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OnlineSupplementary Material to:

Fatty acid intake and its dietary sources in relation with markers of type 2 diabetes risk: the NEO Study

Anne J. Wanders, Marjan Alssema, Eelco J.P. de Koning, Saskia le Cessie, Jeanne H. de Vries, Peter L. Zock, Frits R. Rosendaal, Martin den Heijer, Renée de Mutsert

From Unilever R&D, Vlaardingen, the Netherlands (AJW, MA, PLZ); Dept. of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU medical center, Amsterdam, the Netherlands (MA); Dept. of Nephrology, LUMC, Leiden, the Netherlands (EJPK); Dept. of Endocrinology, LUMC, Leiden, the Netherlands (EJPK); Dept. of Medical Statistics and Bioinformatics, LUMC, Leiden, the Netherlands (SC, FR); Dept. of Clinical Epidemiology, LUMC, Leiden, the Netherlands (SC, MH, RM); Division of Human Nutrition, Wageningen University, the Netherlands (JHV); Dept. of Thrombosis and Hemostasis, LUMC,Leiden, the Netherlands (FR); Dept. of Internal Medicine, VU Medical Center, Amsterdam, the Netherlands (MH)

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This document contains the following supplementary material:

Supplement 1: Members of the NEO Study Group

Supplement 2: Details of subjects and methods

Supplemental Table 1: Detailed list of food groups and food items as assessed by the food frequency questionnaire in the NEO study

Supplemental Table 2: Markers of glucose and insulin metabolism of 5,675 participants in the NEO study, 45-65 years without type 2 diabetes

Supplemental Table 3: Associations of the intake of types of dietary fatty acids and their detailed dietary sources (dairy, meat, plant, other) with markers of type 2 diabetes risk in 5,675 participants in the NEO study, 45-65 years without type 2 diabetes

Supplemental Figure 1: Associations (percentage (95%CI)) of the intake of types of dietary fatty acids and their dietary sources (dairy, meat, plant) with markers of type 2 diabetes risk in 5,675 participants in the NEO study, 45-65 years without type 2 diabetes, Energy substitution model 3.

Supplemental Figure 2: Unweighted associations (percentage (95%CI)) of the intake of types of dietary fatty acids and their dietary sources (dairy, meat, plant) with markers of type 2 diabetes risk in 5,675 participants in the NEO study, 45-65 years without type 2 diabetes

Reference list

Supplement 1:Members of the NEO Study Group

Frits R. Rosendaal, Renée de Mutsert, Ton J. Rabelink, Jan W.A. Smit, J. Wouter Jukema, Albert de Roos, Saskia le Cessie, Pieter S. Hiemstra, Margreet Kloppenburg, Ton W.J. Huizinga, Hanno Pijl, Eelco J.P. de Koning, Pieter H. Reitsma, Ko Willems van Dijk, Aiko P.J. de Vries, Hildo J. Lamb, Ingrid M. Jazet, Olaf M. Dekkers, Nienke R. Biermasz, Christa M. Cobbaert (Leiden University andMedical Center, Leiden, the Netherlands), Martin den Heijer, Jacqueline M. Dekker and Brenda W. Penninx (VU Medical Center, Amsterdam, The Netherlands).

Supplement 2: Details of subjects and methods

Dietary assessment

Habitual diet was assessed using a validated semi-quantitative self-administered 125-item food frequency questionnaire (FFQ) with a reference period of one month (1;2). Participants indicated the frequency of intake of foods within main food groups (times per day, per week, per month, or never) combined with questions on the intake of specific foods within the main food groups (seldom/never, sometimes, often, mostly/always). Specific questions were dedicated to different types of edible fats used for meal preparation and as spread on bread. Dietary intakes of total energy (MJ/day), total fatty acids, SFA, MUFA, PUFA, TFA, protein, carbohydrates, dietary fibre, alcohol (En%), and cholesterol (mg/day) were calculated from the 2011 version of the Dutch food composition table (3). Intakes of fatty acids from major dietary sources were estimated by summing the intakes from specific foods that were categorized into dairy, meat, and plant food groups (see Supplemental Table 1 for a detailed list of dietary sources). Coffee and sugar-sweetened beverage intake (g/day) was estimated by summing the intakes of relevant foods in the FFQ.

Laboratory methods and calculations

Fasting plasma glucose concentrations were determined by enzymatic and colorimetric methods (Roche Modular Analytics P800, Roche Diagnostics, Mannheim, Germany; CV < 5%) and serum insulin concentrations were determined by an immunometric method (Siemens Immulite 2500, Siemens Healthcare Diagnostics, Breda, The Netherlands; CV < 5%). HbA1c concentrations were measured by HPLC boronate affinity chromatography (Primus Ultra, Siemens Healthcare Diagnostics, Breda, The Netherlands; CV < 3%). All analyses were performed in the central clinical chemistry laboratory of the LUMC (4). From measured glucose and insulin concentrations, we calculated Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and HOMA of beta-cell function (HOMA-B) as markers of hepatic insulin resistance and steady-state insulin secretion (5). HOMA-IR was calculated as fasting insulin (μU/ml) * fasting glucose (mmol/l) / 22.5 and HOMA-%B as 20 * fasting insulin (μU/ml) / fasting glucose (mmol/l) − 3.5 (5;6). In addition, we calculated the total area under the curve for overall glucose (glucoseAUC) and insulin (insulinAUC) concentrations by the trapezoidal rule as (15 * fasting concentration + 75 * concentration30min + 60 * concentration150min) / 150. The Disposition Index a marker of whole-body beta-cell function that accounts for variations in whole-body insulin sensitivity, was calculated as Insulinogenic Index * Matsuda Insulin Sensitivity Index (7). Insulinogenic Index was calculated as total insulinAUC / total glucoseAUC and Matsuda Insulin Sensitivity Index as 10,000/square root [fasting glucose (mg/dl) * fasting insulin (μU/ml)] * [meanglucose0-150 * meaninsulin0-150] (7-9).

Statistical analysis

All results presented in this paper are based on weighted analyses to represent a population-based study with normal BMI distribution. In this cohort persons with a BMI of 27 kg/m2or higher are oversampled. To correctly represent associations in the general population, data of the participants were weighted towards the BMI distribution of participants from the Leiderdorp municipality (10;11), whose BMI distribution is comparable to the BMI distribution of the general Dutch population (12).

Underreporting of dietary energy intake may be specific to certain macronutrients, in particular total fat, among obese individuals (13;14). Therefore potential energy under-reporters were identified on the basis of disparities between reported energy intakes and predicted energy requirements, using the ratio of Goldberg’s cut-off point for energy intake (EI) to basal metabolic rate (BMR) ratio (10;15). We assumed a within-subject variation in energy intake of 23%, a within-subject variation in estimated BMR of 8.5%, and a between-subject variation in physical activity level (PAL) of 15% (15). BMR was estimated by an equation for obese and sedentary individuals (16), and the PAL was estimated to be 1.55, the average PAL of a middle-aged, moderately active population (15). Participants with reported energy intake under the cut-off point (EI:BMR < 1.09) were considered energy under-reporters.

For interpretation of the results, regression coefficients were back transformed and expressed as percentage with 95% confidence intervals (CI). For an equal interpretation of regression coefficients below 0 as those above 0, we back transformed the regression coefficients towards percentages increase as: (exp(beta) - 1)*100 if beta > 0 and percentages decrease as: - (exp(-beta) - 1)*100 if beta < 0.

Supplemental Table 1:Detailed list of food groups and food items as assessed by the food frequency questionnaire in the NEO study(1;2).

Food group / Food items
DAIRY & DAIRY PRODUCTS
Cheese / low fat and high fat cheese
cheese in meals and snacks
Milk and milk products / (flavoured) milk, chocolate milk, yoghurt
mousse, (coffee) cream, ice-cream
Butter / butter
MEAT & MEAT PRODUCTS / steak, chicken, chopped steak, minced meat beef
hot dogs, sausages, shawarma, liver
lard, bacon fat
PLANT & VEGETABLE PRODUCTS
Cereals, vegetables, fruits / cereals and grains
fruits, vegetables, legumes, potatoes
Nuts and seeds / nuts, seeds, peanut butter
Oils, fats, condiments / liquid, soft and hard cooking fats and margarines
vegetable oils, mayonnaise, oil-based sauces, dressings
OTHER (MIXED) SOURCES
Sweet snacks / cakes, cookies, biscuits
chocolate, candy bars
Fish / all types of (fried) fish
Other sources of fat / baked potatoes, (homemade) French fries, chips
ready to eat and mixed meals (pizza, pasta, soup)
meat replacer, eggs

Supplemental Table 2: Markers of glucose and insulin metabolism of 5,675 participants in the NEO study, 45-65 years without type 2 diabetes

Markers of glucose and insulin metabolism1 / Median (25th-75th percentile)
Fasting glucose (mmol/L) / 5.3 (5.0-5.6)
GlucoseAUC / 5.8 (5.1-6.6)
HbA1c (%) / 5.3 (5.1-5.4)
Fasting insulin (mU/L) / 7.5 (5.2-11.3)
InsulinAUC / 39.5 (29.0-55.8)
HOMA-IR / 1.8 (1.2-2.7)
HOMA-%B / 86.9 (61.0-125.7)
Disposition Index / 40.1 (31.2-52.2)

1HOMA-IR = fasting insulin (μU/ml) * fasting glucose (mmol/l) / 22.5. HOMA-%B = 20 * fasting insulin (μU/ml) / fasting glucose (mmol/l) − 3.5 (5;6). Total area under the curve for overall glucose (glucoseAUC) and insulin (insulinAUC) concentrations by the trapezoidal rule = (15 * fasting concentration + 75 * concentration30min + 60 * concentration150min) / 150. Disposition Index = Insulinogenic Index * Matsuda Insulin Sensitivity Index (7). Insulinogenic Index = total insulinAUC / total glucoseAUC. Matsuda Insulin Sensitivity Index = 10,000/square root [fasting glucose (mg/dl) * fasting insulin (μU/ml)] * [meanglucose0-150 * meaninsulin0-150] (7-9).

Online Supplementary Material to: Wanders et al., Types and sources of fat and markers of diabetes

Supplemental Table 3:Associations of the intake of types of dietary fatty acidsand their detailed dietary sources (dairy, meat, plant, other) with markers of type 2 diabetes risk in 5,675 participants in the NEO study, 45-65 years without type 2 diabetes1

Percentage (95%CI)2,3
Intake
(En%) / Total fatty acids / Intake
(En%) / SFA / Intake
(En%) / MUFA / Intake
(En%) / PUFA
Expressed per 5 En% / Expressed per 1 En% / Expressed per 1 En% / Expressed per 1 En%
Fasting glucose
total / 34.2 / 0.1 (-0.4, 0.5) / 12.3 / 0.0 (-0.2, 0.2) / 12.1 / 0.1 (-0.1, 0.4) / 6.8 / -0.1 (-0.3, 0.2)
dairy4 / 6.4 / -0.1 (-0.8, 0.5) / 4.2 / 0.0 (-0.2, 0.3) / 1.4 / 0.0 (-0.8, 0.8) / 0.2 / -0.6 (-5.0, 3.7)
cheese / 3.4 / -0.2 (-1.1, 0.6) / 2.3 / 0.0 (-0.3, 0.3) / 0.8 / 0.0 (-1.0, 0.9) / 0.1 / -0.7 (-6.0, 4.5)
milk / 2.2 / -0.2 (-1.7, 1.4) / 1.5 / 0.0 (-0.5, 0.5) / 0.5 / -0.6 (-2.0, 0.7) / 0.05 / -2.3 (-9.5, 4.7)
butter / 0.8 / 0.0 (-1.0, 1.0) / 0.5 / 0.1 (-0.3, 0.5) / 0.2 / 0.4 (-0.5, 1.4) / 0.02 / 2.4 (-5.6, 10.8)
meat / 4.0 / 0.6 (-0.4, 1.6) / 1.4 / 0.3 (-0.3, 0.9) / 1.6 / 0.3 (-0.2, 0.9) / 0.5 / 0.8 (-1.0, 2.6)
plant sources / 14.5 / 0.0 (-0.4, 0.5) / 3.0 / -0.2 (-0.5, 0.2) / 5.6 / 0.0 (-0.2, 0.3) / 4.8 / 0.0 (-0.3, 0.3)
veg/cer/fruit fat / 2.7 / 0.0 (-2.4, 2.3) / 0.8 / 0.1 (-0.8, 1.0) / 0.7 / -0.1 (-1.7, 1.4) / 0.9 / 0.9 (-1.6, 3.4)
nuts / 3.1 / 0.2 (-0.5, 0.9) / 0.5 / 0.0 (-1.0, 0.9) / 1.6 / 0.1 (-0.2, 0.4) / 0.9 / 0.0 (-0.6, 0.6)
oils, fats, condiments / 8.6 / -0.1 (-0.5, 0.4) / 1.8 / -0.2 (-0.6, 0.2) / 3.3 / 0.0 (-0.3, 0.3) / 3.1 / 0.0 (-0.3, 0.2)
other sources / 8.8 / 0.3 (-0.4, 1.0) / 3.5 / 0.0 (-0.3, 0.3) / 3.3 / 0.2 (-0.2, 0.5) / 1.3 / 0.5 (-0.4, 1.4)
sweet snacks / 4.7 / 0.1 (-0.7, 0.9) / 2.3 / 0.0 (-0.3, 0.3) / 1.6 / 0.1 (-0.4, 0.5) / 0.4 / -0.2 (-2.1, 1.7)
fish / 0.6 / 2.1 (-1.2, 5.4) / 0.1 / 1.4 (-1.3, 4.2) / 0.2 / 1.0 (-0.6, 2.6) / 0.1 / 1.1 (-1.6, 3.8)
GlucoseAUC / Intake / Total fatty acids / intake / SFA / intake / MUFA / intake / PUFA
total / 34.2 / 0.5 (-0.4, 1.4) / 12.3 / 0.1 (-0.3, 0.6) / 12.1 / 0.1 (-0.4, 0.5) / 6.8 / 0.3 (-0.2, 0.8)
dairy / 6.4 / -0.3 (-1.6, 0.9) / 4.2 / 0.1 (-0.4, 0.5) / 1.4 / -0.5 (-2.1, 1.1) / 0.2 / -3.3 (-12.3, 5.2)
cheese / 3.4 / -0.2 (-1.9, 1.5) / 2.3 / 0.1 (-0.5, 0.7) / 0.8 / -0.1 (-1.9, 1.7) / 0.1 / -1.0 (-11.3, 9.2)
milk / 2.2 / 0.4 (-2.6, 3.4) / 1.5 / 0.1 (-0.7, 0.9) / 0.5 / -0.3 (-3.0, 2.5) / 0.05 / -2.7 (-16.9, 10.9)
butter / 0.8 / -1.0 (-2.8, 0.8) / 0.5 / -0.1 (-0.7, 0.6) / 0.2 / -0.4 (-2.1, 1.3) / 0.02 / -4.8 (-21.4, 10.6)
meat / 4.0 / 1.7 (-0.4, 3.8) / 1.4 / 0.9 (-0.3, 2.0) / 1.6 / 0.6 (-0.4, 1.7) / 0.5 / 2.4 (-1.1, 6.0)
plant sources / 14.5 / 0.6 (-0.4, 1.5) / 3.0 / 0.1 (-0.7, 0.9) / 5.6 / -0.1 (-0.6, 0.4) / 4.8 / 0.4 (-0.2, 0.9)
veg/cer/fruit fat / 2.7 / -0.1 (-4.9, 4.6) / 0.8 / 0.1 (-1.8, 2.0) / 0.7 / -0.6 (-3.8, 2.7) / 0.9 / 1.2 (-4.2, 6.8)
nuts / 3.1 / 0.5 (-0.7, 1.6) / 0.5 / -0.7 (-2.5, 1.2) / 1.6 / 0.0 (-0.5, 0.5) / 0.9 / -0.2 (-1.3, 1.0)
oils, fats, condiments / 8.6 / 0.7 (-0.3, 1.7) / 1.8 / 0.2 (-0.6, 1.0) / 3.3 / -0.1 (-0.7, 0.6) / 3.1 / 0.3 (-0.3, 0.8)
other sources / 8.8 / 0.6 (-0.8, 2.1) / 3.5 / 0.2 (-0.5, 0.8) / 3.3 / 0.3 (-0.4, 0.9) / 1.3 / 0.9 (-0.8, 2.8)
sweet snacks / 4.7 / 0.4 (-1.2, 2.1) / 2.3 / 0.1 (-0.5, 0.8) / 1.6 / 0.1 (-0.8, 1.0) / 0.4 / 0.3 (-3.3, 3.9)
fish / 0.6 / 5.1 (-1.4, 11.9) / 0.1 / 3.1 (-2.1, 8.5) / 0.2 / 1.8 (-1.3, 5.0) / 0.1 / 3.0 (-2.3, 8.5)
HBA1c / Intake / Total fatty acids / intake / SFA / intake / MUFA / intake / PUFA
total / 34.2 / -0.1 (-0.3, 0.1) / 12.3 / 0.0 (-0.1, 0.1) / 12.1 / 0.0 (-0.2, 0.1) / 6.8 / 0.0 (-0.1, 0.2)
dairy / 6.4 / -0.3 (-0.5, 0.0) / 4.2 / 0.0 (-0.1, 0.1) / 1.4 / -0.2 (-0.6, 0.1) / 0.2 / -0.8 (-2.7, 1.0)
cheese / 3.4 / -0.3 (-0.7, 0.1) / 2.3 / 0.0 (-0.2, 0.1) / 0.8 / -0.2 (-0.6, 0.2) / 0.1 / -0.6 (-2.8, 1.6)
milk / 2.2 / -0.3 (-0.9, 0.4) / 1.5 / -0.1 (-0.2, 0.1) / 0.5 / -0.3 (-0.9, 0.3) / 0.05 / -1.2 (-4.3, 1.8)
butter / 0.8 / -0.3 (-0.6, 0.1) / 0.5 / 0.0 (-0.1, 0.2) / 0.2 / 0.0 (-0.4, 0.3) / 0.02 / 0.2 (-3.0, 3.4)
meat / 4.0 / 0.0 (-0.5, 0.4) / 1.4 / 0.0 (-0.2, 0.3) / 1.6 / 0.0 (-0.3, 0.2) / 0.5 / 0.2 (-0.6, 1.0)
plant sources / 14.5 / -0.1 (-0.2, 0.1) / 3.0 / 0.1 (0.0, 0.3) / 5.6 / 0.0 (-0.1, 0.1) / 4.8 / 0.0 (-0.1, 0.1)
veg/cer/fruit fat / 2.7 / 0.4 (-0.6, 1.4) / 0.8 / 0.3 (-0.2, 0.7) / 0.7 / 0.3 (-0.4, 1.0) / 0.9 / 0.4 (-0.7, 1.6)
nuts / 3.1 / 0.1 (-0.2, 0.3) / 0.5 / 0.3 (-0.2, 0.8) / 1.6 / 0.0 (-0.1, 0.1) / 0.9 / 0.2 (-0.1, 0.5)
oils, fats, condiments / 8.6 / -0.1 (-0.3, 0.1) / 1.8 / 0.0 (-0.1, 0.2) / 3.3 / -0.1 (-0.3, 0.1) / 3.1 / 0.0 (-0.1, 0.2)
other sources / 8.8 / -0.2 (-0.6, 0.1) / 3.5 / 0.0 (-0.2, 0.1) / 3.3 / -0.1 (-0.3, 0.1) / 1.3 / -0.3 (-0.7, 0.1)
sweet snacks / 4.7 / -0.2 (-0.5, 0.1) / 2.3 / 0.0 (-0.1, 0.1) / 1.6 / -0.1 (-0.3, 0.1) / 0.4 / -0.4 (-1.2, 0.5)
fish / 0.6 / -0.6 (-2.5, 1.3) / 0.1 / -0.4 (-1.9, 1.0) / 0.2 / -0.4 (-1.3, 0.6) / 0.1 / -0.5 (-2.0, 1.0)
Fasting insulin / Intake / Total fatty acids / intake / SFA / intake / MUFA / intake / PUFA
total / 34.2 / 0.3 (-2.0, 2.5) / 12.3 / -1.4 (-2.7, -0.1) / 12.1 / 0.8 (-0.6, 2.2) / 6.8 / 0.2 (-1.4, 1.8)
dairy / 6.4 / -2.5 (-6.9, 1.8) / 4.2 / -1.5 (-3.0, -0.1) / 1.4 / -0.1 (-5.1, 5.0) / 0.2 / -7.0 (-41.9, 23.9)
cheese / 3.4 / -2.4 (-7.6, 2.7) / 2.3 / -1.5 (-3.2, 0.2) / 0.8 / 0.6 (-4.9, 6.1) / 0.1 / -3.4 (-39.8, 30.8)
milk / 2.2 / -3.5 (-12.7, 5.2) / 1.5 / -1.5 (-3.9, 0.9) / 0.5 / 0.5 (-7.8, 8.9) / 0.05 / -5.0 (-64.6, 49.2)
butter / 0.8 / -2.5 (-10.1, 4.7) / 0.5 / -1.7 (-4.2, 0.7) / 0.2 / 0.0 (-6.1, 6.0) / 0.02 / -7.9 (-78.1, 52.8)
meat / 4.0 / 10.0 (4.0, 16.3) / 1.4 / 3.7 (0.4, 7.2) / 1.6 / 5.0 (2.0, 8.1) / 0.5 / 17.3 (6.0, 29.7)
plant sources / 14.5 / 0.5 (-1.7, 2.8) / 3.0 / -2.3 (-4.7, 0.0) / 5.6 / 0.3 (-1.2, 1.8) / 4.8 / 0.3 (-1.3, 2.0)
veg/cer/fruit fat / 2.7 / -9.0 (-26.1, 6.1) / 0.8 / -4.2 (-10.7, 1.9) / 0.7 / -5.3 (-16.2, 4.9) / 0.9 / -6.6 (-25.3, 10.2)
nuts / 3.1 / 0.9 (-2.5, 4.3) / 0.5 / -3.1 (-9.4, 2.8) / 1.6 / 0.8 (-0.7, 2.3) / 0.9 / -1.2 (-5.1, 2.7)
oils, fats, condiments / 8.6 / 0.8 (-1.7, 3.3) / 1.8 / -1.7 (-3.9, 0.4) / 3.3 / 0.0 (-2.0, 2.0) / 3.1 / 0.1 (-1.5, 1.8)
other sources / 8.8 / -0.9 (-5.2, 3.3) / 3.5 / -1.7 (-3.6, 0.2) / 3.3 / 0.6 (-1.5, 2.7) / 1.3 / -2.1 (-8.1, 3.7)
sweet snacks / 4.7 / -0.8 (-5.8, 4.2) / 2.3 / -1.3 (-3.1, 0.6) / 1.6 / 1.4 (-1.5, 4.4) / 0.4 / 5.5 (-6.5, 18.6)
fish / 0.6 / -5.1 (-27.8, 15.6) / 0.1 / -8.7 (-28.0, 8.3) / 0.2 / -2.0 (-11.9, 7.7) / 0.1 / -8.1 (-27.2, 8.8)
InsulinAUC / Intake / Total fatty acids / intake / SFA / intake / MUFA / intake / PUFA
total / 34.2 / 0.1 (-2.0, 2.1) / 12.3 / -0.4 (-1.6, 0.8) / 12.1 / -0.3 (-1.4, 0.9) / 6.8 / 0.9 (-0.4, 2.2)
dairy / 6.4 / -0.7 (-3.8, 2.3) / 4.2 / -0.2 (-1.4, 1.0) / 1.4 / 0.3 (-3.9, 4.4) / 0.2 / 0.1 (-23.5, 23.7)
cheese / 3.4 / -2.5 (-6.6, 1.5) / 2.3 / -0.8 (-2.2, 0.6) / 0.8 / -2.3 (-7.3, 2.5) / 0.1 / -11.1 (-43.9, 16.7)
milk / 2.2 / 5.0 (-2.9, 13.5) / 1.5 / 1.4 (-0.9, 3.6) / 0.5 / 3.2 (-4.0, 10.7) / 0.05 / 12.3 (-23.6, 55.8)
butter / 0.8 / -0.7 (-5.8, 4.3) / 0.5 / 0.0 (-1.9, 2.0) / 0.2 / 0.9 (-4.0, 5.9) / 0.02 / 13.1 (-34.1, 71.4)
meat / 4.0 / 2.7 (-2.7, 8.4) / 1.4 / 1.1 (-2.1, 4.4) / 1.6 / 0.9 (-1.7, 3.7) / 0.5 / 5.5 (-4.3, 16.1)
plant sources / 14.5 / 0.4 (-1.8, 2.5) / 3.0 / -1.2 (-3.2, 0.8) / 5.6 / -0.5 (-1.8, 0.8) / 4.8 / 0.9 (-0.4, 2.3)
veg/cer/fruit fat / 2.7 / -17.2 (-32.4, -3.7) / 0.8 / -6.9 (-12.4, -1.7) / 0.7 / -11.7 (-21.5, -2.6) / 0.9 / -15.0 (-32.0, -0.1)
nuts / 3.1 / 0.1 (-3.1, 3.3) / 0.5 / -0.9 (-5.9, 4.1) / 1.6 / -0.3 (-1.6, 1.1) / 0.9 / 0.0 (-2.9, 2.9)
oils, fats, condiments / 8.6 / 1.0 (-1.4, 3.3) / 1.8 / -0.4 (-2.4, 1.7) / 3.3 / -0.4 (-2.0, 1.3) / 3.1 / 0.8 (-0.5, 2.1)
other sources / 8.8 / -1.4 (-4.9, 2.0) / 3.5 / -0.8 (-2.5, 0.9) / 3.3 / -0.3 (-1.9, 1.3) / 1.3 / 0.1 (-4.6, 4.9)
sweet snacks / 4.7 / -1.7 (-5.8, 2.2) / 2.3 / -0.7 (-2.3, 0.9) / 1.6 / -0.4 (-2.6, 1.8) / 0.4 / 0.6 (-8.0, 9.3)
fish / 0.6 / 2.4 (-16.8, 22.4) / 0.1 / -1.4 (-17.1, 13.8) / 0.2 / 0.8 (-8.5, 10.4) / 0.1 / 1.4 (-14.0, 17.1)
HOMA-IR / Intake / Total fatty acids / intake / SFA / intake / MUFA / intake / PUFA
total / 34.2 / 0.3 (-2.1, 2.8) / 12.3 / -1.4 (-2.8, 0.0) / 12.1 / 0.9 (-0.6, 2.4) / 6.8 / 0.2 (-1.5, 1.8)
dairy / 6.4 / -2.6 (-7.2, 1.8) / 4.2 / -1.5 (-3.0, 0.0) / 1.4 / -0.1 (-5.4, 5.2) / 0.2 / -7.6 (-44.9, 25.0)
cheese / 3.4 / -2.6 (-8.2, 2.8) / 2.3 / -1.5 (-3.3, 0.3) / 0.8 / 0.5 (-5.3, 6.4) / 0.1 / -4.1 (-43.5, 32.3)
milk / 2.2 / -3.7 (-13.5, 5.5) / 1.5 / -1.5 (-4.1, 1.0) / 0.5 / -0.1 (-9.0, 8.8) / 0.05 / -7.4 (-72.5, 49.5)
butter / 0.8 / -2.5 (-10.2, 4.8) / 0.5 / -1.6 (-4.2, 0.9) / 0.2 / 0.4 (-5.9, 6.7) / 0.02 / -5.4 (-77.3, 59.7)
meat / 4.0 / 10.6 (4.1, 17.5) / 1.4 / 4.1 (0.5, 7.8) / 1.6 / 5.4 (2.1, 8.7)* / 0.5 / 18.2 (6.2, 31.6)
plant sources / 14.5 / 0.6 (-1.9, 3.0) / 3.0 / -2.5 (-5.0, 0.0) / 5.6 / 0.4 (-1.2, 2.0) / 4.8 / 0.3 (-1.4, 2.0)
veg/cer/fruit fat / 2.7 / -9.0 (-27.0, 6.8) / 0.8 / -4.1 (-10.9, 2.3) / 0.7 / -5.4 (-17.0, 5.2) / 0.9 / -5.7 (-24.9, 11.9)
nuts / 3.1 / 1.1 (-2.5, 4.7) / 0.5 / -3.2 (-9.7, 3.1) / 1.6 / 0.9 (-0.7, 2.5) / 0.9 / -1.2 (-5.3, 2.8)
oils, fats, condiments / 8.6 / 0.7 (-2.0, 3.4) / 1.8 / -1.9 (-4.2, 0.3) / 3.3 / 0.0 (-2.1, 2.1) / 3.1 / 0.1 (-1.6, 1.8)
other sources / 8.8 / -0.7 (-5.2, 3.8) / 3.5 / -1.6 (-3.7, 0.4) / 3.3 / 0.8 (-1.4, 3.0) / 1.3 / -1.6 (-7.9, 4.6)
sweet snacks / 4.7 / -0.6 (-5.9, 4.6) / 2.3 / -1.3 (-3.3, 0.6) / 1.6 / 1.5 (-1.6, 4.7) / 0.4 / 5.3 (-7.5, 19.3)
fish / 0.6 / -3.0 (-26.9, 19.6) / 0.1 / -7.2 (-27.8, 11.1) / 0.2 / -0.9 (-11.5, 9.4) / 0.1 / -7.0 (-27.3, 11.3)
HOMA-B / Intake / Total fatty acids / intake / SFA / intake / MUFA / intake / PUFA
total / 34.2 / -0.1 (-2.5, 2.3) / 12.3 / -1.5 (-2.9, -0.2) / 12.1 / 0.5 (-0.9, 2.0) / 6.8 / 0.3 (-1.3, 1.9)
dairy / 6.4 / -2.1 (-6.8, 2.4) / 4.2 / -1.6 (-3.1, -0.1) / 1.4 / 0.4 (-4.7, 5.5) / 0.2 / -3.5 (-36.8, 27.7)
cheese / 3.4 / -1.7 (-6.8, 3.4) / 2.3 / -1.4 (-3.1, 0.2) / 0.8 / 1.0 (-4.5, 6.6) / 0.1 / 0.7 (-34.2, 36.1)
milk / 2.2 / -2.8 (-12.2, 6.1) / 1.5 / -1.4 (-4.0, 1.0) / 0.5 / 2.7 (-5.6, 11.3) / 0.05 / 2.7 (-51.6, 59.8)
butter / 0.8 / -2.8 (-11.0, 5.1) / 0.5 / -2.1 (-4.8, 0.5) / 0.2 / -1.4 (-7.8, 4.9) / 0.02 / -16.6 (-97.0, 44.9)
meat / 4.0 / 7.8 (2.0, 13.9) / 1.4 / 2.6 (-0.7, 6.1) / 1.6 / 3.9 (1.0, 6.9) / 0.5 / 14.1 (3.2, 26.2)
plant sources / 14.5 / 0.2 (-2.2, 2.7) / 3.0 / -1.7 (-4.0, 0.5) / 5.6 / 0.3 (-1.3, 1.8) / 4.8 / 0.1 (-1.5, 1.8)
veg/cer/fruit fat / 2.7 / -9.9 (-27.1, 5.3) / 0.8 / -4.9 (-11.2, 1.0) / 0.7 / -5.1 (-15.9, 5.0) / 0.9 / -9.8 (-29.7, 7.6)
nuts / 3.1 / 0.3 (-3.3, 3.9) / 0.5 / -2.7 (-9.2, 3.4) / 1.6 / 0.6 (-1.0, 2.2) / 0.9 / -1.2 (-5.1, 2.7)
oils, fats, condiments / 8.6 / 0.7 (-1.9, 3.3) / 1.8 / -1.2 (-3.4, 1.0) / 3.3 / 0.0 (-2.0, 2.0) / 3.1 / 0.1 (-1.6, 1.8)
other sources / 8.8 / -2.1 (-6.5, 2.1) / 3.5 / -1.9 (-3.9, 0.0) / 3.3 / 0.0 (-2.1, 2.1) / 1.3 / -4.2 (-10.1, 1.4)
sweet snacks / 4.7 / -1.5 (-6.6, 3.6) / 2.3 / -1.4 (-3.3, 0.5) / 1.6 / 1.1 (-1.8, 4.2) / 0.4 / 4.9 (-6.7, 17.4)
fish / 0.6 / -11.7 (-34.5, 7.9) / 0.1 / -13.2 (-31.9, 2.8) / 0.2 / -4.9 (-15.0, 4.5) / 0.1 / -11.5 (-30.0, 4.5)
Disposition Index / Intake / Total fatty acids / intake / SFA / intake / MUFA / intake / PUFA
total / 34.2 / -0.9 (-2.6, 0.9) / 12.3 / 0.3 (-0.6, 1.2) / 12.1 / -0.7 (-1.7, 0.2) / 6.8 / -0.1 (-1.2, 1.0)
dairy / 6.4 / 1.5 (-1.2, 4.2) / 4.2 / 0.5 (-0.4, 1.5) / 1.4 / 0.9 (-2.3, 4.2) / 0.2 / 9.0 (-10.2, 31.0)
cheese / 3.4 / 0.4 (-3.1, 3.9) / 2.3 / 0.2 (-0.9, 1.3) / 0.8 / -1.2 (-5.0, 2.5) / 0.1 / -1.8 (-24.4, 20.0)
milk / 2.2 / 3.8 (-1.9, 9.8) / 1.5 / 1.3 (-0.3, 2.9) / 0.5 / 2.0 (-3.3, 7.6) / 0.05 / 14.3 (-18.2, 54.3)
butter / 0.8 / 2.4 (-1.6, 6.6) / 0.5 / 0.9 (-0.6, 2.4) / 0.2 / 0.9 (-2.9, 4.7) / 0.02 / 17.0 (-17.2, 60.5)
meat / 4.0 / -6.4 (-10.6, -2.3) / 1.4 / -2.8 (-5.1, -0.5) / 1.6 / -3.1 (-5.1, -1.1) / 0.5 / -9.7 (-17.3, -2.6)
plant sources / 14.5 / -1.0 (-2.8, 0.8) / 3.0 / 0.5 (-0.9, 2.0) / 5.6 / -0.3 (-1.3, 0.7) / 4.8 / -0.3 (-1.4, 0.8)
veg/cer/fruit fat / 2.7 / -3.5 (-13.0, 5.6) / 0.8 / -1.5 (-5.0, 1.9) / 0.7 / -2.0 (-8.4, 4.2) / 0.9 / -6.3 (-17.9, 4.5)
nuts / 3.1 / -1.2 (-3.6, 1.2) / 0.5 / 2.1 (-1.9, 6.3) / 1.6 / -0.6 (-1.6, 0.5) / 0.9 / 0.8 (-1.8, 3.5)
oils, fats, condiments / 8.6 / -0.9 (-2.9, 1.0) / 1.8 / 0.5 (-0.9, 1.9) / 3.3 / -0.1 (-1.4, 1.2) / 3.1 / -0.1 (-1.2, 1.0)
other sources / 8.8 / -1.3 (-4.4, 1.8) / 3.5 / 0.2 (-1.2, 1.5) / 3.3 / -0.9 (-2.4, 0.4) / 1.3 / -0.6 (-4.3, 3.2)
sweet snacks / 4.7 / -1.2 (-4.8, 2.3) / 2.3 / 0.1 (-1.2, 1.4) / 1.6 / -1.1 (-3.1, 0.9) / 0.4 / -2.7 (-11.0, 5.1)
fish / 0.6 / -4.9 (-19.6, 8.8) / 0.1 / -1.9 (-13.4, 9.3) / 0.2 / -1.8 (-8.7, 4.8) / 0.1 / -0.4 (-11.9, 11.1)

1NEO, Netherlands Epidemiology of Obesity study; %En, percentage of energy; SFA, saturated fatty acids; MUFA, mono-unsaturated fatty acids; PUFA, poly-unsaturated fatty acids; TFA, trans fatty acids; CI, confidence interval; AUC, area under the curve; HbA1c, glycated hemoglobin; HOMA, Homeostatic Model Assessment; IR, Insulin Resistance; B, beta-cell function.

2Linear regression coefficients of the ln-transformed markers of type 2 diabetes risk were back transformed and expressed as percentage with 95% CI. Individual data were weighted to BMI distribution of the general Dutch population.

3Linear regression models (carbohydrate substitution model) were adjusted for age (years), sex (M/F), total energy intake (kJ/day), alcohol (En%), dietary fibre (En%), total body fat (%), smoking (never/former/current smoker), education level (low/middle/high), physical activity (MET hours/week), family history of diabetes (no/yes), statin use (no/yes), energy under-reporter (no/yes), coffee (g/day), sugar-sweetened beverages (g/day), dietary cholesterol (mg/day), protein (En%),all other fatty acids (En%).

4After stratification for dietary source, the multivariate regression models were additionally adjusted for the intake of fatty acids from the other dietary sources.

Online Supplementary Material to: Wanders et al., Types and sources of fat and markers of diabetes

1NEO, Netherlands Epidemiology of Obesity study; %En, percentage of energy; FA, fatty acids; SFA, saturated fatty acids; MUFA, mono-unsaturated fatty acids; PUFA, poly-unsaturated fatty acids; TFA, trans fatty acids; CI, confidence interval; AUC, area under the curve; HbA1c, glycated hemoglobin; HOMA, Homeostatic Model Assessment; IR, Insulin Resistance; B, beta-cell function.

2 Regression coefficients of the ln-transformed markers of type 2 diabetes risk were back transformed and expressed as percentage with 95% CI. Linear regression models (model 3:energy substitution model) were adjusted for age (years), sex (M/F), total energy intake (kJ/day), alcohol (En%), dietary fibre (En%), total body fat (%), smoking (never/former/current smoker), education level (low/middle/high), physical activity (MET hours/week), family history of diabetes (no/yes), statin use (no/yes), energy under-reporter (no/yes), coffee (g/day), sugar-sweetened beverages (g/day), dietary cholesterol (mg/day). NOT adjusted for protein (En%) and all other fatty acids (En%).

2 Regression coefficients of the ln-transformed markers of type 2 diabetes risk were back transformed and expressed as percentage with 95% CI. Individual data were not weighted to BMI distribution of the general Dutch population.Linear regression models (carbohydrate substitution model) were adjusted for age (years), sex (M/F), total energy intake (kJ/day), alcohol (En%), dietary fibre (En%), total body fat (%), smoking (never/former/current smoker), education level (low/middle/high), physical activity (MET hours/week), family history of diabetes (no/yes), statin use (no/yes), energy under-reporter (no/yes), coffee (g/day), sugar-sweetened beverages (g/day), dietary cholesterol (mg/day), protein (En%), all other fatty acids (En%).

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Online Supplementary Material to: Wanders et al., Types and sources of fat and markers of diabetes