Clusters of carbohydrate-rich foods and associations with type 2 diabetes incidence: a prospective cohort study
Abstract Background About one in ten adults are living with diabetes worldwide. Intake of carbohydrates and carbohydrate-rich foods are often identified as modifiable risk factors for incident type 2 diabetes. However, strong correlation between food variables can make it difficult to identify true...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Nutrition Journal |
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| Online Access: | https://doi.org/10.1186/s12937-023-00906-0 |
| _version_ | 1827399677538992128 |
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| author | Kjell Olsson Esther González-Padilla Suzanne Janzi Anna Stubbendorff Yan Borné Stina Ramne Ulrika Ericson Emily Sonestedt |
| author_facet | Kjell Olsson Esther González-Padilla Suzanne Janzi Anna Stubbendorff Yan Borné Stina Ramne Ulrika Ericson Emily Sonestedt |
| author_sort | Kjell Olsson |
| collection | DOAJ |
| description | Abstract Background About one in ten adults are living with diabetes worldwide. Intake of carbohydrates and carbohydrate-rich foods are often identified as modifiable risk factors for incident type 2 diabetes. However, strong correlation between food variables can make it difficult to identify true associations. The purpose of this study was to identify clusters of carbohydrate-rich foods and analyse their associations with type 2 diabetes incidence in the Malmö Diet and Cancer Study cohort in southern Sweden. Methods Dietary intake of 26 622 participants was assessed using a validated three-part diet history method: a 7-day food diary, a 168-item food frequency questionnaire, and a 60-minute interview. K-means clustering analysis identified five clusters from 21 food variables. The Cox proportional hazard regression model was applied to calculate hazard ratios (HR) and 95% confidence intervals (CI) of the association between clusters and incident type 2 diabetes. Results The cluster analysis resulted in five clusters; high vegetables/low added sugar, high sugar-sweetened beverages, high juice, high fruit, and high refined carbohydrates/low fruit & vegetables (reference). During mean follow-up of 18 years, 4046 type 2 diabetes cases were identified. After adjustment for potential confounding (including lifestyle, body mass index, and diet), a high fruit cluster (HR 0.86; 95% CI 0.78, 0.94) was inversely associated with type 2 diabetes compared to the reference cluster. No other significant associations were identified. Conclusions A dietary pattern defined by a high intake of fruits was associated with a lower incidence of type 2 diabetes. The findings provide additional evidence of a potential protective effect from fruit intake in reducing type 2 diabetes risk. Future studies are needed to explore this association further. |
| first_indexed | 2024-03-08T19:49:34Z |
| format | Article |
| id | doaj.art-a8b038f9ad474d92b86ae82f8b4d31b2 |
| institution | Directory Open Access Journal |
| issn | 1475-2891 |
| language | English |
| last_indexed | 2024-03-08T19:49:34Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Nutrition Journal |
| spelling | doaj.art-a8b038f9ad474d92b86ae82f8b4d31b22023-12-24T12:10:22ZengBMCNutrition Journal1475-28912023-12-0122111010.1186/s12937-023-00906-0Clusters of carbohydrate-rich foods and associations with type 2 diabetes incidence: a prospective cohort studyKjell Olsson0Esther González-Padilla1Suzanne Janzi2Anna Stubbendorff3Yan Borné4Stina Ramne5Ulrika Ericson6Emily Sonestedt7Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund UniversityNutritional Epidemiology, Department of Clinical Sciences Malmö, Lund UniversityNutritional Epidemiology, Department of Clinical Sciences Malmö, Lund UniversityNutritional Epidemiology, Department of Clinical Sciences Malmö, Lund UniversityNutritional Epidemiology, Department of Clinical Sciences Malmö, Lund UniversityNutritional Epidemiology, Department of Clinical Sciences Malmö, Lund UniversityDiabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences Malmö, Lund UniversityNutritional Epidemiology, Department of Clinical Sciences Malmö, Lund UniversityAbstract Background About one in ten adults are living with diabetes worldwide. Intake of carbohydrates and carbohydrate-rich foods are often identified as modifiable risk factors for incident type 2 diabetes. However, strong correlation between food variables can make it difficult to identify true associations. The purpose of this study was to identify clusters of carbohydrate-rich foods and analyse their associations with type 2 diabetes incidence in the Malmö Diet and Cancer Study cohort in southern Sweden. Methods Dietary intake of 26 622 participants was assessed using a validated three-part diet history method: a 7-day food diary, a 168-item food frequency questionnaire, and a 60-minute interview. K-means clustering analysis identified five clusters from 21 food variables. The Cox proportional hazard regression model was applied to calculate hazard ratios (HR) and 95% confidence intervals (CI) of the association between clusters and incident type 2 diabetes. Results The cluster analysis resulted in five clusters; high vegetables/low added sugar, high sugar-sweetened beverages, high juice, high fruit, and high refined carbohydrates/low fruit & vegetables (reference). During mean follow-up of 18 years, 4046 type 2 diabetes cases were identified. After adjustment for potential confounding (including lifestyle, body mass index, and diet), a high fruit cluster (HR 0.86; 95% CI 0.78, 0.94) was inversely associated with type 2 diabetes compared to the reference cluster. No other significant associations were identified. Conclusions A dietary pattern defined by a high intake of fruits was associated with a lower incidence of type 2 diabetes. The findings provide additional evidence of a potential protective effect from fruit intake in reducing type 2 diabetes risk. Future studies are needed to explore this association further.https://doi.org/10.1186/s12937-023-00906-0K-means clusteringEpidemiologyMalmö Diet and Cancer StudyType 2 DiabetesDietNutrition |
| spellingShingle | Kjell Olsson Esther González-Padilla Suzanne Janzi Anna Stubbendorff Yan Borné Stina Ramne Ulrika Ericson Emily Sonestedt Clusters of carbohydrate-rich foods and associations with type 2 diabetes incidence: a prospective cohort study Nutrition Journal K-means clustering Epidemiology Malmö Diet and Cancer Study Type 2 Diabetes Diet Nutrition |
| title | Clusters of carbohydrate-rich foods and associations with type 2 diabetes incidence: a prospective cohort study |
| title_full | Clusters of carbohydrate-rich foods and associations with type 2 diabetes incidence: a prospective cohort study |
| title_fullStr | Clusters of carbohydrate-rich foods and associations with type 2 diabetes incidence: a prospective cohort study |
| title_full_unstemmed | Clusters of carbohydrate-rich foods and associations with type 2 diabetes incidence: a prospective cohort study |
| title_short | Clusters of carbohydrate-rich foods and associations with type 2 diabetes incidence: a prospective cohort study |
| title_sort | clusters of carbohydrate rich foods and associations with type 2 diabetes incidence a prospective cohort study |
| topic | K-means clustering Epidemiology Malmö Diet and Cancer Study Type 2 Diabetes Diet Nutrition |
| url | https://doi.org/10.1186/s12937-023-00906-0 |
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