Dietary Protein Intake and Incidence of Type 2 Diabetes in Europe: The EPIC-InterAct Case-Cohort Study

  • Monique van Nielen
    Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
  • Edith J.M. Feskens
    Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
  • Marco Mensink
    Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
  • Ivonne Sluijs
    Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands
  • Esther Molina
    Andalusian School of Public Health, Granada, Spain
  • Pilar Amiano
    Public Health Division of Gipuzkoa, San Sebastian, Spain
  • Eva Ardanaz
    CIBER Epidemiología y Salud Pública, Madrid, Spain
  • Beverly Balkau
    Inserm, Centre for Research in Epidemiology and Population Health, Villejuif, France
  • Joline W.J. Beulens
    Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands
  • Heiner Boeing
    German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
  • Françoise Clavel-Chapelon
    Inserm, Centre for Research in Epidemiology and Population Health, Villejuif, France
  • Guy Fagherazzi
    Inserm, Centre for Research in Epidemiology and Population Health, Villejuif, France
  • Paul W. Franks
    Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
  • Jytte Halkjaer
    Danish Cancer Society Research Center, Copenhagen, Denmark
  • José Maria Huerta
    CIBER Epidemiología y Salud Pública, Madrid, Spain
  • Verena Katzke
    German Cancer Research Center, Heidelberg, Germany
  • Timothy J. Key
    Cancer Epidemiology Unit, University of Oxford, Oxford, U.K.
  • Kay Tee Khaw
    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.
  • Vittorio Krogh
    National Cancer Institute, Milan, Italy
  • Tilman Kühn
    German Cancer Research Center, Heidelberg, Germany
  • Virginia V.M. Menéndez
    Public Health Directorate, Asturias, Spain
  • Peter Nilsson
    Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
  • Kim Overvad
    School of Public Health, Aarhus University, Denmark
  • Domenico Palli
    Cancer Research and Prevention Institute, Florence, Italy
  • Salvatore Panico
    Dipartimento di medicina clinica e chirurgia, federico ii University, Naples, Italy
  • Olov Rolandsson
    Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
  • Isabelle Romieu
    International Agency for Research on Cancer, Lyon, France
  • Carlotta Sacerdote
    Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza-University of Turin and Center for Cancer Prevention, Turin, Italy
  • Maria-José Sánchez
    Andalusian School of Public Health, Granada, Spain
  • Matthias B. Schulze
    German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
  • Annemieke M.W. Spijkerman
    National Institute for Public Health and the Environment, Bilthoven, the Netherlands
  • Anne Tjonneland
    Danish Cancer Society Research Center, Copenhagen, Denmark
  • Rosario Tumino
    Cancer Registry and Histopathology Unit, Ragusa, Italy
  • Daphne L. van der A
    National Institute for Public Health and the Environment, Bilthoven, the Netherlands
  • Anne M.L. Würtz
    School of Public Health, Aarhus University, Denmark
  • Raul Zamora-Ros
    Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, Barcelona, Spain
  • Claudia Langenberg
    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.
  • Stephen J. Sharp
    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.
  • Nita G. Forouhi
    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.
  • Elio Riboli
    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K.
  • Nicholas J. Wareham
    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.

抄録

<jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>The long-term association between dietary protein and type 2 diabetes incidence is uncertain. We aimed to investigate the association between total, animal, and plant protein intake and the incidence of type 2 diabetes.</jats:p> </jats:sec> <jats:sec> <jats:title>RESEARCH DESIGN AND METHODS</jats:title> <jats:p>The prospective European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from eight European countries, with an average follow-up time of 12.0 years. Pooled country-specific hazard ratios (HRs) and 95% CI of prentice-weighted Cox regression analyses were used to estimate type 2 diabetes incidence according to protein intake.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>After adjustment for important diabetes risk factors and dietary factors, the incidence of type 2 diabetes was higher in those with high intake of total protein (per 10 g: HR 1.06 [95% CI 1.02–1.09], Ptrend &lt; 0.001) and animal protein (per 10 g: 1.05 [1.02–1.08], Ptrend = 0.001). Effect modification by sex (P &lt; 0.001) and BMI among women (P &lt; 0.001) was observed. Compared with the overall analyses, associations were stronger in women, more specifically obese women with a BMI &gt;30 kg/m2 (per 10 g animal protein: 1.19 [1.09–1.32]), and nonsignificant in men. Plant protein intake was not associated with type 2 diabetes (per 10 g: 1.04 [0.93–1.16], Ptrend = 0.098).</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>High total and animal protein intake was associated with a modest elevated risk of type 2 diabetes in a large cohort of European adults. In view of the rapidly increasing prevalence of type 2 diabetes, limiting iso-energetic diets high in dietary proteins, particularly from animal sources, should be considered.</jats:p> </jats:sec>

収録刊行物

  • Diabetes Care

    Diabetes Care 37 (7), 1854-1862, 2014-06-12

    American Diabetes Association

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