Incidence of type 2 diabetes has rapidly increased during the last decades. It is a chronic disease caused by impaired insulin action and insulin secretion. Potentially, the majority of the new cases are due to changes in lifestyle, including unfavourable changes in diet. Lifestyle interventions promoting a healthy diet and physical activity indeed showed that diet have a role in the development of type 2 diabetes. However, firm conclusions about the role of most dietary factors and their association with type 2 diabetes cannot be drawn yet.
Evidence for an association between a dietary factor and type 2 diabetes is strengthened when a potential pathway is elucidated through which a dietary factor can be linked to type 2 diabetes. Chronic low-grade inflammation may be one of these pathways. Elevated concentrations of C-reactive protein (CRP) and pro-inflammatory cytokines, like TNF-α and IL-6, have been associated with a higher risk of type 2 diabetes, at least through a connection with overweight and abdominal obesity. Whether chronic low-grade inflammation is an intermediate in the association between dietary factors and risk of type 2 diabetes is not often studied so far.
The first objective of this thesis was to study the role of selected dietary factors, i.e., fatty acids, fish, tea, meat, glycemic index (GI), and glycemic load (GL), on the development of type 2 diabetes in observational studies. The second objective was to study the extent to which chronic low-grade inflammation is a pathway through which diet can affect the processes leading to type 2 diabetes.
Adapted dietary inflammatory index and its association with a summary score for low-grade inflammation and markers of glucose metabolism: the Cohort study on Diabetes and Atherosclerosis Maastricht (CODAM) and the Hoorn studyAmerican Journal of Clinical Nutrition 98 (2013)5. - ISSN 0002-9165 - p. 1533 - 1542.
Meat consumption and its association with C-reactive protein and incident type 2 diabetes : The Rotterdam StudyDiabetes Care 35 (2012)7. - ISSN 0149-5992 - p. 1499 - 1505.
Tea consumption and incidence of type 2 diabetes in Europe: the EPIC-InterAct case-cohort studyPLoS ONE 7 (2012)5. - ISSN 1932-6203 - 8 p.
Comparison of fatty acid proportions in serum cholesteryl esters among people with different glucose tolerance status: The CoDAM studyNutrition, Metabolism & Cardiovascular Diseases 22 (2012). - ISSN 0939-4753 - p. 133 - 140.
Glycemic index and glycemic load and their association with C-reactive protein and incident type 2 diabetesJournal of Nutrition and Metabolism 2011 (2011). - ISSN 2090-0724 - p. 1 - 7.