Nutritional biomarkers and the possibility of diabetes prevention Type 2 diabetes (T2D) is a serious medical condition which is on the rise, highlighting the urgent need to identify factors that can prevent disease onset. European researchers employed nutritional biomarkers to investigate the association between dietary factors and T2D risk more precisely. Digital Economy Fundamental Research Health © Chinnapong, Shutterstock Dietary factors play a crucial role in metabolic disorders like T2D. However, errors in self-reported dietary assessment often limit the science. Inconsistent or unreliable findings pose a major challenge in identifying dietary components that may reduce or promote disease risk. Measurement of nutritional biomarkers offers a more precise and objective approach for assessing nutritional status, which can supplement information from self-reported data. Measurement, quality control, distribution and links with T2D The use of nutritional biomarkers opens up a new frontier to advance dietary research. Scientists of the EU-funded NUTBIO-DIAB project used data from one of the world’s largest studies of T2D incidence, the FP6-funded InterAct project. The EPIC-InterAct study included a case-cohort sample of more than 12 000 new-onset T2D cases and a representative sub-cohort of about 16 000 individuals within 8 European countries. “The aim of NUTBIO-DIAB was to investigate the association between selected nutritional biomarkers and T2D across different European populations, enhancing our understanding of how diet is linked with T2D,″ explains project coordinator Prof. Nita Forouhi. Towards this goal, Dr Jusheng Zheng, postdoctoral fellow funded by the Marie Sklodowska-Curie Individual Fellowship worked with collaborating scientists to lead analyses for blood levels of vitamin C, six carotenoids and 25-hydroxy vitamin D metabolites in the EPIC-InterAct study. Key to accuracy in terms of reproducibility and reliability is the use of rigorous quality control procedures for raw data, which the researchers established. They examined the geographical distribution and demographic, social, lifestyle, and dietary determinants of the blood vitamin C, carotenoids and vitamin D biomarker levels and investigated the link between these biomarkers and the risk of developing diabetes in European populations. Through genome-wide association studies, they also examined genetic variants affecting the levels of these biomarkers. Enhancing diabetes prevention The NUTBIO-DIAB analyses clarify the distribution and determinants of selected biomarkers of dietary intakes and nutritional status within European populations included in the EPIC-InterAct study. They advance the understanding of the relationship between dietary factors and diabetes risk, particularly for fruit and vegetables intake with the use of blood vitamin C and carotenoids levels, and for vitamin D status, using several metabolites of blood vitamin D levels. The potential population impact can be estimated in the future to model the number of new cases of T2D that can be avoided with adherence to optimal status of these dietary factors. Undoubtedly, diabetes is one of the biggest global public health problems affecting millions of individuals worldwide. Dietary and lifestyle changes are paramount for the prevention and management of type 2 diabetes but more evidence-based guidelines are needed. The findings from the NUTBIO-DIAB project, together with other emerging research findings from the EPIC-InterAct Study and wider efforts will help to shape future dietary recommendations. Prof. Forouhi is confident that “building further on the results from the analyses of nutritional biomarkers will contribute to advancing the understanding of the link and causality between dietary factors and new-onset T2D.″ Information on gene-diet interactions can also inform future stratified or personalised nutrition. Though it is too early at present to translate these findings into diagnostic or therapeutic strategies, with further development of this science, and continued team work, that is part of the vision for the future. Keywords NUTBIO-DIAB, type 2 diabetes (T2D), nutritional biomarkers, vitamin C, carotenoids, vitamin D
