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Eur J Clin Nutr. 2014 Feb;68(2):196-202. doi: 10.1038/ejcn.2013.235. Epub 2013 Nov 20.

Dietary vitamin D intake and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition: the EPIC-InterAct study.

Author information

  • 11] German Cancer Research Centre (DKFZ), Heidelberg, Germany [2] Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
  • 21] German Cancer Research Centre (DKFZ), Heidelberg, Germany [2] Helmholtz Centre Munich (HMGU), Neuherberg, Germany.
  • 31] German Cancer Research Centre (DKFZ), Heidelberg, Germany [2] Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland.
  • 4University Medical Center Utrecht, Utrecht, The Netherlands.
  • 5German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam-Rehbruecke, Germany.
  • 61] Public Health Division of Gipuzkoa, San Sebastian, Spain [2] Instituto BIO-Donostia, Basque Government, San Sebastian, Spain [3] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
  • 71] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Navarre Public Health Institute (ISPN), Pamplona, Spain.
  • 81] Inserm, CESP, U1018, Villejuif, France [2] Université Paris-Sud, UMRS 1018, Villejuif, France.
  • 91] Lund University, Malmö, Sweden [2] Umeå University, Umeå, Sweden.
  • 101] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.
  • 11Epidemiology and Prevention Unit, Milan, Italy.
  • 12German Cancer Research Centre (DKFZ), Heidelberg, Germany.
  • 13University of Oxford, Oxford, UK.
  • 14University of Cambridge, Cambridge, UK.
  • 15Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
  • 161] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Andalusian School of Public Health, Granada, Spain.
  • 17Lund University, Malmö, Sweden.
  • 18Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
  • 19Public Health Directorate, Asturias, Spain.
  • 20Umeå University, Umeå, Sweden.
  • 211] Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital, University of Turin and Center for Cancer Prevention (CPO), Torino, Italy [2] Human Genetics Foundation (HuGeF), Torino, Italy.
  • 22Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
  • 23International Agency for Research on Cancer, Lyon, France.
  • 24National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
  • 25Danish Cancer Society Research Center, Copenhagen, Denmark.
  • 261] ASP Ragusa, Ragusa, Italy [2] Aire Onlus, Ragusa, Italy.
  • 27Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
  • 28MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
  • 29School of Public Health, Imperial College, London, UK.



Prospective cohort studies have indicated that serum vitamin D levels are inversely related to risk of type 2 diabetes. However, such studies cannot determine the source of vitamin D. Therefore, we examined the association of dietary vitamin D intake with incident type 2 diabetes within the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study in a heterogeneous European population including eight countries with large geographical variation.


Using a case-cohort design, 11,245 incident cases of type 2 diabetes and a representative subcohort (N=15,798) were included in the analyses. Hazard ratios (HR) and 95% confidence intervals (CIs) for type 2 diabetes were calculated using a Prentice-weighted Cox regression adjusted for potential confounders. Twenty-four-hour diet-recall data from a subsample (N=2347) were used to calibrate habitual intake data derived from dietary questionnaires.


Median follow-up time was 10.8 years. Dietary vitamin D intake was not significantly associated with the risk of type 2 diabetes. HR and 95% CIs for the highest compared to the lowest quintile of uncalibrated vitamin D intake was 1.09 (0.97-1.22) (Ptrend=0.17). No associations were observed in a sex-specific analysis. The overall pooled effect (HR (95% CI)) using the continuous calibrated variable was 1.00 (0.97-1.03) per increase of 1 μg/day dietary vitamin D.


This observational study does not support an association between higher dietary vitamin D intake and type 2 diabetes incidence. This result has to be interpreted in light of the limited contribution of dietary vitamin D on the overall vitamin D status of a person.

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