Am J Epidemiol 2004; 159:73-82.
Copyright © 2004 by the Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Dietary Fat and the Risk of Clinical Type 2 Diabetes
The European Prospective Investigation of Cancer-Norfolk Study
1 Medical Research Council Epidemiology Unit, Cambridge, United Kingdom.
2 Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
3 Medical Research Council Dunn Human Nutrition Unit, Cambridge, United Kingdom.
The role of dietary fat in the etiology of type 2 diabetes remains uncertain. The authors investigated the association between dietary fat composition and risk of clinical type 2 diabetes in the European Prospective Investigation of Cancer-Norfolk study and identified food consumption patterns associated with dietary fat composition. Diet was assessed at baseline (1993–1997) using a semiquantitative food frequency questionnaire. From multiple sources of information, 414 incident cases of diabetes were identified among 23,631 men and women aged 40–78 years during 3–7 years of follow-up. The capture-recapture ascertainment level was 99%. The energy-adjusted dietary polyunsaturated:saturated fat ratio was inversely associated with the risk of diabetes (odds ratio (OR) = 0.84 per standard deviation change, 95% confidence interval (CI): 0.75, 0.94). Adjustment for age, sex, family history of diabetes, smoking, physical activity, total fat, protein, and alcohol attenuated the association (OR = 0.88, 95% CI: 0.78, 0.99), and it was no longer statistically significant after including body mass index and the waist:hip ratio (OR = 0.91, 95% CI: 0.81, 1.03). This prospective study showed that an increased dietary polyunsaturated:saturated fat ratio was associated with a reduced risk of diabetes, independent of age, sex, family history of diabetes, and other lifestyle factors.
diabetes mellitus; dietary fats; prospective studies
Abbreviations: Abbreviations: CI, confidence interval; EPIC, European Prospective Investigation of Cancer; HbA1c, glycated hemoglobin; OR, odds ratio; P:S ratio, polyunsaturated:saturated fat ratio.
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