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The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study

(2013) PLOS ONE. 8(5).
Author
Organization
Abstract
Background: Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake. Methodology/Principal Findings: A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13), which was consistent across countries (l(2) = 2.9%). Conclusions/Significance: In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases.
Keywords
UNITED-STATES, WEIGHT CHANGE, GLYCEMIC LOAD, METABOLIC SYNDROME, LIFE-STYLE, IMPAIRED GLUCOSE-TOLERANCE, US ADULTS, RISK, WOMEN, MELLITUS

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MLA
van den Berg, Saskia W, Daphne L van der A, Annemieke MW Spijkerman, et al. “The Association Between Dietary Energy Density and Type 2 Diabetes in Europe: Results from the EPIC-InterAct Study.” PLOS ONE 8.5 (2013): n. pag. Print.
APA
van den Berg, S. W., van der A, D. L., Spijkerman, A. M., van Woudenbergh, G. J., Tijhuis, M. J., Amiano, P., Ardanaz, E., et al. (2013). The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study. PLOS ONE, 8(5).
Chicago author-date
van den Berg, Saskia W, Daphne L van der A, Annemieke MW Spijkerman, Geertruida J van Woudenbergh, Mariken J Tijhuis, Pilar Amiano, Eva Ardanaz, et al. 2013. “The Association Between Dietary Energy Density and Type 2 Diabetes in Europe: Results from the EPIC-InterAct Study.” Plos One 8 (5).
Chicago author-date (all authors)
van den Berg, Saskia W, Daphne L van der A, Annemieke MW Spijkerman, Geertruida J van Woudenbergh, Mariken J Tijhuis, Pilar Amiano, Eva Ardanaz, Joline WJ Beulens, Heiner Boeing, Françoise Clavel-Chapelon, Francesca L Crowe, Blandine de Lauzon-Guillain, Guy Fagherazzi, Paul W Franks, Heinz Freisling, Carlos Gonzalez, Sara Grioni, Jytte Halkjaer, Jose Maria Huerta, Inge Huybrechts, Rudolf Kaaks, Kay Tee Khaw, Giovanna Masala, Peter M Nilsson, Kim Overvad, Salvatore Panico, J Ramon Quiros, Olov Rolandsson, Carlotta Sacerdote, Maria-Jose Sanchez, Matthias B Schulze, Nadia Slimani, Ellen A Struijk, Anne Tjonneland, Rosario Tumino, Stephen J Sharp, Claudia Langenberg, Nita G Forouhi, Edith JM Feskens, Elio Riboli, and Nicholas J Wareham. 2013. “The Association Between Dietary Energy Density and Type 2 Diabetes in Europe: Results from the EPIC-InterAct Study.” Plos One 8 (5).
Vancouver
1.
van den Berg SW, van der A DL, Spijkerman AM, van Woudenbergh GJ, Tijhuis MJ, Amiano P, et al. The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study. PLOS ONE. 2013;8(5).
IEEE
[1]
S. W. van den Berg et al., “The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study,” PLOS ONE, vol. 8, no. 5, 2013.
@article{5777921,
  abstract     = {Background: Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake. 
Methodology/Principal Findings: A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13), which was consistent across countries (l(2) = 2.9%). 
Conclusions/Significance: In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases.},
  articleno    = {e59947},
  author       = {van den Berg, Saskia W and van der A, Daphne L and Spijkerman, Annemieke MW and van Woudenbergh, Geertruida J and Tijhuis, Mariken J and Amiano, Pilar and Ardanaz, Eva and Beulens, Joline WJ and Boeing, Heiner and Clavel-Chapelon, Françoise and Crowe, Francesca L and de Lauzon-Guillain, Blandine and Fagherazzi, Guy and Franks, Paul W and Freisling, Heinz and Gonzalez, Carlos and Grioni, Sara and Halkjaer, Jytte and Huerta, Jose Maria and Huybrechts, Inge and Kaaks, Rudolf and Khaw, Kay Tee and Masala, Giovanna and Nilsson, Peter M and Overvad, Kim and Panico, Salvatore and Ramon Quiros, J and Rolandsson, Olov and Sacerdote, Carlotta and Sanchez, Maria-Jose and Schulze, Matthias B and Slimani, Nadia and Struijk, Ellen A and Tjonneland, Anne and Tumino, Rosario and Sharp, Stephen J and Langenberg, Claudia and Forouhi, Nita G and Feskens, Edith JM and Riboli, Elio and Wareham, Nicholas J},
  issn         = {1932-6203},
  journal      = {PLOS ONE},
  keywords     = {UNITED-STATES,WEIGHT CHANGE,GLYCEMIC LOAD,METABOLIC SYNDROME,LIFE-STYLE,IMPAIRED GLUCOSE-TOLERANCE,US ADULTS,RISK,WOMEN,MELLITUS},
  language     = {eng},
  number       = {5},
  pages        = {10},
  title        = {The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study},
  url          = {http://dx.doi.org/10.1371/journal.pone.0059947},
  volume       = {8},
  year         = {2013},
}

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