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Nutrition Epidemiology Highlights Original Article

Consumption of fatty foods and incident type 2 diabetes in populations from eight European countries

European Journal of Clinical Nutrition volume 69, pages 455–461 (2015)Cite this article

Subjects

Abstract

Background/Objectives:

Diets high in saturated and trans fat and low in unsaturated fat may increase type 2 diabetes (T2D) risk, but studies on foods high in fat per unit weight are sparse. We assessed whether the intake of vegetable oil, butter, margarine, nuts and seeds and cakes and cookies is related to incident T2D.

Subjects/Methods:

A case-cohort study was conducted, nested within eight countries of the European Prospective Investigation into Cancer (EPIC), with 12 403 incident T2D cases and a subcohort of 16 835 people, identified from a cohort of 340 234 people. Diet was assessed at baseline (1991–1999) by country-specific questionnaires. Country-specific hazard ratios (HRs) across four categories of fatty foods (nonconsumers and tertiles among consumers) were combined with random-effects meta-analysis.

Results:

After adjustment not including body mass index (BMI), nonconsumers of butter, nuts and seeds and cakes and cookies were at higher T2D risk compared with the middle tertile of consumption. Among consumers, cakes and cookies were inversely related to T2D (HRs across increasing tertiles 1.14, 1.00 and 0.92, respectively; P-trend <0.0001). All these associations attenuated upon adjustment for BMI, except the higher risk of nonconsumers of cakes and cookies (HR 1.57). Higher consumption of margarine became positively associated after BMI adjustment (HRs across increasing consumption tertiles: 0.93, 1.00 and 1.12; P-trend 0.03). Within consumers, vegetable oil, butter and nuts and seeds were unrelated to T2D.

Conclusions:

Fatty foods were generally not associated with T2D, apart from weak positive association for margarine. The higher risk among nonconsumers of cakes and cookies needs further explanation.

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Acknowledgements

We thank all EPIC participants and staff for their contributions to the study. We thank Nicola Kerrison (MRC Epidemiology Unit, Cambridge) for managing the data for the InterAct Project.

Author Contributions

Author contributions were as follows: BB had access to all data for this study, analyzed the data, wrote the manuscript and takes primary responsibility for the final content. All authors have contributed to the conception of the design and to the interpretation of data, revising the article critically for important intellectual content and final approval of the version to be published.

Funding

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: IS, JWJB and YTvdS: Verification of diabetes cases was additionally funded by NL Agency grant IGE05012 and an Incentive Grant from the Board of the UMC Utrecht (The Netherlands); HBBdM, AMWS and DLvdA: 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 (The Netherlands); FLC: Cancer Research UK; PWF: Swedish Research Council, Novo nordisk, Swedish Heart Lung Foundation, Swedish Diabetes Association; JH, KO and AT: Danish Cancer Society; RK: Deutsche Krebshilfe; SP: Associazione Italiana per la Ricerca sul Cancro; JRQ: Asturias Regional Government; MT: Health Research Fund (FIS) of the Spanish Ministry of Health; the CIBER en Epidemiología y Salud Pública (CIBERESP), Spain; Murcia Regional Government (Nº 6236); RT: AIRE-ONLUS Ragusa, AVIS-Ragusa, Sicilian Regional Government.

Author information

Authors and Affiliations

  1. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany

    B Buijsse, H Boeing & D Drogan

  2. Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany

    M B Schulze

  3. Division of Human Nutrition—Section Nutrition and Epidemiology, University of Wageningen, Wageningen, The Netherlands

    E J Feskens

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

    P Amiano

  5. Instituto BIO-Donostia, San Sebastian, Spain

    P Amiano

  6. Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain

    P Amiano, A Barricarte, J M Huerta & M-J Sánchez

  7. Navarre Public Health Institute, Pamplona, Spain

    A Barricarte

  8. INSERM, Centre for Research in Epidemiology and Population Health, Villejuif, France

    F Clavel-Chapelon, B de Lauzon-Guillain & G Fagherazzi

  9. Paris South University, Villejuif, France

    F Clavel-Chapelon, B de Lauzon-Guillain & G Fagherazzi

  10. Department of Epidemiology, Unit Nutrition, Environment and Cancer, Catalan Institute of Oncology, Barcelona, Spain

    A Fonseca-Nunes

  11. Department of Clinical Sciences, Clinical Research Center, Skåne University Hospital, Lund University, Malmö, Sweden

    P W Franks & P M Nilsson

  12. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

    P W Franks

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

    J M Huerta

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

    M U Jakobsen & K Overvad

  15. Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany

    R Kaaks

  16. Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, Oxford, UK

    T J Key

  17. Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

    K T Khaw

  18. Cancer Research and Prevention Institute, Florence, Italy

    G Masala

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

    A Moskal

  20. Department of Cardiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

    K Overvad

  21. Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    V Pala

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

    S Panico

  23. Consejería de Sanidad, Public Health Directorate, Oviedo-Asturias, Spain

    M L Redondo

  24. Human Genetics Foundation, Turin, Italy

    F Ricceri

  25. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

    O Rolandsson

  26. Andalusian School of Public Health, Instituto de Investigación Biosanitaria (IBS GRANADA) and Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain

    M-J Sánchez

  27. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

    I Sluijs & Y T van der Schouw

  28. National Institute for Public Health and the Environment, Bilthoven, The Netherlands

    A M Spijkerman & D L van der A

  29. Danish Cancer Society Research Center, Copenhagen, Denmark

    A Tjonneland

  30. Histopathology Unit, 'Civic MP Arezzo' Hospital, ASP Ragusa, Italy

    R Tumino

  31. Associazone Iblea per la Ricerca Epidemiologica—Onlus, Ragusa, Italy

    R Tumino

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

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

  33. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK

    E Riboli

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  1. B Buijsse
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  36. N G Forouhi
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on behalf of The InterAct Consortium

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Correspondence to B Buijsse.

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Competing interests

The California Walnut Commission covered travel expenses for both BB and HB to attend an expert meeting on the health effects of nuts in 2012. None of the other authors declared a conflict of interest.

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Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website

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Buijsse, B., Boeing, H., Drogan, D. et al. Consumption of fatty foods and incident type 2 diabetes in populations from eight European countries. Eur J Clin Nutr 69, 455–461 (2015). https://doi.org/10.1038/ejcn.2014.249

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