Dietary Nonheme, Heme, and Total Iron Intake and the Risk of Diabetes in Adults: Results From the China Health and Nutrition Survey
- 1 April 2020
- journal article
- research article
- Published by American Diabetes Association in Diabetes Care
- Vol. 43 (4), 776-784
- https://doi.org/10.2337/dc19-2202
Abstract
OBJECTIVE Excessive iron intake has been linked to diabetes risk. However, the evidence is inconsistent. This study examined the association between dietary heme and nonheme iron intake and diabetes risk in the Chinese population. RESEARCH DESIGN AND METHODS We included 17,026 adults (8,346 men and 8,680 women) who were part of the China Health and Nutrition Survey (1991-2015) prospective cohort. Dietary intake was measured by three consecutive 24-h dietary recalls combined with a household food inventory. Diabetes cases were identified through a questionnaire. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs. RESULTS A total of 547 men and 577 women developed diabetes during 202,138 person-years of follow-up. For men, the adjusted HRs (95% CIs) for quintiles of nonheme iron intake were 1.00, 0.77 (0.58-1.02), 0.72 (0.54-0.97), 0.63 (0.46-0.85), and 0.87 (0.64-1.19) (P-nonlinearity = 0.0015). The corresponding HRs (95% CIs) for women were 1.00, 0.63 (0.48-0.84), 0.57 (0.43-0.76), 0.58 (0.43-0.77), and 0.67 (0.49-0.91) (P-nonlinearity < 0.0001). The dose-response curves for the association between nonheme iron and total iron intake and diabetes followed a reverse J shape in men and an L shape in women. No significant associations were observed between heme iron intake and diabetes risk. CONCLUSIONS Total iron and nonheme iron intake was associated with diabetes risk, following a reverse J-shaped curve in men and an L-shaped curve in women. Sufficient intake of nonheme or total iron might be protective against diabetes, while excessive iron intake might increase the risk of diabetes among men.This publication has 34 references indexed in Scilit:
- Dietary iron intake, body iron stores, and the risk of type 2 diabetes: a systematic review and meta-analysisBMC Medicine, 2012
- Dissecting Quantitative Trait Loci for Boron Efficiency across Multiple Environments in Brassica napusPLOS ONE, 2012
- Body Iron Stores and Heme-Iron Intake in Relation to Risk of Type 2 Diabetes: A Systematic Review and Meta-AnalysisPLOS ONE, 2012
- Body iron stores and risk of type 2 diabetes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam studyDiabetologia, 2012
- Association of elevated serum ferritin concentration with insulin resistance and impaired glucose metabolism in Korean men and womenMetabolism, 2010
- Diagnosis and Classification of Diabetes MellitusDiabetes Care, 2010
- Iron intake and body iron stores, anaemia and risk of hyperglycaemia among Chinese adults: the prospective Jiangsu Nutrition Study (JIN)Public Health Nutrition, 2009
- The role of iron in type 2 diabetes in humansBiochimica et Biophysica Acta (BBA) - General Subjects, 2008
- Elevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk prospective studyDiabetologia, 2007
- Dietary iron intake and Type 2 diabetes incidence in postmenopausal women: the Iowa Women’s Health StudyDiabetologia, 2004