TY - JOUR A1 - Jannasch, Franziska A1 - Kröger, Janine A1 - Agnoli, Claudia A1 - Barricarte, Aurelio A1 - Boeing, Heiner A1 - Cayssials, Valérie A1 - Colorado-Yohar, Sandra A1 - Dahm, Christina C. A1 - Dow, Courtney A1 - Fagherazzi, Guy A1 - Franks, Paul W. A1 - Freisling, Heinz A1 - Gunter, Marc J. A1 - Kerrison, Nicola D. A1 - Key, Timothy J. A1 - Khaw, Kay-Tee A1 - Kühn, Tilman A1 - Kyro, Cecilie A1 - Mancini, Francesca Romana A1 - Mokoroa, Olatz A1 - Nilsson, Peter A1 - Overvad, Kim A1 - Palli, Domenico A1 - Panico, Salvatore A1 - Quiros Garcia, Jose Ramon A1 - Rolandsson, Olov A1 - Sacerdote, Carlotta A1 - Sanchez, Maria-Jose A1 - Sahrai, Mohammad Sediq A1 - Schübel, Ruth A1 - Sluijs, Ivonne A1 - Spijkerman, Annemieke M. W. A1 - Tjonneland, Anne A1 - Tong, Tammy Y. N. A1 - Tumino, Rosario A1 - Riboli, Elio A1 - Langenberg, Claudia A1 - Sharp, Stephen J. A1 - Forouhi, Nita G. A1 - Schulze, Matthias Bernd A1 - Wareham, Nicholas J. T1 - Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations JF - The Journal of Nutrition 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. KW - dietary patterns KW - principal component analysis KW - diet-disease association KW - type 2 diabetes mellitus KW - replication KW - meta-analysis Y1 - 2019 U6 - https://doi.org/10.1093/jn/nxz031 SN - 0022-3166 SN - 1541-6100 VL - 149 IS - 6 SP - 1047 EP - 1055 PB - Oxford Univ. Press CY - Oxford ER - TY - JOUR A1 - Galbete, Cecilia A1 - Kröger, Janine A1 - Jannasch, Franziska A1 - Iqbal, Khalid A1 - Schwingshackl, Lukas A1 - Schwedhelm, Carolina A1 - Weikert, Cornelia A1 - Boeing, Heiner A1 - Schulze, Matthias Bernd T1 - Nordic diet, Mediterranean diet, and the risk of chronic diseases BT - the EPIC-Potsdam study JF - BMC Medicine N2 - Background: The Mediterranean Diet (MedDiet) has been acknowledged as a healthy diet. However, its relation with risk of major chronic diseases in non-Mediterranean countries is inconclusive. The Nordic diet is proposed as an alternative across Northern Europe, although its associations with the risk of chronic diseases remain controversial. We aimed to investigate the association between the Nordic diet and the MedDiet with the risk of chronic disease (type 2 diabetes (T2D), myocardial infarction (MI), stroke, and cancer) in the EPIC-Potsdam cohort. Methods: The EPIC-Potsdam cohort recruited 27,548 participants between 1994 and 1998. After exclusion of prevalent cases, we evaluated baseline adherence to a score reflecting the Nordic diet and two MedDiet scores (tMDS, reflecting the traditional MedDiet score, and the MedPyr score, reflecting the MedDiet Pyramid). Cox regression models were applied to examine the association between the diet scores and the incidence of major chronic diseases. Results: During a follow-up of 10.6 years, 1376 cases of T2D, 312 of MI, 321 of stroke, and 1618 of cancer were identified. The Nordic diet showed a statistically non-significant inverse association with incidence of MI in the overall population and of stroke in men. Adherence to the MedDiet was associated with lower incidence of T2D (HR per 1 SD 0.93, 95% CI 0.88-0.98 for the tMDS score and 0.92, 0.87-0.97 for the MedPyr score). In women, the MedPyr score was also inversely associated with MI. No association was observed for any of the scores with cancer. Conclusions: In the EPIC-Potsdam cohort, the Nordic diet showed a possible beneficial effect on MI in the overall population and for stroke in men, while both scores reflecting the MedDiet conferred lower risk of T2D in the overall population and of MI in women. KW - Mediterranean diet KW - Nordic diet KW - regional diets KW - chronic diseases KW - diabetes KW - myocardial infarction KW - stroke KW - cancer KW - EPIC-Potsdam study KW - longitudinal analysis Y1 - 2018 U6 - https://doi.org/10.1186/s12916-018-1082-y SN - 1741-7015 VL - 16 PB - BMC CY - London ER -