Vegetable, but not potato, intakes are associated with a lower risk of type 2 diabetes in the Danish Diet, Cancer and Health cohort

   OBJECTIVE To examine the relationship between intakes of a) vegetables/potatoes and incident type 2 diabetes (T2D), and b) explore whether the relationship between vegetable intake and incident T2D is mediated by baseline BMI. RESEARCH DESIGN AND METHODS Cross-sectional associations between exposures (baseline intakes of total vegetables, vegetable subgroups, and potatoes), and baseline BMI were assessed by multivariable-adjusted linear regression models. Associations between exposures and incident T2D were examined by multivariable-adjusted Cox proportional hazards models. Mediation by BMI was quantified through exploring natural direct and indirect effects. RESULTS Among 54,793 participants of the Danish Diet, Cancer and Health cohort, 7,695 T2D cases were recorded during a median follow-up of 16.3 years. Participants in the highest total vegetable intake quintile (median: 319 g/d) had a 0.35 kg/m2 (95%CI:-0.46, -0.24) lower BMI and a 21% (95%CI: 16, 26%) lower risk of incident T2D after multivariable adjustments, compared to those in the lowest quintile (median: 67 g/d). Baseline BMI mediated ~21% of the association between vegetable intakes and incident T2D. Participants in the highest compared to the lowest (median: 256 vs 52 g/d) potato intake quintile had a 9% (95%CI: 2, 16%) higher risk of T2D after multivariable adjustments with no association found after accounting for underlying dietary patterns. Of the vegetable subclasses, higher intakes of green leafy and cruciferous vegetables were associated with a statistically significantly lower risk of T2D.  CONCLUSIONS The findings provide evidence that a higher vegetable, but not potato, intake might help to mitigate T2D risk, partly by reducing BMI.</p

Data_Sheet_1_Source-specific nitrate and nitrite intakes and associations with sociodemographic factors in the Danish Diet Cancer and Health cohort.docx

BackgroundThe dietary source and intake levels of nitrate and nitrite may govern its deleterious versus beneficial effects on human health. Existing evidence on detailed source-specific intake is limited. The objectives of this study were to assess nitrate and nitrite intakes from different dietary sources (plant-based foods, animal-based foods, and water), characterize the background diets of participants with low and high intakes, and investigate how sociodemographic and lifestyle factors associate with intake levels.MethodsIn the Danish Diet, Cancer and Health Cohort, sociodemographic and lifestyle information was obtained from participants at enrolment (1993–1997). Source-dependent nitrate and nitrite intakes were calculated using comprehensive food composition databases, with tap water nitrate intakes estimated via the national drinking water quality monitoring database linked with participants’ residential addresses from 1978 to 2016. Underlying dietary patterns were examined using radar plots comparing high to low consumers while sociodemographic predictors of source-dependent nitrate intakes were investigated using linear regression models.ResultsIn a Danish cohort of 55,754 participants aged 50–65 at enrolment, the median [IQR] intakes of dietary nitrate and nitrite were 58.13 [44.27–74.90] mg/d and 1.79 [1.43–2.21] mg/d, respectively. Plant-based foods accounted for ~76% of nitrate intake, animal-based foods ~10%, and water ~5%. Nitrite intake was sourced roughly equally from plants and animals. Higher plant-sourced nitrate intake was associated with healthier lifestyles, better dietary patterns, more physical activity, higher education, lower age and lower BMI. Females and participants who had never smoked also had significantly higher plant-sourced nitrate intakes. Higher water-sourced nitrate intake was linked to sociodemographic risk factors (smoking, obesity, lower education). Patterns for animal-sourced nitrate were less clear.ConclusionParticipants with higher plant-sourced nitrate intakes tend to be healthier while participants with higher water-sourced nitrate intakes tended to be unhealthier than their low consuming counterparts. Future research in this cohort should account for the sociodemographic and dietary predictors of source-specific nitrate intake we have identified.</p