, 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


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.


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)


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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

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