A nutritional biomarker score of the Mediterranean diet and incident type 2 diabetes: Integrated analysis of data from the MedLey randomised controlled trial and the EPIC-InterAct case-cohort study

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A nutritional biomarker score of the Mediterranean diet and incident type 2 diabetes : Integrated analysis of data from the MedLey randomised controlled trial and the EPIC-InterAct case-cohort study

Sobiecki, Jakub G. (författare): MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom

Imamura, Fumiaki (författare): MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom

Davis, Courtney R. (författare): Alliance for Research in Exercise, Nutrition and Activity, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia

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Sharp, Stephen J. (författare): MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom

Koulman, Albert (författare): MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom; Nutritional Biomarker Laboratory, National Institute for Health Research Biomedical Research Centre, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom

Hodgson, Jonathan M. (författare): Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia; Medical School, University of Western Australia, Perth, Australia

Guevara, Marcela (författare): Navarra Public Health Institute, Pamplona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain

Schulze, Matthias B. (författare): Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; German Center for Diabetes Research (DZD), Neuherberg, Munich, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany

Zheng, Ju-Sheng (författare): MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom; Key Laboratory of Growth Regulation and Translation Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China

Agnoli, Claudia (författare): Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy

Bonet, Catalina (författare): Unit of Nutrition and Cancer, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Nutrition and Cancer Group, Bellvitge Biomedical Research Institute, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain,Bellvitge University Hospital-IDIBELL

Colorado-Yohar, Sandra M. (författare): CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain; Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia

Fagherazzi, Guy (författare): Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Insitute of Health, Strassen, Luxembourg; Center of Epidemiology, Population Health UMR 1018, Inserm, Paris South-Paris Saclay University, Gustave Roussy Institute, Villejuif, France,Centre for Research in Epidemiology and Population Health (CESP)

Franks, Paul W. (författare): Lund University,Lunds universitet,Genetisk och molekylär epidemiologi,Forskargrupper vid Lunds universitet,Genetic and Molecular Epidemiology,Lund University Research Groups

Gundersen, Thomas E. (författare): Vitas AS, Oslo, Norway

Jannasch, Franziska (författare): Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; German Center for Diabetes Research (DZD), Neuherberg, Munich, Germany

Kaaks, Rudolf (författare): Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany

Katzke, Verena (författare): Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany

Molina-Montes, Esther (författare): CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Institute of Nutrition and Food Technology (INYTA) 'José Mataix', Biomedical Research Centre, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain; Department of Nutrition and Food Science, University of Granada, Granada, Spain,Andalusian School Of Public Health (EASP)

Nilsson, Peter M. (författare): Lund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups

Palli, Domenico (författare): Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network-ISPRO, Florence, Italy

Panico, Salvatore (författare): Department of Mental, Physical Health and Preventive Medicine, University “L. Vanvitelli”, Naples, Italy,Second University of Napels

Papier, Keren (författare): Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom

Rolandsson, Olov (författare): Umeå University,Umeå universitet,Allmänmedicin

Sacerdote, Carlotta (författare): Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy

Tjønneland, Anne (författare): Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark

Tong, Tammy Y.N. (författare): Department of Mental, Physical Health and Preventive Medicine, University “L. Vanvitelli”, Naples, Italy,Second University of Napels

van der Schouw, Yvonne T. (författare): Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands

Danesh, John (författare): BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; British Heart Foundation Cambridge Centre of Excellence, Division of Cardiovascular Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Health Data Research UK Cambridge, University of Cambridge, Cambridge, United Kingdom

Butterworth, Adam S. (författare): BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom

Riboli, Elio (författare): School of Public Health, Imperial College London, London, United Kingdom

Murphy, Karen J. (författare): Alliance for Research in Exercise, Nutrition and Activity, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia

Wareham, Nicholas J. (författare): MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom

Forouhi, Nita G. (författare): MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom

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Public Library of Science (PLoS), 2023
2023
Engelska.
Ingår i: PLoS Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 20:4

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Background: Self-reported adherence to the Mediterranean diet has been modestly inversely associated with incidence of type 2 diabetes (T2D) in cohort studies. There is uncertainty about the validity and magnitude of this association due to subjective reporting of diet. The association has not been evaluated using an objectively measured biomarker of the Mediterranean diet.Methods and findings: We derived a biomarker score based on 5 circulating carotenoids and 24 fatty acids that discriminated between the Mediterranean or habitual diet arms of a parallel design, 6-month partial-feeding randomised controlled trial (RCT) conducted between 2013 and 2014, the MedLey trial (128 participants out of 166 randomised). We applied this biomarker score in an observational study, the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study, to assess the association of the score with T2D incidence over an average of 9.7 years of follow-up since the baseline (1991 to 1998). We included 22, 202 participants, of whom 9, 453 were T2D cases, with relevant biomarkers from an original case-cohort of 27, 779 participants sampled from a cohort of 340, 234 people. As a secondary measure of the Mediterranean diet, we used a score estimated from dietary-self report. Within the trial, the biomarker score discriminated well between the 2 arms; the cross-validated C-statistic was 0.88 (95% confidence interval (CI) 0.82 to 0.94). The score was inversely associated with incident T2D in EPIC-InterAct: the hazard ratio (HR) per standard deviation of the score was 0.71 (95% CI: 0.65 to 0.77) following adjustment for sociodemographic, lifestyle and medical factors, and adiposity. In comparison, the HR per standard deviation of the self-reported Mediterranean diet was 0.90 (95% CI: 0.86 to 0.95). Assuming the score was causally associated with T2D, higher adherence to the Mediterranean diet in Western European adults by 10 percentiles of the score was estimated to reduce the incidence of T2D by 11% (95% CI: 7% to 14%). The study limitations included potential measurement error in nutritional biomarkers, unclear specificity of the biomarker score to the Mediterranean diet, and possible residual confounding.Conclusions: These findings suggest that objectively assessed adherence to the Mediterranean diet is associated with lower risk of T2D and that even modestly higher adherence may have the potential to reduce the population burden of T2D meaningfully.

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Av lärosätet: Umeå universitet; Lunds universitet

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A nutritional biomarker score of the Mediterranean diet and incident type 2 diabetes : Integrated analysis of data from the MedLey randomised controlled trial and the EPIC-InterAct case-cohort study

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