Your browser has javascript turned off or blocked. This will lead to some parts of our website to not work properly or at all. Turn on javascript for best performance.

The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here: https://www.microsoft.com/en-us/microsoft-365/windows/end-of-ie-support).

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Paul Franks

Paul Franks

Principal investigator

Paul Franks

The Association between Dietary Energy Density and Type 2 Diabetes in Europe: Results from the EPIC-InterAct Study

Author

  • 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
  • Francoise Clavel-Chapelon
  • Francesca L. Crowe
  • Blandine de Lauzon-Guillain
  • Guy Fagherazzi
  • Paul Franks
  • Heinz Freisling
  • Carlos Gonzalez
  • Sara Grioni
  • Jytte Halkjaer
  • Jose Maria Huerta
  • Inge Huybrechts
  • Rudolf Kaaks
  • Kay Tee Khaw
  • Giovanna Masala
  • Peter Nilsson
  • Kim Overvad
  • Salvatore Panico
  • J. Ramon Quiros
  • Olov Rolandsson
  • Carlotta Sacerdote
  • Maria-Jose Sanchez
  • 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

Summary, in English

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 (l(2) = 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.

Department/s

  • Genetic and Molecular Epidemiology
  • Internal Medicine - Epidemiology
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health

Publishing year

2013

Language

English

Publication/Series

PLoS ONE

Volume

8

Issue

5

Document type

Journal article

Publisher

Public Library of Science

Topic

  • Other Clinical Medicine
  • Endocrinology and Diabetes

Status

Published

Research group

  • Genetic and Molecular Epidemiology
  • Internal Medicine - Epidemiology

ISBN/ISSN/Other

  • ISSN: 1932-6203