Dietary energy density associated with increased risk of diabetes independent of baseline obesity
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There is scanty longitudinal cohort data linking dietary energy density with unfavourable incident metabolic outcomes. Energy-dense foods appear to associate with increased risk of developing type 2 diabetes. This population-based prospective study using data from 21,919 participants of the EPIC-Norfolk Cohort Study aimed to investigate whether there was an independent association between dietary energy density and incident diabetes. Energy density (i.e. the available energy per food unit weight) for overall diet was calculated using a food frequency questionnaire. During the 12-year follow-up, 725 clinically incident cases of diabetes were observed. After adjusting for confounding variables, baseline energy density was significantly higher in subjects who developed type 2 diabetes compared to those who did not. After adjusting for known risk factors, energy density was positively associated with incident diabetes. Adjusted analysis revealed that there was a 60% higher risk of diabetes in the highest quintile of energy density compared to the lowest quintile. A calorically-dense diet appears to be associated with increased risk of developing diabetes, independently of baseline obesity.
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