TY - JOUR
T1 - Dietary protein intake and incidence of type 2 diabetes in Europe
T2 - The EPIC-InterAct case-cohort study
AU - Van Nielen, Monique
AU - Feskens, Edith J.M.
AU - Mensink, Marco
AU - Sluijs, Ivonne
AU - Molina, Esther
AU - Amiano, Pilar
AU - Ardanaz, Eva
AU - Balkau, Beverly
AU - Beulens, Joline W.J.
AU - Boeing, Heiner
AU - Clavel-Chapelon, Françoise
AU - Fagherazzi, Guy
AU - Franks, Paul W.
AU - Halkjaer, Jytte
AU - Huerta, José Maria
AU - Katzke, Verena
AU - Key, Timothy J.
AU - Khaw, Kay Tee
AU - Krogh, Vittorio
AU - Kühn, Tilman
AU - Menéndez, Virginia V.M.
AU - Nilsson, Peter
AU - Overvad, Kim
AU - Palli, Domenico
AU - Panico, Salvatore
AU - Rolandsson, Olov
AU - Romieu, Isabelle
AU - Sacerdote, Carlotta
AU - Sánchez, Maria José
AU - Schulze, Matthias B.
AU - Spijkerman, Annemieke M.W.
AU - Tjonneland, Anne
AU - Tumino, Rosario
AU - Van Der A, Daphne L.
AU - Würtz, Anne M.L.
AU - Zamora-Ros, Raul
AU - Langenberg, Claudia
AU - Sharp, Stephen J.
AU - Forouhi, Nita G.
AU - Riboli, Elio
AU - Wareham, Nicholas J.
PY - 2014/7
Y1 - 2014/7
N2 - 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], Ptrend = 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/m2 (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], Ptrend = 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.
AB - 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], Ptrend = 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/m2 (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], Ptrend = 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.
UR - http://www.scopus.com/inward/record.url?scp=84903537108&partnerID=8YFLogxK
U2 - 10.2337/dc13-2627
DO - 10.2337/dc13-2627
M3 - Article
C2 - 24722499
AN - SCOPUS:84903537108
SN - 0149-5992
VL - 37
SP - 1854
EP - 1862
JO - Diabetes Care
JF - Diabetes Care
IS - 7
ER -