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Emily Sonestedt

Emily Sonestedt

Associate senior lecturer

Emily Sonestedt

The association between dietary intake, lifestyle and incident symptomatic peripheral arterial disease among individuals with diabetes mellitus : insights from the Malmö Diet and Cancer study


  • Erika Lilja
  • Sara Bergwall
  • Emily Sonestedt
  • Anders Gottsäter
  • Stefan Acosta

Summary, in English

With the rising prevalence of both diabetes mellitus (DM) and peripheral arterial disease (PAD), the aim of this project was to examine the association between dietary intake and lifestyle on the risk of developing PAD among individuals with DM. The Malmö Diet and Cancer study was a prospective cohort study with baseline examinations carried out between 1991 and 1996 in Malmö, Sweden (n = 30,446). Individuals with prevalent PAD and cardiovascular disease (prior stroke or myocardial infarction) were excluded from the study, resulting in a total study population of 1112 patients with prevalent DM. The diagnosis of incident PAD was validated and confirmed in 98% of patients. Of the 1112 individuals, 136 (12.2%) were diagnosed with PAD during a median follow up of 19.7 years (interquartile range 12.9–22.4). Kaplan–Meier analysis showed that men with DM more often developed incident PAD compared with women (cumulative incidences 15.5% and 8.9%, respectively, p = 0.012). In Cox multivariable regression analysis, smoking (hazard ratio of 1.96, 95% confidence interval of 1.28–3.00) was associated with increased risk of PAD, and there was a trend that a higher intake of fish and shellfish (hazard ratio per additional gram per week of 0.99, 95% confidence interval of 0.99–1.00; p = 0.051) was associated with a decreased risk of PAD. In conclusion, the present study demonstrated a trend towards a protective effect of higher intake of fish and shellfish upon incident symptomatic PAD among individuals with DM.


  • Vascular Diseases - Clinical Research
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health
  • Diabetes - Cardiovascular Disease

Publishing year







Therapeutic Advances in Endocrinology and Metabolism



Document type

Journal article


SAGE Publications


  • Endocrinology and Diabetes
  • Cardiac and Cardiovascular Systems


  • diabetes mellitus
  • diet
  • fish and shellfish
  • incident peripheral arterial disease



Research group

  • Vascular Diseases - Clinical Research
  • Diabetes - Cardiovascular Disease


  • ISSN: 2042-0188