TY - JOUR AU - Sobiecki, Jakub G AU - Imamura, Fumiaki AU - Davis, Courtney R AU - Sharp, Stephen J AU - Koulman, Albert AU - Hodgson, Jonathan M AU - Guevara, Marcela AU - Schulze, Matthias B AU - Zheng, Ju-Sheng AU - Agnoli, Claudia AU - Bonet, Catalina AU - Colorado-Yohar, Sandra M AU - Fagherazzi, Guy AU - Franks, Paul W AU - Gundersen, Thomas E AU - Jannasch, Franziska AU - Kaaks, Rudolf AU - Katzke, Verena AU - Molina-Montes, Esther AU - Nilsson, Peter M AU - Palli, Domenico AU - Panico, Salvatore AU - Papier, Keren AU - Rolandsson, Olov AU - Sacerdote, Carlotta AU - Tjønneland, Anne AU - Tong, Tammy Y N AU - van der Schouw, Yvonne T AU - Danesh, John AU - Butterworth, Adam S AU - Riboli, Elio AU - Murphy, Karen J AU - Wareham, Nicholas J AU - Forouhi, Nita G TI - A nutritional biomarker score of the Mediterranean diet and incident type 2 diabetes: Integrated analysis of data from the MedLey randomised controlled trial and the EPIC-InterAct case-cohort study. JO - PLoS medicine VL - 20 IS - 4 SN - 1549-1277 CY - Lawrence, Kan. PB - PLoS M1 - DKFZ-2023-00836 SP - e1004221 - PY - 2023 AB - Self-reported adherence to the Mediterranean diet has been modestly inversely associated with incidence of type 2 diabetes (T2D) in cohort studies. There is uncertainty about the validity and magnitude of this association due to subjective reporting of diet. The association has not been evaluated using an objectively measured biomarker of the Mediterranean diet.We derived a biomarker score based on 5 circulating carotenoids and 24 fatty acids that discriminated between the Mediterranean or habitual diet arms of a parallel design, 6-month partial-feeding randomised controlled trial (RCT) conducted between 2013 and 2014, the MedLey trial (128 participants out of 166 randomised). We applied this biomarker score in an observational study, the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study, to assess the association of the score with T2D incidence over an average of 9.7 years of follow-up since the baseline (1991 to 1998). We included 22,202 participants, of whom 9,453 were T2D cases, with relevant biomarkers from an original case-cohort of 27,779 participants sampled from a cohort of 340,234 people. As a secondary measure of the Mediterranean diet, we used a score estimated from dietary-self report. Within the trial, the biomarker score discriminated well between the 2 arms; the cross-validated C-statistic was 0.88 (95 LB - PUB:(DE-HGF)16 C6 - pmid:37104291 DO - DOI:10.1371/journal.pmed.1004221 UR - https://inrepo02.dkfz.de/record/275648 ER -