Total and subtypes of dietary fat intake and risk of type 2 diabetes mellitus in the Prevención con Dieta Mediterránea (PREDIMED) study

The associations between dietary fat and cardiovascular disease have been evaluated in several studies, but less is known about their influence on the risk of diabetes. We examined the associations between total fat, subtypes of dietary fat, and food sources rich in saturated fatty acids and the inc...

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Published in:	The American journal of clinical nutrition 2017-03, Vol.105 (3), p.723-735
Main Authors:	Guasch-Ferré, Marta, Becerra-Tomás, Nerea, Ruiz-Canela, Miguel, Corella, Dolores, Schröder, Helmut, Estruch, Ramon, Ros, Emilio, Arós, Fernando, Gómez-Gracia, Enrique, Fiol, Miquel, Serra-Majem, Lluís, Lapetra, José, Basora, Josep, Martín-Calvo, Nerea, Portoles, Olga, Fitó, Montserrat, Hu, Frank B, Forga, Lluís, Salas-Salvadó, Jordi
Format:	Article
Language:	eng
Subjects:	Aged Animals Butter Cardiovascular Diseases - etiology Cheese Diabetes Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - etiology Diet Diet, Mediterranean Dietary Fats - administration & dosage Fatty acids Fatty Acids - adverse effects Feeding Behavior Female Follow-Up Studies Humans Incidence Male Meat Middle Aged Oils & fats Proportional Hazards Models Prospective Studies Risk Factors Yogurt
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Summary:	The associations between dietary fat and cardiovascular disease have been evaluated in several studies, but less is known about their influence on the risk of diabetes. We examined the associations between total fat, subtypes of dietary fat, and food sources rich in saturated fatty acids and the incidence of type 2 diabetes (T2D). A prospective cohort analysis of 3349 individuals who were free of diabetes at baseline but were at high cardiovascular risk from the PREvención con DIeta MEDiterránea (PREDIMED) study was conducted. Detailed dietary information was assessed at baseline and yearly during the follow-up using a food frequency questionnaire. Multivariable Cox proportional hazards models were used to estimate T2D HRs and 95% CIs according to baseline and yearly updated fat intake. We documented 266 incident cases during 4.3 y of follow-up. Baseline saturated and animal fat intake was not associated with the risk of T2D. After multivariable adjustment, participants in the highest quartile of updated intake of saturated and animal fat had a higher risk of diabetes than the lowest quartile (HR: 2.19; 95% CI: 1.28, 3.73; and trend = 0.01 compared with HR: 2.00; 95% CI: 1.29, 3.09; and trend < 0.01, respectively). In both the Mediterranean diet and control groups, participants in the highest quartile of updated animal fat intake had an ∼2-fold higher risk of T2D than their counterparts in the lowest quartile. The consumption of 1 serving of butter and cheese was associated with a higher risk of diabetes, whereas whole-fat yogurt intake was associated with a lower risk. In a Mediterranean trial focused on dietary fat interventions, baseline intake of saturated and animal fat was not associated with T2D incidence, but the yearly updated intake of saturated and animal fat was associated with a higher risk of T2D. Cheese and butter intake was associated with a higher risk of T2D, whereas whole-fat yogurt intake was associated with a lower risk of T2D. This trial was registered at www.isrctn.com as ISRCTN35739639.
ISSN:	0002-9165 1938-3207