Mediation analyses indicated that the protective association of flavonoid intake with T2D risk may be mediated, in part, by benefits of a flavonoid-rich diet on obesity and sugar metabolism (BMI and IGF-1), basal inflammation (C-reactive protein levels), kidney function (cystatin C and urate), and liver status (GGT and ALT). Here, IGF1 is linked to obesity due to melanocortin 4 receptor deficiency.