Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible across European Populations

Franziska Jannasch; Janine Kröger; Claudia Agnoli; Aurelio Barricarte; Heiner Boeing; Valerie Cayssials; Sandra Colorado-Yohar; Christina C. Dahm; Courtney Dow; Guy Fagherazzi; Paul W. Franks; Heinz Freisling; Marc J. Gunter; Nicola D. Kerrison; Timothy J. Key; Kay Tee Khaw; Tilman Kühn; Cecilie Kyro; Francesca Romana Mancini; Olatz Mokoroa; Peter Nilsson; Kim Overvad; Domenico Palli; Salvatore Panico; Jose Ramón Quirós García; Olov Rolandsson; Carlotta Sacerdote; Mariá José Sánchez; Mohammad Sediq Sahrai; Ruth Schübel; Ivonne Sluijs; Annemieke M.W. Spijkerman; Anne Tjonneland; Tammy Y.N. Tong; Rosario Tumino; Elio Riboli; Claudia Langenberg; Stephen J. Sharp; Nita G. Forouhi; Matthias B. Schulze; Nicholas J. Wareham

doi:10.1093/jn/nxz031

Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible across European Populations

Franziska Jannasch^*, Janine Kröger, Claudia Agnoli, Aurelio Barricarte, Heiner Boeing, Valerie Cayssials, Sandra Colorado-Yohar, Christina C. Dahm, Courtney Dow, Guy Fagherazzi, Paul W. Franks, Heinz Freisling, Marc J. Gunter, Nicola D. Kerrison, Timothy J. Key, Kay Tee Khaw, Tilman Kühn, Cecilie Kyro, Francesca Romana Mancini, Olatz MokoroaPeter Nilsson, Kim Overvad, Domenico Palli, Salvatore Panico, Jose Ramón Quirós García, Olov Rolandsson, Carlotta Sacerdote, Mariá José Sánchez, Mohammad Sediq Sahrai, Ruth Schübel, Ivonne Sluijs, Annemieke M.W. Spijkerman, Anne Tjonneland, Tammy Y.N. Tong, Rosario Tumino, Elio Riboli, Claudia Langenberg, Stephen J. Sharp, Nita G. Forouhi, Matthias B. Schulze, Nicholas J. Wareham

^*Corresponding author for this work

Research output: Contribution to journal › Article › Research › peer-review

6 Citations (Scopus)

Abstract

Background: Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence. Objective: The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries. Methods: Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association. Results: Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HR_France per 1 SD: 1.00; 95% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HR_Spain: 1.09; 95% CI: 0.97, 1.22 and HR_UK-Norfolk: 1.12; 95% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea. Conclusions: Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses.

Original language	English
Pages (from-to)	1047-1055
Number of pages	9
Journal	Journal of Nutrition
Volume	149
Issue number	6
DOIs	https://doi.org/10.1093/jn/nxz031
Publication status	Published - 1 Jun 2019
Externally published	Yes

Keywords

diet-disease association
dietary patterns
meta-analysis
principal component analysis
replication
type 2 diabetes mellitus

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10.1093/jn/nxz031

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Jannasch, F., Kröger, J., Agnoli, C., Barricarte, A., Boeing, H., Cayssials, V., Colorado-Yohar, S., Dahm, C. C., Dow, C., Fagherazzi, G., Franks, P. W., Freisling, H., Gunter, M. J., Kerrison, N. D., Key, T. J., Khaw, K. T., Kühn, T., Kyro, C., Mancini, F. R., ... Wareham, N. J. (2019). Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible across European Populations. Journal of Nutrition, 149(6), 1047-1055. https://doi.org/10.1093/jn/nxz031

@article{154f1197adef4f11b6b388261f82dc8c,

title = "Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible across European Populations",

abstract = "Background: Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence. Objective: The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries. Methods: Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association. Results: Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea. Conclusions: Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses.",

keywords = "diet-disease association, dietary patterns, meta-analysis, principal component analysis, replication, type 2 diabetes mellitus",

author = "Franziska Jannasch and Janine Kr{\"o}ger and Claudia Agnoli and Aurelio Barricarte and Heiner Boeing and Valerie Cayssials and Sandra Colorado-Yohar and Dahm, {Christina C.} and Courtney Dow and Guy Fagherazzi and Franks, {Paul W.} and Heinz Freisling and Gunter, {Marc J.} and Kerrison, {Nicola D.} and Key, {Timothy J.} and Khaw, {Kay Tee} and Tilman K{\"u}hn and Cecilie Kyro and Mancini, {Francesca Romana} and Olatz Mokoroa and Peter Nilsson and Kim Overvad and Domenico Palli and Salvatore Panico and Garc{\'i}a, {Jose Ram{\'o}n Quir{\'o}s} and Olov Rolandsson and Carlotta Sacerdote and S{\'a}nchez, {Mari{\'a} Jos{\'e}} and Sahrai, {Mohammad Sediq} and Ruth Sch{\"u}bel and Ivonne Sluijs and Spijkerman, {Annemieke M.W.} and Anne Tjonneland and Tong, {Tammy Y.N.} and Rosario Tumino and Elio Riboli and Claudia Langenberg and Sharp, {Stephen J.} and Forouhi, {Nita G.} and Schulze, {Matthias B.} and Wareham, {Nicholas J.}",

note = "Publisher Copyright: Copyright {\textcopyright} American Society for Nutrition 2019.",

year = "2019",

month = jun,

day = "1",

doi = "10.1093/jn/nxz031",

language = "English",

volume = "149",

pages = "1047--1055",

journal = "Journal of Nutrition",

issn = "0022-3166",

publisher = "Elsevier B.V.",

number = "6",

}

Jannasch, F, Kröger, J, Agnoli, C, Barricarte, A, Boeing, H, Cayssials, V, Colorado-Yohar, S, Dahm, CC, Dow, C, Fagherazzi, G, Franks, PW, Freisling, H, Gunter, MJ, Kerrison, ND, Key, TJ, Khaw, KT, Kühn, T, Kyro, C, Mancini, FR, Mokoroa, O, Nilsson, P, Overvad, K, Palli, D, Panico, S, García, JRQ, Rolandsson, O, Sacerdote, C, Sánchez, MJ, Sahrai, MS, Schübel, R, Sluijs, I, Spijkerman, AMW, Tjonneland, A, Tong, TYN, Tumino, R, Riboli, E, Langenberg, C, Sharp, SJ, Forouhi, NG, Schulze, MB & Wareham, NJ 2019, 'Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible across European Populations', Journal of Nutrition, vol. 149, no. 6, pp. 1047-1055. https://doi.org/10.1093/jn/nxz031

TY - JOUR

T1 - Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible across European Populations

AU - Jannasch, Franziska

AU - Kröger, Janine

AU - Agnoli, Claudia

AU - Barricarte, Aurelio

AU - Boeing, Heiner

AU - Cayssials, Valerie

AU - Colorado-Yohar, Sandra

AU - Dahm, Christina C.

AU - Dow, Courtney

AU - Fagherazzi, Guy

AU - Franks, Paul W.

AU - Freisling, Heinz

AU - Gunter, Marc J.

AU - Kerrison, Nicola D.

AU - Key, Timothy J.

AU - Khaw, Kay Tee

AU - Kühn, Tilman

AU - Kyro, Cecilie

AU - Mancini, Francesca Romana

AU - Mokoroa, Olatz

AU - Nilsson, Peter

AU - Overvad, Kim

AU - Palli, Domenico

AU - Panico, Salvatore

AU - García, Jose Ramón Quirós

AU - Rolandsson, Olov

AU - Sacerdote, Carlotta

AU - Sánchez, Mariá José

AU - Sahrai, Mohammad Sediq

AU - Schübel, Ruth

AU - Sluijs, Ivonne

AU - Spijkerman, Annemieke M.W.

AU - Tjonneland, Anne

AU - Tong, Tammy Y.N.

AU - Tumino, Rosario

AU - Riboli, Elio

AU - Langenberg, Claudia

AU - Sharp, Stephen J.

AU - Forouhi, Nita G.

AU - Schulze, Matthias B.

AU - Wareham, Nicholas J.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Background: Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence. Objective: The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries. Methods: Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association. Results: Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea. Conclusions: Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses.

AB - Background: Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence. Objective: The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries. Methods: Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association. Results: Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea. Conclusions: Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses.

KW - diet-disease association

KW - dietary patterns

KW - meta-analysis

KW - principal component analysis

KW - replication

KW - type 2 diabetes mellitus

UR - http://www.scopus.com/inward/record.url?scp=85067279649&partnerID=8YFLogxK

U2 - 10.1093/jn/nxz031

DO - 10.1093/jn/nxz031

M3 - Article

C2 - 31149710

AN - SCOPUS:85067279649

SN - 0022-3166

VL - 149

SP - 1047

EP - 1055

JO - Journal of Nutrition

JF - Journal of Nutrition

IS - 6

ER -

Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible across European Populations

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