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Minerals, trace elements, Vit. D and bone health

Dietary vitamin D intake and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition: the EPIC-InterAct study

European Journal of Clinical Nutrition volume 68, pages 196–202 (2014)Cite this article

Subjects

Abstract

Background/Objectives:

Prospective cohort studies have indicated that serum vitamin D levels are inversely related to risk of type 2 diabetes. However, such studies cannot determine the source of vitamin D. Therefore, we examined the association of dietary vitamin D intake with incident type 2 diabetes within the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study in a heterogeneous European population including eight countries with large geographical variation.

Subjects/Methods:

Using a case-cohort design, 11 245 incident cases of type 2 diabetes and a representative subcohort (N=15 798) were included in the analyses. Hazard ratios (HR) and 95% confidence intervals (CIs) for type 2 diabetes were calculated using a Prentice-weighted Cox regression adjusted for potential confounders. Twenty-four-hour diet-recall data from a subsample (N=2347) were used to calibrate habitual intake data derived from dietary questionnaires.

Results:

Median follow-up time was 10.8 years. Dietary vitamin D intake was not significantly associated with the risk of type 2 diabetes. HR and 95% CIs for the highest compared to the lowest quintile of uncalibrated vitamin D intake was 1.09 (0.97–1.22) (Ptrend=0.17). No associations were observed in a sex-specific analysis. The overall pooled effect (HR (95% CI)) using the continuous calibrated variable was 1.00 (0.97–1.03) per increase of 1 μg/day dietary vitamin D.

Conclusions:

This observational study does not support an association between higher dietary vitamin D intake and type 2 diabetes incidence. This result has to be interpreted in light of the limited contribution of dietary vitamin D on the overall vitamin D status of a person.

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Acknowledgements

We thank all EPIC participants and staff for their contribution to the study. We thank Nicola Kerrison (MRC Epidemiology Unit, Cambridge) for managing the data for the InterAct project. We further thank Valentina Gallo (Imperial College, London) for providing information on dividing the EPIC centres into latitude groups. The funding for the InterAct project was provided by the EU FP6 programme (grant number LSHM_CT_2006_037197). In addition, InterAct investigators acknowledge funding from the following agencies: E Ardanaz: Health Research Fund (FIS) of the Spanish Ministry of Health and Navarre Regional Government; JWJ Beulens: verification of diabetes cases in EPIC-NL was additionally funded by NL Agency grant IGE05012 and an incentive grant from the board of the UMC Utrecht; PW Franks: Swedish Research Council, Novo Nordisk, Swedish Diabetes Association, Swedish Heart-Lung Foundation; R Kaaks: German Cancer Aid, German Ministry of Research (BMBF); TJ Key: Cancer Research, UK; KT Khaw: Medical Research Council, UK, Cancer Research, UK; T Kühn: German Cancer Aid; P Nilsson: Swedish Research Council; K Overvad: Danish Cancer Society; JR Quirós: Asturias Regional Government; O Rolandsson: The Västerboten County Council; I Sluijs: verification of diabetes cases was additionally funded by NL Agency grant IGE05012 and an incentive grant from the board of the UMC Utrecht; AMW Spijkerman: Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands; A Tjonneland: Danish Cancer Society; R Tumino: AIRE-ONLUS Ragusa, AVIS-Ragusa, Sicilian Regional Government; DL van der A: Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands; R Zamora-Ros: the Health Research Fund (FIS) of the Spanish Ministry of Health (RTICC DR06/0020/0091); E Riboli: Imperial College Biomedical Research Centre.

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Authors and Affiliations

  1. German Cancer Research Centre (DKFZ), Heidelberg, Germany

    S Abbas, J Linseisen, S Rohrmann, R Kaaks & T Kühn

  2. Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany

    S Abbas

  3. Helmholtz Centre Munich (HMGU), Neuherberg, Germany

    J Linseisen

  4. Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland

    S Rohrmann

  5. University Medical Center Utrecht, Utrecht, The Netherlands

    J W J Beulens & I Sluijs

  6. German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam-Rehbruecke, Germany

    B Buijsse & H Boeing

  7. Public Health Division of Gipuzkoa, San Sebastian, Spain

    P Amiano

  8. Instituto BIO-Donostia, Basque Government, San Sebastian, Spain

    P Amiano

  9. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

    P Amiano, E Ardanaz, D Gavrila & E Molina-Montes

  10. Navarre Public Health Institute (ISPN), Pamplona, Spain

    E Ardanaz

  11. Inserm, CESP, U1018, Villejuif, France

    B Balkau, F Clavel-Chapelon & G Fagherazzi

  12. Université Paris-Sud, UMRS 1018, Villejuif, France

    B Balkau, F Clavel-Chapelon & G Fagherazzi

  13. Lund University, Malmö, Sweden

    P W Franks & P M Nilsson

  14. Umeå University, Umeå, Sweden

    P W Franks & O Rolandsson

  15. Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain

    D Gavrila

  16. Epidemiology and Prevention Unit, Milan, Italy

    S Grioni

  17. University of Oxford, Oxford, UK

    T J Key

  18. University of Cambridge, Cambridge, UK

    K T Khaw

  19. Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy

    A Mattiello

  20. Andalusian School of Public Health, Granada, Spain

    E Molina-Montes

  21. Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark

    K Overvad

  22. Public Health Directorate, Asturias, Spain

    J R Quirós

  23. Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital, University of Turin and Center for Cancer Prevention (CPO), Torino, Italy

    C Sacerdote

  24. Human Genetics Foundation (HuGeF), Torino, Italy

    C Sacerdote

  25. Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy

    C Saieva

  26. International Agency for Research on Cancer, Lyon, France

    N Slimani

  27. National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    A M W Spijkerman & D L van der A

  28. Danish Cancer Society Research Center, Copenhagen, Denmark

    A Tjonneland

  29. ASP Ragusa, Ragusa, Italy

    R Tumino

  30. Aire Onlus, Ragusa, Italy

    R Tumino

  31. Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain

    R Zamora-Ros

  32. MRC Epidemiology Unit, University of Cambridge, Cambridge, UK

    S J Sharp, C Langenberg, N G Forouhi & N J Wareham

  33. School of Public Health, Imperial College, London, UK

    E Riboli

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  1. S Abbas
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Correspondence to J Linseisen.

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Abbas, S., Linseisen, J., Rohrmann, S. et al. Dietary vitamin D intake and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition: the EPIC-InterAct study. Eur J Clin Nutr 68, 196–202 (2014). https://doi.org/10.1038/ejcn.2013.235

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