Change search
ReferencesLink to record
Permanent link

Direct link
The Association between Dietary Energy Density and Type 2 Diabetes in Europe: Results from the EPIC-InterAct Study
Show others and affiliations
2013 (English)In: PLoS ONE, ISSN 1932-6203, Vol. 8, no 5, e59947- p.Article in journal (Refereed) Published
Abstract [en]

Background: Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake.

Methodology/Principal Findings: A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13), which was consistent across countries (l(2) = 2.9%).

Conclusions/Significance: In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases.

Place, publisher, year, edition, pages
Public Library Science , 2013. Vol. 8, no 5, e59947- p.
National Category
Endocrinology and Diabetes
URN: urn:nbn:se:umu:diva-78455DOI: 10.1371/journal.pone.0059947ISI: 000319081900001OAI: diva2:637853
Available from: 2013-07-23 Created: 2013-07-22 Last updated: 2013-07-23Bibliographically approved

Open Access in DiVA

The Association between Dietary Energy Density and Type 2 Diabetes in Europe: Results from the EPIC-InterAct Study(439 kB)80 downloads
File information
File name FULLTEXT02.pdfFile size 439 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Rolandsson, Olov
By organisation
Family Medicine
In the same journal
Endocrinology and Diabetes

Search outside of DiVA

GoogleGoogle Scholar
Total: 80 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 37 hits
ReferencesLink to record
Permanent link

Direct link