OBJECTIVE -The intake of antioxidants was studied for its ability to predict type 2 diabetes.RESEARCH DESIGN AND METHODS -A cohort of 2,285 men and 2,019 women 40 -69 years of age and free of diabetes at baseline (1967)(1968)(1969)(1970)(1971)(1972) was studied. Food consumption during the previous year was estimated using a dietary history interview. The intake of vitamin C, four tocopherols, four tocotrienols, and six carotenoids was calculated. During a 23-year follow-up, a total of 164 male and 219 female incident cases occurred.RESULTS -Vitamin E intake was significantly associated with a reduced risk of type 2 diabetes. The relative risk (RR) of type 2 diabetes between the extreme quartiles of the intake was 0.69 (95% CI 0.51-0.94, P for trend ϭ 0.003). Intakes of ␣-tocopherol, ␥-tocopherol, ␦-tocopherol, and -tocotrienol were inversely related to a risk of type 2 diabetes. Among single carotenoids, -cryptoxanthin intake was significantly associated with a reduced risk of type 2 diabetes (RR 0.58, 95% CI 0.44 -0.78, P Ͻ 0.001). No association was evident between intake of vitamin C and type 2 diabetes risk.CONCLUSIONS -This study supports the hypothesis that development of type 2 diabetes may be reduced by the intake of antioxidants in the diet.
Diabetes Care 27:362-366, 2004A lthough obesity and physical inactivity are known to be major risk factors for type 2 diabetes, recent evidence suggests that oxidative stress may contribute to the pathogenesis of type 2 diabetes by increasing insulin resistance or impairing insulin secretion (1). Dietary antioxidants have been hypothesized to have a protective effect against the development of diabetes by inhibiting peroxidation chain reactions (2). It seems plausible that a sufficient intake of antioxidants plays an important role in protection against type 2 diabetes. However, little epidemiological evidence is available on the role of dietary antioxidant intake in prevention of type 2 diabetes.In one prospective cohort study, vitamin C intake was significantly lower among incident cases of type 2 diabetes (3). In three prospective observational studies, serum ␣-tocopherol levels were associated with lower risk of type 1 or type 2 diabetes (4 -6). Serum -carotene and ␣-tocopherol concentrations were nonsignificantly associated with a reduced risk in a cohort of Finns (7). In some case-control and cross-sectional studies, significantly lower serum levels of ␣-tocopherol, carotene, or vitamin C have been observed in individuals with diabetes than in control subjects (8 -13). In one American study, ␣-tocopherol concentrations were even higher in diabetic patients than in control subjects (14). Some prospective studies have shown that higher vegetable and fruit consumption may lower the risk of developing diabetes, suggesting that antioxidants in the diet may have a synergistic effect (3,15,16).Dietary vitamin E, four tocopherols, four tocotrienols, vitamin C, and six carotenoids were investigated for their ability to predict type 2 diabetes in a large prospective...