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@ARTICLE{Zheng:157046,
author = {J.-S. Zheng and S. J. Sharp and F. Imamura and R. Chowdhury
and T. E. Gundersen and M. Steur and I. Sluijs and Y. T. van
der Schouw and A. Agudo and D. Aune and A. Barricarte and H.
Boeing and M.-D. Chirlaque and M. Dorronsoro and H.
Freisling and D. El-Fatouhi and P. W. Franks and G.
Fagherazzi and S. Grioni and M. J. Gunter and C. Kyrø and
V. Katzke$^*$ and T. Kühn$^*$ and K.-T. Khaw and N. Laouali
and G. Masala and P. M. Nilsson and K. Overvad and S. Panico
and K. Papier and J. R. Quirós and O. Rolandsson and D.
Redondo-Sánchez and F. Ricceri and M. B. Schulze and A. M.
W. Spijkerman and A. Tjønneland and T. Y. N. Tong and R.
Tumino and E. Weiderpass and J. Danesh and A. S. Butterworth
and E. Riboli and N. G. Forouhi and N. J. Wareham},
title = {{A}ssociation of plasma biomarkers of fruit and vegetable
intake with incident type 2 diabetes: {EPIC}-{I}nter{A}ct
case-cohort study in eight {E}uropean countries.},
journal = {The BMJ},
volume = {370},
issn = {1756-1833},
address = {London},
publisher = {British Medical Association56099},
reportid = {DKFZ-2020-01337},
pages = {m2194},
year = {2020},
abstract = {To investigate the association of plasma vitamin C and
carotenoids, as indicators of fruit and vegetable intake,
with the risk of type 2 diabetes.Prospective case-cohort
study.Populations from eight European countries.9754
participants with incident type 2 diabetes, and a subcohort
of 13 662 individuals from the European Prospective
Investigation into Cancer and Nutrition (EPIC) cohort of 340
234 participants: EPIC-InterAct case-cohort study.Incident
type 2 diabetes.In a multivariable adjusted model, higher
plasma vitamin C was associated with a lower risk of
developing type 2 diabetes (hazard ratio per standard
deviation 0.82, $95\%$ confidence interval 0.76 to 0.89). A
similar inverse association was shown for total carotenoids
(hazard ratio per standard deviation 0.75, 0.68 to 0.82). A
composite biomarker score (split into five equal groups),
comprising vitamin C and individual carotenoids, was
inversely associated with type 2 diabetes with hazard ratios
0.77, 0.66, 0.59, and 0.50 for groups 2-5 compared with
group 1 (the lowest group). Self-reported median fruit and
vegetable intake was 274 g/day, 396 g/day, and 508 g/day for
participants in categories defined by groups 1, 3, and 5 of
the composite biomarker score, respectively. One standard
deviation difference in the composite biomarker score,
equivalent to a 66 $(95\%$ confidence interval 61 to 71)
g/day difference in total fruit and vegetable intake, was
associated with a hazard ratio of 0.75 (0.67 to 0.83). This
would be equivalent to an absolute risk reduction of 0.95
per 1000 person years of follow up if achieved across an
entire population with the characteristics of the eight
European countries included in this analysis.These findings
indicate an inverse association between plasma vitamin C,
carotenoids, and their composite biomarker score, and
incident type 2 diabetes in different European countries.
These biomarkers are objective indicators of fruit and
vegetable consumption, and suggest that diets rich in even
modestly higher fruit and vegetable consumption could help
to prevent development of type 2 diabetes.},
cin = {C020},
ddc = {610},
cid = {I:(DE-He78)C020-20160331},
pnm = {323 - Metabolic Dysfunction as Risk Factor (POF3-323)},
pid = {G:(DE-HGF)POF3-323},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:32641421},
pmc = {pmc:PMC7341350},
doi = {10.1136/bmj.m2194},
url = {https://inrepo02.dkfz.de/record/157046},
}