Vitamin C intake modify the impact of dietary nitrite on the incidence of type 2 diabetes: A 6-year follow-up in Tehran Lipid and Glucose Study
Abstract
Background There is no epidemiological study on the association between dietary nitrate (NO 3) and nitrite (NO 2) and intakes and the risk of type 2 diabetes (T2D). Objective The aim of this study was therefore to examine the potential effect of dietary NO 3 and NO 2 on the occurrence of T2D. Design This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) on 2139 T2D-free adults, aged 20-70 years, followed for a median of 5.8 y. Dietary intakes of NO 3 and NO 2 were estimated using a 168-food items validate semi-quantitative food frequency questionnaire, at baseline. Multivariate Hazard Ratios (HR) and 95% confidence intervals (CI), adjusted for diabetes risk score (DRS), and dietary intakes of fat, fiber and vitamin C, were calculated for residual energy-adjusted NO 3 and NO 2 intakes. Since significant interaction (P = 0.024) was found between NO 2 and vitamin C intakes in the multivariable model, stratified analyses were done for < and ≥ median vitamin C intakes. Results Median (inter quartile range; IQR) daily intake of NO 3 and NO 2 were 410 mg/d (343-499) and 8.77 mg/d (7.53-10.2). An increased risk of T2D was observed among participants who had higher intake of total and animal-based NO 2 in participants who had low vitamin C intake (HR = 2.43, 95% CI = 1.45-4.05, HR = 1.88, 95% CI = 1.12-3.15, respectively). We found no significant association between NO 3 in overall, and plant- and animal sources as well, with the risk of T2D. Plant-derived NO 2 was also unrelated to incidence of T2D. Conclusion Our findings indicated that higher intakes of total and animal-based NO 2 may be an independent dietary risk factor for development of T2D in subjects with lower vitamin C intakes.
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Plant-derived nitrate intake is associated with a reduced risk of metabolic syndrome.
“Longitudinal data further indicate that plant-derived nitrate intake is associated with a reduced risk of metabolic syndrome.”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [212]
Nitrite intake, particularly from animal sources, may have no effect or an adverse effect on metabolic syndrome risk, depending on antioxidant status such as vitamin C intake.
“nitrite intake, particularly from animal sources, may have no effect or even have an adverse effect, depending on antioxidant status such as vitamin C intake [212,213].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [212]
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- Authors
- Bahadoran, Z., Mirmiran, P., Ghasemi, A., Carlström, M., Azizi, F., & Hadaegh, F.
- Affiliations
- Research Institute for Endocrine Sciences (IR)
- Karolinska Institutet (SE)
- Corresponding author
- Hadaegh, Farzad
- ORCID
- Venue
- Nitric Oxide
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 62
- Pages
- 24-31
- ISSN
- 1089-8603 (ISSN-L)
- OpenAlex
- W2557777017
- Cited by
- 32
- References
- 54
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 6 · 2023: 3 · 2022: 1 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 6
- FWCI
- 2.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nitric Oxide (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Research Institute for Endocrine Sciences of Shahid Beheshti University of Medical Sciences (759)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Biochemistry › Phytochemicals and Antioxidant Activities
- Keywords
- type 2 diabetes, dietary nitrite, dietary nitrate, vitamin C intake, dietary risk factors, Tehran Lipid and Glucose Study
- MeSH terms
- Adult, Aged, Ascorbic Acid, Blood Glucose, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Iran, Longitudinal Studies, Middle Aged, Nitrates, Nitrites, Incidence, Dietary Supplements, Young Adult
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