Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • Franziska Jannasch, NutriAct-Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany., Germany
  • Janine Kröger, German Center for Diabetes Research (DZD), München-Neuherberg, Germany., Germany
  • Claudia Agnoli, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Italy
  • Aurelio Barricarte, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain., Spain
  • Heiner Boeing, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, 14558, Germany., Germany
  • Valerie Cayssials, Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology (ICO), Avda Gran Via 199-203, L'Hospitalet del Llobregat, 08907 Barcelona, Spain., Spain
  • Sandra Colorado-Yohar, Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia., Colombia
  • Christina C Dahm
  • Courtney Dow, Inserm, Centre for Research in Epidemiology and Population Health [CESP], Villejuif, France; Université Paris-Sud, Villejuif, France., France
  • Guy Fagherazzi, Inserm, Centre for Research in Epidemiology and Population Health [CESP], Villejuif, France; Université Paris-Sud, Villejuif, France., France
  • Paul W Franks, 7Occupational and Environmental Medicine,Department of Public Health and Clinical Medicine,Umeå University,Umeå,Sweden., Sweden
  • Heinz Freisling, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Marc J Gunter, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Nicola D Kerrison, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom., United Kingdom
  • Timothy J Key, Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom., United Kingdom
  • Kay-Tee Khaw, Department of Public Health and Primary Care, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom, United Kingdom
  • Tilman Kühn, German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, 69120 Heidelberg, Germany. V.Katzke@Dkfz-Heidelberg.de., Germany
  • Cecilie Kyro, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark., Denmark
  • Francesca Romana Mancini, Inserm, Centre for Research in Epidemiology and Population Health [CESP], Villejuif, France; Université Paris-Sud, Villejuif, France., France
  • Olatz Mokoroa, Public Health Division of Gipuzkoa, Basque Government, Spain; Health Research Institute, Biodonostia, San Sebastián, Spain., Spain
  • Peter Nilsson, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden., Sweden
  • Kim Overvad
  • Domenico Palli, Cancer Risk Factors and Life-Style Epidemiology Unit. Institute for Cancer Research, Prevention and Clinical Network - ISPRO, 50141, Florence, Italy., Italy
  • Salvatore Panico, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Federico II University, Naples, Italy., Italy
  • Jose Ramón Quirós García, Public Health Directorate, Asturias, Spain., Spain
  • Olov Rolandsson, 7Occupational and Environmental Medicine,Department of Public Health and Clinical Medicine,Umeå University,Umeå,Sweden., Sweden
  • Carlotta Sacerdote, Center for Cancer Prevention, Torino, Italy Human Genetics Foundation (HuGeF), Torino, Italy., Italy
  • Mariá-José Sánchez, Andalusian School of Public Health, Granada, Spain., Spain
  • Mohammad Sediq Sahrai, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Ruth Schübel, German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, 69120 Heidelberg, Germany. V.Katzke@Dkfz-Heidelberg.de., Germany
  • Ivonne Sluijs, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands., Netherlands
  • Annemieke M W Spijkerman, Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands., Netherlands
  • Anne Tjonneland, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark., Denmark
  • Tammy Y N Tong, Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom., United Kingdom
  • Rosario Tumino, 1] Histopathology Unit, 'Civic MP Arezzo' Hospital, ASP Ragusa, Italy [2] Associazone Iblea per la Ricerca Epidemiologica-Onlus, Ragusa, Italy., Italy
  • Elio Riboli, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom., United Kingdom
  • Claudia Langenberg, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom., United Kingdom
  • Stephen J Sharp, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom., United Kingdom
  • Nita G Forouhi, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom., United Kingdom
  • Matthias B Schulze, Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany., Germany
  • Nicholas J Wareham, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom., United Kingdom

BACKGROUND: Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence.

OBJECTIVE: The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries.

METHODS: Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association.

RESULTS: Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea.

CONCLUSIONS: Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses.

Original languageEnglish
JournalThe Journal of Nutrition
Volume149
Issue6
Pages (from-to)1047-1055
Number of pages9
ISSN0022-3166
DOIs
Publication statusPublished - 1 Jun 2019

    Research areas

  • dietary patterns, principal component analysis, diet-disease association, type 2 diabetes mellitus, replication, meta-analysis

See relations at Aarhus University Citationformats

ID: 155392289