Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations

Franziska Jannasch; Janine Kröger; Claudia Agnoli; Aurelio Barricarte; Heiner Boeing; Valerie Cayssials; Sandra Colorado-Yohar; Christina C Dahm; Courtney Dow; Guy Fagherazzi; Paul W Franks; Heinz Freisling; Marc J Gunter; Nicola D Kerrison; Timothy J Key; Kay-Tee Khaw; Tilman Kühn; Cecilie Kyro; Francesca Romana Mancini; Olatz Mokoroa; Peter Nilsson; Kim Overvad; Domenico Palli; Salvatore Panico; Jose Ramón Quirós García; Olov Rolandsson; Carlotta Sacerdote; Mariá-José Sánchez; Mohammad Sediq Sahrai; Ruth Schübel; Ivonne Sluijs; Annemieke M W Spijkerman; Anne Tjonneland; Tammy Y N Tong; Rosario Tumino; Elio Riboli; Claudia Langenberg; Stephen J Sharp; Nita G Forouhi; Matthias B Schulze; Nicholas J Wareham

doi:10.1093/jn/nxz031

Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations

Franziska Jannasch, Janine Kröger, Claudia Agnoli, Aurelio Barricarte, Heiner Boeing, Valerie Cayssials, Sandra Colorado-Yohar, Christina C Dahm, Courtney Dow, Guy Fagherazzi, Paul W Franks, Heinz Freisling, Marc J Gunter, Nicola D Kerrison, Timothy J Key, Kay-Tee Khaw, Tilman Kühn, Cecilie Kyro, Francesca Romana Mancini, Olatz MokoroaPeter Nilsson, Kim Overvad, Domenico Palli, Salvatore Panico, Jose Ramón Quirós García, Olov Rolandsson, Carlotta Sacerdote, Mariá-José Sánchez, Mohammad Sediq Sahrai, Ruth Schübel, Ivonne Sluijs, Annemieke M W Spijkerman, Anne Tjonneland, Tammy Y N Tong, Rosario Tumino, Elio Riboli, Claudia Langenberg, Stephen J Sharp, Nita G Forouhi, Matthias B Schulze, Nicholas J Wareham

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Abstract

BACKGROUND: Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence.

OBJECTIVE: The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries.

METHODS: Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association.

RESULTS: Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea.

CONCLUSIONS: Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses.

Original language	English
Pages (from-to)	1047-1055
Number of pages	9
Journal	The Journal of Nutrition
Volume	149
Issue number	6
DOIs	https://doi.org/10.1093/jn/nxz031
Publication status	Published - 24 Apr 2019
Externally published	Yes

Bibliographical note

Keywords

Adult
Aged
Case-Control Studies
Cohort Studies
Diabetes Mellitus, Type 2/epidemiology
Diet/adverse effects
Disease Susceptibility
Europe/epidemiology
Feasibility Studies
Female
Humans
Incidence
Male
Middle Aged
Principal Component Analysis
Risk Factors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/jn/nxz031Licence: CC BY

Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations
Copyright 2019 the authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 1.26 MBLicence: CC BY

Cite this

Jannasch, F., Kröger, J., Agnoli, C., Barricarte, A., Boeing, H., Cayssials, V., Colorado-Yohar, S., Dahm, C. C., Dow, C., Fagherazzi, G., Franks, P. W., Freisling, H., Gunter, M. J., Kerrison, N. D., Key, T. J., Khaw, K.-T., Kühn, T., Kyro, C., Mancini, F. R., ... Wareham, N. J. (2019). Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations. The Journal of Nutrition, 149(6), 1047-1055. https://doi.org/10.1093/jn/nxz031

@article{8a2d3128e21147f4827c656a34fba8c2,

title = "Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations",

abstract = "BACKGROUND: Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence.OBJECTIVE: The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries.METHODS: Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association.RESULTS: Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95\% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95\% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95\% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea.CONCLUSIONS: Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses.",

keywords = "Adult, Aged, Case-Control Studies, Cohort Studies, Diabetes Mellitus, Type 2/epidemiology, Diet/adverse effects, Disease Susceptibility, Europe/epidemiology, Feasibility Studies, Female, Humans, Incidence, Male, Middle Aged, Principal Component Analysis, Risk Factors",

author = "Franziska Jannasch and Janine Kr{\"o}ger and Claudia Agnoli and Aurelio Barricarte and Heiner Boeing and Valerie Cayssials and Sandra Colorado-Yohar and Dahm, \{Christina C\} and Courtney Dow and Guy Fagherazzi and Franks, \{Paul W\} and Heinz Freisling and Gunter, \{Marc J\} and Kerrison, \{Nicola D\} and Key, \{Timothy J\} and Kay-Tee Khaw and Tilman K{\"u}hn and Cecilie Kyro and Mancini, \{Francesca Romana\} and Olatz Mokoroa and Peter Nilsson and Kim Overvad and Domenico Palli and Salvatore Panico and Garc{\'i}a, \{Jose Ram{\'o}n Quir{\'o}s\} and Olov Rolandsson and Carlotta Sacerdote and Mari{\'a}-Jos{\'e} S{\'a}nchez and Sahrai, \{Mohammad Sediq\} and Ruth Sch{\"u}bel and Ivonne Sluijs and Spijkerman, \{Annemieke M W\} and Anne Tjonneland and Tong, \{Tammy Y N\} and Rosario Tumino and Elio Riboli and Claudia Langenberg and Sharp, \{Stephen J\} and Forouhi, \{Nita G\} and Schulze, \{Matthias B\} and Wareham, \{Nicholas J\}",

note = "Copyright {\textcopyright} American Society for Nutrition 2019.",

year = "2019",

month = apr,

day = "24",

doi = "10.1093/jn/nxz031",

language = "English",

volume = "149",

pages = "1047--1055",

journal = "The Journal of Nutrition",

issn = "0022-3166",

publisher = "Elsevier B.V.",

number = "6",

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Jannasch, F, Kröger, J, Agnoli, C, Barricarte, A, Boeing, H, Cayssials, V, Colorado-Yohar, S, Dahm, CC, Dow, C, Fagherazzi, G, Franks, PW, Freisling, H, Gunter, MJ, Kerrison, ND, Key, TJ, Khaw, K-T, Kühn, T, Kyro, C, Mancini, FR, Mokoroa, O, Nilsson, P, Overvad, K, Palli, D, Panico, S, García, JRQ, Rolandsson, O, Sacerdote, C, Sánchez, M-J, Sahrai, MS, Schübel, R, Sluijs, I, Spijkerman, AMW, Tjonneland, A, Tong, TYN, Tumino, R, Riboli, E, Langenberg, C, Sharp, SJ, Forouhi, NG, Schulze, MB & Wareham, NJ 2019, 'Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations', The Journal of Nutrition, vol. 149, no. 6, pp. 1047-1055. https://doi.org/10.1093/jn/nxz031

TY - JOUR

T1 - Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations

AU - Jannasch, Franziska

AU - Kröger, Janine

AU - Agnoli, Claudia

AU - Barricarte, Aurelio

AU - Boeing, Heiner

AU - Cayssials, Valerie

AU - Colorado-Yohar, Sandra

AU - Dahm, Christina C

AU - Dow, Courtney

AU - Fagherazzi, Guy

AU - Franks, Paul W

AU - Freisling, Heinz

AU - Gunter, Marc J

AU - Kerrison, Nicola D

AU - Key, Timothy J

AU - Khaw, Kay-Tee

AU - Kühn, Tilman

AU - Kyro, Cecilie

AU - Mancini, Francesca Romana

AU - Mokoroa, Olatz

AU - Nilsson, Peter

AU - Overvad, Kim

AU - Palli, Domenico

AU - Panico, Salvatore

AU - García, Jose Ramón Quirós

AU - Rolandsson, Olov

AU - Sacerdote, Carlotta

AU - Sánchez, Mariá-José

AU - Sahrai, Mohammad Sediq

AU - Schübel, Ruth

AU - Sluijs, Ivonne

AU - Spijkerman, Annemieke M W

AU - Tjonneland, Anne

AU - Tong, Tammy Y N

AU - Tumino, Rosario

AU - Riboli, Elio

AU - Langenberg, Claudia

AU - Sharp, Stephen J

AU - Forouhi, Nita G

AU - Schulze, Matthias B

AU - Wareham, Nicholas J

PY - 2019/4/24

Y1 - 2019/4/24

N2 - BACKGROUND: Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence.OBJECTIVE: The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries.METHODS: Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association.RESULTS: Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea.CONCLUSIONS: Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses.

AB - BACKGROUND: Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence.OBJECTIVE: The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries.METHODS: Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association.RESULTS: Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea.CONCLUSIONS: Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses.

KW - Adult

KW - Aged

KW - Case-Control Studies

KW - Cohort Studies

KW - Diabetes Mellitus, Type 2/epidemiology

KW - Diet/adverse effects

KW - Disease Susceptibility

KW - Europe/epidemiology

KW - Feasibility Studies

KW - Female

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Principal Component Analysis

KW - Risk Factors

U2 - 10.1093/jn/nxz031

DO - 10.1093/jn/nxz031

M3 - Article

C2 - 31149710

SN - 0022-3166

VL - 149

SP - 1047

EP - 1055

JO - The Journal of Nutrition

JF - The Journal of Nutrition

IS - 6

ER -

Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations

Abstract

Bibliographical note

Keywords

UN SDGs

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