Endocrine

, Volume 47, Issue 1, pp 107–116 | Cite as

Which diet for prevention of type 2 diabetes? A meta-analysis of prospective studies

  • Katherine Esposito
  • Paolo Chiodini
  • Maria Ida Maiorino
  • Giuseppe Bellastella
  • Demosthenes Panagiotakos
  • Dario Giugliano
Meta-Analysis

Abstract

No specific diet is recommended to prevent type 2 diabetes. We did a meta-analysis of prospective cohort studies to assess the association between different diets and prevention of type 2 diabetes. We did a comprehensive search of multiple electronic databases (Medline, Scopus, EMBASE, and ISI web of knowledge) until August 2013 using predefined criteria. We included prospective cohort studies that evaluated the role of different diets in type 2 diabetes prevention. Studies were selected by 2 independent reviewers. We did random-effects meta-analyses to determine the relative risk (RR) of incident diabetes associated with healthful dietary patterns. A total of 21,372 cases of incident diabetes, from 18 prospective studies, with 20 cohorts, in 4 world regions were identified. In the random-effect meta-analysis of the 20 cohorts, RR was 0.80 (95 % confidence interval (CI) = 0.74–0.86, P < 0.001), with high heterogeneity (I2 = 57 %, P = 0.001) and no evidence of publication bias (Egger’s test, P = 0.653). Exclusion of two cohorts produced identical RR (0.80, 95 % CI 0.76–0.84), with nonsignificant heterogeneity (I2 = 9 %). The risk of incident diabetes did not appreciably change considering the geography (USA, Europe, and Asia), the duration of follow-up (≤10 and >10 years), and type of diets (Mediterranean and DASH, Dietary Approaches to Stop Hypertension, diets). There was a difference between at risk and general population (P = 0.0487), but the evidence was limited to two studies only. The results of our study demonstrate that several healthy diets are equally and consistently associated with a 20 % reduced risk of future type 2 diabetes.

Keywords

Diet Type 2 diabetes Prevention Meta-analysis Prospective studies 

Supplementary material

12020_2014_264_MOESM1_ESM.docx (32 kb)
Supplementary material 1 (DOCX 32 kb)

References

  1. 1.
    D.R. Whiting, L. Guariguata, C. Weil, J. Shaw, IDF Diabetes Atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res. Clin. Pract. 94, 311–321 (2011)PubMedCrossRefGoogle Scholar
  2. 2.
    D. Mozaffarian, P. Wilson, W.B. Kannel, Beyond established and novel risk factors. Lifestyle risk factors for cardiovascular diseases. Circulation 117, 3031–3038 (2008)PubMedCrossRefGoogle Scholar
  3. 3.
    American Diabetes Association, Standard of Medical Care in Diabetes—2014. Diabetes Care 37(Suppl 1), s14–s80 (2014)CrossRefGoogle Scholar
  4. 4.
    K. Esposito, C.M. Kastorini, D.B. Panagiotakos, D. Giugliano, Prevention of type 2 diabetes by dietary patterns: a systematic review of prospective studies and meta-analysis. Metab. Syndr. Relat. Disord. 8, 471–476 (2010)PubMedCrossRefGoogle Scholar
  5. 5.
    A. Liberati, D.G. Altman, J. Tetzlaff et al., The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann. Intern. Med. 151, W65–W69 (2009)PubMedGoogle Scholar
  6. 6.
    D.F. Stroup, J.A. Berlin, S.C. Morton et al., Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283, 2008–2012 (2000)PubMedCrossRefGoogle Scholar
  7. 7.
    G. Wells, B. Shea, D. O’Connell, et al., The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 19 Feb 2014
  8. 8.
    S.L. Normand, Meta-analysis: formulating, evaluating, combining, and reporting. Stat. Med. 18, 321–329 (1999)PubMedCrossRefGoogle Scholar
  9. 9.
    J.P. Higgins, S.G. Thompson, Quantifying heterogeneity in a meta-analysis. Stat. Med. 21, 1539–1558 (2002)PubMedCrossRefGoogle Scholar
  10. 10.
    R.M. van Dam, E.B. Rimm, W.C. Willett, M.J. Stampfer, F.B. Hu, Dietary patterns and risk for type 2 diabetes mellitus in U.S. men. Ann. Intern. Med. 136, 201–209 (2002)PubMedCrossRefGoogle Scholar
  11. 11.
    J. Montonen, P. Knekt, T. Härkänen, R. Järvinen, M. Heliövaara, A. Aromaa, A. Reunanen, Dietary patterns and the incidence of type 2 diabetes. Am. J. Epidemiol. 161, 219–227 (2005)PubMedCrossRefGoogle Scholar
  12. 12.
    A.M. Hodge, D.R. English, K. O’Dea, G.G. Giles, Dietary patterns and diabetes incidence in the Melbourne Collaborative Cohort Study. Am. J. Epidemiol. 165, 603–610 (2007)PubMedCrossRefGoogle Scholar
  13. 13.
    T.T. Fung, M. McCullough, R.M. van Dam, F.B. Hu, A prospective study of overall diet quality and risk of type 2 diabetes in women. Diabetes Care 30, 1753–1757 (2007)PubMedCrossRefGoogle Scholar
  14. 14.
    D. Mozaffarian, Incidence of new-onset diabetes and impaired fasting glucose in patients with recent myocardial infarction and the effect of clinical and lifestyle risk factor. Lancet 370, 667–675 (2007)PubMedCrossRefGoogle Scholar
  15. 15.
    M.A. Martinez-Gonzalez, C. de la Fuente-Arrillaga, J.M. Nunez-Cordoba et al., Adherence to Mediterranean diet and risk of developing diabetes: a prospective cohort study. BMJ 336, 1348–1351 (2008)PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    E.J. Brunner, A. Mosdøl, D.R. Witte, P. Martikainen, M. Stafford, M.J. Shipley, M.G. Marmot, Dietary patterns and 15-y risks of major coronary events, diabetes, and mortality. Am. J. Clin. Nutr. 87, 1414–1422 (2008)PubMedGoogle Scholar
  17. 17.
    J.A. Nettleton, L.M. Steffen, H. Ni, K. Liu, D.R. Jacobs, Dietary patterns and risk of incident type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis. Diabetes Care 31, 1777–1782 (2008)PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    A.D. Liese, M. Nichols, X. Sun, R.B. D’Agostino Jr, S.M. Haffner, Adherence to the DASH diet is inversely associated with incidence of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes Care 32, 1434–1436 (2009)PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    R. Villegas, G. Yang, Y.T. Gao, H. Cai, H. Li, W. Zheng, X.O. Shu, Dietary patterns are associated with lower incidence of type 2 diabetes in middle-aged women: the Shanghai Women’s Health Study. Int. J. Epidemiol. 39, 889–899 (2010)PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    R. Yu, J. Woo, R. Chan, Relationship between dietary intake and the development of type 2 diabetes in a Chinese population: the Hong Kong Dietary Survey. Public Health Nutr. 14, 1133–1141 (2011)PubMedCrossRefGoogle Scholar
  21. 21.
    A.O. Odegaard, W.P. Koh, L.M. Butler, Dietary patterns and incident type 2 diabetes in Chinese men and women: the Singapore Chinese Health Study. Diabetes Care 34, 880–885 (2011)PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    L. de Koning, S.E. Chiuve, T.T. Fung, W.C. Willett, E.B. Rimm, F.B. Hu, Diet-quality scores and the risk of type 2 diabetes in men. Diabetes Care 34, 1150–1156 (2011)PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    A. Morimoto, Y. Ohno, Y. Tatsumi, S. Mizuno, S. Watanabe, Effects of healthy dietary pattern and other lifestyle factors on incidence of diabetes in a rural Japanese population. Asia Pac. J. Clin. Nutr. 21, 601–608 (2012)PubMedGoogle Scholar
  24. 24.
    D.K. Tobias, F.B. Hu, J. Chavarro, B. Rosner, D. Mozaffarian, C. Zhang, Healthful dietary patterns and type 2 diabetes mellitus risk among women with a history of gestational diabetes mellitus. Arch. Intern. Med. 172, 1566–1572 (2012)PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    E.E. Abiemo, A. Alonso, J.A. Nettleton, L.M. Steffen, A.G. Bertoni, A. Jain, P.L. Lutsey, Relationships of the Mediterranean dietary pattern with insulin resistance and diabetes incidence in the Multi-Ethnic Study of Atherosclerosis (MESA). Br. J. Nutr. 109, 1490–1497 (2013)PubMedCentralPubMedCrossRefGoogle Scholar
  26. 26.
    the Japan Public Health Center-based Prospective Study, Japan Public Health Center-based Prospective Study Group, Dietary patterns and type 2 diabetes in Japanese men and women. Eur. J. Clin. Nutr. 67, 18–24 (2013)CrossRefGoogle Scholar
  27. 27.
    M. Rossi, F. Turati, P. Lagiou, D. Trichopoulos, L.S. Augustin, C. La Vecchia, A. Trichopoulou, Mediterranean diet and glycaemic load in relation to incidence of type 2 diabetes: results from the Greek cohort of the population-based European Prospective Investigation into Cancer and Nutrition (EPIC). Diabetologia 56, 2405–2413 (2013)PubMedCrossRefGoogle Scholar
  28. 28.
    F.B. Hu, Dietary pattern analysis: a new direction in nutritional epidemiology. Curr. Opin. Lipidol. 13, 3–9 (2002)PubMedCrossRefGoogle Scholar
  29. 29.
    D. Romaguera, M. Guevara, T. Norat, InterAct Consortium et al., Mediterranean diet and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study: the InterAct project. Diabetes Care 34, 1913–1918 (2011)PubMedCrossRefGoogle Scholar
  30. 30.
    A. Alhazmi, E. Stojanovski, M. McEvoy, M.L. Garg, The association between dietary patterns and type 2 diabetes: a systematic review and meta-analysis of cohort studies. J. Hum. Nutr. Diet. (2013). doi:10.1111/jhn.12139
  31. 31.
    S.E. Chiuve, T.T. Fung, E.B. Rimm, F.B. Hu, M.L. McCullough, M. Wang, M.J. Stampfer, W.C. Willett, Alternative dietary indices both strongly predict risk of chronic disease. J. Nutr. 142, 1009–1018 (2012)PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    J. Salas-Salvado, M. Bullo, N. Babio, PREDIMED Study Investigators et al., Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care 34, 14–19 (2011)PubMedCentralPubMedCrossRefGoogle Scholar
  33. 33.
    K. Esposito, M.I. Maiorino, M. Petrizzo, G. Bellastella, D. Giugliano, The effects of Mediterranean diet on need for diabetes drugs and remission of newly diagnosed type 2 diabetes: follow up of a randomized trial. Diabetes Care (2014). doi:10.2337//dc13-2899 Google Scholar
  34. 34.
    E. Sumamo Schellenberg, D.M. Dryden, B. Vandermeer, C. Ha, C. Korownyk, Lifestyle interventions for patients with and at risk for type 2 diabetes: a systematic review and meta-analysis. Ann Intern Med 159, 543–551 (2013)CrossRefGoogle Scholar
  35. 35.
    K. Esposito, D. Giugliano, Healthy lifestyle for metabolic health: no more excuse! Endocrine (2014). doi:10.1007/s12020-014-0165-6 Google Scholar
  36. 36.
    K. Esposito, F. Ciardiello, D. Giugliano, Unhealthy diets: a common soil for the association of metabolic syndrome and cancer. Endocrine (2014). doi:10.1007/s12020-013-0151-4 Google Scholar
  37. 37.
    M. Bergman, Inadequacies of current approaches to prediabetes and diabetes prevention. Endocrine 44, 623–633 (2013)PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Katherine Esposito
    • 1
  • Paolo Chiodini
    • 2
  • Maria Ida Maiorino
    • 3
  • Giuseppe Bellastella
    • 3
  • Demosthenes Panagiotakos
    • 4
  • Dario Giugliano
    • 3
    • 5
  1. 1.Department of Clinical and Experimental MedicineSecond University of NaplesNaplesItaly
  2. 2.Department of Mental and Physical Health, and Preventive MedicineSecond University of NaplesNaplesItaly
  3. 3.Department of Medical, Surgical, Neurological, Metabolic and Geriatric SciencesSecond University of NaplesNaplesItaly
  4. 4.Department of Nutrition and DieteticsHarokopio UniversityAthensGreece
  5. 5.Division of Endocrinology and Metabolic DiseasesUniversity HospitalNaplesItaly

Personalised recommendations