Dietary antioxidant capacity and risk of type 2 diabetes in the large prospective E3N-EPIC cohort

Abstract

Aims/hypothesis Recent evidence suggests that oxidative stress may contribute to the pathogenesis of type 2 diabetes. The diet, and especially fruit and vegetables, contains a variety of compounds with antioxidant activity, which may have cumulative/synergistic antioxidant effects. The total antioxidant capacity, an index derived from dietary intake, is a single estimate of antioxidant capacity from all dietary antioxidants. The main aim of this study was to investigate the relationship between total antioxidant capacity and risk of type 2 diabetes. Methods Among 64,223 women (mean age 52 ± 7 years) from the French E3N-European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, 1751 women had validated type 2 diabetes during 15 years of follow-up. The total antioxidant capacity was estimated with the ferric ionreducing antioxidant power (FRAP) method. Adjusted Cox proportional hazards regression models were used to calculate HRs and 95% CIs for the associations between total antioxidant capacity and type 2 diabetes risk, adjusted for potential confounders.Results In multivariable models, higher levels of total antioxidant capacity were associated with a lower risk of type 2 diabetes. Compared with women in the lowest quintile, women in the third, fourth and fifth quintiles for total antioxidant capacity had HRs of 0.74 (95% CI 0.63, 0.86), 0.70 (95% CI 0.59, 0.83) and 0.73 (95% CI 0.60, 0.89), respectively. The inverse association between total antioxidant capacity and risk of type 2 diabetes was linear up to values of 15 mmol/day, after which the effect reached a plateau. Conclusions/interpretation Our findings suggest that the total antioxidant capacity may play an important role in reducing the risk of type 2 diabetes in middle-aged women. More studies are warranted to better understand the biological mechanisms underlying this inverse association.

Micronutrient dietary patterns associated with type 2 diabetes mellitus among women of the E3N‐EPIC (Etude Epidémiologique auprès de femmes de l'Education Nationale) cohort study

“…19 Before 2004, women self-reporting diabetes, diabetes diet, diabetes drugs, and hospitalization for diabetes were considered potential T2DM cases and they were asked to answer a specific questionnaire defining the circumstances of diagnosis, therapy, and last measures of fasting glucose and Hb1Ac levels. 19 Before 2004, women self-reporting diabetes, diabetes diet, diabetes drugs, and hospitalization for diabetes were considered potential T2DM cases and they were asked to answer a specific questionnaire defining the circumstances of diagnosis, therapy, and last measures of fasting glucose and Hb1Ac levels.…”

“…All T2DM cases were identified through a well-defined algorithm that has been described in detail elsewhere. 19 Before 2004, women self-reporting diabetes, diabetes diet, diabetes drugs, and hospitalization for diabetes were considered potential T2DM cases and they were asked to answer a specific questionnaire defining the circumstances of diagnosis, therapy, and last measures of fasting glucose and Hb1Ac levels. Women who declared at least one of the following criteria were considered validated cases of T2DM: fasting plasma glucose ≥7.0 mmol/L, random glucose ≥11.1 mmol/L at diagnosis, and/or self-reported use of glucose-lowering medication, and/or most recent values of fasting glucose or HbA1c ≥7.0 mmol/L or ≥7%, respectively.…”

Determinants of 20‐year non‐progression to Type 2 diabetes in women at very high risk: the E3N cohort study

“…Limiting adherence to a Western diet, characterized in the present study by processed meat, French fries, appetizers, rice/pasta, potatoes, pulses, pizza/pies, canned fish, eggs, alcoholic beverages, cakes, mayonnaise and butter/cream, appeared to be the most important determinant in our study population. In women who had a moderate to high Western dietary pattern score, total dietary antioxidant capacity, characterized by a high consumption of coffee, tea, fruit and vegetables and chocolate, and a moderate consumption of wine , was the second most influential factor associated with not developing the disease. Interestingly, although the sample size was relatively small, we identified extreme sleep duration (≤6 h or ≥9 h per night) as the next most important factor discriminating women who developed Type 2 diabetes from those who did not.…”

Associations between early-life food deprivation during World War II and risk of hypertension and type 2 diabetes at adulthood

“…The validation algorithm used in the E3N cohort to assess type 2 diabetes cases has been largely accepted and used in several previous publications (e.g. Mancini et al 26 ). All women who were reimbursed at least twice for any glucose-lowering medications during one year were considered to be validated cases of diabetes 27 .…”