Cow's milk causes diabetes

Influence of individual food groups on the risk of type 2 diabetes mellitus

A meta-analysis shows that whole grains, fruit and dairy products are associated with a lower risk of type 2 diabetes mellitus, while red meat, processed meat and sugar-sweetened beverages seem to increase the risk.

The prevalence of type 2 diabetes mellitus has been increasing worldwide for years. In 2015 around 415 million people suffered from type 2 diabetes mellitus, and an increase to 642 million is forecast for 2040.

The implementation of effective strategies for the prevention of this disease as well as early detection programs are therefore of great importance. In addition to a lack of physical activity and an increasingly sedentary lifestyle, the causes also include unfavorable eating habits. The identification of nutritional factors therefore plays an important role in prevention.

Previous meta-analyzes of prospective studies came to the conclusion that the consumption of whole grain cereals is associated with a lower risk of type 2 diabetes mellitus, while the consumption of red meat and sugar-sweetened beverages is associated with an increased risk.

The relationship between nutrition and health is very complex, however, because consumers do not consume individual nutrients, but rather individually composed foods. When identifying nutritional factors on the disease process, it can therefore be helpful to look at food groups. These 12 food groups play an important role in assessing nutritional quality:

  • Whole grains / cereals
  • refined grain products / cereals
  • vegetables
  • fruit
  • nuts
  • legumes
  • Eggs
  • Dairy products (milk, cheese, yogurt)
  • fish
  • Red meat
  • processed meat
  • sugar-sweetened drinks

So far, however, hardly any data is available on the quality of the respective evidence. Scientists therefore investigated the question of which food groups have a high level of qualitative evidence to have a protective effect on the risk of type 2 diabetes mellitus. They examined the associations of 12 previously defined food groups with the risk of type 2 diabetes mellitus. The results were published in the Eur J Epidemiol (Schwingshackl et al. 2017).

Question

This systematic review examined the extent to which the consumption of certain food groups is associated with a risk of type 2 diabetes mellitus. Both the strength and the form of a dose-response relationship should be examined and optimal food groups identified in order to reduce the risk of type 2 diabetes mellitus.

methodology

Two scientists researched independently in the electronic databases PubMed, Embase, Medline (Ovid), Cochrane Central and Google Scholar. Prospective studies on people over the age of 18 were included in the evaluation of the meta-analysis.

Using a statistical random effect model, the summed up relative risks (RR) and 95% confidence intervals for the associations between type 2 diabetes mellitus and the highest versus the lowest consumption category were calculated for each of the predefined 12 food groups as well as the respective dose-effect relationship.

The dose-response associations were expressed in the following portion sizes (g per day or ml for beverages): Whole grains / cereals (30), refined cereals / cereals (30), vegetables (100), fruit (100), nuts (28 ), Legumes (50), eggs (50), dairy products (200), fish (100), red meat (100), processed meat (50), and sugar-sweetened beverages (250).

The risk-reducing potential was calculated on the basis of the relative risk (RR) and an optimal consumption amount (portion size with the strongest association) of risk-reducing or risk-increasing foods.

The NutriGrade scoring system was used to evaluate the meta-evidence for the association between the 12 food groups and type 2 diabetes mellitus. The meta-evidence was rated according to points: ≥ 8 points (high), 6 - 7.99 points (moderate), 4 - 5.99 (low) and 0 - 3.99 (very low).

Results

Of a total of 14 167 hits in the literature search, 439 publications were evaluated in detail, as they reported in their title or abstract on at least one of the 12 food groups in connection with type 2 diabetes mellitus. 88 studies were suitable for quantitative analysis.

13 studies too Whole grain cereals had a total of 29 633 cases of type 2 diabetes mellitus. The comparison of the lowest versus the highest consumption amount (extent of consumption: 0 - 302 g / d) showed a strong inverse association (RR: 0.77). Each additional increase of 30 g whole grains was inversely associated with the risk of type 2 diabetes mellitus (RR: 0.87). There was evidence of a non-linear dose-response relationship. The risk of type 2 diabetes mellitus decreased by 25% with increasing consumption of whole grain cereals up to 50 g / d. If this amount was increased further, there was only a small benefit.

15 studies with 24,517 diabetes cases were included in the analysis of studies refined grain products included (scope of consumption: 0 - 700 g / d). The comparison of the highest vs. lowest category showed no association (RR: 1.01), not even with an increase of an additional 30 g (RR: 1.01). There was no evidence of a non-linear dose-response relationship. The intake of 200-400 g / d refined cereal products was associated with a 6-14% increased risk of illness.

In connection with vegetables The following picture emerged from 13 studies with 63 299 diabetes cases (extent of consumption: 20.5 - 636 g / d). A borderline inverse association was observed when comparing the lowest versus the highest category (RR: 0.95) and in the dose-response analysis (RR: 0.98). There was evidence of a non-linear dose-response relationship; the risk of disease decreased by 9% when the intake of vegetables was increased to 300 g / d. No additional benefit was observed beyond this amount.

Analysis of 15 studies too fruit with 70,968 cases of type 2 diabetes mellitus (amount consumed: 10-618 g / d), there was a borderline inverse association (RR: 0.96). Each additional 100 g of fruit was inversely associated with the risk of diabetes (RR: 0.98). There was evidence of a non-linear relationship. The risk of disease decreased by 10% when the fruit intake increased to 200-300 g / d. Higher amounts showed no additional benefit.

For the relationship between Nuts and diabetes, 8 studies with 27,017 cases of diabetes were evaluated (extent of consumption: 0 - 27 g / d). No significant association was observed for the comparison of the lowest vs. the highest categories (RR: 0.95), nor for each additional 28 g / d (RR: 0.89). There was no evidence for a non-linear dose-response relationship.

12 studies with 26,778 cases of type 2 diabetes mellitus were re legumes evaluated (extent of consumption: 0 - 190 g / d). No significant associations were observed here for the comparison of the extreme intake quantities (RR: 0.96), nor for each additional intake of 50 g / d (RR: 1.00). There was no evidence for a non-linear dose-response relationship.

The meta-analysis from 13 studies with 17,629 cases of type 2 diabetes mellitus too Eggs When comparing the extreme amounts consumed (extent of consumption: 0 - 60 g / d), there was no significant association (RR: 1.08), not even with an additional intake of 30 g (RR: 1.08). A strong positive association was only observed for studies conducted in America. According to the authors, one possible explanation is that eggs are often consumed in combination with processed meat (bacon, sausages) in America. There was little evidence of a non-linear dose-response relationship (p = 0.09). For an increase in egg intake up to 50 g / d, an increase in the risk of disease of 13% was calculated.

Regarding the relationship with Dairy products 21 studies with 44,474 cases of diabetes were evaluated (amount of consumption: 0 - 2000 g / d). There was a significant inverse association (RR: 0.91). Each additional intake of 200 g dairy products was inversely associated with the risk of type 2 diabetes mellitus (RR: 0.97). There was no evidence of a non-linear dose-response relationship. The risk of illness decreased by 6% with an increase in the intake of dairy products to 400 - 600 g / d.

16 studies with 45 029 diabetes cases were regarding fish evaluated (extent of consumption: 0 - 225 g / d). No significant association was found for the highest vs. lowest category (RR: 1.04) or for an additional daily intake of 100 g (RR: 1.09). There was no evidence of a non-linear dose-response relationship.

When considering the consumption of red meat A significant positive association (RR: 1.21) was calculated from 15 studies with 45,702 cases of diabetes (extent of consumption: 0 - 207 g / d). An additional 100 g of red meat was positively associated with the risk of type 2 diabetes mellitus (RR: 1.17). Positive associations related to studies in America and Europe, but not Asia. This could be because the red meat consumption in America and Europe is around 1.5 times higher than in Asia. There was no evidence of a non-linear dose-response relationship.

In terms of processed meat The scientists found a significant positive association (RR: 1.27) from 14 studies with 43,781 cases of diabetes (extent of consumption: 0-142 g / d). Each additional intake of 50 g processed meat per day was strongly linked to the risk of type 2 diabetes mellitus (RR: 1.37). There was evidence of a non-linear dose-response relationship.

The evaluation of a relationship between sugar-sweetened drinks and diabetes from 10 studies with 25,600 cases of diabetes (amount consumed: 0-748 ml) showed a significant positive association (RR: 1.30). Any additional 250 ml daily was associated with a higher risk (RR: 1.21). There was evidence of a non-linear dose-response relationship.

Conclusion

Based on this meta-analysis, the authors show that the consumption of foods from certain food groups can strongly influence the risk of developing type 2 diabetes mellitus. There was evidence of a non-linear relationship between the risk of type 2 diabetes mellitus and fruits, vegetables, processed meat, whole grains and sugar-sweetened beverages.

According to this meta-analysis, the optimal consumption of risk-reducing foods (whole grains, fruit, vegetables, dairy products) is associated with a 42% reduction in the risk of illness. In contrast, the consumption of risk-increasing foods (red meat, processed meat, sugar-sweetened drinks, eggs) can increase the risk of illness three times compared to not eating these foods.

This meta-analysis shows how strongly diet can influence the prevalence of type 2 diabetes mellitus both positively and negatively.

source

  • Schwingshackl L, Hoffmann G, Lampousi AM et al .: Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies. Eur J Epidemiol (2017): doi10.1007 / s10654-017-0246-y

Source: German Nutrition Society: Influence of individual food groups on the risk of type 2 diabetes mellitus. DGEInfo (6/2017) 82-84