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Associations between exploratory dietary patterns and incident type 2 diabetes: a federated meta-analysis of individual participant data from 25 cohort studies.

Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. franziska.jannasch@dife.de. NutriAct Competence Cluster Nutrition Research Potsdam-Berlin, Nuthetal, Germany. franziska.jannasch@dife.de. German Center for Diabetes Research, Munich-Neuherberg, Germany. franziska.jannasch@dife.de. Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. Department of Food Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany. MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. School of Health and Human Performance, Dublin City University, Dublin, Ireland. Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Office BH10-642, Rue du Bugnon 46, 1011, Lausanne, Switzerland. Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain. CIBERobn, Instituto de Salud Carlos III, Madrid, Spain. Navarra Institute for Health Research (IdiSNA), Pamplona, Spain. Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Biology Department, School of Arts and Sciences, Utica College, Utica, NY, USA. Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil. Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea. Division of Health and Nutrition Survey and Analysis, Korea Disease Control Prevention Agency, Seoul, South Korea. CONACyT-Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico. Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia. Inserm U 1018, Université Paris-Saclay, UVSQ, Villejuif, Maison des Sciences de l'Homme - SUD, Montpellier, France. Department of Epidemiology and Public Health, University College London, London, UK. University of Hawaii Cancer Center, Honolulu, HI, USA. Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, USA. Center of Research On Psychological and Somatic Disorders (CORPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands. Institute for Food, Nutrition and Health, University of Reading, Reading, RG6 6AR, UK. NutriAct Competence Cluster Nutrition Research Potsdam-Berlin, Nuthetal, Germany. German Center for Diabetes Research, Munich-Neuherberg, Germany.

European journal of nutrition. 2022;(7):3649-3667
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Abstract

PURPOSE In several studies, exploratory dietary patterns (DP), derived by principal component analysis, were inversely or positively associated with incident type 2 diabetes (T2D). However, findings remained study-specific, inconsistent and rarely replicated. This study aimed to investigate the associations between DPs and T2D in multiple cohorts across the world. METHODS This federated meta-analysis of individual participant data was based on 25 prospective cohort studies from 5 continents including a total of 390,664 participants with a follow-up for T2D (3.8-25.0 years). After data harmonization across cohorts we evaluated 15 previously identified T2D-related DPs for association with incident T2D estimating pooled incidence rate ratios (IRR) and confidence intervals (CI) by Piecewise Poisson regression and random-effects meta-analysis. RESULTS 29,386 participants developed T2D during follow-up. Five DPs, characterized by higher intake of red meat, processed meat, French fries and refined grains, were associated with higher incidence of T2D. The strongest association was observed for a DP comprising these food groups besides others (IRRpooled per 1 SD = 1.104, 95% CI 1.059-1.151). Although heterogeneity was present (I2 = 85%), IRR exceeded 1 in 18 of the 20 meta-analyzed studies. Original DPs associated with lower T2D risk were not confirmed. Instead, a healthy DP (HDP1) was associated with higher T2D risk (IRRpooled per 1 SD = 1.057, 95% CI 1.027-1.088). CONCLUSION Our findings from various cohorts revealed positive associations for several DPs, characterized by higher intake of red meat, processed meat, French fries and refined grains, adding to the evidence-base that links DPs to higher T2D risk. However, no inverse DP-T2D associations were confirmed.

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Publication Type : Meta-Analysis

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