Joline W. J. Beulens

Amsterdam University Medical Center | VUmc · Department of Epidemiology and Biostatistics

Background Healthy food nudges may be more, or especially, effective among groups experiencing socioeconomic disadvantage. We investigated the modifying role of socioeconomic and demographic characteristics in the effectiveness of nudge interventions targeting healthy foods in real-world grocery store settings on food purchasing patterns. Methods...

Background: To improve consumers’ diet, policy measures such as food reformulation strategies and front-of-pack nutritional labels (FOPNLs) are implemented, aiming to guide consumers’ food choice and to stimulate an improvement in food composition by manufacturers. The FOPNL Nutri-Score has been implemented in several European countries. Changes in...

There is increasing evidence for the effectiveness of population-based policies to reduce the burden of type 2 diabetes. Yet, there are concerns about the equity effects of some policies, whereby socioeconomically disadvantaged populations are not reached or are adversely affected. There is a lack of knowledge on the effectiveness and equity of pol...

Aims Alterations in sleep timing can lead to disturbances in glycaemic control, although the evidence is inconsistent. Therefore, this systematic review summarizes results from human intervention studies of altered sleep timing on glycaemic outcomes. Materials and Methods As part of a broader search on the effect of altering timing of sleep, physi...

Unhealthy lifestyle behaviors such as poor diets and physical inactivity account for most of the cardiometabolic disease (CMD) burden, including type 2 diabetes and cardiovascular diseases. Much of this burden is mediated by the effects of unhealthy lifestyle behaviors on overweight and obesity, and disproportionally impacts certain population grou...

OBJECTIVE To assess longitudinal associations with sudden cardiac arrest (SCA) of clinical characteristics recorded in primary care in people with type 2 diabetes (T2D), both with and without cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS We performed a case-control study, with SCA case subjects with T2D from the Amsterdam Resuscitation...

This systematic review and meta-analysis aimed to quantify differences in type 2 diabetes (T2D) complications between ethnic minority populations and European host populations, in both cross-sectional and prospective studies. Following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, we searched multiple databases for s...

Dietary intake assessment is often complicated by intrinsic bias. This study investigated whether food purchase data could constitute a valid indication of dietary intake, by evaluating the extent to which diet quality as measured by supermarket food purchases is correlated with diet quality as measured by reported dietary intake. We used data from...

Background Very few studies to date investigated the prospective association of changes in exposure to the food environment with cardiovascular disease (CVD) risk. We aim to explore if time-varying exposure to the food environment was associated with hospitalization and mortality due to total and specific types of CVD in The Netherlands. Methods I...

We prospectively examined the association between structure, function, and quality of social relations and self-rated health (SRH) in U.S. adults followed over 10 years in the population-based National Social Life, Health, and Aging Project (NSHAP). Large social network and high positive/negative social support were measured at baseline and defined...

Objectives The social environment (SE), that is, the social relationships and social context in which groups of people live and interact, is an understudied element of the broader living environment which impacts health. We aim to summarise the available evidence on the associations between SE and cardiometabolic disease (CMD) outcomes. Design Sys...

Introduction The association between the gut microbiome and incident type 2 diabetes (T2D) is potentially partly mediated through sphingolipids, however these possible mediating mechanisms have not been investigated. We examined whether sphingolipids mediate the association between gut microbiome and T2D, using data from the Healthy Life in an Urba...

Background Social jetlag is a chronic disruption of sleep timing that is characterized by different sleep timing during workdays and free days. Social jetlag has been associated with disturbed glucose metabolism, insulin resistance, and increased risk of metabolic syndrome and type 2 diabetes. In this study, we aim to investigate whether a combinat...

Aim To uncover differences in small non‐coding RNAs (sncRNAs) in individuals with type 2 diabetes (T2D) categorized into five clusters based on individual characteristics, which may aid in the identification of those prone to rapid progression. Materials and Methods In the Hoorn Diabetes Care System (DCS) cohort, participants were clustered by age...

Background: Diet plays an important role in the development of cardiovascular diseases and in maintaining sustainable planetary boundaries. The EAT-Lancet Planetary Health Diet could potentially provide co-benefits for human and environmental health, yet evidence on the association between adherence to the EAT-Lancet Planetary Health Diet and risk...

Background Supermarket interventions are promising to promote healthier dietary patterns, but not all individuals may be equally susceptible. We explored whether the effectiveness of nudging and pricing strategies on diet quality differs by psychological and grocery shopping characteristics. Methods We used data of the 12-month Supreme Nudge paral...

Objective Metformin is one of the most used drugs worldwide. However, its mechanism of action remains uncertain. Given the potential to reveal novel insights into the pleiotropic effects of metformin treatment, we aimed to undertake a comprehensive analysis of circulating proteins. Research Design and Methods We analysed 1195 proteins using the Som...

Background: Overweight and obesity impose a considerable individual and social burden, and the urban environments might encompass factors that contribute to obesity. Nevertheless, there is a scarcity of research that takes into account the simultaneous interaction of multiple environmental factors. Objectives: Our objective was to perform an exp...

Introduction Micro- and macrovascular complications are common among persons with type 2 diabetes. Recently there has been growing interest to investigate the potential of circulating small non-coding RNAs (sncRNAs) as contributors to the development of diabetic complications. In this study we investigate to what extent circulating sncRNAs levels a...

Apolipoprotein-CIII (apo-CIII) inhibits the clearance of triglycerides from circulation and is associated with an increased risk of diabetes complications. It exists in four main proteoforms: O-glycosylated variants containing either zero, one, or two sialic acids and a non-glycosylated variant. O-glycosylation may affect the metabolic functions of...

Context The role of glucagon-like peptide-1(GLP-1) in Type 2 diabetes (T2D) and obesity is not fully understood. Objective We investigate the association of cardiometabolic, diet and lifestyle parameters on fasting and postprandial GLP-1 in people at risk of, or living with, T2D. Method We analysed cross-sectional data from the two Innovative Med...

Aims/hypothesis This study aimed to explore the added value of subgroups that categorise individuals with type 2 diabetes by k-means clustering for two primary care registries (the Netherlands and Scotland), inspired by Ahlqvist’s novel diabetes subgroups and previously analysed by Slieker et al. Methods We used two Dutch and Scottish diabetes coh...

Aims We aimed to determine the association between serum interleukin‐6 (IL‐6) concentrations and new‐onset heart failure (HF) in persons with type 2 diabetes (T2D). Methods and results We performed a case–control study nested in the Diabetes Care System Cohort, a prospective cohort of persons with T2D in primary care. We included 724 participants,...

Background: Access to fast food outlets (FFO) has increased in recent years and may decrease diet quality and increase cardiovascular disease risk. Inflammation is a well-established cardiovascular disease risk factor, but it remains unclear whether inflammation is one of the pathways explaining associations between the food environment and inflamm...

Background: The food environment is suggested as a risk factor of cardiovascular disease (CVD), but current evidence is inconsistent and does not account for changes in the food environment. We aimed to explore if time-varying exposure to the food environment was associated with hospitalisation and mortality due to total and specific types of CVD i...

Introduction Type 2 diabetes (T2D) onset, progression and outcomes differ substantially between individuals. Multi-omics analyses may allow a deeper understanding of these differences and ultimately facilitate personalised treatments. Here, in an unsupervised “bottom-up” approach, we attempt to group T2D patients based solely on -omics data generat...

Samenvatting In deze review onderzoeken we wat de potentiële waarde is van precisiegeneeskunde op basis van psychische stoornissen binnen diabetespreventie en -behandeling. Dit doen we aan de hand van de vier componenten van precisiegeneeskunde. Als eerste presenteren we een overzicht van de beschikbare literatuur over de rol van psychische stoorni...

Aims/hypothesis People with type 2 diabetes are heterogeneous in their disease trajectory, with some progressing more quickly to insulin initiation than others. Although classical biomarkers such as age, HbA1c and diabetes duration are associated with glycaemic progression, it is unclear how well such variables predict insulin initiation or require...

In 2023, the algorithm underlying the Nutri-Score front-of-pack label was updated to better align with food-based dietary guidelines (FBDGs) across countries engaged in the system. On the basis of a comparison of FBDGs and literature reviews with the current Nutri-Score classification, modification scenarios were developed and tested in nutritional...

Left ventricular diastolic dysfunction (LVDD) without symptoms, and heart failure (HF) with preserved ejection fraction (HFpEF) represent the most common phenotypes of HF in individuals with type 2 diabetes mellitus, and are more common than HF with reduced ejection fraction (HFrEF), HF with mildly reduced ejection fraction (HFmrEF) and left ventri...

Introduction There is conflicting evidence whether lower extremity arterial calcification coincides with coronary arterial calcification (CAC). The aims of this study were to investigate the associations between (1) femoral and crural calcification with CAC, and (2) femoral and crural calcification pattern with CAC. Research design and methods Thi...

Background Geographic access to food may affect dietary choices and health outcomes, but the strength and direction of associations may depend on the operationalization of exposure measures. We aimed to systematically review the literature on up-to-date evidence on the association between food environment exposures based on Global Positioning Syste...

Background Context-specific interventions may contribute to sustained behaviour change and improved health outcomes. We evaluated the real-world effects of supermarket nudging and pricing strategies and mobile physical activity coaching on diet quality, food-purchasing behaviour, walking behaviour, and cardiometabolic risk markers. Methods This pa...

Aim To investigate the association of plasma metabolites with incident and prevalent chronic kidney disease (CKD) in people with type 2 diabetes and establish whether this association is causal. Materials and Methods The Hoorn Diabetes Care System cohort is a large prospective cohort consisting of individuals with type 2 diabetes from the northwes...

Topic To review clinical evidence on systemic factors that might be relevant to update diabetic retinal disease (DRD) staging systems, including prediction of DRD onset, progression, and response to treatment. Clinical relevance Systemic factors may improve new staging systems for DRD to better assess risk of disease worsening and predict response...

Background Approximately 50% of out-of-hospital Sudden Cardiac Arrest (SCA) occurs in people with unrecognized SCA-risk and no preceding cardiologic care records. General practitioner (GP) records include these people, specifically people with type 2 diabetes (T2D) with increased SCA-risk. We aimed to provide a proof-of-concept for using routine pr...

People with type 2 diabetes have a tenfold higher prevalence of hypomagnesemia, which is suggested to be caused by low dietary magnesium intake, medication use, and genetics. This study aims to identify the genetic loci that influence serum magnesium concentration in 3466 people with type 2 diabetes. The GWAS models were adjusted for age, sex, eGFR...

Background: Chronic proton pump inhibitor (PPI) use and hypomagnesemia are common in people with type 2 diabetes (T2D), and both are associated with increased mortality and cardiovascular disease (CVD). Since PPI use can cause hypomagnesemia, we investigated if magnesium is a mediator of the association between PPI use and mortality and CVD in peop...

Background Alcohol consumption has been associated with a lower risk of heart failure (HF) and myocardial infarction. Nevertheless, knowledge of the relationship between alcohol consumption and the two subtypes of HF; HF with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) is lacking. Methods The Cardio...

Aim The social environment (SE), including social contacts, norms and support, is an understudied element of the living environment which impacts health. We aim to comprehensively summarize the evidence on the association between the SE and risk factors of cardiometabolic disease (CMD). Methods We performed a systematic review and meta-analysis ba...

Objective We examined whether associations between the food environment, frequency of home cooking, diet quality, and BMI were modified by level of cooking skills. Design Cross-sectional study using linear and modified Poisson regression models adjusted for age, sex, energy intake, education, income, household size, and urbanization. Frequency of...

Apolipoprotein-CIII (apo-CIII) is involved in triglyceride-rich lipoprotein metabolism and linked to beta-cell damage, insulin resistance, and cardiovascular disease. Apo-CIII exists in four main proteoforms: non-glycosylated (apo-CIII0a), and glycosylated apo-CIII with zero, one, or two sialic acids (apo-CIII0c, apo-CIII1 and apo-CIII2). Our objec...

Review Purpose This review summarises key findings on treatment effects within phenotypical clusters of patients with heart failure (HF), making a distinction between patients with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). Findings Treatment response differed among clusters; ACE inhibitors were beneficial in all HF...

Background Microvascular dysfunction plays a crucial role in complications of type 2 diabetes and might contribute to heart failure with preserved ejection fraction (HFpEF), a disease that disproportionally affects women. We aimed to investigate if presence and degree of microvascular dysfunction (MVD) in skin relates to markers of left ventricular...

Background Premature atrial contractions (PACs) are potential markers for imminent onset of both atrial fibrillation (AF) and brain ischemia (BI; transient ischemic attack [TIA] or ischemic stroke). We investigated the association of PACs with incident AF and BI events separately, and of incident AF with BI events in people with type 2 diabetes (T2...

Introduction This crossover randomized controlled trial (RCT) investigated differences in short-term entero-endocrine response to a mixed-meal tolerance test preceded by nutrient sensing between participants with pre-diabetes (pre-T2D) and type 2 diabetes (T2D). Additionally, differences in gut and oral microbiome composition between participants w...

We evaluate the shared genetic regulation of mRNA molecules, proteins and metabolites derived from whole blood from 3029 human donors. We find abundant allelic heterogeneity, where multiple variants regulate a particular molecular phenotype, and pleiotropy, where a single variant associates with multiple molecular phenotypes over multiple genomic r...

Aim: To provide a comprehensive overview of the current evidence on objectively measured neighbourhood built environment exposures in relation to cardiovascular disease (CVD) events in adults. Review methods: We searched seven databases for systematic reviews on associations between objectively measured long-term built environmental exposures, c...

We assessed the quality of food-related OpenStreetMap (OSM) data in urban areas of five European countries. We calculated agreement statistics between point-of-interests (POIs) from OSM and from Google Street View (GSV) in five European regions. We furthermore assessed correlations between exposure measures (distance and counts) from OSM data and a...

Aims/hypothesis: Inflammation is important in the development of type 2 diabetes complications. The N-glycosylation of IgG influences its role in inflammation. To date, the association of plasma IgG N-glycosylation with type 2 diabetes complications has not been extensively investigated. We hypothesised that N-glycosylation of IgG may be related t...

Considerable heterogeneity exists in Type 2 diabetes disease onset and subsequent outcomes. Multi-omics analysis may provide a means to better assess inter-patient variations and design personalised approaches. Previous T2D biomarker discovery mainly focused on associating biomarkers with clinical pre-assigned patients. Here, we attempt to group T2...

Objective: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been shown to reduce the risk of cardiovascular complications, which largely drive diabetes' health and economic burdens. Trial results indicated that SGLT2i are cost effective. However, these findings may not be generalizable to the real-world target population. This study aims to...

Background The association between common carotid artery intima‐media thickness (CCA‐IMT) and incident carotid plaque has not been characterized fully. We therefore aimed to precisely quantify the relationship between CCA‐IMT and carotid plaque development. Methods and Results We undertook an individual participant data meta‐analysis of 20 prospec...

Background/objective: Prolonged heart rate-corrected QT interval (QTc) on the electrocardiogram (ECG) is maybe associated with the occurrence of cardiovascular diseases (CVD), but the evidence is inconsistent. Therefore, we investigated whether baseline prolongation of the QTc interval is associated with CVD morbidity and mortality and its subtype...

Patient-reported outcomes (PROs) are valuable for shared decision making and research. Patient-reported outcome measures (PROMs) are questionnaires used to measure PROs, such as health-related quality of life (HRQL). Although core outcome sets for trials and clinical practice have been developed separately, they, as well as other initiatives, recom...

Objective: To estimate the impact on lifetime health and economic outcomes of different methods of stratifying individuals with type 2 diabetes, followed by guideline-based treatment intensification targeting BMI and LDL in addition to HbA1c. Research design and methods: We divided 2,935 newly diagnosed individuals from the Hoorn Diabetes Care S...

We identify biomarkers for disease progression in three type 2 diabetes cohorts encompassing 2,973 individuals across three molecular classes, metabolites, lipids and proteins. Homocitrulline, isoleucine and 2-aminoadipic acid, eight triacylglycerol species, and lowered sphingomyelin 42:2;2 levels are predictive of faster progression towards insuli...

Background Microvascular dysfunction (MVD) is an important contributor to major clinical disease such as stroke, dementia, depression, retinopathy, and chronic kidney disease. Alcohol consumption may be a determinant of MVD. Objective Main objectives were (1) to study whether alcohol consumption was associated with MVD as assessed in the brain, re...

Objective: Car dependency contributes to physical inactivity and, consequently, may increase the likelihood of diabetes. We investigated whether neighborhoods that are highly conducive to driving confer a greater risk of developing diabetes and, if so, whether this differs by age. Research design and methods: We used administrative healthcare da...

Abstract Background Recruiting participants for lifestyle programmes is known to be challenging. Insights into recruitment strategies, enrolment rates and costs are valuable but rarely reported. We provide insight into the costs and results of used recruitment strategies, baseline characteristics and feasibility of at-home cardiometabolic measureme...

Associations between human genetic variation and clinical phenotypes have become a foundation of biomedical research. Most repositories of these data seek to be disease-agnostic and therefore lack disease-focused views. The Type 2 Diabetes Knowledge Portal (T2DKP) is a public resource of genetic datasets and genomic annotations dedicated to type 2...

Objective: Social jet lag, i.e., the discordance among social and biological rhythms, is associated with poor metabolic control. This study aimed to assess cross-sectional and longitudinal associations among social jet lag and glycemic and metabolic control in people with type 2 diabetes. Methods: In a prospective cohort (N = 990) with type 2 di...

Introduction: What people eat is dependent on their food environment. However, individuals with better cooking skills may be less dependent on what is available in their food environment. Hypothesis: We assessed the hypothesis that the relation of the food environment around home and work with frequency of home cooking, diet quality, and body mass...