{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:48:20Z","timestamp":1792093700492,"version":"4.4.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":59,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Dietary diversity may affect type 2 diabetes (T2D) but no studies have examined protein diversity by source. We examined five diversity scores and the 10-year risk of T2D and effect modification.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A prospective study of 10\u200a363 incident T2D cases and a representative sub-cohort of 13\u200a937 individuals sampled from a cohort of 340\u200a234 participants in eight European countries (1993\u20132007). Five diversity scores were derived from self-reported diet data (gr\/day): diversity of food groups (range: 0\u20135); and diversity within subtype of vegetables (0\u20134); meat\/alternatives (0\u20136); animal-protein (0\u20138); and plant-protein sources (0\u20135). Country-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained by using Prentice-weighted Cox regression and combined by using mixed-effects models. Models were stratified by sex (male\/female) and obesity status (body mass index \u2265 30\u2009kg\/m2; waist circumference\u2009\u2265\u200988\u2009cm for females and \u2265102\u2009cm for males).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Daily intake of five food groups (versus up to three) was linked to lower T2D incidence overall [HR 0.86 (95% CI 0.75, 0.98)], in females [0.86 (0.77, 0.96)], and in people without central obesity [0.79 (0.70, 0.89)]. Three or more subtypes of plant protein were inversely associated with T2D overall [0.78 (0.65, 0.98)], in females [0.75 (0.62, 0.90)] and people without central obesity [0.82 (0.68, 1.00)]. Additionally, consuming three subtypes of vegetables was inversely associated with T2D overall [0.90 (0.83, 0.98)] and in males [0.85 (0.73, 0.99)].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Diabetes prevention may benefit not only from a diet consisting of five different food groups, but also from a diet that is diverse in plant-protein sources, with specific benefits for female Europeans and those without central obesity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyaf057","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T10:26:03Z","timestamp":1749551163000},"source":"Crossref","is-referenced-by-count":4,"title":["Protein diversity, type 2 diabetes, and effect modifiers: a multi-country prospective study"],"prefix":"10.1093","volume":"54","author":[{"given":"Hadis","family":"Mozaffari","sequence":"first","affiliation":[{"name":"Faculty of Land and Food Systems, University of British Columbia , Vancouver,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6841-8396","authenticated-orcid":false,"given":"Fumiaki","family":"Imamura","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine , Cambridge,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel A","family":"Murphy","sequence":"additional","affiliation":[{"name":"School of Population and Public Health, University of British Columbia , Vancouver, BC,","place":["Canada"]},{"name":"Cancer Control Research, BC Cancer Agency , Vancouver, BC,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahsa","family":"Jessri","sequence":"additional","affiliation":[{"name":"Faculty of Land and Food Systems, University of British Columbia , Vancouver,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J","family":"Sharp","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine , Cambridge,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5041-248X","authenticated-orcid":false,"given":"Nita G","family":"Forouhi","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine , Cambridge,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J","family":"Wareham","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine , Cambridge,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7038-4770","authenticated-orcid":false,"given":"Daniel B","family":"Ibsen","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine , Cambridge,","place":["UK"]},{"name":"Department of Public Health, Aarhus University , Aarhus,","place":["Denmark"]},{"name":"Steno Diabetes Center Aarhus, Aarhus University Hospital , Aarhus,","place":["Denmark"]},{"name":"Department of Nutrition, Exercise and Sports, University of Copenhagen , Frederiksberg,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina C","family":"Dahm","sequence":"additional","affiliation":[{"name":"Department of Public Health, Aarhus University , Aarhus,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Huerta","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Murcia Regional Health Council-IMIB , Murcia,","place":["Spain"]},{"name":"Centro de investigaci\u00f3n Biom\u00e9dica en Red de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP) , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Molina-Montes","sequence":"additional","affiliation":[{"name":"Centro de investigaci\u00f3n Biom\u00e9dica en Red de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP) , Madrid,","place":["Spain"]},{"name":"Department of Nutrition and Food Science, University of Granada , Granada,","place":["Spain"]},{"name":"\u201cJos\u00e9 Mataix Verd\u00fa\u201d Institute of Nutrition and Food Technology (INYTA), University of Granada , Granada,","place":["Spain"]},{"name":"Instituto de Investigacion Biosanitaria de Granada (ibs.Granada), University of Granada , Granada,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela V","family":"Nickel","sequence":"additional","affiliation":[{"name":"Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke , Nuthetal,","place":["Germany"]},{"name":"German Center for Diabetes Research (DZD) , Neuherberg,","place":["Germany"]},{"name":"Institute of Nutritional Science, University of Potsdam , Nuthetal,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olov","family":"Rolandsson","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine, Family Medicine, Ume\u00e5 University , 90187, Ume\u00e5,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8008-5096","authenticated-orcid":false,"given":"Carlotta","family":"Sacerdote","sequence":"additional","affiliation":[{"name":"Unit of Cancer Epidemiology, 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