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Associations Among a Proinflammatory Diet, Habitual Salt Intake, and the Onset of Type 2 Diabetes
abstract
This abstract is available on the publisher's site.
Access this abstract nowAIM
To explore the relationship between proinflammatory diet, habitual salt intake and the onset of type 2 diabetes.
METHODS
This prospective study was conducted among 171 094 UK Biobank participants who completed at least one 24-h dietary questionnaire and were free of diabetes at baseline. Participants were followed up until 1 March 2023 for type 2 diabetes incidence, with diagnosis information obtained from linked medical records. An Energy-adjusted Diet Inflammatory Index (E-DII) was calculated based on 28 food parameters. Habitual salt intake was determined through the self-reported frequency of adding salt to foods. The associations between E-DII, habitual salt intake and type 2 diabetes incidence were tested by the Cox proportional hazard regression model.
RESULTS
Over a median follow-up period of 13.5 years, 6216 cases of type 2 diabetes were documented. Compared with participants with a low E-DII (indicative of an anti-inflammatory diet), participants with a high E-DII (indicative of a proinflammatory diet) had an 18% heightened risk of developing type 2 diabetes. The association between E-DII and type 2 diabetes tends to be linear after adjustment for major confounders. Participants with a proinflammatory diet and always adding salt to foods had the highest risk of type 2 diabetes incidence (hazard ratio 1.60, 95% confidence interval 1.32-1.94).
CONCLUSIONS
Our findings indicate that a proinflammatory diet and higher habitual salt intake were associated with an increased risk of type 2 diabetes. These results support the public health promotion of an anti-inflammatory diet and reducing salt intake to prevent the onset of type 2 diabetes.
Additional Info
Disclosure statements are available on the authors' profiles:
Associations of a proinflammatory diet, habitual salt intake, and the onset of type 2 diabetes: A prospective cohort study from the UK Biobank
Diabetes Obes Metab 2024 Feb 26;[EPub Ahead of Print], W Shen, L Cai, B Wang, J Li, Y Sun, Y Chen, F Xia, N Wang, Y LuFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Inflammation, salt, and the risk of diabetes
There is good research on the health risks of consuming excessive salt and foods that promote inflammation; however, this is the first study to examine whether consuming both is associated with a higher incidence of diabetes.
The UK Biobank study followed patients with a high Diet Inflammatory Index (DII) score and self-reported salt addition to food. The DII score includes 45 foods, spices, and nutrients. A proinflammatory diet has a positive score, and an anti-inflammatory diet has a negative score. For example, a fast-food diet has a score of 4.0, and a Mediterranean diet has a score of –4.0. The salt intake was assessed with the question: do you add salt to your foods? The responses were never/rarely, sometimes, usually, or always.
The study followed 171,094 participants over 13.5 years. The participants who responded “always” to the question on adding salt to diet and with the highest inflammatory diet scores had the highest incidence of type 2 diabetes (HR, 1.6). This was a much greater risk than the risk associated with either alone. The hazard ratio of diabetes among participants with a high inflammatory diet score but who never added salt to their diet was 1.13, whereas that of those with a low inflammatory diet score but who always added salt to their diet was 1.09. This study suggests that there could be an additive risk of type 2 diabetes from consuming both salt and a proinflammatory diet.
Last week, we reviewed a study showing that eating ultra-processed food is associated with risk ratios of 1.66 and 1.44 for dying from heart disease and developing type 2 diabetes, respectively.1 Processed foods have a high DII and are also high in salt. Avoiding these foods may reduce inflammation and salt consumption, decreasing the risk of type 2 diabetes.
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