Application of biomarker-based assessment of dietary patterns to nutritional epidemiology: observational and interventional investigations with a focus on the Mediterranean diet and type 2 diabetes
type: CreativeWork
description: Existing evidence on healthy dietary patterns suggests that they are modestly inversely associated with incidence of common non-communicable diseases, and in particular cardiometabolic diseases. Trials are rarely feasible to assess causality of these relationships which motivates leveraging observational data with improved methodological approaches. In this PhD thesis, I attempted to address the common limitation in nutritional epidemiology of subjective assessment of adherence to dietary patterns. Chapter 2: I conducted a systematic review of the effects of Mediterranean diet interventions on nutritional biomarkers. I identified 29 trials reporting on 25 biomarkers eligible for meta-analysis (5-18 studies available per biomarker). Circulating carotenoids, vitamin C and fatty acids emerged as candidate biomarkers of compliance. Effect sizes were mostly small which likely reflected the multifaceted nature of whole diet interventions and insufficient validity of single analytes as biomarkers of adherence to the Mediterranean dietary pattern. Chapter 3: I used the EPIC-InterAct case-cohort study which measured nutritional biomarkers at scale (~13,000 subcohort participants and ~9,000 incident type 2 diabetes cases) to evaluate the utility of combining them into biomarker scores predictive of adherence to dietary patterns, and to test their associations with incidence of type 2 diabetes. The available biomarkers included circulating carotenoids, vitamins C and 25(OH)D, fatty acid profiles, iron status biomarkers and cations. The dietary patterns of interest were the Mediterranean diet, alternative Healthy Eating Index-2010 and the Dietary Approaches to Stop Hypertension. The analyses showed modest correlations of the biomarker scores with their respective dietary patterns (r ~0.3) and statistically significant inverse associations with disease risk (hazard ratios ~0.8 per standard deviations of the scores). Chapter 4: I established a collaboration with one of the random…
abstract: Existing evidence on healthy dietary patterns suggests that they are modestly inversely associated with incidence of common non-communicable diseases, and in particular cardiometabolic diseases. Trials are rarely feasible to assess causality of these relationships which motivates leveraging observational data with improved methodological approaches. In this PhD thesis, I attempted to address the common limitation in nutritional epidemiology of subjective assessment of adherence to dietary patterns. Chapter 2: I conducted a systematic review of the effects of Mediterranean diet interventions on nutritional biomarkers. I identified 29 trials reporting on 25 biomarkers eligible for meta-analysis (5-18 studies available per biomarker). Circulating carotenoids, vitamin C and fatty acids emerged as candidate biomarkers of compliance. Effect sizes were mostly small which likely reflected the multifaceted nature of whole diet interventions and insufficient validity of single analytes as biomarkers of adherence to the Mediterranean dietary pattern. Chapter 3: I used the EPIC-InterAct case-cohort study which measured nutritional biomarkers at scale (~13,000 subcohort participants and ~9,000 incident type 2 diabetes cases) to evaluate the utility of combining them into biomarker scores predictive of adherence to dietary patterns, and to test their associations with incidence of type 2 diabetes. The available biomarkers included circulating carotenoids, vitamins C and 25(OH)D, fatty acid profiles, iron status biomarkers and cations. The dietary patterns of interest were the Mediterranean diet, alternative Healthy Eating Index-2010 and the Dietary Approaches to Stop Hypertension. The analyses showed modest correlations of the biomarker scores with their respective dietary patterns (r ~0.3) and statistically significant inverse associations with disease risk (hazard ratios ~0.8 per standard deviations of the scores). Chapter 4: I established a collaboration with one of the random…
author: Sobiecki, Jakub Grzegorz
language: eng
keywords: Epidemiology, Mediterranean diet, Nutrition, Nutritional Epidemiology, Type 2 diabetes
license: http://purl.org/NET/rdflicense/allrightsreserved
date published: 2022-12-01
date modified: 2026-07-22T22:23:54Z
provider: Cambridge University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: University of Cambridge

PropertyValue
property ID: DOI
value: 10.17863/CAM.95859