Associations of carbohydrates and carbohydrate-rich foods with incidence of type 2 diabetes

Dietary carbohydrates have long been expected to be associated with risk of type 2 diabetes; however, the associations for many carbohydrates and carbohydrate-rich foods remain inconclusive. This study analysed associations between intakes of six types of carbohydrates and thirteen carbohydrate-rich foods with incident type 2 diabetes in 26 622 participants (61 % women) in the Malmo Diet and Cancer Study in southern Sweden. Dietary intake was assessed at baseline (1991-1996) by using a modified diet history method. During mean follow-up of 18 years, 4046 cases were identified. Adjusting for potential confounders (including lifestyle, BMI and dietary factors), comparing highest v. lowest quintile of intake, monosaccharides (hazard ratio (HR) 0 center dot 88; 95 % CI 0 center dot 79, 0 center dot 98; P-trend = 0 center dot 02) and fruits (HR 0 center dot 91; 95 % CI 0 center dot 82, 1 center dot 01; P-trend = 0 center dot 03) were inversely associated with incident type 2 diabetes, while disaccharides (HR 1 center dot 17; 95 % CI 1 center dot 04, 1 center dot 30; P-trend = 0 center dot 002) and sweets (HR 1 center dot 09; 95 % CI 1 center dot 00, 1 center dot 19; P-trend = 0 center dot 02) were positively associated. After stratification by sex, marmalade/honey/jam (HR 0 center dot 82; 95 % CI 0 center dot 72, 0 center dot 94; P-trend < 0 center dot 001) and vegetables (HR 0 center dot 85; 95 % CI 0 center dot 73, 0 center dot 98; P-trend = 0 center dot 06) were inversely associated with incident type 2 diabetes in men and chocolate (HR 1 center dot 26; 95 % CI 1 center dot 09, 1 center dot 46; P-trend < 0 center dot 001) was positively associated in women. In conclusion, we identified inverse associations for intake of monosaccharides and fruits with type 2 diabetes risk, and positive associations for disaccharides and sweets. Additional sex-specific associations were also identified. Future studies are needed to explore these associations further.

Automated summary

This study found that the intake of monosaccharides and fruits was negatively associated with the risk of type 2 diabetes, while the intake of disaccharides and sweets was positively associated. There were also additional sex-specific associations identified in the study. Further research is needed to explore these associations.