Insulinemic and Inflammatory Dietary Patterns Show Enhanced Predictive Potential for Type 2 Diabetes Risk in Postmenopausal Women

10.2337/figshare.13312649.v1 ◽

2021 ◽

Author(s):

Qi Jin ◽

Ni Shi ◽

Desmond Aroke ◽

Dong Hoon Lee ◽

Joshua J. Joseph ◽

...

Keyword(s):

Type 2 Diabetes ◽

Postmenopausal Women ◽

Dietary Patterns ◽

Cox Regression ◽

Absolute Risk ◽

Glycemic Load ◽

Insulin Response ◽

Diabetes Risk ◽

Dietary Index

Objective: The empirical dietary index for hyperinsulinemia(EDIH) and empirical dietary inflammatory pattern(EDIP) scores assess the insulinemic and inflammatory potentials of habitual dietary patterns, irrespective of the macronutrient content, and are based on plasma insulin response or inflammatory biomarkers, respectively. The glycemic index (GI) and glycemic load (GL) assess postprandial glycemic potential based on dietary carbohydrate content. We tested the hypothesis that dietary patterns promoting hyperinsulinemia, chronic inflammation, or hyperglycemia may influence type 2 diabetes risk. Research Design and Methods: We calculated dietary scores from baseline (1993-1998) food frequency questionnaires among 73,495 postmenopausal women in the Women’s Health Initiative, followed through March 2019. We used multivariable-adjusted Cox regression to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) for type 2 diabetes risk. We also estimated multivariable-adjusted absolute risk of type 2 diabetes. Results: During a median 13.3 years of follow-up, 11,009 incident type 2 diabetes cases were diagnosed. Participants consuming the most hyperinsulinemic or proinflammatory dietary patterns experienced greater risk of type 2 diabetes: HRs(95%CI) comparing highest to lowest dietary index quintiles were: EDIH: 1.49 (1.32-1.68),Ptrend<.0001; EDIP: 1.45 (1.29-1.63),Ptrend<.0001). The absolute excess incidence for the same comparison was +220 (EDIH) and +271 (EDIP) cases per 100,000 person-years. GI and GL were not associated with type 2 diabetes risk: GI: 0.99 (0.88-1.12),Ptrend=0.46; GL: 1.01 (0.89, 1.16),Ptrend=0.30. Conclusions: <a>Our findings in this diverse cohort of postmenopausal women, suggest that lowering the insulinemic and inflammatory potentials of the diet may be more effective in preventing type 2 diabetes than focusing on glycemic foods.</a>

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The Insulinemic, Inflammatory, and Glycemic Potential of the Diet in Relation to Risk of Type 2 Diabetes

Current Developments in Nutrition ◽

10.1093/cdn/nzaa061_048 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1420-1420

Author(s):

Qi Jin ◽

Ni Shi ◽

Desmond Aroke ◽

Joshua Joseph ◽

Macarius Donneyong ◽

...

Keyword(s):

Type 2 Diabetes ◽

Postmenopausal Women ◽

Dietary Patterns ◽

Cox Regression ◽

Glycemic Load ◽

Plasma Concentrations ◽

Insulin Response ◽

Obese Women ◽

Incident Cases

Abstract Objectives Dietary patterns that promote chronic systemic inflammation, hyperinsulinemia, or hyperglycemia may influence type 2 diabetes (T2D) risk. We evaluated an empirical dietary index for hyperinsulinemia (EDIH), empirical dietary inflammatory pattern (EDIP), glycemic index (GI), and glycemic load (GL), and risk of T2D among US postmenopausal women. EDIH and EDIP assess the insulinemic or inflammatory potential of habitual diets, irrespective of macronutrient content, and are based on plasma concentrations of insulin response or inflammatory biomarkers, respectively. The GI and GL assess postprandial glycemic potential based on carbohydrate content of the diet. Methods We calculated dietary scores from baseline food frequency questionnaires among 73,495 participants aged 50–79 years in the Women's Health Initiative Observational Study and Clinical Trials. We used multivariable-adjusted Cox regression to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for risk of T2D according to quintiles of dietary scores. Results There were 11,009 incident cases of T2D during a median 13.3 years of follow-up. In multivariable-adjusted analyses, participants in the highest dietary score quintiles (consuming the most hyperinsulinemic, proinflammatory, or hyperglycemic diets) were at highest risk of T2D compared to those in the lowest quintiles: EDIH: HR, 1.54(1.37, 1.74); Ptrend < .0001; EDIP: HR, 1.45 (1.29, 1.64); Ptrend < .0001). GI and GL were not associated with T2D risk: GI: HR, 0.99 (0.88, 1.12); Ptrend = 0.94; GL: HR, 0.98 (0.85, 1.12); Ptrend = 0.32. In subgroup analyses, associations of EDIH and EDIP with T2D risk were stronger among overweight or obese than normal-weight women (Pinteraction: EDIH = 0.02, EDIP = 0.003), and findings did not significantly vary by race/ethnicity. Conclusions In this large sample of postmenopausal women, hyperinsulinemic, and pro-inflammatory dietary patterns were associated with higher risk of T2D, more so among overweight and obese women, whereas dietary glycemic potential was not associated with T2D risk. Funding Sources NCI grant # R00CA207736 and the WHI program is funded by NHLBI grant #s HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C.

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Insulinemic and Inflammatory Dietary Patterns Show Enhanced Predictive Potential for Type 2 Diabetes Risk in Postmenopausal Women

Diabetes Care ◽

10.2337/dc20-2216 ◽

2021 ◽

pp. dc202216

Author(s):

Qi Jin ◽

Ni Shi ◽

Desmond Aroke ◽

Dong Hoon Lee ◽

Joshua J. Joseph ◽

...

Keyword(s):

Type 2 Diabetes ◽

Postmenopausal Women ◽

Dietary Patterns ◽

Diabetes Risk

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Understanding the complexity of socioeconomic disparities in type 2 diabetes risk: a study of 4.3 million people in Sweden

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000749 ◽

2019 ◽

Vol 7 (1) ◽

pp. e000749 ◽

Cited By ~ 1

Author(s):

Maria Wemrell ◽

Louise Bennet ◽

Juan Merlo

Keyword(s):

Public Health ◽

Type 2 Diabetes ◽

Low Income ◽

Educational Achievement ◽

Absolute Risk ◽

Diabetes Risk ◽

Socioeconomic Disparities ◽

Heterogeneous Distribution ◽

Discriminatory Accuracy

ObjectiveInvestigating demographic and socioeconomic factors as intersecting rather than as separate dimensions may improve our understanding of the heterogeneous distribution of type 2 diabetes in the population. However, this complexity has scarcely been investigated and we still do not know the accuracy of these factors for predicting type 2 diabetes. Improved understanding of the demographic and socioeconomic disparities predicting type 2 diabetes risk in the population would contribute to more precise and effective public health interventions.Research design and methodsWe analyzed the risk of type 2 diabetes among 4 334 030 individuals aged 40–84 years who by 2010 had resided in Sweden for at least 5 years. We stratified the study population into 120 strata defined by categories of age, gender, income, education, and immigration status. We calculated measures of absolute risk (prevalence) and relative risk (prevalence ratio), and quantified the discriminatory accuracy of the information for predicting type 2 diabetes in the population.ResultsThe distribution of type 2 diabetes risk in the population was highly heterogeneous. For instance, immigrated men aged 70–79 years with low educational achievement and low income had a risk around 32 times higher than native women aged 40–49 years with high income and high educational achievement (ie, 17.6% vs 0.5%). The discriminatory accuracy of the information was acceptable.ConclusionA more detailed, intersectional mapping of socioeconomic and demographic distribution of type 2 diabetes can assist in public health management aiming to reduce the prevalence of the disease.

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Pure Fruit Juice and Fruit Consumption Are Not Associated with Incidence of Type 2 Diabetes after Adjustment for Overall Dietary Quality in the European Prospective Investigation into Cancer and Nutrition–Netherlands (EPIC-NL) Study

Journal of Nutrition ◽

10.1093/jn/nxz340 ◽

2020 ◽

Vol 150 (6) ◽

pp. 1470-1477 ◽

Cited By ~ 1

Author(s):

Floor R Scheffers ◽

Alet H Wijga ◽

W M Monique Verschuren ◽

Yvonne T van der Schouw ◽

Ivonne Sluijs ◽

...

Keyword(s):

Type 2 Diabetes ◽

Fruit Juice ◽

Cox Regression ◽

Diabetes Risk ◽

Dietary Guidelines ◽

Dietary Quality ◽

Fruit Consumption ◽

Incident Cases ◽

Prospective Investigation

ABSTRACT Background Dietary guidelines on pure fruit juice consumption vary from country to country regarding the inclusion of pure fruit juice in the recommendations as an acceptable alternative for fruit. Current epidemiological evidence on the association between pure fruit juice consumption and diabetes risk is scarce. Objective We studied the association of both pure fruit juice and fruit consumption with diabetes risk and investigated the differences between low and high fruit consumers in the association of pure fruit juice consumption with diabetes risk. Methods This prospective cohort study included 36,147 participants in the European Prospective Investigation into Cancer and Nutrition–Netherlands (EPIC-NL) Study aged 20–69 y at baseline. Fruit juice and fruit consumption were assessed using a validated food-frequency questionnaire; amounts of consumption were divided into 5 categories and quintiles, respectively. Incident type 2 diabetes cases were mainly self-reported and verified against medical records. Cox regression was used to estimate adjusted HRs and 95% CIs. Results After an average follow-up of 14.6 y, 1477 verified incident cases of type 2 diabetes were documented. Compared with no consumption, pure fruit juice consumption was not significantly associated with type 2 diabetes, with adjusted HRs ranging from 0.92 (95% CI: 0.79, 1.09) to 1.03 (95% CI: 0.83, 1.26). The associations did not differ between participants with low and high fruit consumption. None of the categories of fruit consumption were associated with type 2 diabetes (lowest quintile as reference). Adjusted HRs ranged between 0.93 (95% CI: 0.78, 1.10) and 1.00 (95% CI: 0.84, 1.19). Adjustment for the Dutch Healthy Diet Index, as an overall measure of dietary quality, strongly attenuated the observed associations of type 2 diabetes with both fruit juice and fruit consumption. Conclusions We found no evidence for associations between pure fruit juice and fruit consumption and diabetes risk after adjustment for overall dietary quality for participants in the EPIC-NL study. This trial was registered at https://www.trialregister.nl/trial/6939 as NL6939.

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Dietary Patterns Derived by Reduced Rank Regression Are Inversely Associated with Type 2 Diabetes Risk across 5 Ethnic Groups in the Multiethnic Cohort

Current Developments in Nutrition ◽

10.3945/cdn.117.000620 ◽

2017 ◽

Vol 1 (5) ◽

pp. e000620 ◽

Cited By ~ 10

Author(s):

Simone Jacobs ◽

Janine Kroeger ◽

Matthias B Schulze ◽

Laura K Frank ◽

Adrian A Franke ◽

...

Keyword(s):

Type 2 Diabetes ◽

Ethnic Groups ◽

Dietary Patterns ◽

Diabetes Risk ◽

Reduced Rank Regression ◽

Rank Regression ◽

Reduced Rank ◽

Multiethnic Cohort

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Dietary manganese, plasma markers of inflammation, and the development of type 2 diabetes in postmenopausal women: findings from the Women’s Health Initiative

10.2337/dc20-1234/suppl.12026796.v1 ◽

2020 ◽

Author(s):

Jung Ho Gong ◽

Kenneth Lo ◽

Qing Liu ◽

Jie Li ◽

Shuiqing Lai ◽

...

Keyword(s):

Type 2 Diabetes ◽

Postmenopausal Women ◽

Case Control Study ◽

Case Control ◽

Diabetes Risk ◽

Inflammatory Biomarkers ◽

Health Initiative ◽

Markers Of Inflammation ◽

Control Study

Objective: To examine the association between manganese intake and the risk of type 2 diabetes in postmenopausal women and determine whether this association is mediated by circulating markers of inflammation. Research Design and Methods: We included 84,285 postmenopausal women without history of diabetes from the national Women’s Health Initiative Observational Study (WHI-OS). Replication analysis was then conducted among 62,338 women participated in the WHI-Clinical Trial (WHI-CT). Additionally, data from a case-control study of 3,749 women nested in the WHI-OS with information on biomarkers of inflammation and endothelial dysfunction were examined using mediation analysis to determine the relative contributions of these known biomarkers by which manganese affect T2D risk. Results: Compared with the lowest quintile of energy-adjusted dietary manganese, WHI-OS participants in the highest quintile had a 30% lower risk of type 2 diabetes (hazards ratio [HR] 0.70 [95% CI 0.65, 0.76]). A consistent association was also confirmed in the WHI-CT (HR 0.79 [95% CI 0.73, 0.85]). In the nested case-control study, higher energy-adjusted dietary manganese was associated with lower circulating levels of inflammatory biomarkers that significantly mediated the association between dietary manganese and type 2 diabetes risk. Specifically, 19% and 12% of type 2 diabetes risk due to manganese were mediated through interleukin 6 and high-sensitivity C-reactive protein, respectively. Conclusions: Higher intake of manganese was directly associated with a lower type 2 diabetes risk independent of known risk factors. This association may be partially mediated by inflammatory biomarkers.

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A Shift Toward a Plant-Centered Diet from Young to Middle Adulthood and Subsequent Risk of Type 2 Diabetes and Weight Gain: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

10.2337/figshare.12733598.v1 ◽

2020 ◽

Author(s):

Yuni Choi ◽

Nicole Larson ◽

Daniel D. Gallaher ◽

Andrew O. Odegaard ◽

Jamal S. Rana ◽

...

Keyword(s):

Type 2 Diabetes ◽

Young Adults ◽

Body Size ◽

Diet Quality ◽

Regression Models ◽

Cox Regression ◽

Multivariable Analysis ◽

Diabetes Risk ◽

Middle Adulthood

OBJECTIVE: To examine the associations between change in plant-centered diet quality and type 2 diabetes risk and change in body size. RESEARCH DESIGN AND METHODS: A prospective study conducted in the US enrolled adults ages 18–30 years in 1985–1986 (exam year [Y0]) and followed them through 2015–2016. <a>We analyzed the associations between change in plant-centered diet quality over 20 years (Y0–Y20) and diabetes (Y20–30, n=2,534) and change (Y0–Y20 and Y20–30) in body mass index (BMI), waist circumference (WC), and weight (n > 2,434). </a>Plant-centered diet quality was measured using the A Priori Diet Quality Score (APDQS); a higher score favors nutritionally-rich plant foods. Cox regression models were used to assess diabetes risk and linear regression models were used to examine change in body size. RESULTS: During mean follow-up of 9.3 (±1.7) years, 206 incident diabetes cases occurred. In multivariable analysis, participants with the largest increase in APDQS over 20 years had a 48% (95% CI: 0.31–0.85; P-trend < 0.001) lower risk of diabetes over the subsequent 10–years compared with participants whose score remained stable. <a>Each 1–SD increment in APDQS over 20 years was associated with lower gains in BMI (-0.39 kg/m2, SE: 0.14; P=0.004), WC (-0.90 cm, SE: 0.27; P < 0.001), and weight (-1.14 kg, SE: 0.33; P < 0.001) during the same period, but not with subsequent changes.</a> CONCLUSIONS: Young adults who increased plant-centered diet quality had a lower diabetes risk and gained less weight by middle adulthood.

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Are Malaysian Type 2 Diabetes patients willing to be trained to speak to their offspring about risk of diabetes and preventive measures?

10.21203/rs.2.11507/v2 ◽

2020 ◽

Author(s):

Siti Fatimah Badlishah-Sham ◽

Anis Safura Ramli ◽

Mohamad Rodi Isa ◽

Nurzakiah Mohd-Zaki ◽

David Leonard Whitford

Keyword(s):

Type 2 Diabetes ◽

Risk Factor ◽

Perceived Risk ◽

Absolute Risk ◽

Positive Family History ◽

Diabetes Risk ◽

Willingness To Accept ◽

Training Methods ◽

Diabetes Patients

Abstract Background : Offspring of diabetes patients have an absolute risk of 20-40% of developing the condition. Diabetes patients should be encouraged to speak to their offspring regarding diabetes risk and prevention strategies. The Health Belief Model conceptualises that the higher the perceived risk, the more likely an individual will modify their behaviour. The objectives of this study were to i) determine the distribution of type 2 diabetes patients regarding their willingness to accept training to speak to their offspring, ii) determine the distribution of type 2 diabetes patients regarding their willingness to accept training based on the HBM and iii) to determine the factors associated with their willingness to accept training. Methods : This was a cross-sectional study amongst type 2 diabetes patients attending two primary care clinics in Malaysia. Sociodemographic data and knowledge of diabetes risk factors were collected. The adapted, translated and validated Diabetes Mellitus in the Offspring Questionnaire-Malay version (DMOQ-Malay) was self-administered. Statistical analysis included descriptive statistics, univariate and multiple logistic regression. Results : A total of 425 participants were recruited. Of these, 61.6% were willing to accept training. In MLogR, six variables were found to be significantly associated with willingness to accept training. These were i) positive family history [Adj. OR 2.06 (95% CI: 1.27, 3.35)], ii) having correct knowledge that being overweight is a risk factor [Adj. OR 1.49 (95%CI: 1.01, 2.29)], iii) correctly identifying age 40 years old as a risk factor [Adj. OR 1.88 (95%CI: 1.22, 2.90)], iv) agreeing that speaking to their offspring would help them to prevent type 2 diabetes [Adj. OR 4.34 (95%: 1.07, 17.73)], v) being neutral with the statement ‘I do not have much contact with my offspring’ [Adj. OR: 0.31 (95% CI: 0.12, 0.810] and vi) being neutral with the statement ‘my offspring are not open to advice from me’ [Adj. OR: 0.63 (95% CI: 0.31, 0.84]. Conclusion : The majority of type 2 diabetes patients were willing to accept training to speak to their offspring to prevent diabetes. A training module should be designed to enhance their knowledge, attitude and skills to become family health educators.

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Dietary manganese, plasma markers of inflammation, and the development of type 2 diabetes in postmenopausal women: findings from the Women’s Health Initiative

10.2337/dc20-1234/suppl.12026796 ◽

2020 ◽

Author(s):

Jung Ho Gong ◽

Kenneth Lo ◽

Qing Liu ◽

Jie Li ◽

Shuiqing Lai ◽

...

Keyword(s):

Type 2 Diabetes ◽

Postmenopausal Women ◽

Case Control Study ◽

Case Control ◽

Diabetes Risk ◽

Inflammatory Biomarkers ◽

Health Initiative ◽

Markers Of Inflammation ◽

Control Study

Objective: To examine the association between manganese intake and the risk of type 2 diabetes in postmenopausal women and determine whether this association is mediated by circulating markers of inflammation. Research Design and Methods: We included 84,285 postmenopausal women without history of diabetes from the national Women’s Health Initiative Observational Study (WHI-OS). Replication analysis was then conducted among 62,338 women participated in the WHI-Clinical Trial (WHI-CT). Additionally, data from a case-control study of 3,749 women nested in the WHI-OS with information on biomarkers of inflammation and endothelial dysfunction were examined using mediation analysis to determine the relative contributions of these known biomarkers by which manganese affect T2D risk. Results: Compared with the lowest quintile of energy-adjusted dietary manganese, WHI-OS participants in the highest quintile had a 30% lower risk of type 2 diabetes (hazards ratio [HR] 0.70 [95% CI 0.65, 0.76]). A consistent association was also confirmed in the WHI-CT (HR 0.79 [95% CI 0.73, 0.85]). In the nested case-control study, higher energy-adjusted dietary manganese was associated with lower circulating levels of inflammatory biomarkers that significantly mediated the association between dietary manganese and type 2 diabetes risk. Specifically, 19% and 12% of type 2 diabetes risk due to manganese were mediated through interleukin 6 and high-sensitivity C-reactive protein, respectively. Conclusions: Higher intake of manganese was directly associated with a lower type 2 diabetes risk independent of known risk factors. This association may be partially mediated by inflammatory biomarkers.

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