Dietary Protein Intake and Incidence of Type 2 Diabetes in Europe: The EPIC-InterAct Case-Cohort Study
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- Monique van Nielen
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
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- Edith J.M. Feskens
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
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- Marco Mensink
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
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- Ivonne Sluijs
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands
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- Esther Molina
- Andalusian School of Public Health, Granada, Spain
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- Pilar Amiano
- Public Health Division of Gipuzkoa, San Sebastian, Spain
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- Eva Ardanaz
- CIBER Epidemiología y Salud Pública, Madrid, Spain
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- Beverly Balkau
- Inserm, Centre for Research in Epidemiology and Population Health, Villejuif, France
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- Joline W.J. Beulens
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands
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- Heiner Boeing
- German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
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- Françoise Clavel-Chapelon
- Inserm, Centre for Research in Epidemiology and Population Health, Villejuif, France
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- Guy Fagherazzi
- Inserm, Centre for Research in Epidemiology and Population Health, Villejuif, France
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- Paul W. Franks
- Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
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- Jytte Halkjaer
- Danish Cancer Society Research Center, Copenhagen, Denmark
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- José Maria Huerta
- CIBER Epidemiología y Salud Pública, Madrid, Spain
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- Verena Katzke
- German Cancer Research Center, Heidelberg, Germany
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- Timothy J. Key
- Cancer Epidemiology Unit, University of Oxford, Oxford, U.K.
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- Kay Tee Khaw
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.
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- Vittorio Krogh
- National Cancer Institute, Milan, Italy
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- Tilman Kühn
- German Cancer Research Center, Heidelberg, Germany
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- Virginia V.M. Menéndez
- Public Health Directorate, Asturias, Spain
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- Peter Nilsson
- Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
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- Kim Overvad
- School of Public Health, Aarhus University, Denmark
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- Domenico Palli
- Cancer Research and Prevention Institute, Florence, Italy
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- Salvatore Panico
- Dipartimento di medicina clinica e chirurgia, federico ii University, Naples, Italy
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- Olov Rolandsson
- Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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- Isabelle Romieu
- International Agency for Research on Cancer, Lyon, France
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- Carlotta Sacerdote
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza-University of Turin and Center for Cancer Prevention, Turin, Italy
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- Maria-José Sánchez
- Andalusian School of Public Health, Granada, Spain
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- Matthias B. Schulze
- German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
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- Annemieke M.W. Spijkerman
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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- Anne Tjonneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
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- Rosario Tumino
- Cancer Registry and Histopathology Unit, Ragusa, Italy
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- Daphne L. van der A
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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- Anne M.L. Würtz
- School of Public Health, Aarhus University, Denmark
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- Raul Zamora-Ros
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, Barcelona, Spain
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- Claudia Langenberg
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.
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- Stephen J. Sharp
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.
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- Nita G. Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K.
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- Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K.
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- 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 < 0.001) and animal protein (per 10 g: 1.05 [1.02–1.08], Ptrend = 0.001). Effect modification by sex (P < 0.001) and BMI among women (P < 0.001) was observed. Compared with the overall analyses, associations were stronger in women, more specifically obese women with a BMI >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
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- Diabetes Care
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Diabetes Care 37 (7), 1854-1862, 2014-06-12
American Diabetes Association