Associations Between Linoleic Acid Intake and Incident Type 2 Diabetes Among U.S. Men and Women

Geng Zong, Gang Liu, Walter C. Willett, Anne J. Wanders, Marjan Alssema, Peter L. Zock, Frank B. Hu, Qi Sun

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVE: To investigate the association between intakes of n-6 polyunsaturated fatty acids (PUFAs) and type 2 diabetes risk in three prospective cohort studies of U.S. men and women. RESEARCH DESIGN AND METHODS: We followed 83,648 women from the Nurses' Health Study (NHS) (1980-2012), 88,610 women from NHSII (1991-2013), and 41,771 men from the Health Professionals Follow-Up Study (HPFS) (1986-2012). Dietary data were collected every 2-4 years by using validated food-frequency questionnaires. Self-reported incident diabetes, identified biennially, was confirmed by using a validated supplementary questionnaire. RESULTS: During 4.93 million person-years of follow-up, 18,442 type 2 diabetes cases were documented. Dietary n-6 PUFAs accounted for 4.4-6.8% of total energy, on average, and consisted primarily of linoleic acid (LA) (≥98%). In multivariate-adjusted models, hazard ratios (95% CIs) of type 2 diabetes risk comparing extreme n-6 PUFA quintiles (highest vs. lowest) were 0.91 (0.85, 0.96) (Ptrend = 0.002) for total n-6 PUFAs and 0.92 (0.87, 0.98) (Ptrend = 0.01) for LA. In an isocaloric substitution model, diabetes risk was 14% (95% CI 5%, 21%) (P = 0.002) lower when LA isocalorically replaced saturated fats (5% of energy), 17% (95% CI 9%, 24%) (P < 0.001) lower for trans fats (2% of energy), or 9% (95% CI 17%, 0.1%) (P = 0.047) lower for carbohydrates (5% of energy). Replacing n-3 PUFAs or monounsaturated fats with LA was not significantly associated with type 2 diabetes risk. CONCLUSIONS: Our study provides additional evidence that LA intake is inversely associated with risk of type 2 diabetes, especially when replacing saturated fatty acids, trans fats, or carbohydrates.
Original languageEnglish
Pages (from-to)1406-1413
JournalDiabetes Care
Volume42
Issue number8
DOIs
Publication statusPublished - 2019

Cite this

Zong, G., Liu, G., Willett, W. C., Wanders, A. J., Alssema, M., Zock, P. L., ... Sun, Q. (2019). Associations Between Linoleic Acid Intake and Incident Type 2 Diabetes Among U.S. Men and Women. Diabetes Care, 42(8), 1406-1413. https://doi.org/10.2337/dc19-0412
Zong, Geng ; Liu, Gang ; Willett, Walter C. ; Wanders, Anne J. ; Alssema, Marjan ; Zock, Peter L. ; Hu, Frank B. ; Sun, Qi. / Associations Between Linoleic Acid Intake and Incident Type 2 Diabetes Among U.S. Men and Women. In: Diabetes Care. 2019 ; Vol. 42, No. 8. pp. 1406-1413.
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title = "Associations Between Linoleic Acid Intake and Incident Type 2 Diabetes Among U.S. Men and Women",
abstract = "OBJECTIVE: To investigate the association between intakes of n-6 polyunsaturated fatty acids (PUFAs) and type 2 diabetes risk in three prospective cohort studies of U.S. men and women. RESEARCH DESIGN AND METHODS: We followed 83,648 women from the Nurses' Health Study (NHS) (1980-2012), 88,610 women from NHSII (1991-2013), and 41,771 men from the Health Professionals Follow-Up Study (HPFS) (1986-2012). Dietary data were collected every 2-4 years by using validated food-frequency questionnaires. Self-reported incident diabetes, identified biennially, was confirmed by using a validated supplementary questionnaire. RESULTS: During 4.93 million person-years of follow-up, 18,442 type 2 diabetes cases were documented. Dietary n-6 PUFAs accounted for 4.4-6.8{\%} of total energy, on average, and consisted primarily of linoleic acid (LA) (≥98{\%}). In multivariate-adjusted models, hazard ratios (95{\%} CIs) of type 2 diabetes risk comparing extreme n-6 PUFA quintiles (highest vs. lowest) were 0.91 (0.85, 0.96) (Ptrend = 0.002) for total n-6 PUFAs and 0.92 (0.87, 0.98) (Ptrend = 0.01) for LA. In an isocaloric substitution model, diabetes risk was 14{\%} (95{\%} CI 5{\%}, 21{\%}) (P = 0.002) lower when LA isocalorically replaced saturated fats (5{\%} of energy), 17{\%} (95{\%} CI 9{\%}, 24{\%}) (P < 0.001) lower for trans fats (2{\%} of energy), or 9{\%} (95{\%} CI 17{\%}, 0.1{\%}) (P = 0.047) lower for carbohydrates (5{\%} of energy). Replacing n-3 PUFAs or monounsaturated fats with LA was not significantly associated with type 2 diabetes risk. CONCLUSIONS: Our study provides additional evidence that LA intake is inversely associated with risk of type 2 diabetes, especially when replacing saturated fatty acids, trans fats, or carbohydrates.",
author = "Geng Zong and Gang Liu and Willett, {Walter C.} and Wanders, {Anne J.} and Marjan Alssema and Zock, {Peter L.} and Hu, {Frank B.} and Qi Sun",
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volume = "42",
pages = "1406--1413",
journal = "Diabetes Care",
issn = "0149-5992",
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Zong, G, Liu, G, Willett, WC, Wanders, AJ, Alssema, M, Zock, PL, Hu, FB & Sun, Q 2019, 'Associations Between Linoleic Acid Intake and Incident Type 2 Diabetes Among U.S. Men and Women' Diabetes Care, vol. 42, no. 8, pp. 1406-1413. https://doi.org/10.2337/dc19-0412

Associations Between Linoleic Acid Intake and Incident Type 2 Diabetes Among U.S. Men and Women. / Zong, Geng; Liu, Gang; Willett, Walter C.; Wanders, Anne J.; Alssema, Marjan; Zock, Peter L.; Hu, Frank B.; Sun, Qi.

In: Diabetes Care, Vol. 42, No. 8, 2019, p. 1406-1413.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Associations Between Linoleic Acid Intake and Incident Type 2 Diabetes Among U.S. Men and Women

AU - Zong, Geng

AU - Liu, Gang

AU - Willett, Walter C.

AU - Wanders, Anne J.

AU - Alssema, Marjan

AU - Zock, Peter L.

AU - Hu, Frank B.

AU - Sun, Qi

PY - 2019

Y1 - 2019

N2 - OBJECTIVE: To investigate the association between intakes of n-6 polyunsaturated fatty acids (PUFAs) and type 2 diabetes risk in three prospective cohort studies of U.S. men and women. RESEARCH DESIGN AND METHODS: We followed 83,648 women from the Nurses' Health Study (NHS) (1980-2012), 88,610 women from NHSII (1991-2013), and 41,771 men from the Health Professionals Follow-Up Study (HPFS) (1986-2012). Dietary data were collected every 2-4 years by using validated food-frequency questionnaires. Self-reported incident diabetes, identified biennially, was confirmed by using a validated supplementary questionnaire. RESULTS: During 4.93 million person-years of follow-up, 18,442 type 2 diabetes cases were documented. Dietary n-6 PUFAs accounted for 4.4-6.8% of total energy, on average, and consisted primarily of linoleic acid (LA) (≥98%). In multivariate-adjusted models, hazard ratios (95% CIs) of type 2 diabetes risk comparing extreme n-6 PUFA quintiles (highest vs. lowest) were 0.91 (0.85, 0.96) (Ptrend = 0.002) for total n-6 PUFAs and 0.92 (0.87, 0.98) (Ptrend = 0.01) for LA. In an isocaloric substitution model, diabetes risk was 14% (95% CI 5%, 21%) (P = 0.002) lower when LA isocalorically replaced saturated fats (5% of energy), 17% (95% CI 9%, 24%) (P < 0.001) lower for trans fats (2% of energy), or 9% (95% CI 17%, 0.1%) (P = 0.047) lower for carbohydrates (5% of energy). Replacing n-3 PUFAs or monounsaturated fats with LA was not significantly associated with type 2 diabetes risk. CONCLUSIONS: Our study provides additional evidence that LA intake is inversely associated with risk of type 2 diabetes, especially when replacing saturated fatty acids, trans fats, or carbohydrates.

AB - OBJECTIVE: To investigate the association between intakes of n-6 polyunsaturated fatty acids (PUFAs) and type 2 diabetes risk in three prospective cohort studies of U.S. men and women. RESEARCH DESIGN AND METHODS: We followed 83,648 women from the Nurses' Health Study (NHS) (1980-2012), 88,610 women from NHSII (1991-2013), and 41,771 men from the Health Professionals Follow-Up Study (HPFS) (1986-2012). Dietary data were collected every 2-4 years by using validated food-frequency questionnaires. Self-reported incident diabetes, identified biennially, was confirmed by using a validated supplementary questionnaire. RESULTS: During 4.93 million person-years of follow-up, 18,442 type 2 diabetes cases were documented. Dietary n-6 PUFAs accounted for 4.4-6.8% of total energy, on average, and consisted primarily of linoleic acid (LA) (≥98%). In multivariate-adjusted models, hazard ratios (95% CIs) of type 2 diabetes risk comparing extreme n-6 PUFA quintiles (highest vs. lowest) were 0.91 (0.85, 0.96) (Ptrend = 0.002) for total n-6 PUFAs and 0.92 (0.87, 0.98) (Ptrend = 0.01) for LA. In an isocaloric substitution model, diabetes risk was 14% (95% CI 5%, 21%) (P = 0.002) lower when LA isocalorically replaced saturated fats (5% of energy), 17% (95% CI 9%, 24%) (P < 0.001) lower for trans fats (2% of energy), or 9% (95% CI 17%, 0.1%) (P = 0.047) lower for carbohydrates (5% of energy). Replacing n-3 PUFAs or monounsaturated fats with LA was not significantly associated with type 2 diabetes risk. CONCLUSIONS: Our study provides additional evidence that LA intake is inversely associated with risk of type 2 diabetes, especially when replacing saturated fatty acids, trans fats, or carbohydrates.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/31182488

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