TY - JOUR
T1 - Impact of intra-category food substitutions on the risk of type 2 diabetes
T2 - a modelling study on the pizza category
AU - Adjibade, Moufidath
AU - Mariotti, François
AU - Leroy, Pascal
AU - Souchon, Isabelle
AU - Saint-Eve, Anne
AU - Fagherazzi, Guy
AU - Soler, Louis Georges
AU - Huneau, Jean François
N1 - Acknowledgements: This study was supported by a grant from Université Paris-Saclay (Nutriperso project). The author contributions were as follows: F.M., L.-G.S. and J.-F.H. designed the study; I.S. and A.S.-E. supplied the databases essential for the research; G.F. and P.L. provided methodological support; M.A. and P.L. analyzed the data. M.A., F.M., P.L. and J-F.H interpreted the results; M.A. wrote the first draft of the manuscript; F.M. and J.-F.H. contributed to writing the manuscript; all authors provided critical comments on the manuscript. All authors read and approved the final manuscript. None of the other authors declare any conflicts of interest.
Publisher Copyright:
© 2021 The Authors.
PY - 2022/4/28
Y1 - 2022/4/28
N2 - Advice on replacing unhealthy foods with healthier alternatives within the same food category may be more acceptable and might ease the transition towards a healthy diet. Here, we studied the potential impact of substitutions within the pizza category on the risk of type 2 diabetes (T2D). The study sample consisted of 2510 adults from the INCA2 French national survey. Based on their nutritional characteristics, the 353 pizzas marketed in France were grouped into 100 clusters that were used to run various scenarios of pizza substitutions, which were either isoenergetic (IE) or non-isoenergetic (NIE). We then used a model structurally similar to the Preventable Risk Integrated ModEl to assess the expected rate of change in risk of T2D. Pizzas characterised by a low energy, high vegetable content and whole grain dough were associated with a greater reduction in the risk of T2D. The rates of change in risk of T2D were markedly stronger in men and for NIE substitutions. When the rates of change were estimated in the subsample of pizza consumers, replacing the observed pizzas with the best pizza resulted in a T2D risk reduction of-6·7 % (-8·4 %;-4·9 %, IE) and-8·9 % (-11·2 %;-6·3 %, NIE), assuming that this is their usual diets. The greatest risk reduction induced by an IE substitution of the observed pizza with a mixed dish was similar to that observed with the best pizzas. Overall, this modelling study suggests that healthy swaps within a category can effectively supplement broader dietary changes towards a healthier diet.
AB - Advice on replacing unhealthy foods with healthier alternatives within the same food category may be more acceptable and might ease the transition towards a healthy diet. Here, we studied the potential impact of substitutions within the pizza category on the risk of type 2 diabetes (T2D). The study sample consisted of 2510 adults from the INCA2 French national survey. Based on their nutritional characteristics, the 353 pizzas marketed in France were grouped into 100 clusters that were used to run various scenarios of pizza substitutions, which were either isoenergetic (IE) or non-isoenergetic (NIE). We then used a model structurally similar to the Preventable Risk Integrated ModEl to assess the expected rate of change in risk of T2D. Pizzas characterised by a low energy, high vegetable content and whole grain dough were associated with a greater reduction in the risk of T2D. The rates of change in risk of T2D were markedly stronger in men and for NIE substitutions. When the rates of change were estimated in the subsample of pizza consumers, replacing the observed pizzas with the best pizza resulted in a T2D risk reduction of-6·7 % (-8·4 %;-4·9 %, IE) and-8·9 % (-11·2 %;-6·3 %, NIE), assuming that this is their usual diets. The greatest risk reduction induced by an IE substitution of the observed pizza with a mixed dish was similar to that observed with the best pizzas. Overall, this modelling study suggests that healthy swaps within a category can effectively supplement broader dietary changes towards a healthier diet.
KW - Food substitutions
KW - Pizza categories
KW - Public health
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85108503222&partnerID=8YFLogxK
UR - https://pubmed.ncbi.nlm.nih.gov/34121638
U2 - 10.1017/S0007114521002130
DO - 10.1017/S0007114521002130
M3 - Article
C2 - 34121638
AN - SCOPUS:85108503222
SN - 0007-1145
VL - 127
SP - 1240
EP - 1249
JO - British Journal of Nutrition
JF - British Journal of Nutrition
IS - 8
ER -