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Association of Carbohydrates, Fats, and Protein Intake with Type 2 Diabetes Mellitus: A Prospective Cohort Study of UK Biobank Participants
24 Pages Posted: 5 Jan 2024
More...Abstract
Background: This study aimed to investigate the relationship between macronutrient intake and the risk of type 2 diabetes mellitus (T2DM).
Methods: This study analyzed 192,402 participants from the UK Biobank who completed at least one 24-hour dietary recall questionnaire. Restricted cubic splines (four-knot points) in the COX proportional hazards model were used to evaluate the non-linear relationships between macronutrients and T2DM. A multivariable nutrient density model was used to estimate the relationship between the isocaloric replacement of macronutrients and T2DM.
Findings: During a median of 12·4 years of follow-up, 4,614 incident cases of T2DM were documented. The relationships between many macronutrients and T2DM were nonlinear, with sugars exhibiting a possible "wide U-shaped" pattern. A higher intake of protein (average HR 1·19, 95%CI: 1·02-1·38 (>22% vs 16% of energy)), polyunsaturated fat (average HR 1·27, 95%CI: 1·09-1·47 (10-15% vs 6% of energy)), starch (average HR 1·22, 95%CI: 1·05-1·42 (>30% vs 25% of energy)), and sugars (average HR 1·26, 95%CI: 1·04-1·53 (>40% vs 30% of energy)) was positively related to a higher risk of T2DM. A lower intake of monounsaturated fat (average HR 1·21, 95%CI: 1·04-1·40 (5-10% vs 14% of energy)) and fiber (average HR 1·45, 95%CI: 1·29-1·64 (<13 vs 16 g per day)) was related to a higher risk of T2DM. Besides, the impact of macronutrients on T2DM might vary across different total energy intake subgroups and gender subgroups.
Interpretation: Altering the proportion of macronutrient intake without restricting total energy intake could decrease the risk of incident T2DM.
Funding: This work was supported by National Natural Science Foundation of China (82130025).
Declaration of Interest: All authors declare no competing interests.
Ethical Approval: The UK Biobank received ethical approval from the North West Multicenter Research Ethics Committee, Manchester, UK (REC reference for UK Biobank 11/NW/0382), and all participants provided written informed consent.
Keywords: macronutrient, carbohydrate, fat, protein, type 2 diabetes mellitus
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