Types of diet, obesity, and incident type 2 diabetes: findings from the UK Biobank prospective cohort study

Boonpor, J., Petermann-Rocha, F., Parra-Soto, S., Pell, J. P. , Gray, S. R. , Celis-Morales, C. and Ho, F. K. (2022) Types of diet, obesity, and incident type 2 diabetes: findings from the UK Biobank prospective cohort study. Diabetes, Obesity and Metabolism, 24(7), pp. 1351-1359. (doi: 10.1111/dom.14711) (PMID:35373896) (PMCID:PMC9325356)

Abstract

Aims: Current evidence on the associations between alternative (e.g. fish and vegetarian) diets and incident type 2 diabetes is elusive. This study aimed to investigate the associations between types of diet and incident type 2 diabetes and whether adiposity mediated these associations. Materials and Methods: 203,790 participants from UK Biobank (mean age 55.2 years; 55.8% women) without diabetes at baseline were included in this prospective study. Using the dietary intake data self-reported at baseline, participants were categorized as vegetarians (n=3,237), fish eaters (n=4,405), fish & poultry eaters (n=2,217), meat eaters (n=178,004) and varied diet (n=15,927). The association between type of diet and incident type 2 diabetes was investigated using Cox-proportional hazards models with a 2-years landmark analysis. The mediation role of adiposity was tested under a counterfactual framework. Results: After excluding the first two years of follow-up, the median follow-up was 5.4 (IQR: 4.8-6.3) years, during which 5,067 (2.5%) participants were diagnosed with type 2 diabetes. After adjusting for lifestyle factors, fish eaters (HR 0.52 [95% CI: 0.39-0.69]) and fish & poultry eaters (HR 0.62 [95% CI: 0.45-0.88]) had lower risk of incident type 2 diabetes compared with meat eaters. The association for vegetarians was not significant. Varied diet had a higher risk of type 2 diabetes. Obesity partially mediated the association of fish (30.6%), fish & poultry (49.8%) and varied (55.2%) diets. Conclusions: Fish and fish & poultry eaters were at a lower risk of incident type 2 diabetes than meat eaters, partially attributable to lower obesity risk.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ho, Dr Frederick and Celis, Dr Carlos and Gray, Professor Stuart and Pell, Professor Jill and Boonpor, Jirapitcha and Parra, Solange and Petermann-Rocha, Mrs Fanny
• Authors: Boonpor, J., Petermann-Rocha, F., Parra-Soto, S., Pell, J. P., Gray, S. R., Celis-Morales, C., and Ho, F. K.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Diabetes, Obesity and Metabolism
• Publisher: Wiley
• ISSN: 1462-8902
• ISSN (Online): 1463-1326
• Published Online: 04 April 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Diabetes, Obesity and Metabolism 24(7): 1351-1359
• Publisher Policy: Reproduced under a Creative Commons License