【文献Abstract】２型糖尿病発症に対する食事の関係性

〈要点〉

・全穀物ならびに穀物線維、中等度のアルコールの摂取は2型糖尿病の発症率を下げる一方で、赤身の肉や加工肉、ベーコン、清涼飲料水の摂取は発症率増加に相関していた。
・しかし総じて２型糖尿病の発症と食生活は関連しているという研究結果であったが、あまり質の高い研究はなかった。そのため、２型糖尿病の予防についてはさらなる質の高い研究が求められる。

〈雑感〉

・やはり糖尿病のコントロールと同じように発症についても食生活として上記のようなものが関係しているのは、まぁそうなのかなというところ。ソーセージやベーコンは子供の食事に手軽だし好きだから結構だしていたな…と反省。。

〈文献〉

BMJ. 2019 Jul 3;366:l2368. doi: 10.1136/bmj.l2368.
Role of diet in type 2 diabetes incidence: umbrella review of meta-analyses of prospective observational studies.
Neuenschwander M, Ballon A, Weber KS, Norat T, Aune D, Schwingshackl L, Schlesinger S.

Abstract
OBJECTIVE:
To summarise the evidence of associations between dietary factors and incidence of type 2 diabetes and to evaluate the strength and validity of these associations.

DESIGN:
Umbrella review of systematic reviews with meta-analyses of prospective observational studies.

DATA SOURCES:
PubMed, Web of Science, and Embase, searched up to August 2018.

ELIGIBILITY CRITERIA:
Systematic reviews with meta-analyses reporting summary risk estimates for the associations between incidence of type 2 diabetes and dietary behaviours or diet quality indices, food groups, foods, beverages, alcoholic beverages, macronutrients, and micronutrients.

RESULTS:
53 publications were included, with 153 adjusted summary hazard ratios on dietary behaviours or diet quality indices (n=12), food groups and foods (n=56), beverages (n=10), alcoholic beverages (n=12), macronutrients (n=32), and micronutrients (n=31), regarding incidence of type 2 diabetes. Methodological quality was high for 75% (n=115) of meta-analyses, moderate for 23% (n=35), and low for 2% (n=3). Quality of evidence was rated high for an inverse association for type 2 diabetes incidence with increased intake of whole grains (for an increment of 30 g/day, adjusted summary hazard ratio 0.87 (95% confidence interval 0.82 to 0.93)) and cereal fibre (for an increment of 10 g/day, 0.75 (0.65 to 0.86)), as well as for moderate intake of total alcohol (for an intake of 12-24 g/day v no consumption, 0.75 (0.67 to 0.83)). Quality of evidence was also high for the association for increased incidence of type 2 diabetes with higher intake of red meat (for an increment of 100 g/day, 1.17 (1.08 to 1.26)), processed meat (for an increment of 50 g/day, 1.37 (1.22 to 1.54)), bacon (per two slices/day, 2.07 (1.40 to 3.05)), and sugar sweetened beverages (for an increase of one serving/day, 1.26 (1.11 to 1.43)).

CONCLUSIONS:
Overall, the association between dietary factors and type 2 diabetes has been extensively studied, but few of the associations were graded as high quality of evidence. Further factors are likely to be important in type 2 diabetes prevention; thus, more well conducted research, with more detailed assessment of diet, is needed.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO CRD42018088106.

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