Intakes of Fish and Long-Chain n-3 Polyunsaturated Fatty Acid Supplements During Pregnancy and Subsequent Risk of Type 2 Diabetes in a Large Prospective Cohort Study of Norwegian Women

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Jannike Øyen
  • Anne Lise Brantsæter
  • Ole Jakob Nøstbakken
  • Kåre I. Birkeland
  • Margareta Haugen
  • Lise Madsen
  • Grace M. Egeland

OBJECTIVE To investigate associations between intakes of total fish, lean fish, fatty fish, and long-chain n-3 polyunsaturated fatty acid (LCn-3PUFA) supplements and risk of type 2 diabetes in women after pregnancy. Furthermore, we sought to compare the estimated intakes of methylmercury (MeHg) and sum of dioxins and dioxin-like polychlorinated biphenyls (dl-PCBs) with tolerable weekly intakes (TWI). RESEARCH DESIGN AND METHODS Women free of diabetes at baseline (n 5 60,831) who participated in the popula-tion-based Norwegian Mother, Father and Child Cohort Study (MoBa) were pro-spectively evaluated for incident type 2 diabetes, identified on the basis of medication usage >90 days after delivery, ascertained through the Norwegian Prescription Database. Dietary intake data were obtained with a validated 255-item food-frequency questionnaire (FFQ), which assessed habitual diet during the first 4–5 months of pregnancy. Intakes of MeHg and sum of dioxins and dl-PCBs were derived with use of a contaminant database and the FFQ. RESULTS Median age was 31 years (interquartile range 27, 34) at time of delivery, and follow-up time was 7.5 years (6.5, 8.5). Type 2 diabetes occurred in 683 (1.1%) participants. Multivariable Cox regression analyses identified lower risk of type 2 diabetes with increasing energy-adjusted lean fish intake (25 g/1,000 kcal: hazard ratio 0.71, 95% CI 0.53–0.95, P = 0.022). However, in stratified analyses, a lower risk was found only in women with prepregnancy BMI ‡25 kg/m2. There were no associations between intake of total fish, fatty fish, or LCn-3PUFA supplements and type 2 diabetes. MeHg intake was low, but the intake of the sum of dioxins and dl-PCBs (picograms of toxic equivalents/kilograms of body weight/week) exceeded the TWI set by the European Food Safety Authority (EFSA) for the majority of participants. CONCLUSIONS Intake of lean fish, but not fatty fish or LCn-3PUFA supplements, was associated with lower risk of pharmacologically treated type 2 diabetes in Norwegian women who were overweight or obese. Fatty fish, which contain dioxins and dl-PCBs, did not increase the risk of type 2 diabetes, but the exceedance of the EFSA TWI for dioxins and dl-PCBs is a health concern.

OriginalsprogEngelsk
TidsskriftDiabetes Care
Vol/bind44
Udgave nummer10
Sider (fra-til)2337-2345
Antal sider9
ISSN0149-5992
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
Acknowledgments. The authors thank Svet-lana Skurtveit for her assessment of NorPD data for medication usage prior to, during, and after pregnancy. The authors are grateful for all the participating families in Norway who take part in this ongoing cohort study. Funding. MoBa is supported by the Norwegian Ministry of Health and Care Services and the Norwegian Ministry of Education and Research.

Publisher Copyright:
© 2021 by the American Diabetes Association.

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