# Higher intake of dietary dicarbonyl compounds is associated with lower incidence of type 2 diabetes: European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study

## TL;DR

Higher dietary intake of certain dicarbonyl compounds is linked to a lower risk of developing type 2 diabetes.

## Contribution

This study reveals a protective effect of dietary dicarbonyls against type 2 diabetes, contrasting with their harmful effects when formed endogenously.

## Key findings

- Higher intake of methylglyoxal (MGO) and 3-deoxyglucosone (3-DG) was associated with lower type 2 diabetes risk.
- No significant association was found for glyoxal (GO) intake and diabetes risk.
- The protective effect of dietary dicarbonyls contrasts with the harmful effects of endogenously formed dicarbonyls.

## Abstract

Dicarbonyls are reactive precursors of advanced glycation end-products. They are formed during food processing, and endogenously in humans during glycolysis and lipid peroxidation. Higher plasma dicarbonyls, particularly methylglyoxal (MGO), promote insulin resistance and type 2 diabetes, but the association between dietary dicarbonyls intake and type 2 diabetes is unknown. This study examined the associations between dietary dicarbonyls and type 2 diabetes incidence.

11,995 incident type 2 diabetes cases and a sub-cohort of 15,797 controls from the prospective multi-center European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct cohort were included. Intakes of three major dicarbonyls MGO, glyoxal [GO], and 3-deoxyglucosone [3-DG] were estimated at baseline using dietary questionnaires. Type 2 diabetes risk according to dietary dicarbonyl intake was estimated by multivariable-adjusted hazard ratios from Prentice-weighted Cox-regression analyses.

Higher intakes of MGO (sample-specific mean intake 3.4 ± 1.3 mg/d) and 3-DG (13.8 ± 10.5) were associated with lower incidence of type 2 diabetes (HR 0.92 [95% CI 0.90–0.95] for 1 SD higher MGO intake and 0.93 [0.90–0.95] for 1 SD higher 3-DG intake). No associations were observed for dietary GO.

Participants who consumed more dietary dicarbonyls MGO and 3-DG had a lower risk to develop type 2 diabetes. This protective association contrasts with the harmful effects on type 2 diabetes risk reported for endogenously formed dicarbonyls.

The online version contains supplementary material available at 10.1007/s00394-026-03904-0.