Association between Dietary Energy Density and Incident Type 2 Diabetes in the Women’s Health Initiative

Hingle, Melanie; Wertheim, Betsy C.; Neuhouser, Marian L.; Tinker, Lesley F.; Howard, Barbara V.; Johnson, Karen C.; Liu, Simin; Phillips, Lawrence S.; Qi, Lihong; Sarto, Gloria E.; Turner, Tami; Waring, Molly E.; Thomson, Cynthia A.

doi:10.1016/j.jand.2016.11.010

Cited by 14 publications

(28 citation statements)

References 41 publications

(51 reference statements)

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“…Despite the relatively strong associations that have been observed between DED and cancer-associated metabolic disorders (3,4), in this study, there was no evidence to support independent associations between DED and risk of breast, endometrial, ovarian, and colorectal cancers with or without adjustment for BMI. Contrary to our results, one large prospective study reported a positive association between DED and risk of breast cancer (n ¼ 2,509 breast cancer cases; ref.…”

Section: Discussioncontrasting

confidence: 91%

“…The mechanism that underpins the development of these cancers is not completely understood, but epidemiologic and experimental studies suggest that relatively common metabolic disorders such as obesity, diabetes, and the metabolic syndrome are potential risk factors for these cancers (2). These metabolic disorders result partly from poor-quality diets characterized by high intake of nutrient-deficient foods which are high in fats, refined sugars, and alcohol (3,4). In this regard, dietary energy density (DED), a new indicator of diet quality, has been positively associated with risk of these cancer-associated metabolic disorders (3,4).…”

Section: Introductionmentioning

confidence: 99%

“…These metabolic disorders result partly from poor-quality diets characterized by high intake of nutrient-deficient foods which are high in fats, refined sugars, and alcohol (3,4). In this regard, dietary energy density (DED), a new indicator of diet quality, has been positively associated with risk of these cancer-associated metabolic disorders (3,4). Therefore, it is possible that DED may influence carcinogenesis, but very few studies have assessed the association between DED and cancer risk.…”

Section: Introductionmentioning

confidence: 99%

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Association between Dietary Energy Density and Risk of Breast, Endometrial, Ovarian, and Colorectal Cancer among Canadian Women

Arthur

Kirsh

Rohan

2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Dietary energy density (DED) is strongly associated with cancer-associated metabolic disorders such as obesity and metabolic syndrome and may thus influence carcinogenesis. However, little is known about its association with cancer. Therefore, we investigated the association of DED with risk of breast, endometrial, ovarian, and colorectal cancers in the Canadian Study of Diet, Lifestyle, and Health. We conducted a case-cohort study that included an age-stratified subcohort of 3,120 of the 39,532 female participants who completed self-administered lifestyle and dietary questionnaires at baseline, and in whom, respectively, 922, 188, 104, and 269 incident breast, endometrial, ovarian, and colorectal cancer cases were diagnosed, respectively. We estimated HRs and 95% confidence intervals for the association of DED with risk of these cancers using Cox proportional hazards regression models modified for the case-cohort design. There was no statistically significant association between DED and risk of breast, endometrial, ovarian, and colorectal cancers. Our study suggests that DED is not independently associated with risk of breast, endometrial, ovarian, and colorectal cancers among women. Further investigation of the association between DED and risk of these cancers in larger prospective studies is warranted, as demonstration of associations may have important implications for primary prevention of these cancers. .

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Section: Discussioncontrasting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between Dietary Energy Density and Risk of Breast, Endometrial, Ovarian, and Colorectal Cancer among Canadian Women

Arthur

Kirsh

Rohan

2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Our study further indicated that all-cause mortality risk increased significantly with the increase of DEI in participants with DEI ≥167•4 kJ/kg IBW per d (40 kcal/kg IBW per d). Consistently, previous studies reported that high energy intake was associated with increased risks of cancer, incident diabetes, all-cause mortality and CVD mortality in general populations (41)(42)(43) . Iff et al (44) found that higher relative energy intake increases mortality in patients with estimated glomerular filtration rate <60 ml/min per 1•73 m 2 .…”

Section: Discussionsupporting

confidence: 84%

The association between dietary energy intake and the risk of mortality in maintenance haemodialysis patients: a multi-centre prospective cohort study

Yang

Lei

et al. 2019

Br J Nutr

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Maintenance haemodialysis (MHD) is the use of a machine to filter wastes, salts and fluid from blood for at least 3 months to prolong the life of patients with advanced kidney failure. Although low dietary energy intake (DEI) has been observed in MHD patients, few studies have related DEI to the risk of mortality. To explore this relationship, a study included 1039 MHD patients from eight centres was conducted. DEI was assessed by three 24-h diet recalls and was normalised to ideal body weight (IBW). All-cause mortality and CVD mortality were the primary and secondary outcomes, respectively. During a median follow-up of 28 months, a U-shaped relationship was observed between DEI and all-cause or CVD mortality. The risk of all-cause mortality decreased significantly with the increase of DEI in participants with DEI <167·4 kJ/kg IBW per d (hazard ratio (HR) 0·98; 95 % CI 0·96, 1·00) and increased significantly with the increase of DEI in those with DEI ≥167·4 kJ/kg IBW per d (HR 1·12; 95 % CI 1·04, 1·20). Similarly, the risk of CVD mortality decreased with the increase of DEI in participants with DEI <152·7 kJ/kg IBW per d (HR 0·96; 95 % CI 0·93, 0·99) and increased with the increase of DEI in participants with DEI ≥152·7 kJ/kg IBW per d (HR 1·11; 95 % CI 1·04, 1·18). In summary, there was a U-shaped association between DEI and all-cause or CVD mortality, with a turning point at about 167·4 and 152·7 kJ/kg IBW per d, respectively, in MHD patients.

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“…High sensory appeal, low cost, wide availability and large portions of energy-dense foods can promote overeating and weight gain (6,7) . Previous studies have noted strong associations between dietary energy density and obesity (9)(10)(11) and type 2 diabetes (12,13) . Among potential mechanisms linking dietary choices and health outcomes were high glycaemic index, low fibre content and high reward value of energy-dense foods (12)(13)(14)(15) .…”

mentioning

confidence: 96%

Nutrient density: addressing the challenge of obesity

Drewnowski

2017

Br J Nutr

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Obesity rates are increasing worldwide. Potential reasons include excessive consumption of sugary beverages and energy-dense foods instead of more nutrient-rich options. On a per kJ basis, energy-dense grains, added sugars and fats cost less, whereas lean meats, seafood, leafy greens and whole fruit generally cost more. Given that consumer food choices are often driven by price, the observed social inequities in diet quality and health can be explained, in part, by nutrition economics. Achieving a nutrient-rich diet at an affordable cost has become progressively more difficult within the constraints of global food supply. However, given the necessary metrics and educational tools, it may be possible to eat better for less. New metrics of nutrient density help consumers identify foods, processed and unprocessed, that are nutrient-rich, affordable and appealing. Affordability metrics, created by adding food prices to food composition data, permit calculations of both kJ and nutrients per penny, allowing for new studies on the economic drivers of food choice. Merging dietary intake data with local or national food prices permits the estimation of individual-level diet costs. New metrics of nutrient balance can help identify those food patterns that provide optimal nutritional value. Behavioural factors, including cooking at home, have been associated with nutrition resilience, defined as healthier diets at lower cost. Studies of the energy and nutrient costs of the global food supply and diverse food patterns will permit a better understanding of the socioeconomic determinants of health. Dietary advice ought to be accompanied by economic feasibility studies.

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Association between Dietary Energy Density and Incident Type 2 Diabetes in the Women’s Health Initiative

Cited by 14 publications

References 41 publications

Association between Dietary Energy Density and Risk of Breast, Endometrial, Ovarian, and Colorectal Cancer among Canadian Women

Association between Dietary Energy Density and Risk of Breast, Endometrial, Ovarian, and Colorectal Cancer among Canadian Women

The association between dietary energy intake and the risk of mortality in maintenance haemodialysis patients: a multi-centre prospective cohort study

Nutrient density: addressing the challenge of obesity

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