The Association between Dietary Energy Density and Type 2 Diabetes in Europe

Results from the EPIC-InterAct Study

Saskia W. van den Berg, Daphne L. van der A, Annemieke M W Spijkerman, Geertruida J. van Woudenbergh, Mariken J. Tijhuis, Pilar Amiano, Eva Ardanaz, Joline W J Beulens, Heiner Boeing, Françoise Clavel-Chapelon, Francesca L. Crowe, Blandine de Lauzon-Guillain, Guy Fagherazzi, Paul W. Franks, Heinz Freisling, Carlos Gonzalez, Sara Grioni, Jytte Halkjaer, José María Huerta, Inge Huybrechts & 21 others Rudolf Kaaks, Kay Tee Khaw, Giovanna Masala, Peter M. Nilsson, Kim Overvad, Salvatore Panico, J. Ramón Quirós, Olov Rolandsson, Carlotta Sacerdote, María José Sánchez, Matthias B. Schulze, Nadia Slimani, Ellen A. Struijk, Anne Tjonneland, Rosario Tumino, Stephen J. Sharp, Claudia Langenberg, Nita G. Forouhi, Edith J M Feskens, Elio Riboli, Nicholas J. Wareham

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background:Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake.Methodology/Principal Findings:A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13), which was consistent across countries (I2 = 2.9%).Conclusions/Significance:In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases.

Original languageEnglish
Article numbere59947
JournalPLoS One
Volume8
Issue number5
DOIs
Publication statusPublished - May 16 2013

Fingerprint

energy density
Medical problems
noninsulin-dependent diabetes mellitus
Type 2 Diabetes Mellitus
neoplasms
Neoplasms
Beverages
Food
Cohort Studies
Food and Beverages
cohort studies
beverages
food intake
Energy Intake
Proportional Hazards Models
Weight Gain
Observational Studies
Meta-Analysis
Chronic Disease
Obesity

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

van den Berg, S. W., van der A, D. L., Spijkerman, A. M. W., van Woudenbergh, G. J., Tijhuis, M. J., Amiano, P., ... Wareham, N. J. (2013). The Association between Dietary Energy Density and Type 2 Diabetes in Europe: Results from the EPIC-InterAct Study. PLoS One, 8(5), [e59947]. https://doi.org/10.1371/journal.pone.0059947

The Association between Dietary Energy Density and Type 2 Diabetes in Europe : Results from the EPIC-InterAct Study. / van den Berg, Saskia W.; van der A, Daphne L.; Spijkerman, Annemieke M W; van Woudenbergh, Geertruida J.; Tijhuis, Mariken J.; Amiano, Pilar; Ardanaz, Eva; Beulens, Joline W J; Boeing, Heiner; Clavel-Chapelon, Françoise; Crowe, Francesca L.; de Lauzon-Guillain, Blandine; Fagherazzi, Guy; Franks, Paul W.; Freisling, Heinz; Gonzalez, Carlos; Grioni, Sara; Halkjaer, Jytte; Huerta, José María; Huybrechts, Inge; Kaaks, Rudolf; Khaw, Kay Tee; Masala, Giovanna; Nilsson, Peter M.; Overvad, Kim; Panico, Salvatore; Quirós, J. Ramón; Rolandsson, Olov; Sacerdote, Carlotta; Sánchez, María José; Schulze, Matthias B.; Slimani, Nadia; Struijk, Ellen A.; Tjonneland, Anne; Tumino, Rosario; Sharp, Stephen J.; Langenberg, Claudia; Forouhi, Nita G.; Feskens, Edith J M; Riboli, Elio; Wareham, Nicholas J.

In: PLoS One, Vol. 8, No. 5, e59947, 16.05.2013.

Research output: Contribution to journalArticle

van den Berg, SW, van der A, DL, Spijkerman, AMW, van Woudenbergh, GJ, Tijhuis, MJ, Amiano, P, Ardanaz, E, Beulens, JWJ, Boeing, H, Clavel-Chapelon, F, Crowe, FL, de Lauzon-Guillain, B, Fagherazzi, G, Franks, PW, Freisling, H, Gonzalez, C, Grioni, S, Halkjaer, J, Huerta, JM, Huybrechts, I, Kaaks, R, Khaw, KT, Masala, G, Nilsson, PM, Overvad, K, Panico, S, Quirós, JR, Rolandsson, O, Sacerdote, C, Sánchez, MJ, Schulze, MB, Slimani, N, Struijk, EA, Tjonneland, A, Tumino, R, Sharp, SJ, Langenberg, C, Forouhi, NG, Feskens, EJM, Riboli, E & Wareham, NJ 2013, 'The Association between Dietary Energy Density and Type 2 Diabetes in Europe: Results from the EPIC-InterAct Study', PLoS One, vol. 8, no. 5, e59947. https://doi.org/10.1371/journal.pone.0059947
van den Berg SW, van der A DL, Spijkerman AMW, van Woudenbergh GJ, Tijhuis MJ, Amiano P et al. The Association between Dietary Energy Density and Type 2 Diabetes in Europe: Results from the EPIC-InterAct Study. PLoS One. 2013 May 16;8(5). e59947. https://doi.org/10.1371/journal.pone.0059947
van den Berg, Saskia W. ; van der A, Daphne L. ; Spijkerman, Annemieke M W ; van Woudenbergh, Geertruida J. ; Tijhuis, Mariken J. ; Amiano, Pilar ; Ardanaz, Eva ; Beulens, Joline W J ; Boeing, Heiner ; Clavel-Chapelon, Françoise ; Crowe, Francesca L. ; de Lauzon-Guillain, Blandine ; Fagherazzi, Guy ; Franks, Paul W. ; Freisling, Heinz ; Gonzalez, Carlos ; Grioni, Sara ; Halkjaer, Jytte ; Huerta, José María ; Huybrechts, Inge ; Kaaks, Rudolf ; Khaw, Kay Tee ; Masala, Giovanna ; Nilsson, Peter M. ; Overvad, Kim ; Panico, Salvatore ; Quirós, J. Ramón ; Rolandsson, Olov ; Sacerdote, Carlotta ; Sánchez, María José ; Schulze, Matthias B. ; Slimani, Nadia ; Struijk, Ellen A. ; Tjonneland, Anne ; Tumino, Rosario ; Sharp, Stephen J. ; Langenberg, Claudia ; Forouhi, Nita G. ; Feskens, Edith J M ; Riboli, Elio ; Wareham, Nicholas J. / The Association between Dietary Energy Density and Type 2 Diabetes in Europe : Results from the EPIC-InterAct Study. In: PLoS One. 2013 ; Vol. 8, No. 5.
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abstract = "Background:Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake.Methodology/Principal Findings:A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95{\%} CI: 0.93-1.13), which was consistent across countries (I2 = 2.9{\%}).Conclusions/Significance:In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases.",
author = "{van den Berg}, {Saskia W.} and {van der A}, {Daphne L.} and Spijkerman, {Annemieke M W} and {van Woudenbergh}, {Geertruida J.} and Tijhuis, {Mariken J.} and Pilar Amiano and Eva Ardanaz and Beulens, {Joline W J} and Heiner Boeing and Fran{\cc}oise Clavel-Chapelon and Crowe, {Francesca L.} and {de Lauzon-Guillain}, Blandine and Guy Fagherazzi and Franks, {Paul W.} and Heinz Freisling and Carlos Gonzalez and Sara Grioni and Jytte Halkjaer and Huerta, {Jos{\'e} Mar{\'i}a} and Inge Huybrechts and Rudolf Kaaks and Khaw, {Kay Tee} and Giovanna Masala and Nilsson, {Peter M.} and Kim Overvad and Salvatore Panico and Quir{\'o}s, {J. Ram{\'o}n} and Olov Rolandsson and Carlotta Sacerdote and S{\'a}nchez, {Mar{\'i}a Jos{\'e}} and Schulze, {Matthias B.} and Nadia Slimani and Struijk, {Ellen A.} and Anne Tjonneland and Rosario Tumino and Sharp, {Stephen J.} and Claudia Langenberg and Forouhi, {Nita G.} and Feskens, {Edith J M} and Elio Riboli and Wareham, {Nicholas J.}",
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TY - JOUR

T1 - The Association between Dietary Energy Density and Type 2 Diabetes in Europe

T2 - Results from the EPIC-InterAct Study

AU - van den Berg, Saskia W.

AU - van der A, Daphne L.

AU - Spijkerman, Annemieke M W

AU - van Woudenbergh, Geertruida J.

AU - Tijhuis, Mariken J.

AU - Amiano, Pilar

AU - Ardanaz, Eva

AU - Beulens, Joline W J

AU - Boeing, Heiner

AU - Clavel-Chapelon, Françoise

AU - Crowe, Francesca L.

AU - de Lauzon-Guillain, Blandine

AU - Fagherazzi, Guy

AU - Franks, Paul W.

AU - Freisling, Heinz

AU - Gonzalez, Carlos

AU - Grioni, Sara

AU - Halkjaer, Jytte

AU - Huerta, José María

AU - Huybrechts, Inge

AU - Kaaks, Rudolf

AU - Khaw, Kay Tee

AU - Masala, Giovanna

AU - Nilsson, Peter M.

AU - Overvad, Kim

AU - Panico, Salvatore

AU - Quirós, J. Ramón

AU - Rolandsson, Olov

AU - Sacerdote, Carlotta

AU - Sánchez, María José

AU - Schulze, Matthias B.

AU - Slimani, Nadia

AU - Struijk, Ellen A.

AU - Tjonneland, Anne

AU - Tumino, Rosario

AU - Sharp, Stephen J.

AU - Langenberg, Claudia

AU - Forouhi, Nita G.

AU - Feskens, Edith J M

AU - Riboli, Elio

AU - Wareham, Nicholas J.

PY - 2013/5/16

Y1 - 2013/5/16

N2 - Background:Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake.Methodology/Principal Findings:A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13), which was consistent across countries (I2 = 2.9%).Conclusions/Significance:In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases.

AB - Background:Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake.Methodology/Principal Findings:A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13), which was consistent across countries (I2 = 2.9%).Conclusions/Significance:In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases.

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