorate, Asturias, Spain
  • Isabelle Romieu
    Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
  • Carlotta Sacerdote
    Center for Cancer Prevention in Piemonte, and Human Genetic Foundation, Torino, Italy
  • Augustin Scalbert
    Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
  • Matthias Schulze
    Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
  • Nadia Slimani
    Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
  • Annemieke M.W. Spijkerman
    National Institute for Public Health and the Environment, Bilthoven, the Netherlands
  • Anne Tjonneland
    Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
  • Maria Jose Tormo
    CIBER Epidemiología y Salud Pública, Madrid, Spain
  • Rosario Tumino
    Cancer Registry and Histopathology Unit, “Civile M.P. Arezzo” Hospital, ASP Ragusa, Italy
  • Daphne L. van der A
    Epidemiology Department, Murcia Regional Health Council, Murcia, Spain
  • Claudia Langenberg
    Medical Research Council, Epidemiology Unit, Cambridge, U.K.
  • Elio Riboli
    School of Public Health, Imperial College, London, U.K.
  • Nicholas J. Wareham
    Medical Research Council, Epidemiology Unit, Cambridge, U.K.

抄録

<jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>To study the association between dietary flavonoid and lignan intakes, and the risk of development of type 2 diabetes among European populations.</jats:p> </jats:sec> <jats:sec> <jats:title>RESEARCH DESIGN AND METHODS</jats:title> <jats:p>The European Prospective Investigation into Cancer and Nutrition-InterAct case-cohort study included 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants from among 340,234 participants with 3.99 million person-years of follow-up in eight European countries. At baseline, country-specific validated dietary questionnaires were used. A flavonoid and lignan food composition database was developed from the Phenol-Explorer, the U.K. Food Standards Agency, and the U.S. Department of Agriculture databases. Hazard ratios (HRs) from country-specific Prentice-weighted Cox regression models were pooled using random-effects meta-analysis.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>In multivariable models, a trend for an inverse association between total flavonoid intake and type 2 diabetes was observed (HR for the highest vs. the lowest quintile, 0.90 [95% CI 0.77–1.04]; P valuetrend = 0.040), but not with lignans (HR 0.88 [95% CI 0.72–1.07]; P valuetrend = 0.119). Among flavonoid subclasses, flavonols (HR 0.81 [95% CI 0.69–0.95]; P valuetrend = 0.020) and flavanols (HR 0.82 [95% CI 0.68–0.99]; P valuetrend = 0.012), including flavan-3-ol monomers (HR 0.73 [95% CI 0.57–0.93]; P valuetrend = 0.029), were associated with a significantly reduced hazard of diabetes.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Prospective findings in this large European cohort demonstrate inverse associations between flavonoids, particularly flavanols and flavonols, and incident type 2 diabetes. This suggests a potential protective role of eating a diet rich in flavonoids, a dietary pattern based on plant-based foods, in the prevention of type 2 diabetes.</jats:p> </jats:sec>

収録刊行物

  • Diabetes Care

    Diabetes Care 36 (12), 3961-3970, 2013-11-13

    American Diabetes Association

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