Associations of a proinflammatory diet, habitual salt intake, and the onset of type 2 diabetes: A prospective cohort study from the UK Biobank

Abstract

AbstractAimTo explore the relationship between proinflammatory diet, habitual salt intake and the onset of type 2 diabetes.MethodsThis 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.ResultsOver 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).ConclusionsOur 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.