RT Journal Article T1 Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations. A1 Jannasch, Franziska A1 Kröger, Janine A1 Agnoli, Claudia A1 Barricarte, Aurelio A1 Boeing, Heiner A1 Cayssials, Valerie A1 Colorado-Yohar, Sandra A1 Dahm, Christina C A1 Dow, Courtney A1 Fagherazzi, Guy A1 Franks, Paul W A1 Freisling, Heinz A1 Gunter, Marc J A1 Kerrison, Nicola D A1 Key, Timothy J A1 Khaw, Kay-Tee A1 Kühn, Tilman A1 Kyro, Cecilie A1 Mancini, Francesca Romana A1 Mokoroa, Olatz A1 Nilsson, Peter A1 Overvad, Kim A1 Palli, Domenico A1 Panico, Salvatore A1 García, Jose Ramón Quirós A1 Rolandsson, Olov A1 Sacerdote, Carlotta A1 Sanchez-Perez, Maria-Jose A1 Sahrai, Mohammad Sediq A1 Schübel, Ruth A1 Sluijs, Ivonne A1 Spijkerman, Annemieke M W A1 Tjonneland, Anne A1 Tong, Tammy Y N A1 Tumino, Rosario A1 Riboli, Elio A1 Langenberg, Claudia A1 Sharp, Stephen J A1 Forouhi, Nita G A1 Schulze, Matthias B A1 Wareham, Nicholas J K1 diet-disease association K1 dietary patterns K1 meta-analysis K1 principal component analysis K1 replication K1 type 2 diabetes mellitus AB Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence. The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries. Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association. Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea. Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses. YR 2019 FD 2019 LK http://hdl.handle.net/10668/14045 UL http://hdl.handle.net/10668/14045 LA en DS RISalud RD Feb 18, 2025