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. 2014 Jul;37(7):1854-62.
doi: 10.2337/dc13-2627. Epub 2014 Apr 10.

Dietary protein intake and incidence of type 2 diabetes in Europe: the EPIC-InterAct Case-Cohort Study

Monique van Nielen  1 , Edith J M Feskens  2 , Marco Mensink  2 , Ivonne Sluijs  3 , Esther Molina  4 , Pilar Amiano  5 , Eva Ardanaz  6 , Beverly Balkau  7 , Joline W J Beulens  3 , Heiner Boeing  8 , Françoise Clavel-Chapelon  9 , Guy Fagherazzi  9 , Paul W Franks  10 , Jytte Halkjaer  11 , José Maria Huerta  12 , Verena Katzke  13 , Timothy J Key  14 , Kay Tee Khaw  15 , Vittorio Krogh  16 , Tilman Kühn  13 , Virginia V M Menéndez  17 , Peter Nilsson  10 , Kim Overvad  18 , Domenico Palli  19 , Salvatore Panico  20 , Olov Rolandsson  21 , Isabelle Romieu  22 , Carlotta Sacerdote  23 , Maria-José Sánchez  24 , Matthias B Schulze  8 , Annemieke M W Spijkerman  25 , Anne Tjonneland  11 , Rosario Tumino  26 , Daphne L van der A  25 , Anne M L Würtz  18 , Raul Zamora-Ros  27 , Claudia Langenberg  15 , Stephen J Sharp  15 , Nita G Forouhi  15 , Elio Riboli  28 , Nicholas J Wareham  15 ; InterAct Consortium
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Free article

Dietary protein intake and incidence of type 2 diabetes in Europe: the EPIC-InterAct Case-Cohort Study

Monique van Nielen et al. Diabetes Care. 2014 Jul.
Free article

Erratum in

  • Erratum. Dietary protein intake and incidence of type 2 diabetes in europe: the EPIC-InterAct case-cohort study. Diabetes Care 2014;37:1854-1862.
    van Nielen M, Feskens EJ, Mensink M, Sluijs I, Molina E, Amiano P, Ardanaz E, Balkau B, Beulens JW, Boeing H, Clavel-Chapelon F, Fagherazzi G, Franks PW, Halkjaer J, Huerta JM, Katzke V, Key TJ, Khaw KT, Krogh V, Kühn T, Menéndez VV, Nilsson P, Overvad K, Palli D, Panico S, Rolandsson O, Romieu I, Sacerdote C, Sánchez MJ, Schulze MB, Spijkerman AM, Tjonneland A, Tumino R, van der A DL, Würtz AM, Zamora-Ros R, Langenberg C, Sharp SJ, Forouhi NG, Riboli E, Wareham NJ; InterAct Consortium. van Nielen M, et al. Diabetes Care. 2015 Oct;38(10):1992. doi: 10.2337/dc15-er10b. Diabetes Care. 2015. PMID: 26404931 Free PMC article. No abstract available.

Abstract

Objective: The long-term association between dietary protein and type 2 diabetes incidence is uncertain. We aimed to investigate the association between total, animal, and plant protein intake and the incidence of type 2 diabetes.

Research design and methods: The prospective European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from eight European countries, with an average follow-up time of 12.0 years. Pooled country-specific hazard ratios (HRs) and 95% CI of prentice-weighted Cox regression analyses were used to estimate type 2 diabetes incidence according to protein intake.

Results: After adjustment for important diabetes risk factors and dietary factors, the incidence of type 2 diabetes was higher in those with high intake of total protein (per 10 g: HR 1.06 [95% CI 1.02-1.09], P(trend) < 0.001) and animal protein (per 10 g: 1.05 [1.02-1.08], P(trend) = 0.001). Effect modification by sex (P < 0.001) and BMI among women (P < 0.001) was observed. Compared with the overall analyses, associations were stronger in women, more specifically obese women with a BMI >30 kg/m(2) (per 10 g animal protein: 1.19 [1.09-1.32]), and nonsignificant in men. Plant protein intake was not associated with type 2 diabetes (per 10 g: 1.04 [0.93-1.16], P(trend) = 0.098).

Conclusions: High total and animal protein intake was associated with a modest elevated risk of type 2 diabetes in a large cohort of European adults. In view of the rapidly increasing prevalence of type 2 diabetes, limiting iso-energetic diets high in dietary proteins, particularly from animal sources, should be considered.

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