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Kazemi A, Golzarand M, Shojaei-Zarghani S, Babajafari S, Mirmiran P, Azizi F. Is variety more important than quantity of fruits and vegetables in relation to cardiovascular disease incidence and mortality? Results from a prospective cohort study. Int J Food Sci Nutr 2024; 75:306-316. [PMID: 38253525 DOI: 10.1080/09637486.2024.2304134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/06/2024] [Indexed: 01/24/2024]
Abstract
We aimed to prospectively assess the association between variety and quantity of fruits and vegetables (FV) and cardiovascular diseases (CVD) incidence and mortality due to the limited evidence. Our analysis included 2,918 adults with a follow-up period of 29,559 person-years. An inverse association was detected between fruit intake and the risk of incidence and mortality from CVD. We found no association between diversity scores of fruits, vegetables, and FV with CVD risk. Subjects with high quantity-high variety, high quantity-low variety, and low quantity-high variety of fruits, vegetables, or FV exhibited no difference in CVD risk compared to the subjects with low quantity-low variety intake. Increasing the variety of FV was associated with increases in the intake of β-carotene, lycopene, lutein, vitamin C, selenium, fibre, fat, and protein after adjustment for the quantity and covariates. We detected an inverse association between fruit intake and the incidence and mortality rates of CVD.
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Affiliation(s)
- Asma Kazemi
- Nutrition Research Center, School of Nutrition and food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdieh Golzarand
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Siavash Babajafari
- Nutrition Research Center, School of Nutrition and food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Burch AE, Elliott SK, Harris ST. Associations between social determinants of health and diabetes self-care behaviors among insured adult patients. Diabetes Res Clin Pract 2024; 207:111048. [PMID: 38070544 DOI: 10.1016/j.diabres.2023.111048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/09/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
AIMS This study explored the association between social determinants of health (SDOH) and diabetes care behaviors among individuals with health insurance. METHODS Data from 57,206 US residents, representing a population of over 25.58 million adults with health insurance and diagnosed diabetes, were included in this cross-sectional analysis of data from the 2017 Behavioral Risk Factor Surveillance System. Logistic regression models were constructed to evaluate the likelihood of various diabetes care behaviors given the presence of several SDOH (e.g., food insecurity, poverty, housing insecurity, rurality). RESULTS Most respondents exercised, ate vegetables, saw a provider for diabetes-related care in the last year, and reported checking their feet and testing their blood sugar daily. Not feeling safe (odds ratio (OR) 1.77, 95 % confidence interval (CI) 1.04, 3.01) was related to never checking blood sugar. Experiencing frequent stress was associated with a lower likelihood of exercise (OR .77, 95% CI 0.60, 0.999) and lower likelihood of checking blood sugar at least once a day (OR 0.73, 95% CI 0.54, 0.99). Food insecurity was associated with lower likelihood of vegetable consumption (OR 0.63, 95 % CI 0.47, 0.85) but a higher likelihood of checking blood sugar (OR 1.80, 95 % CI 1.26, 2.57). Low-income respondents were less likely to exercise (OR 0.72, 95 % CI 0.64, 0.80) or eat vegetables (OR 0.83, 95 % CI 0.75, 0.93) but more likely to check their feet (OR 1.19, 95 % CI 1.04, 1.35) and blood sugar at least once per day (OR 1.15, 95% CI 1.01, 1.31). Those who rent their home were also more likely to check their blood sugar (OR 1.22, 95% CI 1.07, 1.37) but less likely to have eaten vegetables in the last week (OR 0.87, 95% CI 0.78, 0.97). Respondents living in rural areas were more likely to have visited a provider in the last year (OR 1.21 95% CI 1.00, 1.47). CONCLUSIONS SDOH can adversely affect diabetes self-care behaviors, providers should assist vulnerable patients by connecting them with community resources and providing individualized care.
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Affiliation(s)
- Ashley E Burch
- Department of Health Services and Information Management, Department of Internal Medicine, 600 Moye Blvd., Mail Stop 668, 4340N Health Sciences Building, Greenville, NC 27858, USA.
| | - Sarah K Elliott
- Department of Nutrition Science, College of Allied Health Sciences, Health Sciences Building 2435, Greenville, NC 27834, USA.
| | - Susie T Harris
- Department of Health Services and Information Management, 4340F Health Sciences Building, Greenville, NC 27858, USA.
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Nouri M, Gerami S, Borazjani M, Rajabzadeh-Dehkordi M, Askarpour M, Najafi M, Faghih S. Diet quality indices and their relationship with dyslipidemia in adults: A cross-sectional study. Clin Nutr ESPEN 2023; 58:21-26. [PMID: 38057008 DOI: 10.1016/j.clnesp.2023.08.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Food habits may influence a range of modifiable risk factors of cardiovascular diseases (CVDs) including dyslipidemia. This study was conducted to find whether healthy eating index (HEI) and dietary quality index-international (DQI-I) were associated with the risk of dyslipidemia among the Iranian adults in Shiraz. METHOD In this study, 236 participants with the age of 20-50 years were recruited from Shiraz medical centers through random cluster sampling. The HEI-2015 and DQI-I scores were computed using dietary intakes based on a 168-item food frequency questionnaire (FFQ). Logistic regression was utilized to estimate the relation between HEI-2015 and DQI-I score and lipid profile. RESULTS Individuals in the greatest adherence to the HEI-2015 was associated with reduced odds ratio (OR) of total cholesterol (TC) and low-density lipoprotein (LDL) in the crude model (OR: 0.46 and OR: 0.30). This association was significant after adjustment for potential confounders (OR: 0.40 and OR: 0.31). Also, we observed significant association between DQI-I with TC and LDL in crude model (OR: 0.42 and OR: 0.45). In the adjusted model, participants in the last tertile of DQI-I were 55%, 58% and 57% less likely to have abnormal TC (OR: 0.45), LDL (OR: 0.42) and high-density lipoprotein (HDL) (OR: 0.43), compared those in the first tertile. CONCLUSION In conclusion, higher adherence to DQI-I score was related to lower LDL and total cholesterol and higher HDL levels. Furthermore, in participants with higher adherence of HEI-2015 score, LDL and total cholesterol level were lower.
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Affiliation(s)
- Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Shirin Gerami
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohadeseh Borazjani
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Milad Rajabzadeh-Dehkordi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Moein Askarpour
- Department of Clinical Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Maryam Najafi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Nishi SK, Khoury N, Valle Hita C, Zurbau A, Salas-Salvadó J, Babio N. Vegetable and Fruit Intake Variety and Cardiovascular Health and Mortality: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2023; 15:4913. [PMID: 38068771 PMCID: PMC10707746 DOI: 10.3390/nu15234913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/03/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION A multitude of evidence supports the consumption of a higher quantity of vegetables and fruits for their cardiovascular benefits. Nonetheless, the extent to which variety is associated with cardiovascular health remains unclear. OBJECTIVE To conduct a systematic review and meta-analysis of observational studies (prospective cohort and cross-sectional studies) assessing the role of a variety of vegetable and fruit consumption in cardiovascular morbidity and mortality in adults. DATA SOURCES MEDLINE-PubMed, Cochrane databases, and reference lists were searched through March 2023. DATA EXTRACTION Two independent reviewers extracted data and assessed the risk of bias (National Heart, Lung, and Blood Institute Tool and Newcastle-Ottawa Scale). DATA ANALYSIS Data were pooled (fixed and random [DerSimonian and Laird] effects for <5 and ≥5 study comparisons, respectively), and heterogeneity was assessed using the Cochran Q statistic and quantified (I2 statistic). The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to assess the overall certainty of the evidence. Five cross-sectional (n = 45,761) and seven prospective studies (n = 253,422) met the eligibility criteria. Greater variety of vegetable and fruit consumption was prospectively related to decreased all-cause mortality (risk ratio, 0.89 [95% CI, 0.82-0.97], seven study comparisons, n = 196,925), while no significant associations were observed with assessed cardiovascular-related mortality or morbidity. For all outcomes, the certainty of the evidence was graded as "low" or "very low" owing to inconsistency and/or imprecision. CONCLUSIONS Overall, this study shows that greater variety in vegetable and fruit consumption may reduce all-cause mortality and highlights the need for additional studies with a higher degree of evidence to better understand its role in cardiovascular health.
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Affiliation(s)
- Stephanie K. Nishi
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, 43201 Reus, Spain; (N.K.); (C.V.H.); (J.S.-S.)
- Institut d’Investigació Pere Virgili (IISPV), Carrer Dr. Mallafré Guasch, 4, 43007 Tarragona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada;
| | - Nadine Khoury
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, 43201 Reus, Spain; (N.K.); (C.V.H.); (J.S.-S.)
- Institut d’Investigació Pere Virgili (IISPV), Carrer Dr. Mallafré Guasch, 4, 43007 Tarragona, Spain
| | - Cristina Valle Hita
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, 43201 Reus, Spain; (N.K.); (C.V.H.); (J.S.-S.)
- Institut d’Investigació Pere Virgili (IISPV), Carrer Dr. Mallafré Guasch, 4, 43007 Tarragona, Spain
| | - Andreea Zurbau
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada;
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, 43201 Reus, Spain; (N.K.); (C.V.H.); (J.S.-S.)
- Institut d’Investigació Pere Virgili (IISPV), Carrer Dr. Mallafré Guasch, 4, 43007 Tarragona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Nancy Babio
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, 43201 Reus, Spain; (N.K.); (C.V.H.); (J.S.-S.)
- Institut d’Investigació Pere Virgili (IISPV), Carrer Dr. Mallafré Guasch, 4, 43007 Tarragona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
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Carr AC, Lunt H, Wareham NJ, Myint PK. Estimating Vitamin C Intake Requirements in Diabetes Mellitus: Analysis of NHANES 2017-2018 and EPIC-Norfolk Cohorts. Antioxidants (Basel) 2023; 12:1863. [PMID: 37891943 PMCID: PMC10604478 DOI: 10.3390/antiox12101863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Vitamin C is an essential enzyme cofactor and antioxidant with pleiotropic roles in human physiology. Circulating vitamin C concentrations are lower in people with diabetes mellitus, suggesting a higher dietary requirement for the vitamin. We interrogated the NHANES 2017-2018 and EPIC-Norfolk datasets to compare vitamin C requirements between those with and without diabetes mellitus using dose-concentration relationships fitted with sigmoidal (four-parameter logistic) curves. The NHANES cohort (n = 2828 non-supplementing adults) comprised 488 (17%) participants with diabetes (self-reported or HbA1c ≥ 6.5%). The participants with diabetes had a lower vitamin C status (median [IQR]) than those without (38 [17, 52] µmol/L vs. 44 [25, 61] µmol/L, p < 0.0001), despite comparable dietary intakes between the two groups (51 [26, 93] mg/d vs. 53 [24, 104] mg/d, p = 0.5). Dose-concentration relationships indicated that the group without diabetes reached adequate vitamin C concentrations (50 µmol/L) with an intake of 81 (72, 93) mg/d, whilst those with diabetes required an intake of 166 (126, NA) mg/d. In the EPIC-Norfolk cohort, comprising 20692 non-supplementing adults, 475 (2.3%) had self-reported diabetes at baseline. The EPIC cohort had a lower BMI than the NHANES cohort (26 [24, 28] kg/m2 vs. 29 [25, 34] kg/m2, p < 0.0001). Correspondingly, the EPIC participants without diabetes required a lower vitamin C intake of 64 (63, 65) mg/d while those with diabetes required 129 (104, NA) mg/d to reach adequate circulating vitamin C status. C-reactive protein concentrations were strongly correlated with body weight and BMI and provided a surrogate biomarker for vitamin C requirements. In conclusion, people with diabetes had 1.4 to 1.6 fold higher requirements for vitamin C than those without diabetes. This corresponds to additional daily vitamin C intake requirements of ~30-40 mg for people with diabetes, equating to a total daily intake of at least 125 mg/d.
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Affiliation(s)
- Anitra C. Carr
- Nutrition in Medicine Research Group, University of Otago, Christchurch 8011, New Zealand
| | - Helen Lunt
- Diabetes Outpatients, Health New Zealand Waitaha Canterbury, Christchurch 8011, New Zealand;
- Department of Medicine, University of Otago, Christchurch 8011, New Zealand
| | | | - Phyo K. Myint
- Ageing Clinical & Experimental Research (ACER) Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK;
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Li SY, Leung JCS, Lu ZH, Kwok TCY. Quantity and Variety of Fruit and Vegetable Intake with Changes in Measures of Adiposity among Community-Dwelling Chinese Older Adults. Nutrients 2023; 15:4096. [PMID: 37836380 PMCID: PMC10574446 DOI: 10.3390/nu15194096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The association between fruit and vegetable intake, considering both quantity and variety, and weight change among older adults remains controversial. We aimed to investigate the association between fruit and vegetable intake, variety, and changes in adiposity measures among community-dwelling Chinese older adults. METHODS A total of 2944 participants aged ≥65 years from Hong Kong communities were included. Fruit and vegetable intake was estimated by a locally validated food frequency questionnaire. Adiposity measures (weight, body mass index (BMI), waist circumference, fat and lean mass) were assessed at baseline and the year four follow-up. Restricted cubic spline and logistic models were performed to estimate the associations between fruit and vegetable intake, variety, and changes in adiposity measures. RESULTS A nonlinear association between vegetable intake and weight change was found, following a J-shape curve. Increased vegetable intake was associated with less increases in weight, BMI, and fat mass among those below median intakes. However, these associations became insignificant at higher intakes (all P-nonlinearity < 0.05). The ORs (95% CIs) for weight gain across the quartiles of vegetable intake were as follows: 1.00 (reference), 0.81 (0.56, 1.17), 0.55 (0.36, 0.83), and 0.88 (0.58, 1.33). Similar patterns were observed in overweight and normal weight participants, but not in those with low body weight. No associations with weight change were found for fruit intake or fruit and vegetable variety. CONCLUSIONS Moderate vegetable intake was associated with less weight gain among community-dwelling Chinese older adults, but not in those with low body weight. No association was observed between fruit intake or variety with weight change.
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Affiliation(s)
- Shu-Yi Li
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Jason C. S. Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhi-Hui Lu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Timothy C. Y. Kwok
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
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Rikhtehgaran R, Shamsi K, Renani EM, Arab A, Nouri F, Mohammadifard N, Marateb HR, Mansourian M, Sarrafzadegan N. Population food intake clusters and cardiovascular disease incidence: a Bayesian quantifying of a prospective population-based cohort study in a low and middle-income country. Front Nutr 2023; 10:1150481. [PMID: 37521422 PMCID: PMC10374205 DOI: 10.3389/fnut.2023.1150481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Aims This study was designed to explore the relationship between cardiovascular disease incidence and population clusters, which were established based on daily food intake. Methods The current study examined 5,396 Iranian adults (2,627 males and 2,769 females) aged 35 years and older, who participated in a 10-year longitudinal population-based study that began in 2001. The frequency of food group consumption over the preceding year (daily, weekly, or monthly) was assessed using a 49-item qualitative food frequency questionnaire (FFQ) administered via a face-to-face interview conducted by an expert dietitian. Participants were clustered based on their dietary intake by applying the semi-parametric Bayesian approach of the Dirichlet Process. In this approach, individuals with the same multivariate distribution based on dietary intake were assigned to the same cluster. The association between the extracted population clusters and the incidence of cardiovascular diseases was examined using Cox proportional hazard models. Results In the 10-year follow-up, 741 participants (401 men and 340 women) were diagnosed with cardiovascular diseases. Individuals were categorized into three primary dietary clusters: healthy, unhealthy, and mixed. After adjusting for potential confounders, subjects in the unhealthy cluster exhibited a higher risk for cardiovascular diseases [Hazard Ratio (HR): 2.059; 95% CI: 1.013, 4.184] compared to those in the healthy cluster. In the unadjusted model, individuals in the mixed cluster demonstrated a higher risk for cardiovascular disease than those in the healthy cluster (HR: 1.515; 95% CI: 1.097, 2.092). However, this association was attenuated after adjusting for potential confounders (HR: 1.145; 95% CI: 0.769, 1.706). Conclusion The results have shown that individuals within an unhealthy cluster have a risk that is twice as high for the incidence of cardiovascular diseases. However, these associations need to be confirmed through further prospective investigations.
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Affiliation(s)
- Reyhaneh Rikhtehgaran
- Department of Mathematical Sciences, Isfahan University of Technology, Isfahan, Iran
| | - Khadijeh Shamsi
- Student Research Committee, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elnaz Mojoudi Renani
- Department of Mathematical Sciences, Isfahan University of Technology, Isfahan, Iran
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Reza Marateb
- Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran
| | - Marjan Mansourian
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Liao YP, Zheng QX, Jiang XM, Chen XQ, Gao XX, Pan YQ. Fruit, vegetable, and fruit juice consumption and risk of gestational diabetes mellitus: a systematic review and meta-analysis : List of all authors. Nutr J 2023; 22:27. [PMID: 37208776 DOI: 10.1186/s12937-023-00855-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 05/10/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Fruit, vegetable, and fruit juice intake is associated with the risk of gestational diabetes mellitus (GDM). However, the conclusion is limited and conflicted. The purpose of this systematic review and meta-analysis is to investigate the association between fruit, vegetable, and fruit juice consumption and the risk of GDM. METHODS To find relevant studies, we searched PubMed, The Cochrane Library, Web of Science, Embase, ScienceDirect, PsycINFO, CINAHL, Ovid, EBSCO, CBM, CNKI, Wanfang Data, and VIP for the report on prospective cohort studies published from inception to April 8, 2022. Summary relative risks (RR) and 95% confidence intervals (Cis) were estimated using a random-effects model. RESULTS A total of 12 studies with 32,794 participants were included in the meta-analysis. Total fruit consumption was associated with a lower risk of GDM (RR = 0.92, 95% CI = 0.86-0.99). Whereas an increasing the consumption of vegetable, including all vegetable (RR = 0.95, 95% CI = 0.87-1.03), starchy vegetable (RR = 1.01, 95% CI = 0.82-1.26), and fruit juice (RR = 0.97, 95% CI = 0.91-1.04) was not associated with a reduction in the risk of GDM. In a dose‒response analysis of eight studies, a 3% reduction in risk of GDM for a 100 g/d increase in fruit consumption (RR = 0.97, 95% CI = 0.96-0.99). CONCLUSIONS The findings suggest that higher fruit consumption may reduce the risk of GDM, with a 3% reduction in the risk of GDM for every 100 g/d increase in fruit intake. Higher-quality prospective studies or randomized clinical trials are required to validate the effect of different variations of fruits, vegetables, and fruit juice consumption on the risk of GDM.
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Affiliation(s)
- Yan-Ping Liao
- School of Nursing, Fujian Medical University, No. 1 Xuefu North Road, University Town, Shangjie Zhen, Minhou County, Fuzhou City, 350000, Fujian Province, China
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Street, Gulou District, Fuzhou City, 350000, Fujian Province, China
| | - Qing-Xiang Zheng
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Street, Gulou District, Fuzhou City, 350000, Fujian Province, China
- Fujian Obstetrics and Gynecology Hospital, Zhanban Street, Jinan District, Fuzhou City, 350000, Fujian Province, China
| | - Xiu-Min Jiang
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Street, Gulou District, Fuzhou City, 350000, Fujian Province, China.
| | - Xiao-Qian Chen
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Street, Gulou District, Fuzhou City, 350000, Fujian Province, China
- Fujian Obstetrics and Gynecology Hospital, Zhanban Street, Jinan District, Fuzhou City, 350000, Fujian Province, China
| | - Xiao-Xia Gao
- School of Nursing, Fujian Medical University, No. 1 Xuefu North Road, University Town, Shangjie Zhen, Minhou County, Fuzhou City, 350000, Fujian Province, China
| | - Yu-Qing Pan
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Street, Gulou District, Fuzhou City, 350000, Fujian Province, China
- Fujian Obstetrics and Gynecology Hospital, Zhanban Street, Jinan District, Fuzhou City, 350000, Fujian Province, China
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Using Multiple Statistical Methods to Derive Dietary Patterns Associated with Cardiovascular Disease in Patients with Type 2 Diabetes: Results from a Multiethnic Population-Based Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2802828. [PMID: 35983006 PMCID: PMC9381206 DOI: 10.1155/2022/2802828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 01/17/2023]
Abstract
Background There are few reports on the relationship between dietary patterns and cardiovascular disease (CVD) risk in patients with type 2 diabetes (T2D). This study aimed to explore relationships between dietary patterns and CVD risk in the T2D population using multiple statistical analysis methods. Methods A total of 2,984 patients with T2D from the Xinjiang Multi-Ethnic Cohort, 555 of whom were suffering from CVD, were enrolled in this study. Participants' dietary intake was measured by the semiquantitative food frequency questionnaire (FFQ). Three statistical methods were used to construct dietary patterns, including principal component analysis (PCA) method, reduced-rank regressions (RRR) method, and partial least-squares regression (PLS) method. Then, the association between dietary patterns and CVD risk in T2D patients was analyzed by logistic regression. After excluding participants with CVD, the associations between dietary patterns and 10-year CVD risk scores were subsequently evaluated to reduce reverse causality. Results In this study, four dietary patterns were identified by three methods. Adjustment for confounding factors, subjects with the highest scores on the "high-protein and high-carbohydrate" patterns derived from PCA, RRR, and PLS had higher odds of CVD than those with the lowest scores (OR: 2.89, 95% CI: 2.11-3.96, P trend < 0.001; OR: 2.96, 95% CI: 2.17-4.03, P trend < 0.001; OR: 2.01, 95% CI: 1.50-2.70, P trend < 0.001, respectively). However, the dietary pattern of PCA-prudent was not significantly related to the odds of having CVD in T2D patients (adjusted ORQ4vsQ1: 0.93, 95% CI: 0.70-1.24, P trend =0.474). Interestingly, we also found significant associations between "high-protein and high-carbohydrate" patterns and the elevated predicted 10-year CVD risk in T2D patients (all P trend < 0.05). Conclusion The positive correlation between "high-protein and high-carbohydrate" patterns and CVD risk in T2D patients was robust across all three data-driven approaches. These findings may have public health significance, encouraging an emphasis on food choices in the usual diet and promoting nutritional interventions for patients with T2D to prevent CVD.
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Jiang W, Song Q, Zhang J, Chen Y, Jiang H, Long Y, Li Y, Han T, Sun H, Wei W. The Association of Consumption Time for Food With Cardiovascular Disease and All-Cause Mortality Among Diabetic Patients. J Clin Endocrinol Metab 2022; 107:e3066-e3075. [PMID: 35290452 DOI: 10.1210/clinem/dgac069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Indexed: 11/19/2022]
Abstract
AIMS This study aims to investigate whether food intake time across 3 meals is associated with long-term survival among the people with diabetes. MATERIALS AND METHODS This study included 4642 diabetic patients participating in the National Health and Nutrition Examination Survey from 2003 to 2014. Food consumed across a day including the forenoon, afternoon, and evening was divided into quantiles based on their distribution. Cox proportional hazards regression models were used to analyze the survival relationship between food intakes time and mortality. RESULTS In the forenoon, compared to the participants in the lowest quantile of potato and starchy vegetable, participants in the highest quantile had lower mortality risk of cardiovascular disease (CVD) [hazard ratio (HR)potato = 0.46, 95% CI 0.24-0.89; HRstarchy-vegetable = 0.32, 95% CI 0.15-0.72]. In the afternoon, participants who consumed whole grain had lower mortality of CVD (HRwhole grain = 0.67, 95% CI 0.48-0.95). In the evening, the highest quantile of dark vegetable and milk intake is related to lower mortality risk of CVD (HRdark vegetable = 0.55, 95% CI 0.35-0.87; HRmilk = 0.56, 95% CI 0.36-0.88) and all-cause mortality (HRmilk = 0.71, 95% CI 0.54-0.92), whereas participants in the highest quantile of intakes of processed meat are more likely to die due to CVD (HRprocessed-meat = 1.74, 95% CI 1.07-2.82). Isocalorically switching 0.1 serving potato or starchy vegetable consumed in the afternoon or evening to the forenoon, 0.1 serving dark vegetable consumed in the afternoon to the evening, and 0.1 serving whole grain consumed in the forenoon to the afternoon reduced the risk of CVD mortality. CONCLUSIONS Higher intake of potato or starchy vegetable in forenoon, whole grain in the afternoon, and dark vegetable and milk in the evening and lower intake of processed meat in the evening was associated with better long-term survival in people with diabetes.
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Affiliation(s)
- Wenbo Jiang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Qingrao Song
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Jia Zhang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Yunyan Chen
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Hongyan Jiang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Yujia Long
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Ying Li
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Tianshu Han
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Hongru Sun
- Department of Epidemiology, School of Public Health, Harbin Medical University, China
| | - Wei Wei
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
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López-González L, Becerra-Tomás N, Babio N, Martínez-González MÁ, Nishi SK, Corella D, Goday A, Romaguera D, Vioque J, Alonso-Gómez ÁM, Wärnberg J, Martínez JA, Serra-Majem L, Estruch R, Bernal-López MR, Lapetra J, Pintó X, Tur JA, López-Miranda J, Bueno-Cavanillas A, Delgado-Rodríguez M, Matía-Martín P, Daimiel L, Martín-Sánchez V, Vidal J, Vázquez C, Ros E, Vázquez-Ruiz Z, Martín-Luján FM, Sorlí JV, Castañer O, Zulet MA, Tojal-Sierra L, Carabaño-Moral R, Román-Maciá J, Rayó E, García-Ríos A, Casas R, Gómez-Pérez AM, Santos-Lozano JM, Buil-Cosiales P, Asensio EM, Lassale C, Abete I, Salaverria-Lete I, Sayón-Orea C, Schröder H, Salas-Salvadó J. One-year changes in fruit and vegetable variety intake and cardiometabolic risk factors changes in a middle-aged Mediterranean population at high cardiovascular risk. Eur J Clin Nutr 2022; 76:1393-1402. [PMID: 35411026 DOI: 10.1038/s41430-022-01124-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/04/2022] [Accepted: 03/14/2022] [Indexed: 01/04/2023]
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Vitamin C Status in People with Types 1 and 2 Diabetes Mellitus and Varying Degrees of Renal Dysfunction: Relationship to Body Weight. Antioxidants (Basel) 2022; 11:antiox11020245. [PMID: 35204128 PMCID: PMC8868094 DOI: 10.3390/antiox11020245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 12/17/2022] Open
Abstract
Diabetes mellitus is a chronic metabolic disorder and is associated with depleted vitamin C status. The underlying aetiologies and pathogeneses responsible for this association are poorly understood. This retrospective study explored the vitamin C status of 136 adult outpatients with types 1 and 2 diabetes mellitus (T1DM/T2DM), with a focus on indices of renal function and metabolic health, including body weight. In the T1DM group (n = 73), the median plasma vitamin C concentration was 33 (18, 48) µmol/L, with 37% hypovitaminosis C and 12% deficiency. In the T2DM group (n = 63), the median plasma concentration was 15 (7, 29) µmol/L, with 68% hypovitaminosis C and 38% deficiency. Lower vitamin C was associated with macroalbuminuria (p = 0.03), renal dysfunction (p = 0.08), and hypertension (p = 0.0005). Inverse associations were also observed between plasma vitamin C and various other metabolic health parameters (p < 0.05), especially body weight (p < 0.0001), which was higher in those with hypovitaminosis C (<23 µmol/L; p = 0.0001). The association with bodyweight remained, even after multivariable analysis. In summary, body weight was a significant predictor of low vitamin C status in people with diabetes. This suggests that people with both diabetes and a high body weight may have greater than average vitamin C requirements.
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Dono I, Dwipajati D, Dirgahayu P, Wibowo YC, Pratama YM. Acute Effects of Breakfast Fruits Meal Sequence and Postprandial Exercise on the Blood Glucose Level and DPP4 Activity among Type 2 Diabetes Mellitus Patients: A Pilot Study. J Obes 2022; 2022:4875993. [PMID: 36204396 PMCID: PMC9532157 DOI: 10.1155/2022/4875993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/07/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Type 2 diabetes mellitus (T2DM) is a major global public health issue. Diet and physical exercise are modifiable factors that influence the glycaemic status of patients with T2DM. We aimed to investigate the acute effects of breakfast fruits meal sequence and postprandial exercise on the blood glucose level and dipeptidyl peptidase 4 (DPP4) activity among type 2 diabetes mellitus patients. METHODS A randomized pilot study recruited patients with T2DM who attended two primary health care centres in Tasikmadu District, Karanganyar Regency, and Kartasura District, Sukoharjo Regency, Central Java, Indonesia, from July to October 2016. Eligible patients (4 men and 32 women) were randomly divided into four treatment groups. Venous blood samples were analyzed for fasting and one-hour postprandial blood glucose (FBG and 1 h PPG) levels and DPP4 activity. Blood glucose levels were measured using a routine hexokinase method, and serum DPP4 activity was determined spectrophotometrically after incubation with the Gly-Pro-p-nitroanilide substrate. RESULTS Fruits last meal decreased FBG level whilst fruits first meal did not significantly decrease 1 h PPG level. Both treatments had no acute effects on DPP4 activity but the addition of postprandial exercise helped lower DPP4 activity. Fruit last and first meals showed significant opposite effects on mean changes of FBG level (p < 0.05). CONCLUSIONS This preliminary report of fruits meal sequence is potentially involved in acute regulation of blood glucose levels and that it might be independent of DPP4 activity in Indonesian patients with T2DM. Moreover, postprandial exercise may be an important intervention for T2DM through the mediation of DPP4 but has no acute effects on the regulation of blood glucose levels. Further studies are required to investigate whether or not different types of fruits and longer treatment intervals can affect blood glucose levels and DPP4 activity differently. This study also gives an insight into the feasibility of conducting food order modification with or without the combination of postprandial exercise in a primary health setting for our next studies.
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Affiliation(s)
- Indarto Dono
- Department of Physiology, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36A, Surakarta, Jawa Tengah 57126, Indonesia
- Program of Nutrition Sciences, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36A, Surakarta, Jawa Tengah 57126, Indonesia
- Biomedical Laboratory, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36A, Surakarta, Jawa Tengah 57126, Indonesia
| | - Dwipajati Dwipajati
- Program of Nutrition Sciences, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36A, Surakarta, Jawa Tengah 57126, Indonesia
- Department of Nutrition, Politeknik Kesehatan Kemenkes Malang, Jl. Besar Ijen No. 77C, Malang City, Jawa Timur 65119, Indonesia
| | - Paramasari Dirgahayu
- Program of Nutrition Sciences, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36A, Surakarta, Jawa Tengah 57126, Indonesia
- Department of Parasitology, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36A, Surakarta, Jawa Tengah 57126, Indonesia
| | - Yohanes Cakrapradipta Wibowo
- Biomedical Laboratory, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36A, Surakarta, Jawa Tengah 57126, Indonesia
| | - Yoga Mulia Pratama
- Biomedical Laboratory, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36A, Surakarta, Jawa Tengah 57126, Indonesia
- Department of Internal Medicine, Faculty of Medicine, Jenderal Soedirman University, Jl. Profesor DR. HR Boenyamin No. 708, Banyumas, Jawa Tengah 53122, Indonesia
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Nattagh-Eshtivani E, Barghchi H, Pahlavani N, Barati M, Amiri Y, Fadel A, Khosravi M, Talebi S, Arzhang P, Ziaei R, Ghavami A. Biological and pharmacological effects and nutritional impact of phytosterols: A comprehensive review. Phytother Res 2021; 36:299-322. [PMID: 34729825 DOI: 10.1002/ptr.7312] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/01/2021] [Accepted: 09/30/2021] [Indexed: 12/20/2022]
Abstract
Phytosterols (PSs), classified into plant sterols and stanols, are bioactive compounds found in foods of plant origin. PSs have been proposed to exert a wide number of pharmacological properties, including the potential to reduce total and low-density lipoprotein (LDL) cholesterol levels and thereby decreasing the risk of cardiovascular diseases. Other health-promoting effects of PSs include anti-obesity, anti-diabetic, anti-microbial, anti-inflammatory, and immunomodulatory effects. Also, anticancer effects have been strongly suggested, as phytosterol-rich diets may reduce the risk of cancer by 20%. The aim of this review is to provide a general overview of the available evidence regarding the beneficial physiological and pharmacological activities of PSs, with special emphasis on their therapeutic potential for human health and safety. Also, we will explore the factors that influence the physiologic response to PSs.
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Affiliation(s)
- Elyas Nattagh-Eshtivani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanieh Barghchi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Naseh Pahlavani
- Nutrition and Biochemistry Department, School of Medicine, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.,Department of Clinical Biochemistry and Nutrition, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mehdi Barati
- Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Yasaman Amiri
- Medical School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abdulmannan Fadel
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Maryam Khosravi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Talebi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pishva Arzhang
- Department of Biochemistry and Diet Therapy, Faculty of Nutritional Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rahele Ziaei
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abed Ghavami
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Development and Validation of a Short Questionnaire on Dietary and Physical Activity Habits for Patients Submitted to Bariatric Endoscopic Therapies. Obes Surg 2021; 32:142-151. [PMID: 34664149 PMCID: PMC8752550 DOI: 10.1007/s11695-021-05754-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022]
Abstract
Purpose Individuals with obesity frequently regain weigh after endoscopic bariatric therapies (EBT) unless they adhere to healthy habits. The objective was to create and validate a short, self-administered questionnaire (EMOVE) to assess healthy dietary and physical activity (PA) habits’ adherence to be used in clinical practice. Materials and Methods In this prospective, unicentric study, 463 patients completed the short, Spanish EMOVE questionnaire, to be validated following the Medical Outcome Trust Criteria. Conceptual and measurement model, reliability (internal consistency and test–retest [subgroup of 93 patients]), construct validity, responsiveness, interpretability, and burden were evaluated. Patients enrolled from January 2017 through August 2018 and auto-filled the EMOVE at baseline and at 3, 6, and 12 months. Results Patients submitted to intragastric ballon for 6 and 12 months or POSE were 82.7% women with a mean age of 42.7 years, and a mean BMI of 37.1 kg/m2. Four factors were extracted with exploratory factor analysis related to intake frequency, portions and proportions, time and place of eating, and physical activity. EMOVE showed adequate internal consistency (α = 0.73), very good test–retest (r = 0.91, CI: 0.86–0.94; p < 0.001), moderate construct validity of dietary (r = 0.24, CI: 0.11–0.37, p < 0.001), and PA habits (r = 0.44, CI 0.30–0.58; p < 0.001). Stable responsiveness, with correlations from 0.29 to 0.39 (p < 0.001) between the EMOVE scores and the % of total weight loss at 3, 6, and 12 months. Participants categorized as having good or excellent habits (score ≥ 30 points) lost significantly more weight (p < 0.05). Finally, the administration burden was 2.96 min. Conclusion The EMOVE is a useful tool in Spanish language to easily assess the level of adherence to healthy dietary and PA habits to be used routinely in clinical practice. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s11695-021-05754-7.
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Estlin AFL, Ahern AL, Griffin SJ, Strelitz J. Modification of cardiovascular disease risk by health behaviour change following type 2 diabetes diagnosis. Diabet Med 2021; 38:e14646. [PMID: 34270827 DOI: 10.1111/dme.14646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/03/2021] [Accepted: 07/14/2021] [Indexed: 11/30/2022]
Abstract
AIMS Among adults with type 2 diabetes (T2D), unhealthy behaviours are associated with increased risk of cardiovascular disease (CVD) events. To date, little research has considered whether healthy changes in behaviours following T2D diagnosis reduce CVD risk. METHODS A cohort of 867 adults with screen-detected T2D, participating in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION)-Cambridge trial, were followed for 10 years for incidence of CVD events. Diet, alcohol consumption, moderate/vigorous physical activity and smoking were assessed by questionnaire at the time of T2D screening and 1 year later. We estimated associations between health behaviours and CVD using Cox regression. We assessed modification of the associations by behaviour change in the year following T2D diagnosis. RESULTS Smoking [hazard ratio (HR): 1.73 (95% CI: 1.04, 2.87)] and high fat intake [HR: 1.70 (95% CI: 1.02, 2.85)] were associated with a higher hazard of CVD, while high plasma vitamin C [HR: 0.44 (95% CI: 0.22, 0.87)] and high fibre intake [HR: 0.60 (95% CI: 0.36, 0.99)] were associated with a lower hazard of CVD. Reduction in fat intake following T2D diagnosis modified associations with CVD. In particular, among those with the highest fat intake, decreasing intake attenuated the association with CVD [HR: 0.75 (95% CI: 0.36, 1.56)]. CONCLUSION Following T2D diagnosis, decreasing fat intake was associated with lower long-term CVD risk. This evidence may raise concerns about low-carbohydrate, high-fat diets to achieve weight loss following T2D diagnosis. Further research considering the sources of fat is needed to inform dietary recommendations. TRIAL REGISTRATION This trial is registered as ISRCTN86769081. Retrospectively registered on 15 December 2006.
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Affiliation(s)
- Annabel F L Estlin
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Amy L Ahern
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Simon J Griffin
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Jean Strelitz
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge, UK
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Huang K, Yuan Y, Baojun X. A Critical Review on the Microencapsulation of Bioactive Compounds and Their Application. FOOD REVIEWS INTERNATIONAL 2021. [DOI: 10.1080/87559129.2021.1963978] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Kehao Huang
- Food Science and Technology Program, BNU-HKBU United International College, Zhuhai, China
- Department Of Food Science And Agricultural Chemistry, McGill University, Quebec, Canada
| | - Yingzhi Yuan
- Food Science and Technology Program, BNU-HKBU United International College, Zhuhai, China
- Department Of Biochemistry, University College London, London, UK
| | - Xu Baojun
- Food Science and Technology Program, BNU-HKBU United International College, Zhuhai, China
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Fruit and vegetable consumption in relation to primary headaches: the MEPHASOUS study. Eat Weight Disord 2021; 26:1617-1626. [PMID: 32789621 DOI: 10.1007/s40519-020-00984-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 06/25/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Fruit and vegetable consumption may beneficially affect the odds of primary headaches due to their antioxidant contents. However, no study has examined the association between fruit and vegetable consumption and primary headaches among university students. AIM To assess the relation between fruit and vegetable intakes and primary headaches among Iranian university students. METHODS Overall, 83,214 university students with an age range of ≥ 18 years participated in the present study. Dietary intakes and also data on confounding variables were collected using validated questionnaires. Data on dietary intakes were collected using a validated dietary habits questionnaire. We used the International Classification of Headache Disorders-3 (ICHD-3) criteria to define primary headaches. RESULTS Fruit consumption was negatively associated with primary headaches; such that after controlling for potential confounders, greater intake of fruits was associated with 30% lower odds of primary headaches (OR: 0.70, 95% CI 0.58-0.84). Such an inverse association was also found for vegetable consumption. In the fully adjusted model, students in the top category of vegetable consumption were 16% less likely to have primary headaches compared with those in the bottom category (OR: 0.84, 95% CI 0.74-0.95). Subgroup analysis revealed that fruit consumption was inversely associated with primary headaches in females, unlike males, and vegetable consumption was inversely associated with these headaches in males, as opposed to females. Moreover, fruit and vegetable consumption was related to lower odds of primary headaches in normal-weight students. CONCLUSION Fruit and vegetable intakes were associated with reduced odds of primary headaches. LEVEL OF EVIDENCE Level III, cross-sectional analytic studies.
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Haimoto H, Watanabe S, Maeda K, Murase T, Wakai K. Reducing Carbohydrate from Individual Sources Has Differential Effects on Glycosylated Hemoglobin in Type 2 Diabetes Mellitus Patients on Moderate Low-Carbohydrate Diets. Diabetes Metab J 2021; 45:390-403. [PMID: 32794380 PMCID: PMC8164948 DOI: 10.4093/dmj.2020.0033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/21/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND We evaluated decreases in glycosylated hemoglobin (HbA1c) achieved by reducing carbohydrate from various sources in type 2 diabetes mellitus patients. METHODS We followed up 138 male and 107 female outpatients on a moderate low-carbohydrate diet without diabetic medication for 6 months. Changes in carbohydrate sources (Δcarbohydrate) were assessed from 3-day dietary records at baseline and 6 months, and associations with changes in HbA1c (ΔHbA1c) were examined with Spearman's correlation coefficients (rs) and multiple regression analysis. RESULTS ΔHbA1c was -1.5%±1.6% in men and -0.9%±1.3% in women, while Δtotal carbohydrate was -115.3±103.7 g/day in men and -63.6±71.1 g/day in women. Positive associations with ΔHbA1c were found for Δtotal carbohydrate (rs=0.584), Δcarbohydrate from soft drinks (0.368), confectionery (0.361), rice (0.325), bread (0.221), Chinese soup noodles (0.199) in men, and Δtotal carbohydrate (0.547) and Δcarbohydrate from rice (0.376) and confectionery (0.195) in women. Reducing carbohydrate sources by 50 g achieved decreases in HbA1c of 0.43% for total carbohydrate, 1.33% for soft drinks, 0.88% for confectionery, 0.63% for bread, 0.82% for Chinese soup noodles and 0.34% for rice in men and 0.45% for total carbohydrate, 0.67% for confectionery and 0.34% for rice in women, although mean reductions in carbohydrate from these sources were much smaller than that from rice. CONCLUSION Decreases in HbA1c achieved by reducing carbohydrate from soft drinks, confectionery, bread and Chinese soup noodles were 2- to 4-fold greater than that for rice. Our results will enable patients to decrease HbA1c efficiently (UMIN000009866).
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Affiliation(s)
- Hajime Haimoto
- Department of Internal Medicine, Haimoto Clinic, Kasugai, Japan
| | - Shiho Watanabe
- Division of Clinical Nutrition, Haimoto Clinic, Kasugai, Japan
| | - Keiko Maeda
- Department of Health and Nutritional Sciences, Faculty of Health and Sciences, Aichi Shukutoku University, Nagakute, Japan
| | - Takashi Murase
- Division of Endocrinology and Diabetes, Libra Sasashima Medical Clinic, Nagoya, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Higher intakes of fruits and vegetables are related to fewer menopausal symptoms: a cross-sectional study. ACTA ACUST UNITED AC 2021; 27:593-604. [PMID: 32068682 DOI: 10.1097/gme.0000000000001511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The aim of this study was to explore the associations between fruit and vegetable (FV) intake, and its subgroups and menopausal symptoms along with its subtypes in postmenopausal women. METHODS This cross-sectional study included 393 postmenopausal women in municipality health centers in the south of Tehran, Iran. Sociodemographic data, dietary intakes, and anthropometric measures were obtained from individuals. Menopause rating scale (MRS) questionnaire was employed to measure menopausal symptoms. The total MRS score (TMRSS) was the sum of the somatic score (SS), psychological score (PS), and urogenital score (US). Participants were divided into low and high total MRS and its domain scores. RESULTS After adjustment for confounding variables, an inverse relationship was found between total FV with TMRSS (odds ratio [OR] 0.23, 95% confidence interval [CI] 0.06-0.81) and SS (OR 0.30, 95% CI 0.11-0.82). In addition, the consumption of total fruits was significantly related to lower SS (OR 0.27, 95% CI 0.10-0.71). Only intake of citrus fruits was inversely associated with TMRSS (OR 0.23, 95% CI 0.07-0.71) and SS (OR 0.28, 95% CI 0.11-0.70). Likewise, intakes of total FV (OR 2.46, 95% CI 1.37-4.41), total vegetables (OR 2.54, 95% CI 1.10-5.88), green leafy vegetables (OR 3.59, 95% CI 1.47-8.75), dark yellow vegetables (OR 2.28, 95% CI 1.00-5.18), other vegetables (OR 5.23, 95% CI 1.17-15.39), and citrus fruits were linked to higher US (OR 4.35, 95% CI 1.77-10.71). CONCLUSION The results of the present study showed that some FV subgroups had inverse associations with climacteric symptoms, whereas higher intake of some subgroups of FV appeared to be associated with more urogenital symptoms in postmenopausal women.
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Mphwanthe G, Weatherspoon D, Li W, Weatherspoon L. Dietary Association with Glycemic Status Among Adults Clinically Diagnosed with Type 2 Diabetes in Malawi. J Community Health Nurs 2020; 37:233-243. [PMID: 33150812 DOI: 10.1080/07370016.2020.1809855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We elucidated diet and its association with glycemic status among adults clinically diagnosed with type 2 diabetes mellitus (T2DM) through across-sectional study in Malawi. Glycosylated hemoglobin (A1C) and dietary intakes were assessed. Consumption of cereals, roots, and tubers and sweet, sugary food, including sweetened beverages, was significantly higher among participants with A1C≥8%. Fruit and vegetable intake were disproportionately low overall. Consuming adiet high in carbohydrates (OR: 1.167; CI = 1.107-1.231; p < .001) and having <3 meals/day (OR: 2.680; CI = 1.445-4.970; p = .002) were both associated with A1C≥8%. Therefore, dietary interventions for T2DM focusing on carbohydrate counting, total dietary quality, and meal planning are needed in Malawi.
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Affiliation(s)
- Getrude Mphwanthe
- Department of Food Science and Human Nutrition, Michigan State University , East Lansing, Michigan, USA.,Department of Human Nutrition and Health, Lilongwe University of Agriculture and Natural Resources (LUANAR) , Lilongwe, Malawi
| | - Dave Weatherspoon
- Department of Agricultural, Food, and Resource Economics, Michigan State University , East Lansing, Michigan, USA
| | - Wei Li
- Department of Food Science and Human Nutrition, Michigan State University , East Lansing, Michigan, USA
| | - Lorraine Weatherspoon
- Department of Food Science and Human Nutrition, Michigan State University , East Lansing, Michigan, USA
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Turton J, Brinkworth GD, Field R, Parker H, Rooney K. An evidence-based approach to developing low-carbohydrate diets for type 2 diabetes management: A systematic review of interventions and methods. Diabetes Obes Metab 2019; 21:2513-2525. [PMID: 31347236 DOI: 10.1111/dom.13837] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/06/2019] [Accepted: 07/22/2019] [Indexed: 12/13/2022]
Abstract
AIM To identify core diet and delivery components of low-carbohydrate (CHO) diets that have demonstrated efficacy for type 2 diabetes (T2D) management. MATERIALS AND METHODS MEDLINE, Pre-MEDLINE, EMBASE, CINAHL and the Cochrane Library of Controlled Trials databases were systematically searched from inception until August 18, 2018. Primary intervention studies of low-CHO diets (≤130 g/d or 26% total energy intake [TEI]) were included. Content analysis was performed on the low-CHO diet protocols classified as safe and effective for T2D management. RESULTS A total of 41 studies published between 1963 and 2018 were included, of which 40 were classified as safe and effective for inclusion in the primary analysis. Thirteen studies (13/40) were on very-low-CHO diets (<50 g/d), 14/40 included low-CHO diets (≤130 g/d or 26% TEI), and 13/40 were adapted according to participant progress. Thirty-one studies reported a total energy prescription, of which 18/31 encouraged ad libitum intakes. Twenty studies reported a prescribed dietary fat amount, of which 18/20 were unrestricted or high-fat (>35% TEI). Twenty-six studies reported a prescribed dietary protein amount, of which 22 were unrestricted or were high-protein (>25% TEI). The types of dietary CHO, fat and protein recommended were predominantly whole foods. Common delivery methods reported were dietician and/or physician involvement, moderate to high frequency of contact (≥1 session/month) and use of participant self-monitoring. CONCLUSIONS Multiple approaches for developing and delivering a low-CHO diet intervention for T2D management are safe and effective. A comprehensive set of core dietary components to consider in the formulation of low-CHO diet protocols were identified for use in clinical practice and to inform evidence-based guidelines for T2D management.
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Affiliation(s)
- Jessica Turton
- Faculty of Health Sciences, Discipline of Exercise and Sport Science, University of Sydney, Sydney, New South Wales, Australia
| | | | - Rowena Field
- Faculty of Health Sciences, Discipline of Exercise and Sport Science, University of Sydney, Sydney, New South Wales, Australia
| | - Helen Parker
- Faculty of Health Sciences, Discipline of Exercise and Sport Science, University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Kieron Rooney
- Faculty of Health Sciences, Discipline of Exercise and Sport Science, University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
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Jayachandran M, Chung SSM, Xu B. A critical review on diet-induced microbiota changes and cardiovascular diseases. Crit Rev Food Sci Nutr 2019; 60:2914-2925. [PMID: 31552753 DOI: 10.1080/10408398.2019.1666792] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Cardiovascular diseases (CVDs) commonly denote the disorders that generally occur as a result of unhealthy food habits. Heart failure, cerebrovascular illness, rheumatic heart disease are the common CVDs. The prevalence of CVD is increased considerably in recent decades upon unhealthy food habits and varied alternative factors such as diabetes, smoking and excessive use of alcohol. A change into a healthy food habit can reverse the strategy during a course of time.Objectives of the study: The objective of this review is to summarize the research findings and elaborate the relationship between the diet, gut microbiota, and CVD.Results: The dietary products containing the least saturated, trans-fat and cholesterol have the tendency to scale back the burden of CVDs, for instance, vegetables and fruits. The potential reason for the cardioprotective activity of the diet ought to be its high-unsaturated fatty acid composition and less saturated fat. Recent studies have found that gut microbiota plays a key role in mediating disease prevention. The metabolism of dietary products into varied bioactive metabolites is regulated by gut microbiota. The contributory role of gut microbiota in dietary metabolism and CVD prevention studies are increasing with promising outcomes.Conclusion: Hence, the review was proposed to reach the researchers within this field of study and share the available knowledge in gut microbiota-mediated CVD prevention. In our current review, we have updated all the research findings within the field of diet-mediated cardiovascular prevention through gut microbiota.
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Affiliation(s)
- Muthukumaran Jayachandran
- Program of Food Science and Technology, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, China
| | - Stephen Sum Man Chung
- Program of Food Science and Technology, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, China
| | - Baojun Xu
- Program of Food Science and Technology, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, China
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Guyenet SJ. Impact of Whole, Fresh Fruit Consumption on Energy Intake and Adiposity: A Systematic Review. Front Nutr 2019; 6:66. [PMID: 31139631 PMCID: PMC6518666 DOI: 10.3389/fnut.2019.00066] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/23/2019] [Indexed: 11/13/2022] Open
Abstract
Background: The energy content of whole, fresh fruit derives primarily from simple sugars, which are currently under heightened scrutiny for their potential contribution to obesity and chronic disease risk. Yet fruit also has a relatively low energy density, moderate palatability/reward value, and high fiber content, which together may limit energy intake. Although reasoned arguments can be made that fruit is fattening or slimming, the question is best resolved empirically. Methods: Methods were preregistered with PROSPERO (CRD42018111830). The primary outcome is the impact of whole, fresh fruit consumption on measures of adiposity including body weight in randomized controlled trials (RCTs). Secondary outcomes are the impact of whole, fresh fruit consumption on energy intake in RCTs, and the association between whole, fresh fruit consumption and changes in measures of adiposity in prospective observational studies. CENTRAL and PubMed databases were searched through October 2018. Cochrane risk of bias tool was used to assess risk of bias in RCTs, and the GRADE method was used to judge and convey the certainty of conclusions. Reporting follows PRISMA guidelines. Results: RCTs, and particularly those of higher quality, suggest that increasing whole, fresh fruit consumption promotes weight maintenance or modest weight loss over periods of 3-24 weeks (moderate certainty), with limited evidence suggesting that a high intake of fruit favors weight loss among people with overweight or obesity. Consistent with this, single-meal RCTs suggest that consuming whole, fresh fruit tends to decrease energy intake, particularly when consumed prior to a meal or when displacing more energy-dense foods (moderate certainty). Prospective observational studies suggest that habitually higher fruit intake is not associated with weight change, or is associated with modest protection against weight gain, over five or more years. Conclusions: Current evidence suggests that whole, fresh fruit consumption is unlikely to contribute to excess energy intake and adiposity, but rather has little effect on these outcomes or constrains them modestly. Single-meal RCTs, RCTs lasting 3-24 weeks, and long-term observational studies are relatively consistent in supporting this conclusion. Whole, fresh fruit probably does not contribute to obesity and may have a place in the prevention and management of excess adiposity.
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The relationship between vitamin C status, the gut-liver axis, and metabolic syndrome. Redox Biol 2018; 21:101091. [PMID: 30640128 PMCID: PMC6327911 DOI: 10.1016/j.redox.2018.101091] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/20/2018] [Accepted: 12/20/2018] [Indexed: 12/13/2022] Open
Abstract
Metabolic syndrome (MetS) is a constellation of cardiometabolic risk factors, which together predict increased risk of more serious chronic diseases. We propose that one consequence of dietary overnutrition is increased abundance of Gram-negative bacteria in the gut that cause increased inflammation, impaired gut function, and endotoxemia that further dysregulate the already compromised antioxidant vitamin status in MetS. This discussion is timely because "healthy" individuals are no longer the societal norm and specialized dietary requirements are needed for the growing prevalence of MetS. Further, these lines of evidence provide the foundational basis for investigation that poor vitamin C status promotes endotoxemia, leading to metabolic dysfunction that impairs vitamin E trafficking through a mechanism involving the gut-liver axis. This report will establish a critical need for translational research aimed at validating therapeutic approaches to manage endotoxemia-an early, but inflammation-inducing phenomenon, which not only occurs in MetS, but is also prognostic of more advanced metabolic disorders including type 2 diabetes mellitus, as well as the increasing severity of nonalcoholic fatty liver diseases.
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Guo VYW, Yu EYT, Wong CKH, Sit RWS, Wang JHL, Lam CLK. Hypertriglyceridaemic-waist phenotype and risk of diabetes in people with impaired fasting glucose in primary care: a cohort study. Diabet Med 2018; 35:576-582. [PMID: 29438572 DOI: 10.1111/dme.13601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2018] [Indexed: 01/19/2023]
Abstract
AIM We aimed to determine the prospective association between baseline triglyceridaemic-waist phenotypes and diabetic mellitus incidence in individuals with impaired fasting glucose seen in primary care. METHODS A cohort of 1101 participants (84.4% of the recruited individuals) with impaired fasting glucose were recruited from three primary care clinics during regular follow-ups to monitor their chronic conditions. Baseline triglyceridaemic-waist phenotypes were divided into four groups: (1) normal waistline and triglyceride level (n = 252); (2) isolated central obesity (n = 518); (3) isolated high triglyceride level (n = 80); and (4) central obesity with high triglyceride level (i.e. hypertriglyceridaemic-waist phenotype) (n = 251). The presence of diabetes at follow-up was determined by fasting plasma glucose (≥ 7.0 mmol/l) and/or 2-h 75-g oral glucose tolerance test (≥ 11.1 mmol/l) and/or HbA1c (47.5 mmol/mol; ≥ 6.5%) according to American Diabetes Association diagnostic criteria. Multivariable Cox proportional hazards regressions were established to assess the impact of different triglyceridaemic-waist phenotypes on time to diabetes onset. RESULTS After a mean follow-up period of 6.5 months (sd 4.7 months), the number of diabetes cases was significantly higher in the group with hypertriglyceridaemic-waist phenotype (52.2%) compared with the other three phenotype groups (group 1: 28.2%; group 2: 34.6%; group 3: 30.0%). Only the hypertriglyceridaemic-waist phenotype showed an increased risk of developing diabetes (hazard ratio 1.581, 95% CI 1.172-2.134; P = 0.003) compared with the group with normal waistline and triglyceride level after controlling for confounders. CONCLUSIONS The combination of central obesity and hypertriglyceridaemia is associated with > 50% risk of progression to diabetes within 6 months among individuals with impaired fasting glucose seen in primary care.
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Affiliation(s)
- V Y-W Guo
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - E Y-T Yu
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - C K-H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - R W-S Sit
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - J H-L Wang
- Department of Family Medicine and Health Care, Hong Kong West Cluster Hospital Authority, Hong Kong
| | - C L-K Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
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