Different types of industry-produced and ruminant trans fatty acid intake and risk of type 2 diabetes: findings from the NutriNet-Santé prospective cohort

Background

While the deleterious effects of trans fatty acids -TFAs- on cardiovascular health are well established, their impact on type 2 diabetes remains poorly understood. In particular, little is known on the impact of specific TFA types on type 2 diabetes etiology.

Objectives

To explore the associations between different types of TFAs (total, ruminant, industry-produced and corresponding specific isomers) and risk of type 2 diabetes. 

Research Design and Methods

105,551 participants aged ≥18y from the French NutriNet-Santé cohort (2009-2021) were included (mean baseline age=42.7y (SD=14.6y), 79.2% women). Dietary intake data, including usual TFA intake, were collected using repeated 24-hour dietary records (n= 5.7 [SD=3.1]). Associations between sex-specific quartiles of dietary TFAs and diabetes risk were assessed using multivariable Cox models. 

Results

Total TFAs was associated with higher type 2 diabetes risk (HRquartile 4vs.1=1.38; 95% CI=1.11-1.73; Ptrend<0.001, 969 incident cases). This association, specifically observed for industry-produced TFAs (HR=1.45; 95% CI=1.15-1.83; Ptrend<0.001), was mainly driven by elaidic acid (HR=1.37; 95% CI=1.09-1.72; Ptrend<0.001) and linolelaidic acid (HR=1.29; 95% CI=1.04-1.58; Ptrend=0.07). In contrast, ruminant trans fatty acids were not significantly associated with risk of type 2 diabetes.

Conclusions

In this large prospective cohort, higher intakes of total and industry-produced TFAs were associated with increased type 2 diabetes risk. These findings support WHO’s recommendation to eliminate industry-produced TFAs from the food supply worldwide. Consumers should be advised to limit the consumption of food products containing partially hydrogenated oils (main vector of iTFAs). This may contribute to lower the substantial global burden of type 2 diabetes.