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

Abstract

Aim To investigate the associations between types of diet and incident type 2 diabetes and whether adiposity mediated these associations. Materials and Methods In total, 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 = 3237), fish eaters (n = 4405), fish and poultry eaters (n = 2217), 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‐year landmark analysis. The mediation role of adiposity was tested under a counterfactual framework. Results After excluding the first 2 years of follow‐up, the median follow‐up was 5.4 (IQR: 4.8‐6.3) years, during which 5067 (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 and poultry eaters (HR 0.62 [95% CI: 0.45‐0.88]) had a 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 and poultry (49.8%) and varied (55.2%) diets. Conclusions Fish eaters, as well as fish and poultry eaters, were at a lower risk of incident type 2 diabetes than meat eaters, partially attributable to lower obesity risk.

Associations of diabesity with all‐cause and cardiovascular disease mortality: Findings from the Mexico City Prospective Study

“…Metabolic alterations linked to insulin resistance and decreased muscle mass probably play a crucial role. For instance, Boonpor et al have recently described this phenomenon in a prospective cohort that identified an increased risk of developing CVD in individuals with diabetes and sarcopenia 30 . Moreover, both in obesity and diabetes, dietary choices and lifestyles play a decisive role.…”

“…For instance, Boonpor et al have recently described this phenomenon in a prospective cohort that identified an increased risk of developing CVD in individuals with diabetes and sarcopenia. 30 Moreover, both in obesity and diabetes, dietary choices and lifestyles play a decisive role. In this context, the role of public policies becomes fundamentally important.…”

Novel plant-based meat alternatives: future opportunities and health considerations

“…Whilst the interrelationship between dietary pattern and sociodemographic characteristics warrants further investigation it is clear that affordability of novel PBMAs is a key consideration when it comes to their adoption across a range of consumer segments (74,81,82,(88)(89)(90)(91) .…”

“…Inconsistency in findings may be the result of variation across consumer subgroups (74,76) , with rural consumers less influenced than urban consumers (98) , and personal experience of animal husbandry or limited access to large supermarkets also influencing this phenomenon (85,98) . Vegetarian and vegan consumers also tend to place greater value on the welfare of animals (54,58,63,(89)(90)(91)(92) .…”

Longitudinal changes in diet quality and food intake before and after diabetes awareness in American adults: the Coronary Artery Risk Development in Young Adults (CARDIA) study

“…During younger adulthood, there is a tendency to consume less fruit, vegetables, and dairy and more meat, potatoes, and sweets, which results in poor diet quality 9 11 12. Since diet quality is associated with the development of T2D, and early-onset T2D is increasing,1 13–15 it is important to know how young adults make dietary change over time, whether diabetes awareness or the age of diabetes awareness are associated with dietary quality, and what dietary changes are made when people learn of their diabetes. Existing studies are short-term, qualitative, have small samples, lower quality of evidence, start with middle-aged cohorts, or focus only on whether diet quality predicts future risk of developing diabetes and diabetes-related complications 8 15–17…”