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Dietary Protein Intake and Incidence of Type 2 Diabetes in Europe: The EPIC-InterAct Case-Cohort Study

Author:
  • Monique van Nielen
  • Edith J. M. Feskens
  • Marco Mensink
  • Ivonne Sluijs
  • Esther Molina
  • Pilar Amiano
  • Eva Ardanaz
  • Beverly Balkau
  • Joline W. J. Beulens
  • Heiner Boeing
  • Francoise Clavel-Chapelon
  • Guy Fagherazzi
  • Paul Franks
  • Jytte Halkjaer
  • Jose Maria Huerta
  • Verena Katzke
  • Timothy J. Key
  • Kay Tee Khaw
  • Vittorio Krogh
  • Tilman Kuhn
  • Virginia V. M. Menendez
  • Peter Nilsson
  • Kim Overvad
  • Domenico Palli
  • Salvatore Panico
  • Olov Rolandsson
  • Isabelle Romieu
  • Carlotta Sacerdote
  • Maria-Jose Sanchez
  • Matthias B. Schulze
  • Annemieke M. W. Spijkerman
  • Anne Tjonneland
  • Rosario Tumino
  • L. van der A. Daphne
  • Anne M. L. Wurtz
  • Raul Zamora-Ros
  • Claudia Langenberg
  • Stephen J. Sharp
  • Nita G. Forouhi
  • Elio Riboli
  • Nicholas J. Wareham
Publishing year: 2014
Language: English
Pages: 1854-1862
Publication/Series: Diabetes Care
Volume: 37
Issue: 7
Document type: Journal article
Publisher: American Diabetes Association

Abstract english

OBJECTIVE The long-term association between dietary protein and type 2 diabetes incidence is uncertain. We aimed to investigate the association between total, animal, and plant protein intake and the incidence of type 2 diabetes. RESEARCH DESIGN AND METHODS The prospective European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from eight European countries, with an average follow-up time of 12.0 years. Pooled country-specific hazard ratios (HRs) and 95% CI of prentice-weighted Cox regression analyses were used to estimate type 2 diabetes incidence according to protein intake. RESULTS After adjustment for important diabetes risk factors and dietary factors, the incidence of type 2 diabetes was higher in those with high intake of total protein (per 10 g: HR 1.06 [95% CI 1.02-1.09], P-trend < 0.001) and animal protein (per 10 g: 1.05 [1.02-1.08], P-trend = 0.001). Effect modification by sex (P < 0.001) and BMI among women (P < 0.001) was observed. Compared with the overall analyses, associations were stronger in women, more specifically obese women with a BMI > 30 kg/m(2) (per 10 g animal protein: 1.19 [1.09-1.32]), and nonsignificant in men. Plant protein intake was not associated with type 2 diabetes (per 10 g: 1.04 [0.93-1.16], P-trend = 0.098). CONCLUSIONS High total and animal protein intake was associated with a modest elevated risk of type 2 diabetes in a large cohort of European adults. In view of the rapidly increasing prevalence of type 2 diabetes, limiting iso-energetic diets high in dietary proteins, particularly from animal sources, should be considered.

Keywords

  • Endocrinology and Diabetes

Other

Published
  • Genetic and Molecular Epidemiology
  • Internal Medicine
  • ISSN: 1935-5548
Paul Franks
E-mail: paul [dot] franks [at] med [dot] lu [dot] se

Principal investigator

Genetic and Molecular Epidemiology

+46 40 39 11 49

60-12-021

33

Lund University Diabetes Centre, CRC, SUS Malmö, Entrance 72, House 91:12. SE-205 02 Malmö. Telephone: +46 40 39 10 00