Article open access publication

Consumption of fatty foods and incident type 2 diabetes in populations from eight European countries

European Journal of Clinical Nutrition, Springer Nature, ISSN 0954-3007

Volume 69, 4, 2015

DOI:10.1038/ejcn.2014.249, Dimensions: pub.1038594542, PMID: 25424603,


Buijsse, B * (1)
Boeing, H (1)
Drogan, D (1)
Amiano, P (3) (4) (5)
Barricarte, A (5) (6)
Fagherazzi, G (7) (8)
Franks, P W (10) (11)
Huerta, J M (5) (12)
Kaaks, R (14)
Key, T J (15)
Khaw, K T (16)
Masala, G (17)
Moskal, A (18)
Overvad, K (13) (19)
Pala, V (20)
Panico, S (21)
Ricceri, F (23)
Sánchez, M-J (5) (24) (25)
Sluijs, I (26)
Tumino, R (29) (30)
Sharp, S J (16)
Riboli, E (31)

* Corresponding author



  1. (1) German Institute of Human Nutrition, grid.418213.d
  2. (2) Wageningen University & Research, grid.4818.5
  3. (3) Biodonostia, grid.432380.e
  4. (4) Public Health Division of Gipuzkoa, San Sebastian, Spain
  5. (5) Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
  6. (6) Instituto de Salud Pública de Navarra, grid.419126.9
  7. (7) Centre for research in epidemiology and population health, grid.463845.8
  8. (8) Paris South University, Villejuif, France
  9. (9) Catalan Institute of Oncology, grid.418701.b
  10. (10) Department of Clinical Sciences, Clinical Research Center, Skåne University Hospital, Lund University, Malmö, Sweden
  11. (11) Umeå University, grid.12650.30
  12. (12) Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
  13. (13) Aarhus University, grid.7048.b, AU
  14. (14) German Cancer Research Center, grid.7497.d
  15. (15) University of Oxford, grid.4991.5
  16. (16) University of Cambridge, grid.5335.0
  17. (17) Cancer Research and Prevention Institute, Florence, Italy
  18. (18) International Agency For Research On Cancer, grid.17703.32
  19. (19) Aalborg Hospital, grid.27530.33, North Denmark Region
  20. (20) Fondazione IRCCS Istituto Nazionale dei Tumori, grid.417893.0
  21. (21) University of Naples Federico II, grid.4691.a
  22. (22) Consejería de Sanidad, Public Health Directorate, Oviedo-Asturias, Spain
  23. (23) Human Genetics Foundation, grid.428948.b
  24. (24) Andalusian School of Public Health, Instituto de Investigación Biosanitaria (IBS GRANADA) and Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
  25. (25) University of Granada, grid.4489.1
  26. (26) University Medical Center Utrecht, grid.7692.a
  27. (27) National Institute for Public Health and the Environment, grid.31147.30
  28. (28) Danish Cancer Society, grid.417390.8
  29. (29) Associazone Iblea per la Ricerca Epidemiologica–Onlus, Ragusa, Italy
  30. (30) Histopathology Unit, 'Civic MP Arezzo' Hospital, ASP Ragusa, Italy
  31. (31) Imperial College London, grid.7445.2


BACKGROUND/OBJECTIVES: Diets high in saturated and trans fat and low in unsaturated fat may increase type 2 diabetes (T2D) risk, but studies on foods high in fat per unit weight are sparse. We assessed whether the intake of vegetable oil, butter, margarine, nuts and seeds and cakes and cookies is related to incident T2D. SUBJECTS/METHODS: A case-cohort study was conducted, nested within eight countries of the European Prospective Investigation into Cancer (EPIC), with 12,403 incident T2D cases and a subcohort of 16,835 people, identified from a cohort of 340,234 people. Diet was assessed at baseline (1991-1999) by country-specific questionnaires. Country-specific hazard ratios (HRs) across four categories of fatty foods (nonconsumers and tertiles among consumers) were combined with random-effects meta-analysis. RESULTS: After adjustment not including body mass index (BMI), nonconsumers of butter, nuts and seeds and cakes and cookies were at higher T2D risk compared with the middle tertile of consumption. Among consumers, cakes and cookies were inversely related to T2D (HRs across increasing tertiles 1.14, 1.00 and 0.92, respectively; P-trend <0.0001). All these associations attenuated upon adjustment for BMI, except the higher risk of nonconsumers of cakes and cookies (HR 1.57). Higher consumption of margarine became positively associated after BMI adjustment (HRs across increasing consumption tertiles: 0.93, 1.00 and 1.12; P-trend 0.03). Within consumers, vegetable oil, butter and nuts and seeds were unrelated to T2D. CONCLUSIONS: Fatty foods were generally not associated with T2D, apart from weak positive association for margarine. The higher risk among nonconsumers of cakes and cookies needs further explanation.


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