2
IRUS Total
Downloads

Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes: EPIC-InterAct case-cohort study in eight European countries

Title: Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes: EPIC-InterAct case-cohort study in eight European countries
Authors: Zheng, J-S
Sharp, SJ
Imamura, F
Chowdhury, R
Gundersen, TE
Steur, M
Sluijs, I
Schouw, YTVD
Agudo, A
Aune, D
Barricarte, A
Boeing, H
Chirlaque, M-D
Dorronsoro, M
Freisling, H
El-Fatouhi, D
Franks, PW
Fagherazzi, G
Grioni, S
Gunter, MJ
Kyro, C
Katzke, V
Kuhn, T
Khaw, K-T
Laouali, N
Masala, G
Nilsson, PM
Overvad, K
Panico, S
Papier, K
Quiros, JR
Rolandsson, O
Redondo-Sanchez, D
Ricceri, F
Schulze, MB
Spijkerman, AMW
Tjonneland, A
Tong, TYN
Tumino, R
Weiderpass, E
John, D
Butterworth, AS
Riboli, E
Forouhi, NG
Wareham, NJ
Item Type: Journal Article
Abstract: Objective To investigate the association of plasma vitamin C and carotenoids, as indicators of fruit and vegetable intake, with the risk of type 2 diabetes. Design Prospective case-cohort study. Setting Populations from eight European countries. Participants 9754 participants with incident type 2 diabetes, and a subcohort of 13 662 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort of 340 234 participants: EPIC-InterAct case-cohort study. Main outcome measure Incident type 2 diabetes. Results In a multivariable adjusted model, higher plasma vitamin C was associated with a lower risk of developing type 2 diabetes (hazard ratio per standard deviation 0.82, 95% confidence interval 0.76 to 0.89). A similar inverse association was shown for total carotenoids (hazard ratio per standard deviation 0.75, 0.68 to 0.82). A composite biomarker score (split into five equal groups), comprising vitamin C and individual carotenoids, was inversely associated with type 2 diabetes with hazard ratios 0.77, 0.66, 0.59, and 0.50 for groups 2-5 compared with group 1 (the lowest group). Self-reported median fruit and vegetable intake was 274 g/day, 396 g/day, and 508 g/day for participants in categories defined by groups 1, 3, and 5 of the composite biomarker score, respectively. One standard deviation difference in the composite biomarker score, equivalent to a 66 (95% confidence interval 61 to 71) g/day difference in total fruit and vegetable intake, was associated with a hazard ratio of 0.75 (0.67 to 0.83). This would be equivalent to an absolute risk reduction of 0.95 per 1000 person years of follow up if achieved across an entire population with the characteristics of the eight European countries included in this analysis. Conclusions These findings indicate an inverse association between plasma vitamin C, carotenoids, and their composite biomarker score, and incident type 2 diabetes in different European countries. These biomarkers are objective indicators of fruit and vegetable consumption, and suggest that diets rich in even modestly higher fruit and vegetable consumption could help to prevent development of type 2 diabetes.
Issue Date: 8-Jul-2020
Date of Acceptance: 2-Apr-2020
URI: http://hdl.handle.net/10044/1/86233
DOI: 10.1136/bmj.m2194
ISSN: 0959-535X
Publisher: BMJ Publishing Group
Journal / Book Title: BMJ: British Medical Journal
Volume: 370
Copyright Statement: © 2020 The Author(s). This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/.
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
BETA-CAROTENE SUPPLEMENTATION
VITAMIN-C
CARDIOVASCULAR-DISEASE
LEVEL CORRELATIONS
GUT MICROBIOTA
CANCER
RISK
METAANALYSIS
MELLITUS
HEALTH
Ascorbic Acid
Biomarkers
Carotenoids
Case-Control Studies
Diabetes Mellitus, Type 2
Diet
Europe
Female
Fruit
Humans
Male
Prospective Studies
Vegetables
Humans
Fruit
Vegetables
Diabetes Mellitus, Type 2
Ascorbic Acid
Carotenoids
Diet
Case-Control Studies
Prospective Studies
Europe
Female
Male
Biomarkers
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
BETA-CAROTENE SUPPLEMENTATION
VITAMIN-C
CARDIOVASCULAR-DISEASE
LEVEL CORRELATIONS
GUT MICROBIOTA
CANCER
RISK
METAANALYSIS
MELLITUS
HEALTH
General & Internal Medicine
1103 Clinical Sciences
1117 Public Health and Health Services
Publication Status: Published
Article Number: ARTN 2194
Appears in Collections:School of Public Health



This item is licensed under a Creative Commons License Creative Commons