Elsevier

Clinical Nutrition ESPEN

Volume 27, October 2018, Pages 86-91
Clinical Nutrition ESPEN

Original article
Potato consumption and risk of type 2 diabetes: A dose–response meta-analysis of cohort studies

https://doi.org/10.1016/j.clnesp.2018.06.004Get rights and content

Summary

Background & aims

High potato intake has been suggested as a risk factor for the development of type 2 diabetes. We aimed to investigate the association between potato consumption and risk of type 2 diabetes.

Methods

A systematic review was conducted on PubMed and Embase from the database commencement until September 2017 (updated by June 2018) following the MOOSE guidelines. The random effect model dose–response meta-analysis method of Greenland and Longneck was used to estimate the maximally adjusted log hazard ratio (HR) for a unit (serving per day) increment of potato consumption. A restricted cubic spline model with three knots was used to evaluate the potential non-linear relationship.

Results

A total of 3544 citations were retrieved from the databases, of which six prospective cohort studies including 4545230 person-year of follow-up and 17,758 diabetes cases met the inclusion criteria. The pooled dose–response HR per an increment of 1 serving/day of total potato consumption was 1.20 (95% CI 1.13 to 1.127, P < 0.001, I2 = 27.1%, P for heterogeneity = 0.23) both in men and women. The larger risk were observed for 2 serving/day (HR 1.44, 95% CI 1.28 to 1.63) and 3 serving/day (HR 1.74, 95% CI 1.45 to 2.09). We found significant evidence of a non-linear association between total potato consumption and risk of type 2 diabetes (X2 = 17.5, P for linearity < 0.001).

Conclusion

Long-term high consumption of potato (each serving a day increase) may be strongly associated with increased risk of diabetes. These findings suggest that diet–health policy may be of importance in the prevention of diabetes.

Introduction

Potato is the most consumed staple food after rice and wheat [1] with a global mean per capita intake of 33 kg/year and a notable higher mean intake in the US of 54 kg/year [2]. Recently, potatoes consumption has been the topic of much scientific research regarding their effect on chronic diseases [1], [3]. This is due to their frequency and wide range of consumption globally, but also due to the fact that they are a rich source of minerals while they have a low fat and sodium content. Besides, potatoes have a high glycemic index (GI) and glycemic load (GL) and are a source of starch. This may contribute to a detrimental effect on health and some prospective studies have shown a positive association between dietary GL with higher risk of developing diabetes [4], [5]. Although compelling evidence is available linking metabolic and cardiovascular disease risk factors to diabetes, our understanding of the association between some staple foods such as potatoes and risk of type 2 diabetes remains limited.

Dietary factors play an important role in developing of type 2 diabetes [6]. In the United State dietary guidelines, potatoes are included in the vegetable food groups and similar to other vegetables encourage to be consumed [7]. Although the beneficial association between dietary vegetable intake and chronic disease were shown, there was some debates for dietary recommendation intake of potatoes, because some studies demonstrate adverse relation between high potato intake and chronic disease include diabetes and hypertension [8], [9], [10]. Higher potato intake indicated that increase fasting blood glucose and insulin resistance, and may increase the risk of diabetes [11]. We therefore undertook a dose–response meta-analysis of prospective cohort studies to reliably determine and combine the available evidence in the association between potato consumption (per serving/day) and risk of type 2 diabetes.

Section snippets

Search strategy

A systematic review was conducted on Medline/PubMed and Elsevier/Embase for relevant studies from the database commencement until September 2017 (updated by June 2018) without time or language restrictions and following the MOOSE guidelines [12]. A complementary search was carried out on leading diabetes and nutritional journals and all reference lists of identified papers, reviews, meta-analyses, letters, and other relevant documents, with terms related to potatoes as well as those for

Literature search

The process of systematic-review exhibited in Fig. 1. First, we retrieved 3544 citations from which duplicate citations and studies that did not meet the inclusion criteria were excluded (n = 2914). Next, 630 papers included in the abstract screening. In the second step, 46 papers selected for full text screening (see follow-chart for detailed description) (Fig. 1). Among 46 selected full-text papers, four papers included for statistical analysis. In addition, one paper retrieved from manual

Important findings

In the present dose–response meta-analysis of six cohort studies, higher consumption of potato was positively associated with risk of type 2 diabetes. Furthermore, we found that each serving/day increases in potato consumption was associated significantly with 20% (CI 13%–27%) increased risk of type 2 diabetes. Although, the statistical test suggested a non-linear relationship (P < 0.001), but dose–response plot exhibited near linear association. The largest observed risk increase was for 3

Conclusions

Consumption of total potato is in association with higher risk of type 2 diabetes based on studies from developed countries. These findings suggest that diet–health policy may be of importance in the prevention of diabetes. We suggest further large prospective cohort studies for assessing the causal association in different population with different dietary pattern.

Funding

This study was funded by research grants from the Sabzevar University of Medical Sciences, Sabzevar, Iran. The funding sources had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

Acknowledgment

Duality of interest: There is no conflict of interest for declaration.

Author contributions:

Study concept and design: ZB, MN.

Data extraction: ZB, SJD, FT.

Statistical analysis: MN.

Analysis and interpretation of data: MN, ZB, FT.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: All authors.

Study supervision: MN.

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