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Eur J Epidemiol. 2019 Sep;34(9):853-861. doi: 10.1007/s10654-019-00548-9. Epub 2019 Aug 9.

Dietary antioxidant capacity and risk of type 2 diabetes mellitus, prediabetes and insulin resistance: the Rotterdam Study.

Author information

1
Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
2
Department of Internal Medicine, Erasmus University Medical Center, 3000 CA, Rotterdam, The Netherlands.
3
German Center for Diabetes Research, Neuherberg, Germany.
4
Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.
5
Department of Public Health and Primary Care/LUMC Campus The Hague, Leiden University Medical Center, Leiden, The Netherlands.
6
Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
7
Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. trudy.voortman@erasmusmc.nl.

Abstract

Intake of individual antioxidants has been related to a lower risk of type 2 diabetes. However, the overall diet may contain many antioxidants with additive or synergistic effects. Therefore, we aimed to determine associations between total dietary antioxidant capacity and risk of type 2 diabetes, prediabetes and insulin resistance. We estimated the dietary antioxidant capacity for 5796 participants of the Rotterdam Study using a ferric reducing ability of plasma (FRAP) score. Of these participants, 4957 had normoglycaemia and 839 had prediabetes at baseline. We used covariate-adjusted proportional hazards models to estimate associations between FRAP and risk of type 2 diabetes, risk of type 2 diabetes among participants with prediabetes, and risk of prediabetes. We used linear regression models to determine the association between FRAP score and insulin resistance (HOMA-IR). We observed 532 cases of incident type 2 diabetes, of which 259 among participants with prediabetes, and 794 cases of incident prediabetes during up to 15 years of follow-up. A higher FRAP score was associated with a lower risk of type 2 diabetes among the total population (HR per SD FRAP 0.84, 95% CI 0.75; 0.95) and among participants with prediabetes (HR 0.85, 95% CI 0.73; 0.99), but was not associated with risk of prediabetes. Dietary FRAP was also inversely associated with HOMA-IR (β - 0.04, 95% CI - 0.06; - 0.03). Effect estimates were generally similar between sexes. The findings of this population-based study emphasize the putative beneficial effects of a diet rich in antioxidants on insulin resistance and risk of type 2 diabetes.

KEYWORDS:

Diet; Dietary antioxidant capacity; Insulin resistance; Prediabetes; Type 2 diabetes

PMID:
31399939
DOI:
10.1007/s10654-019-00548-9
[Indexed for MEDLINE]
Free PMC Article

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