Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, SE-21428 Malmö, Sweden.
Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences Malmö, Lund University, SE-21428 Malmö, Sweden.
Br J Nutr. 2021 Oct 14;126(7):1065-1075. doi: 10.1017/S0007114520005140. Epub 2020 Dec 23.
Dietary carbohydrates have long been expected to be associated with risk of type 2 diabetes; however, the associations for many carbohydrates and carbohydrate-rich foods remain inconclusive. This study analysed associations between intakes of six types of carbohydrates and thirteen carbohydrate-rich foods with incident type 2 diabetes in 26 622 participants (61 % women) in the Malmö Diet and Cancer Study in southern Sweden. Dietary intake was assessed at baseline (1991-1996) by using a modified diet history method. During mean follow-up of 18 years, 4046 cases were identified. Adjusting for potential confounders (including lifestyle, BMI and dietary factors), comparing highest v. lowest quintile of intake, monosaccharides (hazard ratio (HR) 0·88; 95 % CI 0·79, 0·98; Ptrend = 0·02) and fruits (HR 0·91; 95 % CI 0·82, 1·01; Ptrend = 0·03) were inversely associated with incident type 2 diabetes, while disaccharides (HR 1·17; 95 % CI 1·04, 1·30; Ptrend = 0·002) and sweets (HR 1·09; 95 % CI 1·00, 1·19; Ptrend = 0·02) were positively associated. After stratification by sex, marmalade/honey/jam (HR 0·82; 95 % CI 0·72, 0·94; Ptrend < 0·001) and vegetables (HR 0·85; 95 % CI 0·73, 0·98; Ptrend = 0·06) were inversely associated with incident type 2 diabetes in men and chocolate (HR 1·26; 95 % CI 1·09, 1·46; Ptrend < 0·001) was positively associated in women. In conclusion, we identified inverse associations for intake of monosaccharides and fruits with type 2 diabetes risk, and positive associations for disaccharides and sweets. Additional sex-specific associations were also identified. Future studies are needed to explore these associations further.
长期以来，人们一直认为膳食碳水化合物与 2 型糖尿病的风险有关；然而，许多碳水化合物和富含碳水化合物的食物的相关性仍不确定。本研究在瑞典南部马尔默饮食与癌症研究中，分析了 26622 名参与者（61%为女性）的六种碳水化合物类型和 13 种富含碳水化合物的食物的摄入量与 2 型糖尿病发病之间的关联。膳食摄入量在基线（1991-1996 年）时通过改良饮食史法进行评估。在平均 18 年的随访期间，共确定了 4046 例病例。调整了潜在的混杂因素（包括生活方式、BMI 和饮食因素）后，最高五分位组与最低五分位组相比，单糖（风险比 (HR) 0·88；95%CI 0·79，0·98；Ptrend = 0·02）和水果（HR 0·91；95%CI 0·82，1·01；Ptrend = 0·03）与 2 型糖尿病发病呈负相关，而二糖（HR 1·17；95%CI 1·04，1·30；Ptrend = 0·002）和甜食（HR 1·09；95%CI 1·00，1·19；Ptrend = 0·02）与 2 型糖尿病发病呈正相关。按性别分层后，在男性中，果酱/蜂蜜/果冻（HR 0·82；95%CI 0·72，0·94；Ptrend < 0·001）和蔬菜（HR 0·85；95%CI 0·73，0·98；Ptrend = 0·06）与 2 型糖尿病发病呈负相关，而在女性中，巧克力（HR 1·26；95%CI 1·09，1·46；Ptrend < 0·001）与 2 型糖尿病发病呈正相关。总之，我们发现单糖和水果的摄入量与 2 型糖尿病风险呈负相关，而二糖和甜食的摄入量与 2 型糖尿病风险呈正相关。还发现了其他性别特异性关联。需要进一步的研究来探索这些关联。
