Background/Objectives: Prospective cohort studies have indicated that serum vitamin D levels are inversely related to risk of type 2 diabetes. However, such studies cannot determine the source of vitamin D. Therefore, we examined the association of dietary vitamin D intake with incident type 2 diabetes within the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study in a heterogeneous European population including eight countries with large geographical variation. Subjects/Methods: Using a case-cohort design, 11 245 incident cases of type 2 diabetes and a representative subcohort (N=15 798) were included in the analyses. Hazard ratios (HR) and 95% confidence intervals (CIs) for type 2 diabetes were calculated using a Prentice-weighted Cox regression adjusted for potential confounders. Twenty-four-hour diet-recall data from a subsample (N=2347) were used to calibrate habitual intake data derived from dietary questionnaires. Results: Median follow-up time was 10.8 years. Dietary vitamin D intake was not significantly associated with the risk of type 2 diabetes. HR and 95% CIs for the highest compared to the lowest quintile of uncalibrated vitamin D intake was 1.09 (0.97-1.22) (Ptrend =0.17). No associations were observed in a sex-specific analysis. The overall pooled effect (HR (95% CI)) using the continuous calibrated variable was 1.00 (0.97-1.03) per increase of 1 μg/day dietary vitamin D. Conclusions: This observational study does not support an association between higher dietary vitamin D intake and type 2 diabetes incidence. This result has to be interpreted in light of the limited contribution of dietary vitamin D on the overall vitamin D status of a person.
Bibliographical noteFunding Information:
We thank all EPIC participants and staff for their contribution to the study. We thank Nicola Kerrison (MRC Epidemiology Unit, Cambridge) for managing the data for the InterAct project. We further thank Valentina Gallo (Imperial College, London) for providing information on dividing the EPIC centres into latitude groups. The funding for the InterAct project was provided by the EU FP6 programme (grant number LSHM_CT_2006_037197). In addition, InterAct investigators acknowledge funding from the following agencies: E Ardanaz: Health Research Fund (FIS) of the Spanish Ministry of Health and Navarre Regional Government; JWJ Beulens: verification of diabetes cases in EPIC-NL was additionally funded by NL Agency grant IGE05012 and an incentive grant from the board of the UMC Utrecht; PW Franks: Swedish Research Council, Novo Nordisk, Swedish Diabetes Association, Swedish Heart-Lung Foundation; R Kaaks: German Cancer Aid, German Ministry of Research (BMBF); TJ Key: Cancer Research, UK; KT Khaw: Medical Research Council, UK, Cancer Research, UK; T Kühn: German Cancer Aid; P Nilsson: Swedish Research Council; K Overvad: Danish Cancer Society; JR Quirós: Asturias Regional Government; O Rolandsson: The Västerboten County Council; I Sluijs: verification of diabetes cases was additionally funded by NL Agency grant IGE05012 and an incentive grant from the board of the UMC Utrecht; AMW Spijkerman: Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands; A Tjonneland: Danish Cancer Society; R Tumino: AIRE-ONLUS Ragusa, AVIS-Ragusa, Sicilian Regional Government; DL van der A: Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands; R Zamora-Ros: the Health Research Fund (FIS) of the Spanish Ministry of Health (RTICC DR06/0020/ 0091); E Riboli: Imperial College Biomedical Research Centre.
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Nutrition and Dietetics