Fatty acids measured in plasma and erythrocyte-membrane phospholipids and derived by food-frequency questionnaire and the risk of new-onset type 2 diabetes: a pilot study in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort

Am J Clin Nutr. 2010 Nov;92(5):1214-22. doi: 10.3945/ajcn.2010.29182. Epub 2010 Sep 22.


Background: Epidemiologic evidence for the association between types of fatty acid and risk of type 2 diabetes is inconsistent. This may in part be due to the limitations of fatty acid measurement methods.

Objective: The objective was to use 3 different measures of fatty acid to estimate the prospective association between fatty acid composition and development of incident diabetes.

Design: We analyzed 199 cases of clinically incident diabetes and 184 noncases aged 40-79 y at baseline in the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk study. Fatty acids were derived from a food-frequency questionnaire (FFQ) and measured in plasma phospholipid (P-FA) and erythrocyte-membrane phospholipid (Ery-FA) fractions by gas chromatography.

Results: There were stronger associations with diabetes risk with the use of objectively measured fatty acids (P-FA and Ery-FA) than with the FFQ in analyses adjusted for age, sex, and potential confounders. Positive associations with diabetes were greater in magnitude with the use of P-FA than with Ery-FA (highest:lowest tertiles): for example, the palmitic acid odds ratios (ORs) were 2.47 (95% CI: 1.37, 4.46) and 1.96 (95% CI: 1.10, 3.49), respectively. Inverse associations with diabetes were also stronger with the use of P-FA than with Ery-FA: for example, the OR for linoleic acid was 0.50 (95% CI: 0.28, 0.91) compared with 0.77 (95% CI: 0.43, 1.37), respectively.

Conclusions: The objective measurement of fatty acids with the use of either P-FA or Ery-FA identifies important associations with diabetes incidence that may be missed when assessed by FFQ. Fatty acids measured in P-FA appear to be more strongly associated with diabetes incidence. These findings endorse the use of objective measurement of fatty acids for nutritional-epidemiologic studies, and the apparently stronger findings for the plasma fraction should be confirmed in larger studies and in different populations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / etiology*
  • Diet Records
  • Dietary Fats / adverse effects*
  • Erythrocyte Membrane / chemistry*
  • Fatty Acids / adverse effects
  • Fatty Acids / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Phospholipids / blood
  • Phospholipids / chemistry*
  • Pilot Projects
  • Prospective Studies
  • Risk Factors
  • Surveys and Questionnaires*


  • Dietary Fats
  • Fatty Acids
  • Phospholipids