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Titova, O. E., Brunius, C., Warensjö Lemming, E., Stattin, K., Baron, J. A., Byberg, L., . . . Larsson, S. C. (2023). Comprehensive analyses of circulating cardiometabolic proteins and objective measures of fat mass.. International Journal of Obesity, 47(11), 1043-1049
Open this publication in new window or tab >>Comprehensive analyses of circulating cardiometabolic proteins and objective measures of fat mass.
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2023 (English)In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 47, no 11, p. 1043-1049Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The underlying molecular pathways for the effect of excess fat mass on cardiometabolic diseases is not well understood. Since body mass index is a suboptimal measure of body fat content, we investigated the relationship of fat mass measured by dual-energy X-ray absorptiometry with circulating cardiometabolic proteins.

METHODS: We used data from a population-based cohort of 4950 Swedish women (55-85 years), divided into discovery and replication samples; 276 proteins were assessed with three Olink Proseek Multiplex panels. We used random forest to identify the most relevant biomarker candidates related to fat mass index (FMI), multivariable linear regression to further investigate the associations between FMI characteristics and circulating proteins adjusted for potential confounders, and principal component analysis (PCA) for the detection of common covariance patterns among the proteins.

RESULTS: Total FMI was associated with 66 proteins following adjustment for multiple testing in discovery and replication multivariable analyses. Five proteins not previously associated with body size were associated with either lower FMI (calsyntenin-2 (CLSTN2), kallikrein-10 (KLK10)), or higher FMI (scavenger receptor cysteine-rich domain-containing group B protein (SSC4D), trem-like transcript 2 protein (TLT-2), and interleukin-6 receptor subunit alpha (IL-6RA)). PCA provided an efficient summary of the main variation in FMI-related circulating proteins involved in glucose and lipid metabolism, appetite regulation, adipocyte differentiation, immune response and inflammation. Similar patterns were observed for regional fat mass measures.

CONCLUSIONS: This is the first large study showing associations between fat mass and circulating cardiometabolic proteins. Proteins not previously linked to body size are implicated in modulation of postsynaptic signals, inflammation, and carcinogenesis.

Place, publisher, year, edition, pages
Springer Nature, 2023
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-509317 (URN)10.1038/s41366-023-01351-z (DOI)001042537300001 ()37550405 (PubMedID)
Available from: 2023-08-17 Created: 2023-08-17 Last updated: 2024-01-25Bibliographically approved
Karlsson, M., Becker, W., Cederholm, T. E. & Byberg, L. (2022). A posteriori Dietary Patterns in 71-year-old Swedish Men and the Prevalence of Sarcopenia 16 Years Later. British Journal of Nutrition, 128(5), 909-920
Open this publication in new window or tab >>A posteriori Dietary Patterns in 71-year-old Swedish Men and the Prevalence of Sarcopenia 16 Years Later
2022 (English)In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 128, no 5, p. 909-920Article in journal (Refereed) Published
Abstract [en]

The role of diet in sarcopenia is unclear, and results from studies using dietary patterns (DP) are inconsistent. We assessed how adherences to a posteriori DP are associated with the prevalence of sarcopenia and its components 16 years later. Four DP were defined in the Uppsala Longitudinal Study of Adult Men at baseline (n 1133, average age 71 years). Among 257 men with information at follow-up, 19 % (n 50) had sarcopenia according to the European Working Group on sarcopenia in Older People 2 definition. Adherence to DP2 (mainly characterised by high intake of vegetables, green salad, fruit, poultry, rice and pasta) was non-linearly associated with sarcopenia; adjusted OR and 95 % CI for medium and high v. low adherence: 0·41 (0·17, 0·98) and 0·40 (0·17, 0·94). The OR per standard deviation (sd) higher adherence to DP2 was 0·70 (0·48, 1·03). Adjusted OR (95 % CI) for 1 sd higher adherence to DP1 (mainly characterised by high consumption of milk and cereals), DP3 (mainly characterised by high consumption of bread, cheese, marmalade, jam and sugar) and DP4 (mainly characterised by high consumption of potatoes, meat and egg and low consumption of fermented milk) were 1·04 (0·74, 1·46), 1·19 (0·71, 2·00) and 1·08 (0·77, 1·53), respectively. There were no clear associations between adherence to the DP and muscle strength, muscle mass, physical performance or sarcopenia using EWGSOP1 (sarcopenia n 54). Our results indicate that diet may be a potentially modifiable risk factor for sarcopenia in old Swedish men.

Place, publisher, year, edition, pages
Cambridge University Press, 2022
Keywords
sarcopenia, dietary pattern, principal component analysis, longitudinal, muscle mass
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-455968 (URN)10.1017/s0007114521003901 (DOI)000744725700001 ()34585650 (PubMedID)
Funder
Region Örebro County
Available from: 2021-10-14 Created: 2021-10-14 Last updated: 2024-01-15Bibliographically approved
Jannasch, F., Dietrich, S., Bishop, T. R., Pearce, M., Fanidi, A., O'Donoghue, G., . . . Schulze, M. B. (2022). Associations between exploratory dietary patterns and incident type 2 diabetes: a federated meta-analysis of individual participant data from 25 cohort studies.. European Journal of Nutrition, 61(7), 3649-3667
Open this publication in new window or tab >>Associations between exploratory dietary patterns and incident type 2 diabetes: a federated meta-analysis of individual participant data from 25 cohort studies.
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2022 (English)In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 61, no 7, p. 3649-3667Article in journal (Refereed) Published
Abstract [en]

PURPOSE: In several studies, exploratory dietary patterns (DP), derived by principal component analysis, were inversely or positively associated with incident type 2 diabetes (T2D). However, findings remained study-specific, inconsistent and rarely replicated. This study aimed to investigate the associations between DPs and T2D in multiple cohorts across the world.

METHODS: This federated meta-analysis of individual participant data was based on 25 prospective cohort studies from 5 continents including a total of 390,664 participants with a follow-up for T2D (3.8-25.0 years). After data harmonization across cohorts we evaluated 15 previously identified T2D-related DPs for association with incident T2D estimating pooled incidence rate ratios (IRR) and confidence intervals (CI) by Piecewise Poisson regression and random-effects meta-analysis.

RESULTS: 29,386 participants developed T2D during follow-up. Five DPs, characterized by higher intake of red meat, processed meat, French fries and refined grains, were associated with higher incidence of T2D. The strongest association was observed for a DP comprising these food groups besides others (IRRpooled per 1 SD = 1.104, 95% CI 1.059-1.151). Although heterogeneity was present (I2 = 85%), IRR exceeded 1 in 18 of the 20 meta-analyzed studies. Original DPs associated with lower T2D risk were not confirmed. Instead, a healthy DP (HDP1) was associated with higher T2D risk (IRRpooled per 1 SD = 1.057, 95% CI 1.027-1.088).

CONCLUSION: Our findings from various cohorts revealed positive associations for several DPs, characterized by higher intake of red meat, processed meat, French fries and refined grains, adding to the evidence-base that links DPs to higher T2D risk. However, no inverse DP-T2D associations were confirmed.

Place, publisher, year, edition, pages
Springer Nature, 2022
Keywords
Dietary patterns, Exploratory, Federated meta-analysis, Type 2 diabetes mellitus
National Category
Endocrinology and Diabetes Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-489554 (URN)10.1007/s00394-022-02909-9 (DOI)000803874400001 ()35641800 (PubMedID)
Available from: 2022-12-01 Created: 2022-12-01 Last updated: 2023-02-10Bibliographically approved
Olsson, E., Larsson, S. C., Höijer, J., Kilander, L. & Byberg, L. (2022). Milk and Fermented Milk Consumption and Risk of Stroke: Longitudinal Study. Nutrients, 14(5), Article ID 1070.
Open this publication in new window or tab >>Milk and Fermented Milk Consumption and Risk of Stroke: Longitudinal Study
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2022 (English)In: Nutrients, E-ISSN 2072-6643, Vol. 14, no 5, article id 1070Article in journal (Refereed) Published
Abstract [en]

The role of milk and fermented milk consumption in stroke risk is unclear. We investigated associations of time-updated information on milk and fermented milk consumption (1997 and 2009) with total stroke, cerebral infarction, and hemorrhagic stroke risk among 79,618 Swedish women and men (mean age 61.3 years). During a mean follow-up of 17.7 years, we identified 9735 incident cases of total stroke, of which 7573 were cerebral infarctions, 1470 hemorrhagic strokes, and 692 unspecified strokes. Compared with an intake of 100 g/day of milk, the multivariable-adjusted hazard ratios (95% confidence interval) of cerebral infarction were 1.05 (1.02-1.08) for 0 g/day, 0.97 (0.95-0.99) for 200 g/day, 0.96 (0.92-1.00) for 400 g/day, 0.98 (0.94-1.03) for 600 g/day, and 1.01 (0.94-1.07) for 800 g/day. Corresponding estimates for hemorrhagic stroke were 0.98 (0.91-1.05) for 0 g/day, 1.02 (0.97-1.07) for 200 g/day, 1.07 (0.98-1.17) for 400 g/day, 1.13 (1.02-1.25) for 600 g/day, and 1.19 (1.03-1.36) for 800 g/day. No associations were observed between milk consumption and total stroke or for fermented milk consumption and any of the stroke outcomes. Higher long-term milk consumption based on repeated measures of intake was weakly and non-linearly associated with cerebral infarction, and was directly associated with hemorrhagic stroke.

Place, publisher, year, edition, pages
MDPI AG, 2022
Keywords
milk, stroke, cohort, risk factors
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-470954 (URN)10.3390/nu14051070 (DOI)000771497600001 ()35268043 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-00963Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-00123EU, Horizon 2020
Available from: 2022-04-01 Created: 2022-04-01 Last updated: 2023-08-28Bibliographically approved
Lind, L., Zethelius, B. & Byberg, L. (2022). Self-reported physical activity and different cardiovascular diseases-Results from updated measurements over 40 years. PLOS ONE, 17(6), Article ID e0269402.
Open this publication in new window or tab >>Self-reported physical activity and different cardiovascular diseases-Results from updated measurements over 40 years
2022 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 17, no 6, article id e0269402Article in journal (Refereed) Published
Abstract [en]

Background Self-reported leisure-time physical activity (PA) has previously been linked to risk of cardiovascular disease (CVD). We now aim to investigate the strength of associations between PA and different CVDs and how the risk varies with age. Methods PA and traditional CV risk factors assessed by a questionnaire on a four-level scale in 2,175 men at age 50 years in the ULSAM study. Examinations were thereafter repeated at ages 60, 70, and 77. Results During 40 years follow-up, 883 individuals experienced a CVD (myocardial infarction, stroke, or heart failure). Using data from all four examinations, a graded reduction in risk of incident CVD was seen with increasing PA (HR 0.84, 95%CI; 0.77-0.93, p= 0.001 for trend test). PA was related to myocardial infarction (HR 0.84, 95%CI; 0.74-0.95, 490 cases), heart failure (HR 0.79, 95%CI; 0.68-0.91, 356 cases), but only of borderline significance vs ischemic stroke (HR 0.85, 95%CI; 0.73-1.00, 315 cases) when the CVDs were analyzed separately. Adjusting for traditional CV risk factors attenuated all relationships between PA and incident CVD, and PA did not improve discrimination of CVD when added on top of risk factors. When 10-year risk was calculated from each examination, age 70 was the time-point when PA was most closely related to incident CVD. Conclusion Leisure-time physical activity is related to future CVD. This was most evident at 70 years of age. If a causal relationship between self-reported PA and CVD exists, this relationship might to a major degree be mediated by traditional risk factors.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2022
National Category
Cardiac and Cardiovascular Systems Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-485360 (URN)10.1371/journal.pone.0269402 (DOI)000843567600083 ()35657994 (PubMedID)
Available from: 2022-09-23 Created: 2022-09-23 Last updated: 2022-09-23Bibliographically approved
Michaelsson, M., Yuan, S., Melhus, H., Baron, J. A., Byberg, L., Larsson, S. C. & Michaëlsson, K. (2022). The impact and causal directions for the associations between diagnosis of ADHD, socioeconomic status, and intelligence by use of a bi-directional two-sample Mendelian randomization design. BMC Medicine, 20(1), Article ID 106.
Open this publication in new window or tab >>The impact and causal directions for the associations between diagnosis of ADHD, socioeconomic status, and intelligence by use of a bi-directional two-sample Mendelian randomization design
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2022 (English)In: BMC Medicine, E-ISSN 1741-7015, Vol. 20, no 1, article id 106Article in journal (Refereed) Published
Abstract [en]

Background Previous studies have reported associations between attention-deficit/hyperactivity disorder (ADHD) and lower socioeconomic status and intelligence. We aimed to evaluate the causal directions and strengths for these associations by use of a bi-directional two-sample Mendelian randomization (MR) design. Methods We used summary-level data from the largest available genome-wide association studies (GWAS) to identify genetic instruments for ADHD, intelligence, and markers of socioeconomic status including the Townsend deprivation index, household income, and educational attainment. Effect estimates from individual genetic variants were combined using inverse-variance weighted regression. Results A genetically predicted one standard deviation (SD) increment in the Townsend deprivation index conferred an odds ratio (OR) of 5.29 (95% confidence interval (CI) 1.89-14.76) for an ADHD diagnosis (p<0.001). A genetically predicted one SD higher education level conferred an OR of 0.30 (95% CI 0.25-0.37) (p<0.001), and a genetically predicted one SD higher family income provided an OR of 0.35 (95% CI 0.25-0.49; p<0.001). The associations remained after adjustment for intelligence whereas the lower odds of an ADHD diagnosis with higher intelligence did not persist after adjustment for liability to greater educational attainment (adjusted OR 1.03, 95% CI 0.68-1.56; p=0.87). The MR analysis of the effect of ADHD on socioeconomic markers found that genetic liability to ADHD was statistically associated with each of them (p<0.001) but not intelligence. However, the average change in the socioeconomic markers per doubling of the prevalence of ADHD corresponded only to 0.05-0.06 SD changes. Conclusions Our results indicate that an ADHD diagnosis may be a direct and strong intelligence-independent consequence of socioeconomic related factors, whereas ADHD appears to lead only to modestly lowered socioeconomic status. Low intelligence seems not to be a major independent cause or consequence of ADHD.

Place, publisher, year, edition, pages
BioMed Central (BMC)BMC, 2022
Keywords
Attention-deficit, hyperactivity disorder, ADHD, Socioeconomic status, Education, Intelligence, Income, Townsend deprivation index, Mendelian randomization, Gene, GWAS
National Category
Psychiatry Clinical Medicine
Identifiers
urn:nbn:se:uu:diva-473190 (URN)10.1186/s12916-022-02314-3 (DOI)000779948300001 ()35399077 (PubMedID)
Funder
Swedish Research Council, 2017-00644Swedish Research Council, 2017-06100Swedish Research Council, 2019-01291
Available from: 2022-04-27 Created: 2022-04-27 Last updated: 2024-01-15Bibliographically approved
Grauman, Å., Byberg, L., Veldwijk, J. & James, S. (2022). What CVD risk factors predict self-perceived risk of having a myocardial infarction?: A cross-sectional study. International Journal of Cardiology Cardiovascular Risk and Prevention, 12, Article ID 200125.
Open this publication in new window or tab >>What CVD risk factors predict self-perceived risk of having a myocardial infarction?: A cross-sectional study
2022 (English)In: International Journal of Cardiology Cardiovascular Risk and Prevention, ISSN 2772-4875, Vol. 12, article id 200125Article in journal (Refereed) Published
Abstract [en]

Background: This study aims to identify predictors of self-perceived risk of myocardial infarction (MI).

Methods: Among 564 men and women (50–65 years; randomly selected from the Swedish population), we assessed risk perception as relative self-perceived risk compared to others (lower, same, higher) and percentage ten-year absolute risk. Predictors (added blockwise) were identified using multinomial or linear regression, providing odds ratios (ORs) or β coefficients with their 95% confidence intervals (CI).

Results: The mean of self-perceived 10-year MI risk was 12%. Lower BMI (AOR 0.57, 95% CI: 0.44–0.75), low stress (AOR 2.51, 95% CI: 1.39–4.52), high level of physical activity (AOR 1.66, 95% CI:1.01–2.74), hypertension (AOR 0.42, 95% CI: 0.23–0.76), family history (AOR 0.38, 95% CI: 0.21–0.69), and poor general health (AOR 0.41, 95% CI: 0.19–0.89) predicted if respondents perceived their MI risk as lower. Poor general health (AOR 1.94, 95% CI: 1.01–3.73), family history (AOR 2.72, 95% CI: 1.57–4.72), and high cholesterol (AOR 2.45, 95% CI: 1.18–5.09) predicted if respondents perceived their MI risk as higher. Low level of self-perceived CVD knowledge and low numeracy predicted if respondents perceived their MI risk as the same as others. High cholesterol (B 6.85, 95% CI: 2.47–11.32) and poor general health (B 8.75, 95% CI: 4.58–13.00) predicted a higher percentage of perceived ten-year risk.

Conclusion: General health was a common predictor of self-perceived MI risk. Lifestyle factors (BMI, physical activity) and stress dominated the predictors for perceiving MI risk as lower than others, while high cholesterol predicted perception of high risk.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Risk perception, Relative risk, Absolute risk, Myocardial infarction, CVD risk factors, General populatio
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-464358 (URN)10.1016/j.ijcrp.2022.200125 (DOI)000850207200002 ()35243482 (PubMedID)
Funder
Swedish Heart Lung Foundation, 20150049
Available from: 2022-01-14 Created: 2022-01-14 Last updated: 2022-09-16Bibliographically approved
Ludvigsson, J. F., Appelros, P., Askling, J., Byberg, L., Carrero, J.-J., Ekström, A. M., . . . Sundström, J. (2021). Adaptation of the Charlson Comorbidity Index for Register-Based Research in Sweden. Clinical Epidemiology, 13, 21-41
Open this publication in new window or tab >>Adaptation of the Charlson Comorbidity Index for Register-Based Research in Sweden
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2021 (English)In: Clinical Epidemiology, ISSN 1179-1349, E-ISSN 1179-1349, Vol. 13, p. 21-41Article in journal (Refereed) Published
Abstract [en]

Purpose: Comorbidity indices are often used to measure comorbidities in register-based research. We aimed to adapt the Charlson comorbidity index (CCI) to a Swedish setting.

Methods: Four versions of the CCI were compared and evaluated by disease-specific experts.

Results: We created a cohesive coding system for CCI to 1) harmonize the content between different international classification of disease codes (ICD-7,8,9,10), 2) delete incorrect codes, 3) enhance the distinction between mild, moderate or severe disease (and between diabetes with and without end-organ damage), 4) minimize duplication of codes, and 5) briefly explain the meaning of individual codes in writing.

Conclusion: This work may provide an integrated and efficient coding algorithm for CCI to be used in medical register-based research in Sweden.

Place, publisher, year, edition, pages
Dove Medical PressDOVE MEDICAL PRESS LTD, 2021
Keywords
Charlson comorbidity score, comorbidity, disease, epidemiology, public health, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-439831 (URN)10.2147/CLEP.S282475 (DOI)000614055700001 ()33469380 (PubMedID)
Available from: 2021-04-12 Created: 2021-04-12 Last updated: 2024-01-15Bibliographically approved
Enarsson, M., Feldreich, T., Byberg, L., Nowak, C., Lind, L. & Ärnlöv, J. (2021). Association between Cardiorespiratory Fitness and Circulating Proteins in 50-Year-Old Swedish Men and Women: a Cross-Sectional Study. SPORTS MEDICINE-OPEN, 7, Article ID 52.
Open this publication in new window or tab >>Association between Cardiorespiratory Fitness and Circulating Proteins in 50-Year-Old Swedish Men and Women: a Cross-Sectional Study
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2021 (English)In: SPORTS MEDICINE-OPEN, ISSN 2199-1170, Vol. 7, article id 52Article in journal (Refereed) Published
Abstract [en]

Background and Aims: A strong cardiorespiratory fitness is suggested to have beneficial effects on cardiovascular risk; the exact mechanisms underlying the cardioprotective effects of fitness remain uncertain. Our aim was to investigate associations between cardiorespiratory fitness and multiple plasma proteins, in order to obtain insights about physiological pathways associated with the effects of exercise on cardiovascular health.

Methods: In the Prospective investigation of Obesity, Energy and Metabolism (POEM) study (n=444 adults aged 50 years, 50% women), cardiorespiratory fitness was measured by a maximal exercise test on bicycle ergometer with gas exchange (VO(2)peak) normalized for body lean mass (dual-energy X-ray absorptiometry (DXA)). We measured 82 cardiovascular proteins associated with cardiovascular pathology and inflammation in plasma samples with a proximity extension assay.

Results: In sex-adjusted linear regression, VO(2)peak was associated with 18 proteins after Bonferroni correction for multiple testing (p<0.0006). Following additional adjustment for fat mass (DXA), fasting glucose (mmol/L), low-density lipoprotein (LDL, mmol/L), smoking status, waist/hip ratio, blood pressure (mmHg), education level, and lpnr (lab sequence number), higher VO(2)peak was significantly associated with lower levels of 6 proteins: fatty-acid binding protein-4 (FABP4), interleukin-6 (IL-6), leptin, cystatin-B (CSTB), interleukin-1 receptor antagonist (IL-1RA), and growth differentiation factor 15 (GDF-15), and higher levels of 3 proteins: galanin, kallikrein-6 (KLK6), and heparin-binding EGF-like growth factor (HB-EGF), at nominal p-values (p<0.05).

Conclusions: We identified multiple novel associations between cardiorespiratory fitness and plasma proteins involved in several atherosclerotic processes and key cellular mechanisms such as inflammation, energy homeostasis, and protease activity, which shed new light on how exercise asserts its beneficial effects on cardiovascular health. Our findings encourage additional studies in order to understand the underlying causal mechanisms for these associations.

Place, publisher, year, edition, pages
SpringerSPRINGER, 2021
Keywords
Biomarkers, Proteomics, Cardiorespiratory fitness
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-452312 (URN)10.1186/s40798-021-00343-5 (DOI)000678208600001 ()34312731 (PubMedID)
Funder
Swedish Research CouncilSwedish Heart Lung Foundation
Available from: 2021-09-06 Created: 2021-09-06 Last updated: 2024-01-15Bibliographically approved
Pearce, M., Fanidi, A., Bishop, T. R. P., Sharp, S. J., Imamura, F., Dietrich, S., . . . Forouhi, N. G. (2021). Associations of Total Legume, Pulse, and Soy Consumption with Incident Type 2 Diabetes: Federated Meta-Analysis of 27 Studies from Diverse World Regions. Journal of Nutrition, 151(5), 1231-1240
Open this publication in new window or tab >>Associations of Total Legume, Pulse, and Soy Consumption with Incident Type 2 Diabetes: Federated Meta-Analysis of 27 Studies from Diverse World Regions
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2021 (English)In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 151, no 5, p. 1231-1240Article in journal (Refereed) Published
Abstract [en]

Background

The consumption of legumes is promoted as part of a healthy diet in many countries but associations of total and types of legume consumption with type 2 diabetes (T2D) are not well established. Analyses across diverse populations are lacking despite the availability of unpublished legume consumption data in prospective cohort studies.

Objective

To examine the prospective associations of total and types of legume intake with the risk of incident T2D.

Methods

Meta-analyses of associations between total legume, pulse, and soy consumption and T2D were conducted using a federated approach without physical data-pooling. Prospective cohorts were included if legume exposure and T2D outcome data were available and the cohort investigators agreed to participate. We estimated incidence rate ratios (IRRs) and CIs of associations using individual participant data including ≤42,473 incident cases among 807,785 adults without diabetes in 27 cohorts across the Americas, Eastern Mediterranean, Europe, and Western Pacific. Random-effects meta-analysis was used to combine effect estimates and estimate heterogeneity.

Results

Median total legume intake ranged from 0–140 g/d across cohorts. We observed a weak positive association between total legume consumption and T2D (IRR = 1.02, 95% CI: 1.01 to 1.04) per 20 g/d higher intake, with moderately high heterogeneity (I2 = 74%). Analysis by region showed no evidence of associations in the Americas, Eastern Mediterranean, and Western Pacific. The positive association in Europe (IRR = 1.05, 95% CI: 1.01 to 1.10, I2 = 82%) was mainly driven by studies from Germany, UK, and Sweden. No evidence of associations was observed for the consumption of pulses or soy.

Conclusions

These findings suggest no evidence of an association of legume intakes with T2D in several world regions. The positive association observed in some European studies warrants further investigation relating to overall dietary contexts in which legumes are consumed, including accompanying foods which may be positively associated with T2D.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
bean, chickpea, diabetes, legumes, lentil, pea, peanut, pulse, soy
National Category
Nutrition and Dietetics Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-452664 (URN)10.1093/jn/nxaa447 (DOI)000731800900024 ()33693815 (PubMedID)
Funder
SIMPLER, 2017-00644EU, FP7, Seventh Framework Programme, 602068EU, Horizon 2020, 824989European Regional Development Fund (ERDF), PI17/01795NIH (National Institute of Health)Swedish Research Council, 2017-00644
Available from: 2021-09-08 Created: 2021-09-08 Last updated: 2024-01-15Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4421-6466

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