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Stina Ramne


ludc web

Associations of carbohydrates and carbohydrate-rich foods with incidence of type 2 diabetes


  • Kjell Olsson
  • Stina Ramne
  • Esther González-Padilla
  • Ulrika Ericson
  • Emily Sonestedt

Summary, in English

Dietary carbohydrates have long been expected to be associated with risk of type 2 diabetes; however, the associations for many carbohydrates and carbohydrate-rich foods remain inconclusive. This study analysed associations between intakes of six types of carbohydrates and thirteen carbohydrate-rich foods with incident type 2 diabetes in 26 622 participants (61% women) in the Malmö Diet and Cancer Study in southern Sweden. Dietary intake was assessed at baseline (1991-1996) by using a modified diet history method. During mean follow-up of 18 years, 4046 cases were identified. Adjusting for potential confounders (including lifestyle, BMI, and dietary factors), comparing highest v. lowest quintile of intake, monosaccharides (hazard ratio (HR) 0·88; 95% CI 0·79, 0·98; P trend = 0·02) and fruits (HR 0·91; 95% CI 0·82, 1·01; P trend = 0·03) were inversely associated with incident type 2 diabetes, while disaccharides (HR 1·17; 95% CI 1·04, 1·30; P trend = 0·002) and sweets (HR 1·09; 95% CI 1·00, 1·19; P trend = 0·02) were positively associated. After stratification by sex, marmalade/honey/jam (HR 0·82; 95% CI 0·72, 0·94; P trend < 0·001) and vegetables (HR 0·85; 95% CI 0·73, 0·98; P trend = 0·06) were inversely associated with incident type 2 diabetes in men, and chocolate (HR 1·26; 95% CI 1·09, 1·46; P trend < 0·001) was positively associated in women. In conclusion, we identified inverse associations for intake of monosaccharides and fruits with type 2 diabetes risk, and positive associations for disaccharides and sweets. Additional sex-specific associations were also identified. Future studies are needed to explore these associations further.


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

Publishing year







British Journal of Nutrition





Document type

Journal article


Cambridge University Press


  • Endocrinology and Diabetes
  • Nutrition and Dietetics


  • Carbohydrate-rich foods
  • Carbohydrates
  • Epidemiology
  • Malmö Diet and Cancer Study
  • Type 2 diabetes




  • Carbohydrate quality, microbiota and cardiometabolic risk
  • Carbohydrate quality and type 2 diabetes

Research group

  • Nutrition Epidemiology
  • Diabetes - Cardiovascular Disease


  • ISSN: 0007-1145