Since there is limited evidence suggesting that energy-dense foods may be associated with an increased risk of type 2 diabetes, investigators of the European Prospective Investigation of Cancer (EPIC)-Norfolk Cohort Study investigated whether there was an independent association between dietary energy density and incidence of diabetes. During the 12-year follow-up, 725 new-onset diabetes cases occurred in this prospective cohort of 21,919 individuals without diabetes, cancer, or cardiovascular disease at baseline. In this study, baseline energy density adjusted for potential confounders (age, sex, and body mass index) was higher in participants who developed diabetes than in those who remained diabetes free. Energy density was also positively associated with incident diabetes. Indeed, the adjusted odds ratio per unit increase in energy density was 1.21 (95% CI, 1.06-1.38). Finally, adjusted analyses revealed that there was a 60% greater risk of diabetes (1.60, 95% CI, 1.19-2.16) in subjects in the highest quintile of energy density compared to subjects in the lowest quintile.
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