Lund University is celebrating 350 years.


Javascript is not activated in your browser. This website needs javascript activated to work properly.
You are here

Adherence to predefined dietary patterns and incident type 2 diabetes in European populations: EPIC-InterAct Study

  • Janine Kroeger
  • Matthias B. Schulze
  • Dora Romaguera
  • Marcela Guevara
  • Brian Buijsse
  • Heiner Boeing
  • Joline W. J. Beulens
  • Edith J. M. Feskens
  • Pilar Amiano
  • Eva Ardanaz
  • Claudia Agnoli
  • Genevieve Buckland
  • Francoise Clavel-Chapelon
  • Christina C. Dahm
  • Guy Fagherazzi
  • Paul Franks
  • Rudolf Kaaks
  • Timothy J. Key
  • Kay Tee Khaw
  • Martin Lajous
  • Amalia Mattiello
  • Virginia Menendez Garcia
  • Carmen Navarro
  • Peter Nilsson
  • Kim Overvad
  • Domenico Palli
  • Fulvio Ricceri
  • Olov Rolandsson
  • Maria-Jose Sanchez
  • Nadia Slimani
  • Annemieke M. W. Spijkerman
  • Anne Tjonneland
  • Rosario Tumino
  • Daphne L. van der A
  • Claudia Langenberg
  • Stephen J. Sharp
  • Nita G. Forouhi
  • Elio Riboli
  • Nicholas J. Wareham
Publishing year: 2014
Language: English
Pages: 321-333
Publication/Series: Diabetologia
Volume: 57
Issue: 2
Document type: Journal article
Publisher: Springer Verlag

Abstract english

Few studies have investigated the relationship between predefined dietary patterns and type 2 diabetes incidence; little is known about the generalisability of these associations. We aimed to assess the association between predefined dietary patterns and type 2 diabetes risk in European populations. From among a case-cohort of 12,403 incident diabetes cases and 16,154 subcohort members nested within the prospective European Prospective Investigation into Cancer and Nutrition study, we used data on 9,682 cases and 12,595 subcohort participants from seven countries. Habitual dietary intake was assessed at baseline with country-specific dietary questionnaires. Two diet-quality scores (alternative Healthy Eating Index [aHEI], Dietary Approaches to Stop Hypertension [DASH] score) and three reduced rank regression (RRR)-derived dietary-pattern scores were constructed. Country-specific HRs were calculated and combined using a random-effects meta-analysis. After multivariable adjustment, including body size, the aHEI and DASH scores were not significantly associated with diabetes, although for the aHEI there was a tendency towards an inverse association in countries with higher mean age. We observed inverse associations of the three RRR-derived dietary-pattern scores with diabetes: HRs (95% CIs) for a 1-SD difference were 0.91 (0.86, 0.96), 0.92 (0.84, 1.01) and 0.87 (0.82, 0.92). Random-effects meta-analyses revealed heterogeneity between countries that was explainable by differences in the age of participants or the distribution of dietary intake. Adherence to specific RRR-derived dietary patterns, commonly characterised by high intake of fruits or vegetables and low intake of processed meat, sugar-sweetened beverages and refined grains, may lower type 2 diabetes risk.


  • Endocrinology and Diabetes
  • Alternative Healthy Eating Index
  • Case-cohort
  • Dietary Approaches to
  • Stop Hypertension
  • Dietary patterns
  • Reduced rank regression
  • Type 2
  • diabetes


  • Genetic and Molecular Epidemiology
  • Internal Medicine
  • ISSN: 1432-0428
Paul Franks
E-mail: paul [dot] franks [at] med [dot] lu [dot] se

Principal investigator

Genetic and Molecular Epidemiology

+46 40 39 11 49



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