Higher intake of dietary dicarbonyl compounds is associated with lower incidence of type 2 diabetes: European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study.
Maasen K., Mayen A-L., Hana C., Knaze V., van Greevenbroek MMJ., Eussen SJPM., Debras C., Stehouwer CDA., Tjønneland A., Kyrø C., Ibsen DB., Dah CC., Mancini F., Laouali N., Hajji M., Schulze MB., Bajracharya R., Katzke V., Masala G., Pasanisi F., Milani L., Pala V., Mañé MF., Moreno-Iribas C., Rodriguez-Barranco M., Yohar SMC., Mokoroa O., Papier K., Weiderpass E., Freisling H., Wareham NJ., Forouhi NG., Christakoudi S., Vangrieken P., Jenab M., Schalkwijk CG.
PURPOSE: Dicarbonyls are reactive precursors of advanced glycation end-products. They are formed during food processing, and endogenously in humans during glycolysis and lipid peroxidation. Higher plasma dicarbonyls, particularly methylglyoxal (MGO), promote insulin resistance and type 2 diabetes, but the association between dietary dicarbonyls intake and type 2 diabetes is unknown. This study examined the associations between dietary dicarbonyls and type 2 diabetes incidence. METHODS: 11,995 incident type 2 diabetes cases and a sub-cohort of 15,797 controls from the prospective multi-center European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct cohort were included. Intakes of three major dicarbonyls MGO, glyoxal [GO], and 3-deoxyglucosone [3-DG] were estimated at baseline using dietary questionnaires. Type 2 diabetes risk according to dietary dicarbonyl intake was estimated by multivariable-adjusted hazard ratios from Prentice-weighted Cox-regression analyses. RESULTS: Higher intakes of MGO (sample-specific mean intake 3.4 ± 1.3 mg/d) and 3-DG (13.8 ± 10.5) were associated with lower incidence of type 2 diabetes (HR 0.92 [95% CI 0.90–0.95] for 1 SD higher MGO intake and 0.93 [0.90–0.95] for 1 SD higher 3-DG intake). No associations were observed for dietary GO. CONCLUSION: Participants who consumed more dietary dicarbonyls MGO and 3-DG had a lower risk to develop type 2 diabetes. This protective association contrasts with the harmful effects on type 2 diabetes risk reported for endogenously formed dicarbonyls. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00394-026-03904-0.