Table 1 Characteristics of included studies
References | Author | Year | Location | Follow-up | Exposure assessment | Number of participants, sex, age | Total cases | T2D assessment | Exposure | Categories | RR (95% CI), HR [95% CI] | Adjustment factors |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
[18] | Alhazmi | 2013 | Australia | 6 years | Validated dietary Questionnaire for Epidemiological Studies (DQES) version 2 | 8370, w, 45–50 years | 311 | Self-report, validated by linking to Medicare (MBS) and Pharmaceutical Benefits Scheme (PBS) databases for the years 2002–2005 | PUFA | 4.31 g/d (REF) 6.77 g/d 9.15 g/d 11.95 g/d 16.52 g/d | 1.00 0.81 (0.53, 1.25) 1.10 (0.73, 1.67) 1.07 (0.71, 1.61) 1.27 (0.84, 1.90) | Area of residence, education, current smoking status, physical activity, self-rated health as good, menopausal status, BMI, alcohol consumption, total energy intake (kj/d), SFA and MUFA intakes for total carbohydrate, SFA, MUFA and fibre intakes for total protein, and fibre intake for total fat |
Total omega-3 | 0.61 g/d (REF) 0.86 g/d 1.08 g/d 1.37 g/d 1.97 g/d | 1.00 0.98 (0.63, 1.52) 1.27 (0.84, 1.92) 1.44 (0.97, 2.16) 1.55 (1.03, 2.32) | ||||||||||
EPA + DHA | 0.09 g/d (REF) 0.17 g/d 0.25 g/d 0.38 g/d 0.73 g/d | 1.00 1.07 (0.71. 1.60) 1.16 (0.77, 1.75) 1.12 (0.75, 1.68) 1.23 (0.84, 1.80) | ||||||||||
EPA | 0.02 g/d (REF) 0.04 g/d 0.07 g/d 0.12 g/d 0.24 g/d | 1.00 1.06 (0.71. 1.59) 1.19 (0.79, 1.79) 1.07 (0.71, 1.62) 1.24 (0.85, 1.82) | ||||||||||
DHA | 0.06 g/d (REF) 0.11 g/d 0.17 g/d 0.26 g/d 0.49 g/d | 1.00 1.04 (0.69, 1.55) 1.07 (0.71, 1.61) 1.10 (0.73, 1.64) 1.19 (0.81, 1.74) | ||||||||||
ALA | 0.42 g/d (REF) 0.61 g/d 0.78 g/d 0.98 g/d 1.40 g/d | 1.00 1.20 (0.78, 1.82) 1.17 (0.76, 1.80) 1.32 (0.86, 2.01) 1.84 (1.25, 2.71) | ||||||||||
Total omega-6 | 3.54 g/d (REF) 5.47 g/d 7.43 g/d 9.86 g/d 13.87 g/d | 1.00 1.25 (0.83, 1.90) 1.18 (0.76, 1.83) 1.28 (0.82, 1.99) 1.60 (1.03, 2.48) | ||||||||||
[19] | Brostow | 2011 | China | 5.7 years | Validated, semi-quantitative FFQ including 165 commonly consumed items | 43,176, m/w, 45–74 years | 2252 | Self-reported, validation study of incident diabetes mellitus cases | Total omega-3 | 0.45 g/d (REF) 0.66 g/d 0.82 g/d 1.02 g/d 1.54 g/d | 1.00 0.87 [0.75, 1.00] 0.88 [0.76, 1.02] 0.80 [0.68, 0.94] 0.78 [0.65, 0.94] | Age, sex, dialect, year of interview, educational level, BMI, physical activity, smoking status, alcohol use, hypertension, intakes of omega-6 or omega-3, MUFA, SFA, dietary fiber, protein, and total energy |
Total omega-6 | 3.50 g/d (REF) 5.40 g/d 7.10 g/d 9.30 g/d 14.60 g/d | 1.00 0.94 [0.81, 1.08] 1.00 [0.87, 1.17] 0.91 [0.78, 1.07] 0.93 [0.87, 1.12] | ||||||||||
EPA and DHA | 0.11 g/d (REF) 0.22 g/d 0.30 g/d 0.38 g/d 0.60 g/d | 1.00 1.01 [0.88, 1.17] 0.99 [0.85, 1.14] 0.94 [0.80, 1.10] 0.93 [0.77, 1.11] | ||||||||||
ALA | 0.27 g/d (REF) 0.40 g/d 0.51 g/d 0.65 g/d 1.06 g/d | 1.00 0.91 [0.80, 1.04] 0.81 [0.70, 0.93] 0.78 [0.67, 0.90] 0.79 [0.67, 0.93] | ||||||||||
[20] | Djoussé | 2011 | USA | 12.4 years | Validated baseline 128-FFQ | 36,328, w, 54.6 years | 2370 | Self-report, validated using the ADA criteria (additional information via telephone interview and supplemental questionnaire) | ALA | 0.79 g/d (REF) 0.96 g/d 1.11 g/d 1.29 g/d 1.59 g/d | 1.00 0.94 [0.82, 1.09] 0.98 [0.85, 1.14] 1.00 [0.86, 1.17] 1.01 [0.85, 1.21] | Age, BMI, parental history of diabetes, smoking, exercise, alcohol intake, menopausal state, red-meat intake, quintiles of energy intake, linoleic acid, a-linolenic acid, dietary magnesium, trans fat, saturated fat, cereal fiber, and glycemic index |
EPA | 0.01 g/d (REF) 0.02 g/d 0.03 g/d 0.08 g/d 0.12 g/d | 1.00 1.08 [0.94, 1.24] 1.25 [1.11, 1.42] 1.30 [1.13, 1.49] 1.38 [1.21, 1.59] | ||||||||||
DHA | 0.04 g/d (REF) 0.09 g/d 0.12 g/d 0.17 g/d 0.17 g/d | 1.00 1.21 [1.06, 1.38] 1.21 [1.06, 1.39] 1.46 [1.28, 1.68] 1.52 [1.33, 1.75] | ||||||||||
Marine-n3 | 0.07 g/d (REF) 0.13 g/d 0.18 g/d 0.28 g/d 0.43 g/d | 1.00 1.17 [1.03, 1.33] 1.20 [1.05, 1.38] 1.46 [1.28, 1.66] 1.44 [1.25, 1.65] | ||||||||||
[21] | Djoussé | 2011 | USA | 9.6 years | Validated picture-sort FFQ in 1989–1990 and a FFQ (1995–1996 examination) | 3088, m/w, 75.6 years for men, 74.7 years for women | 204 | (1) The new use of insulin or oral hypoglycemic agents, (2) A Fasting glucose concentration ≥ 7 mmol/l (126 mg/dl), or (3) a Nonfasting glucose concentration ≥ 11.1 mmol/l (200 mg/dl) | EPA + DHA | 0.105 g/d (REF) 0.235 g/d 0.430 g/d 0.690 g/d | 1.00 1.11 (0.74, 1.66) 0.78 (0.50, 1.22) 1.04 (0.67, 1.60) | Age, race (black or nonblack), sex, clinic site, BMI, alcohol consumption, physical activity, current smoking, LDL cholesterol, and linoleic acid |
ALA | 0.095 g/d (REF) 0.125 g/d 0.160 g/d 0.200 g/d | 1.00 0.82 (0.51, 1.33) 0.99 (0.56, 1.77) 0.50 (0.24, 1.05) | ||||||||||
[22] | Dow | 2016 | France | 18 years | Validated 208-item FFQ | 71,334, w, 52.9 years | 2610 | Self-report or reimbursements from health insurance records at least once between January 2004 and March 2012 Additional questionnaire → cases validated, if one of the following criteria was met: (1) fasting plasma glucose ≥ 7.0 mmol/l, (2) random glucose ≥ 11.1 mmol/l at diagnosis, (3) report of diabetic medication use. (4) Or last values of fasting glucose or hba1c concentrations ≥ 7.0 mmol/l o ≥ 7%, respectively | PUFA | < 12.0 g/d (REF) 12.0–15.3 g/d ≥ 15.3 g/d | 1.00 1.03 [0.93, 1.14] 1.06 [0.96, 1.17] | Daily energy intake, alcohol consumption, level of education, family history of diabetes, physical activity, hypertension, Hypercholesterolaemia, smoking status, tertile groups of remaining fatty acid groups and BMI (age as time-scale in cox regression model) |
Total omega-3 | < 1.3 g/d (REF) 1.3–1.6 g/d ≥ 1.6 g/d | 1.00 1.10 [0.99, 1.22] 1.26 [1.13, 1.41] | ||||||||||
EPA | < 0.09 g/d (REF) 0.09–0.20 g/d ≥ 0.20 g/d | 1.00 0.88 [0.73, 1.06] 0.88 [0.67, 1.15] | ||||||||||
DHA | < 0.19 g/d (REF) 0.19–0.38 g/d ≥ 0.38 g/d | 1.00 1.15 [0.95, 1.38] 1.11 [0.85, 1.44] | ||||||||||
ALA | < 0.90 g/d (REF) 0.90–1.14 g/d ≥ 1.14 g/d | 1.00 1.00 [0.90, 1.12] 1.03 [0.92, 1.15] | ||||||||||
Total omega-6 | < 10.5 g/d (REF) 10.5–13.7 g/d ≥ 13.7 g/d | 1.00 1.01 [0.91, 1.12] 1.00 [0.90, 1.10] | ||||||||||
LA | < 10.3 g/d (REF) 10.3–13.5 g/d ≥ 13.5 g/d | 1.00 0.98 [0.89, 1.08] 0.97 [0.87, 1.07] | ||||||||||
AA | < 0.19 g/d (REF) 0.19–0.25 g/d ≥ 0.25 g/d | 1.00 1.11 [0.99, 1.24] 1.49 [1.33, 1.66] | ||||||||||
[23] | Ericson | 2015 | Sweden | 14 years | Interview-based, modified diet history Method (validated): - 7-d menu book - 168-item FFQ - a 45-min Interview | 26,930, m/w, 45–74 years | 2860 | Via at least one of 7 registries or at new screenings or examinations during follow-up Information on date of diagnosis was used from 2 registries (the regional Diabetes 2000 Registry of Scania and the Swedish National Diabetes Registry) that required a physician diagnosis According to established diagnosis criteria: fasting plasma glucose Concentration ≥ 7.0 mmol/l or fasting whole blood concentration ≥ 6.1 mmol/l, measured at two different occasions | PUFA | 4 E% (REF) 5 E% 6 E% 7 E% 8 E% | 1.00 1.08 [0.96, 1.22] 1.04 [0.92, 1.17] 1.08 [0.96, 1.22] 1.07 [0.95, 1.20] | Age, sex, method version, season, total energy intake, leisure-time physical activity, smoking, alcohol intake, education and BMI |
Total omega-3 | 0.7 E% (REF) 0.8 E% 0.9 E% 1.1 E% 1.4 E% | 1.00 0.90 [0.80, 1.02] 0.91 [0.81, 1.02] 0.93 [0.83, 1.05] 1.00 [0.89, 1.12] | ||||||||||
Long-chain omega-3 | 0.07 E% (REF) 0.12 E% 0.19 E% 0.29 E% 0.52 E% | 1.00 1.01 [0.90, 1.14] 0.99 [0.88, 1.12] 0.92 [0.81, 1.04] 1.07 [0.94, 1.20] | ||||||||||
ALA | 0.5 E% (REF) 0.6 E% 0.7 E% 0.8 E% 1.0 E% | 1.00 0.85 [0.76, 0.95] 0.94 [0.84, 1.05] 0.85 [0.76, 0.95] 0.94 [0.83, 1.05] | ||||||||||
Total omega-6 | 3.2 E% (REF) 4.0 E% 4.7 E% 5.5 E% 6.8 E% | 1.00 1.13 [1.00, 1.28] 1.07 [0.95, 1.21] 1.11 [0.98, 1.25] 1.09 [0.97, 1.23] | ||||||||||
[24] | Guasch-Ferre | 2017 | Spain | 4.3 years | Validated semiquantitative FFQ, completed in a face-to-face interview by trained dieticians | 3349, m/w, 55–80 years | 266 | T2D incidence diagnosed according to ADA criteria | PUFA | 4.14 En% (REF) 5.20 En% 6.23 En% 8.28 En% | 1.00 1.25 [0.81, 1.91] 1.32 [0.85, 2.05] 1.56 [1.03, 2.35] | Age, sex, intervention group, BMI, smoking status, educational status, leisure-time physical activity, baseline hypertension or use of antihypertensive medication, total energy intake, alcohol intake, quartiles of fiber, protein intake, dietary cholesterol, specific types of fat, hypercholesterolemia or use of lipid-lowering drugs and fasting plasma glucose at baseline |
Marine omega-3 | 0.14 En% (REF) 0.23 En% 0.32 En% 0.57 En% | 1.00 1.28 [0.87, 1.88] 1.06 [0.69, 1.61] 1.10 [0.71, 1.72] | ||||||||||
Nonmarine omega-3 | 0.35 En% (REF) 0.44 En% 0.55 En% 0.80 En% | 1.00 1.20 [0.78, 1.84] 1.20 [0.75, 1.93] 1.19 [0.72, 1.97] | ||||||||||
LA | 3.24 En% (REF) 4.21 En% 5.20 En% 7.11 En% | 1.00 1.46 [0.95, 2.25] 1.47 [0.91, 2.37] 1.59 [0.96, 2.63] | ||||||||||
[25]-a | Kaushik | 2009 | USA | 29 years | Validated semi-quantitative FFQ, 120 items | 61,031, w, 30–55 years | 4159 | Self-report, validated according to the National Diabetes Data Group criteria | Long-chain omega-3 | 0.06 g/d (REF) 0.12 g/d 0.18 g/d 0.27 g/d 0.49 g/d | 1.00 1.00 (0.91, 1.11) 1.12 (1.02, 1.24) 1.17 (1.05, 1.29) 1.23 (1.11, 1.37) | Age, smoking, alcohol consumption, physical activity, family history of diabetes, BMI, intakes of SFA, TFA, ALA, LA, caffeine, cereal fiber, glycemic index, calories, menopausal status and postmenopausal hormone use |
[25]-b | Kaushik | 2009 | USA | 15 years | Validated semi-quantitative FFQ, 120 items | 61,669, w, 26–46 years | 2728 | Self-report, validated according to the National Diabetes Data Group criteria | Long-chain omega-3 | 0.06 g/d (REF) 0.10 g/d 0.15 g/d 0.22 g/d 0.36 g/d | 1.00 1.04 (0.92, 1.17) 1.08 (0.95, 1.22) 1.15 (1.02, 1.30) 1.25 (1.10, 1.42) | Age, smoking, alcohol consumption, physical activity, family history of diabetes, BMI, intakes of SFA, TFA, ALA, LA, caffeine, cereal fiber, glycemic index, calories, hormone replacement therapy and contraceptive use |
[25]-c | Kaushik | 2009 | USA | 18 years | Validated semi-quantitative FFQ, 120 items | 42,504, m, 39–78 years | 2493 | Self-report, validated according to the National Diabetes Data Group criteria | Long-chain omega-3 | 0.09 g/d (REF) 0.18 g/d 0.28 g/d 0.39 g/d 0.62 g/d | 1.00 1.00 (0.88, 1.13) 0.99 (0.87, 1.12) 1.11 (0.98, 1.26) 1.12 (0.98, 1.28) | Age, smoking, alcohol consumption, physical activity, family history of diabetes, BMI, intakes of SFA, TFA, ALA, LA, caffeine, cereal fiber, glycemic index and calories |
[26] | Kröger | 2011 | Germany | 7 years | Self-administered validated FFQ | 2714, m/w, 50 years | 670 | The prevalence of diabetes at baseline was evaluated by a physician who used information on self-reported medical diagnoses, Medication records, and dieting behavior. Uncertainties regarding a proper diagnosis at baseline were clarified with the participant or treating physician | PUFA | 11.6 E% fat (REF) 14.8 E% fat 17.5 E% fat 20.2 E% fat 24.5 E% fat | 1.00 1.01 (0.71, 1.43) 1.30 (0.91, 1.86) 1.21 (0.86, 1.72) 1.26 (0.89, 1.77) | Age, sex, BMI, waist circumference, cycling, sports activity, education, smoking status, alcohol intake, occupational activity, coffee intake (energy adjusted), fiber intake (energy adjusted), total fat intake, and total energy intake |
Long-chain omega-3 | 0.04 E% fat (REF) 0.16 E% fat 0.23 E% fat 0.32 E% fat 0.59 E% fat | 1.00 1.01 (0.71, 1.46) 0.82 (0.58, 1.18) 0.97 (0.69, 1.36) 1.29 (0.95, 1.75) | ||||||||||
ALA | 1.4 E% fat (REF) 1.7 E% fat 1.9 E% fat 2.1 E% fat 2.6 E% fat | 1.00 1.13 (0.80, 1.59) 1.27 (0.90, 1.80) 1.31 (0.93, 1.85) 1.13 (0.80, 1.59) | ||||||||||
LA | 9.0 E% fat (REF) 12.1 E% fat 14.8 E% fat 17.4 E% fat 21.8 E% fat | 1.00 0.90 (0.63, 1.28) 1.14 (0.80, 1.63) 1.08 (0.76, 1.54) 1.11 (0.79, 1.56) | ||||||||||
[27] | Meyer | 2001 | USA | 11 years | Validated 127-item FFQ | 35,988, w, 55–69 years | 1890 | Self-report, with validation of 85 cohort participants in 1988 | PUFA | 8.9 g/d (REF) 9.2 g/d 10.4 g/d 12.2 g/d 16.6 g/d | 1.00 0.94 (0.81, 1.08) 0.91 (0.78, 1.06) 0.85 (0.73, 0.99) 0.88 (0.76, 1.02) | Age, total energy, WHR, BMI, physical activity, cigarette smoking, alcohol consumption, education, marital status, residential area, hormone replacement therapy, dietary magnesium and cereal fiber |
Long-chain omega-3 | 0.03 g/d (REF) 0.09 g/d 0.13 g/d 0.20 g/d 0.39 g/d | 1.00 0.98 (0.84, 1.14) 1.01 (0.87, 1.18) 0.99 (0.85, 1.15) 1.20 (1.03, 1.39) | ||||||||||
[28] | Salmeron | 1997 | USA | 6 years | Validated semi-quantitative 131-item FFQ | 42,759, m, 40–75 years | 523 | According the criteria of NIDDM proposed by the National Diabetes Data Group (1979) and the World Health Organization (1985) | PUFA | 9.2 g/d (REF) 11.3 g/d 12.8 g/d 14.5 g/d 17.4 g/d | 1.00 1.00 (0.76, 1.34) 1.00 (0.76, 1.34) 1.16 (0.89, 1.54) 1.01 (0.77, 1.35) | Age, BMI, alcohol intake, smoking status, physical activity and family history of diabetes |
[29] | Salmeron | 2001 | USA | 14 years | Validated semi-quantitative FFQ including 61-items (1980) and 116–136 items (1840 and on) | 84,204, w, 30–55 years | 2507 | According the criteria of NIDDM Proposed by the National Diabetes Data Group (1979) and the World Health Organization (1985) | PUFA | 2.9 E% (REF) 3.4 E% 4.1 E% 4.8 E% 6.2 E% | 1.00 0.86 (0.76, 0.97) 0.77 (0.67, 0.88) 0.75 (0.65, 0.86) 0.75 (0.65, 0.88) | Age, time period, BMI, cigarette smoking, parental history of diabetes, alcohol consumption, physical activity, percentage of energy from protein, total energy intake and dietary cholesterol |
[30] | Song | 2004 | USA | 8.8 years | Validated, semi-quantitative FFQ | 37,309, w, 53.5–54.6 years | 1558 | Self-report, validation in subgroups via blood samples and telephone interviews according to the ADA criteria | Omega-3 | 0.95 g/d (REF) 1.17 g/d 1.34 g/d 1.54 g/d 1.88 g/d | 1.00 1.09 (0.92, 1.29) 1.06 (0.89, 1.25) 1.13 (0.96, 1.34) 1.10 (0.93, 1.30) | Age, BMI, total energy intake, smoking, exercise, alcohol use, family history of diabetes, fiber intake, glycemic load, magnesium and total fat |
Omega-6 | 7.35 g/d (REF) 9.12 g/d 10.5 g/d 12.0 g/d 14.5 g/d | 1.00 1.06 (0.89, 1.26) 1.09 (0.91, 1.31) 1.04 (0.86, 1.25) 0.95 (0.78, 1.16) | ||||||||||
[31] | Van Dam | 2002 | USA | 12 years | Validated semi-quantitative 131-item FFQ | 42,504, m, 40–75 years | 1321 | Self-report, validation according to WHO criteria (1985) | LA | 3.5 E% (REF) 4.4 E% 4.9 E% 5.6 E% 6.8 E% | 1.00 0.99 (0.83, 1.18) 1.03 (0.86, 1.23) 1.06 (0.89, 1.26) 0.89 (0.74, 1.06) | Age, total energy intake, time period, physical activity, cigarette smoking, alcohol consumption, hypercholesterolemia, hypertension, family history of diabetes, cereal fiber, magnesium and BMI |
ALA | 321 mg/d (REF) 396 mg/d 458 mg/d 533 mg/d 671 mg/d | 1.00 1.03 (0.86, 1.23) 1.10 (0.92, 1.31) 1.00 (0.84, 1.20) 0.93 (0.78, 1.11) | ||||||||||
Long-chain omega.3 | 80 mg/d (REF) 155 mg/d 250 mg/d 350 mg/d 570 mg/d | 1.00 1.01 (0.85, 1.19) 0.95 (0.79, 1.13) 1.05 (0.88, 1.25) 1.01 (0.84, 1.21) | ||||||||||
[32] | Van Woudenbergh | 2009 | Netherlands | 12.4 years | Validated semi-quantitative 170-item FFQ | 4472, m/w, 67.2 years | 463 | Defined according to WHO (1999) and ADA criteria (1997) | Long-chain omega-3 | 23.8 mg/d (REF) 89.4 mg/d 236.8 mg/d | 1.00 1.06 (0.84, 1.34) 1.05 (0.80, 1.38) | Age, sex, smoking, education level, intake of energy, alcohol, TFA, fiber, selenium, Vitamin D and cholesterol |
[33]-a | Villegas | 2011 | China | 8.9 years | Validated FFQ | 64,193, w, 40–70 years | 2262 | Self-report and confirmation according to ADA criteria | Long-chain omega-3 | 0.02 g/d (REF) 0.04 g/d 0.07 g/d 0.11 g/d 0.20 g/d | 1.00 0.90 (0.80, 1.00) 0.84 (0.75, 0.94) 0.87 (0.77, 0.98) 0.84 (0.74, 0.95) | Age, energy intake, WHR, BMI, smoking, alcohol consumption, physical activity, income level, education level, occupation, family history of diabetes, hypertension and dietary pattern |
[33]-b | Villegas | 2011 | China | 4.1 years | Validated FFQ | 51,963, m, 40–74 years | 833 | Self-report and confirmation according to ADA criteria | Long-chain omega-3 | 0.02 g/d (REF) 0.04 g/d 0.07 g/d 0.11 g/d 0.20 g/d | 1.00 0.95 (0.77, 1.17) 0.86 (0.69, 1.07) 0.96 (0.77, 1.19) 0.89 (0.70, 1.12) | Age, energy intake, WHR, BMI, smoking, alcohol consumption, physical activity, income level, education level, occupation, family history of diabetes, hypertension and dietary pattern |
[34] | Virtanen | 2014 | Finland | 19.3 years | 4-day food record | 2212, m, 42–60 years | 422 | Self-report, fasting plasma glucose ≥ 7.0 mmol/l or 2-h oral glucose tolerance test plasma glucose ≥ 11.1 mmol/l, record linkage | Long-chain omega-3 | < 0.05 g/d (REF) 0.05–0.19 g/d 0.20–0.43 g/d > 0.43 g/d | 1.00 0.80 [0.61, 1.06] 0.91 [0.70, 1.19] 0.85 [0.65, 1.12] | Age, examination year, BMI, family history of diabetes, smoking, education years, leisure-time physical activity, intake of alcohol, serum linoleic acid and energy |
[35] | Wang | 2015 | USA | 50,105 person-years (follow-up in years not available) | 1989–1990: validated 99-item, picture sort FFQ, 1995–1996: validated 131-item self-administered FFQ | 4207, m/w, ≥ 65 years | 407 | (1) The new use of insulin or oral hypoglycemic agents, (2) a Fasting glucose concentration ≥ 7 mmol/l (126 mg/dl), or 3) a Nonfasting glucose concentration ≥ 11.1 mmol/l (200 mg/dl) | ALA | < 1.02 g/d (REF) 1.02–1.41 g/d 1.42–1.83 g/d > 1.83 g/d | 1.00 0.91 [0.69, 1.20] 1.09 [0.82, 1.45] 1.06 [0.79. 1.43] | Age, sex, race, education, enrolment site, smoking site, alcohol consumption, prevalence of physical activity, BMI, waist circumference, CVD, hypertension at baseline, total energy intake, dietary score that comprised Consumption of whole grains, fish, fruits and vegetables, nuts and seeds, red and processed meat, sugar-sweetened beverages, and fried potatoes |
[36] | Zheng | 2018 | China | 5.6 years | Validated FFQ | 2671, m, w, 40–75 years | 213 | Defined according to ADA criteria | Long-chain omega-3 | 0.021 g/d (REF) 0.042 g/d 0.068 g/d 0.12 g/d | 1.00 0.75 [0.50, 1.14] 0.87 [0.59, 1.29] 0.78 [0.52, 1.19] | Age, sex, BMI, WHR, physical activity, education, alcohol, smoking, household income, family history of diabetes, total energy intake, intake of dairy products, red and processed meat, fruits and vegetables, fasting blood glucose and erythrocyte total n-6 PUFA |
EPA | 0.008 g/d (REF) 0.016 g/d 0.025 g/d 0.042 g/d | 1.00 0.77 [0.51, 1.15] 0.85 [0.57, 1.27] 0.76 [0.50, 1.16] | ||||||||||
DHA | 0.011 g/d (REF) 0.024 g/d 0.039 g/d 0.067 g/d | 1.00 0.77 [0.51, 1.17] 0.87 [0.59, 1.30] 0.74 [0.49, 1.13] | ||||||||||
ALA | 0.49 g/d (REF) 0.66 g/d 0.84 g/d 1.19 g/d | 1.00 1.37 [0.90, 2.09] 1.11 [0.72, 1.71] 1.53 [1.01, 2.33] | ||||||||||
[37]-a | Zong | 2019 | USA | 32 years | Validated FFQ | 83,648, w, 30–55 years | 9375 | Self-report, validated according to the National Diabetes Data Group criteria | Omega-6 | 2.62 E% (REF) 3.47 E% 4.16 E% 4.95 E% 6.32 E% | 1.00 0.95 [0.89, 1.02] 1.00 [0.93, 1.07] 0.94 [0.87, 1.01] 0.97 [0.90, 1.06] | Age, ethnicity, smoking status, alcohol intake, family history of diabetes, menopausal status and postmenopausal hormone use, physical activity, multivitamin use, baseline hypertension, baseline hypercholesterolemia, updated BMI, total energy intake, intake of fruits and vegetable, total fat, trans fats, monounsaturated fats, other PUFAs Age, ethnicity, smoking status, alcohol intake, family history of diabetes, menopausal status and postmenopausal hormone use, physical activity, multivitamin use, baseline hypertension, baseline hypercholesterolemia, updated BMI, total energy intake, intake of fruits and vegetable, total fat, trans fats, monounsaturated fats, other PUFAs |
Linoleic acid | 2.54 E% (REF) 3.39 E% 4.07 E% 4.86 E% 6.23 E% | 1.00 0.96 [0.89, 1.02] 0.99 [0.93, 1.07] 0.96 [0.89, 1.03] 0.98 [0.91, 1.06] | ||||||||||
[37]-b | Zong | 2019 | USA | 32 years | Validated FFQ | 88,610, w, 25–44 years | 5460 | Self-report, validated according to the National Diabetes Data Group criteria | Omega-6 | 3.41 E% (REF) 4.17 E% 4.76 E% 5.43 E% 6.60 E% | 1.00 0.93 [0.85, 1.02] 0.91 [0.82, 1.00] 0.94 [0.85, 1.04] 0.91 [0.80, 1.02] | |
Linoleic acid | 3.33 E% (REF) 4.08 E% 4.68 E% 5.35 E% 6.51 E% | 1.00 0.95 [0.87, 1.04] 0.91 [0.82, 1.00] 0.94 [0.85, 1.04] 0.93 [0.82, 1.05] | ||||||||||
[37]-c | Zong | 2019 | USA | 26 years | Validated FFQ | 41,771, m, 40.75 years | 3607 | Self-report, validated according to the National Diabetes Data Group criteria | Omega-6 | 3.53 E% (REF) 4.43 E% 5.13 E% 5.91 E% 7.24 E% | 1.00 0.86 [0.77, 0.96] 0.90 [0.80, 1.01] 0.82 [0.73, 0.92] 0.74 [0.65, 0.85] | Age, ethnicity, smoking status, alcohol intake, family history of diabetes, physical activity, multivitamin use, baseline hypertension, baseline hypercholesterolemia, updated BMI, total energy intake, intake of fruits and vegetable, total fat, trans fats, monounsaturated fats, other PUFAs |
Linoleic acid | 3.45 E% (REF) 4.35 E% 5.05 E% 5.83 E% 7.16 E% | 1.00 0.87 [0.78, 0.97] 0.88 [0.79, 0.99] 0.83 [0.74, 0.94] 0.77 [0.67, 0.88] | ||||||||||
[38] | Hodge | 2007 | Australia | 4 years | A Kodak Ektachem Analyzer and the World Health Organization criteria current at the time | 3737, m/w, 36–72 years | 346 | A self-administered 121-item food-frequency questionnaire | Omega-6 | 2.456 g/d (REF) 4.912 g/d 7.368 g/d 9.824 g/d 12.280 g/d | 1.00 1.27 (0.83, 1.85) 1.10 (0.71, 1.68) 1.49 (0.98, 2.27) 1.42 (0.93, 2.18) | Age, sex, country of birth, family history of diabetes, physical activity, alcohol intake, BMI, and waist-hip ratio |
Omega-3 | 0.27 g/d (REF) 0.54 g/d 0.81 g/d 1.08 g/d 1.35 g/d | 1.00 1.10 (0.72, 1.69) 1.06 (0.69, 1.63) 0.88 (0.57, 1.36) 0.97 (0.63, 1.48) | ||||||||||
PUFA | 2.724 g/d (REF) 5.448 g/d 8.172 g/d 10.896 g/d 13.620 g/d | 1.00 1.18 (0.78, 1.81) 0.91 (0.59, 1.41) 1.46 (0.97, 2.21) 1.29 (0.84, 1.97) | ||||||||||
[39] | Nanri | 2011 | Japan | 5 years | A food-frequency questionnaire (FFQ) | 22,921, m, 40–69 years | 572 | A self-administered questionnaire at the third survey | PUFA | 11.6 g/d (REF) 12.3 g/d 12.9 g/d 14.2 g/d | 1.00 0.84 (0.67, 1.07) 0.80 (0.62, 1.03) 0.73 (0.54, 1.00) | Age (y), study area (11 areas), BMI (in kg/m2; 21, 21–22.9, 23–24.9, 25–26.9, or 27), smoking status (never; past; current: ,20 or 20 cigarettes/d), alcohol consumption (nondrinker, occasional drinker, or drinker with a consumption of, 150, 150–299, 300–449, or 450 g ethanol/week for men; nondrinker, occasional drinker, or drinker with a consumption of, 150 or 150 g ethanol/week for women), family history of diabetes mellitus (yes or no), total physical activity (quartile, metabolic equivalent-h/d), history of hypertension (yes or no), total energy intake (kcal/d), coffee consumption (almost never or, 1, 1, or 2 cups/d), and intakes of calcium (mg/d), magnesium (mg/d), dietary fiber (g/d), vegetables (g/d), fruit (g/d), meat (g/d), and rice (g/d) |
[40] | Mirmiran | 2018 | Iran | 5.8 years | The food frequency questionnaire (FFQ) | 2139, m/w, 20–70 years | 143 | Using anti-diabetic drugs, fasting plasma glucose (FPG) ≥ 126 mg/ or 2 h plasma glucose (2-h PG) ≥ 11.1 mmol/l | PUFA | 3.33 E% 6.67 E% 10.00 E% | 1.00 0.77 (0.48 -1.21) 0.45 (0.24 -0.93) | Age, diabetes risk score (SBP (mm Hg) < 120 (0 point), 120 < SBP < 140 (3 point) and SBP ≥ 140 (7 point); family history of diabetes (5 point); waist to height ratio (whtr): < 0.54 (0 point), 0.54–0.59 (6 Point) and ≥ 0.59 (11 point); TG/HDL-C: < 3.5 (0 point) and ≥ 3.5 (3 point); FSG (mmol/l): < 5 (0 point), 50–5.5 (12 Point) and 5.6–6.9 (33 point), energy intake, total fiber and magnesium |
Omega-3 | 3.33 E% 6.67 E% 10.00 E% | 1.00 0.86 (0.56 -1.34) 0.55 (0.31 -0.88) | ||||||||||
LA | 3.33 E% 6.67 E% 10.00 E% | 1.00 1.00 (0.59–1.70) 0.72 (0.36–1.42) | ||||||||||
ALA | 3.33 E% 6.67 E% 10.00 E% | 1.00 0.69 (0.41–1.18) 0.71 (0.37–1.38) | ||||||||||
[16] | Zhang | 2019 | China | 14 years | Updated versions of Chinese Food Composition Table (FCT) | 7069, m, ≥ 20 years | 492 | Both self-reported and plasma Glucose/hba1c diagnosed | Omega-3 | 0 mg/day (REF) 0–23.1 mg/day 23.1–73.8 mg/day ≥ 73.8 mg/day | 1.00 1.50 (1.11–2.01) 1.66 (1.20–2.28) 1.74 (1.22–2.47) | Age, marital status, BMI, income, education, physical activity, smoking, alcohol use, hypertension, north–south position (north or south), site (urban or rural), intake of total energy, fruit, vegetable, protein, saturated fat, monounsaturated fat, omega-6 fatty acids, and α-linolenic acid |
[41] | Øyen | 2021 | Norway | 7.5 years | A validated 255-item semiquantitative food-frequency questionnaire (FFQ) | 60,831, w, 31 years | 683 | Moba questionnaire, MBRN, and use of Medications noted in the norpd during pregnancy | Long-chain omega-3 | 0 g/d (REF) < 0.40 g/d ≥ 0.40 g/d | 1.00 0.95 (0.83–1.09) 1.08 (0.95–1.23) | Energy intake, age, prepregnancy BMI, gestational diabetes mellitus, and gestational hypertension including preeclampsia |