Dietary fibre and incidence of type 2 diabetes in eight European countries: the EPIC-InterAct Study and a meta-analysis of prospective studies

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Title: Dietary fibre and incidence of type 2 diabetes in eight European countries: the EPIC-InterAct Study and a meta-analysis of prospective studies
Authors: Kuijsten, A
Aune, D
Schulze, MB
Norat, T
Van Woudenbergh, GJ
Beulens, JWJ
Sluijs, I
Spijkerman, AMW
Van der A, DL
Palli, D
Kühn, T
Wendt, A
Buijsse, B
Boeing, H
Pala, V
Amiano, P
Buckland, G
Huerta Castaño, JM
Tjønneland, A
Kyrø, C
Redondo, ML
Sacerdote, C
Sánchez, MJ
Fagherazzi, G
Balkau, B
Lajous, M
Panico, S
Franks, PW
Rolandsson, O
Nilsson, P
Orho-Melander, M
Overvad, K
Huybrechts, I
Slimani, N
Tumino, R
Barricarte, A
Key, TJ
Feskens, EJM
Langenberg, C
Sharp, S
Forouhi, NG
Riboli, E
Wareham, NJ
Item Type: Journal Article
Abstract: Aims/hypothesis: Intake of dietary fibre has been associated with a reduced risk of type 2 diabetes, but few European studies have been published on this. We evaluated the association between intake of dietary fibre and type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study and in a meta-analysis of prospective studies. Methods: During 10.8 years of follow-up, 11,559 participants with type 2 diabetes were identified and a subcohort of 15,258 participants was selected for the case-cohort study. Country-specific HRs were estimated using Prentice-weighted Cox proportional hazards models and were pooled using a random effects meta-analysis. Eighteen other cohort studies were identified for the meta-analysis. Results: In the EPIC-InterAct Study, dietary fibre intake was associated with a lower risk of diabetes (HR<inf>Q4 vs Q1</inf> 0.82; 95% CI 0.69, 0.97) after adjustment for lifestyle and dietary factors. Similar inverse associations were observed for the intake of cereal fibre and vegetable fibre, but not fruit fibre. The associations were attenuated and no longer statistically significant after adjustment for BMI. In the meta-analysis (19 cohorts), the summary RRs per 10 g/day increase in intake were 0.91 (95% CI 0.87, 0.96) for total fibre, 0.75 (95% CI 0.65, 0.86) for cereal fibre, 0.95 (95% CI 0.87, 1.03) for fruit fibre and 0.93 (95% CI 0.82, 1.05) for vegetable fibre. Conclusions/interpretation: The overall evidence indicates that the intake of total and cereal fibre is inversely related to the risk of type 2 diabetes. The results of the EPIC-InterAct Study suggest that the association may be partially explained by body weight.
Issue Date: 29-May-2015
Date of Acceptance: 16-Mar-2015
ISSN: 0012-186X
Publisher: Springer
Start Page: 1394
End Page: 1408
Journal / Book Title: Diabetologia
Volume: 58
Issue: 7
Copyright Statement: © 2015 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Endocrinology & Metabolism
1103 Clinical Sciences
1114 Paediatrics And Reproductive Medicine
1117 Public Health And Health Services
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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