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Bélanger A, Desjardins C, Leblay L, Filiatrault M, Barbier O, Gangloff A, Leclerc J, Lefebvre J, Zongo A, Drouin-Chartier JP. Relationship Between Diet Quality and Statin Use Among Adults With Metabolic Syndrome From the CARTaGENE Cohort. CJC Open 2024; 6:11-19. [PMID: 38313338 PMCID: PMC10837700 DOI: 10.1016/j.cjco.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/24/2023] [Indexed: 02/06/2024] Open
Abstract
Background In metabolic syndrome (MetS), cardiovascular disease (CVD) risk reduction relies on the complementary use of diet and lipid-lowering medication. Evidence suggests that initiating such medication may impede diet quality. The objective of this study was to evaluate the relationship between diet quality and statin use among adults with MetS and free of CVD from the Province of Québec. Methods This cross-sectional study included 2481 adults with MetS (40-69 years of age) from the CARTaGENE Québec population-based cohort, of whom 463 self-reported using statin monotherapy. Diet was assessed using the Canadian Dietary History Questionnaire II, a food- frequency questionnaire, and diet quality was assessed using the Alternative Healthy Eating Index (AHEI). Results In multivariable-adjusted linear regression models, statin users had lower AHEI (%) compared with nonusers (users: 40.0; 95% confidence interval [CI], 38.9, 41.2 vs nonusers: 41.2; 95% CI, 40.4, 42.0; P = 0.03] because of a lower consumption of vegetables and whole grains. Stratified interaction analyses showed that the lower diet quality among statin users was mostly prevalent among men aged ≥ 50 years and women aged ≥ 60 years, among individuals with annual household incomes of < $50,000 and persons who self-reported history of high blood pressure. Conclusions In this cohort of adults with MetS from Quebéc, the use of statin monotherapy in primary prevention of CVD was associated with a slightly lower diet quality. These data suggest suboptimal complementarity between diet quality and use of cholesterol-lowering medication in primary prevention of CVD in MetS.
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Affiliation(s)
- Amélie Bélanger
- NUTRISS (Nutrition, Health and Society) Research Centre, Institute on Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
| | - Clémence Desjardins
- NUTRISS (Nutrition, Health and Society) Research Centre, Institute on Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
| | - Lise Leblay
- NUTRISS (Nutrition, Health and Society) Research Centre, Institute on Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
| | | | - Olivier Barbier
- NUTRISS (Nutrition, Health and Society) Research Centre, Institute on Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
- CHU de Québec-Laval University Research Center, Québec City, Québec, Canada
| | - Anne Gangloff
- CHU de Québec-Laval University Research Center, Québec City, Québec, Canada
- Faculty of Medicine, Laval University, Québec City, Québec, Canada
| | - Jacinthe Leclerc
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
- Research Center, Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Québec, Canada
| | - Jean Lefebvre
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
| | - Arsène Zongo
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
- CHU de Québec-Laval University Research Center, Québec City, Québec, Canada
| | - Jean-Philippe Drouin-Chartier
- NUTRISS (Nutrition, Health and Society) Research Centre, Institute on Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
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Desjardins C, Leblay L, Bélanger A, Filiatrault M, Barbier O, Guénette L, Leclerc J, Lefebvre J, Zongo A, Drouin-Chartier JP. Relationship Between Diet Quality and Glucose-Lowering Medication Intensity Among Adults With Type 2 Diabetes: Results From the CARTaGENE Cohort. CJC Open 2024; 6:20-29. [PMID: 38313340 PMCID: PMC10837702 DOI: 10.1016/j.cjco.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/24/2023] [Indexed: 02/06/2024] Open
Abstract
Background In real-world settings, whether diet and medication are used as complements for glycemic management in type 2 diabetes (T2D) remains unclear. This study assessed the relationship between diet quality and intensity of glucose-lowering medication among adults with T2D. Methods This cross-sectional study included 352 adults with T2D from the CARTaGENE Québec population-based cohort. Diet quality was assessed using the Healthful Plant-Based Diet Index (hPDI). Glucose-lowering medication intensity was graded according to self-reported information on the type and number of drugs: no medication; oral monotherapy; oral polytherapy; and insulin with and without oral medication. In the subsample of 239 individuals who reported the medication dosages, intensity was also graded using the Medication Effect Score (MES). Results In multivariable-adjusted models, we found no evidence of a relationship between the hPDI and medication intensity, assessed using the categorical approach (Pbetween-group = 0.25) or the MES (P = 0.43). However, the hPDI was inversely associated with the MES among men < 50 years of age and women < 60 years (β1-point MES = -2.24 [95% confidence interval, -4.46, -0.02] hPDI points), but not among older individuals (β = -0.03 [-1.28, 1.21] hPDI points). Evidence of a nonsignificant inverse relationship between the hPDI and HbA1c was observed (β10-point hPDI = -0.23% [-0.63, 0.17]), whereas a positive and significant association between the MES and hemoglobin (Hb)A1c was found (β1-point MES = 0.30% [0.10, 0.51]). Conclusions In this cohort of adults with T2D, there was an overall lack of complementarity between diet quality and intensity of glucose-lowering medication. The issue was particularly important among younger adults for whom diet quality was inversely associated with intensity of medication.
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Affiliation(s)
- Clémence Desjardins
- Nutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, Québec, Canada
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
| | - Lise Leblay
- Nutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, Québec, Canada
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
| | - Amélie Bélanger
- Nutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, Québec, Canada
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
| | | | - Olivier Barbier
- Nutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, Québec, Canada
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
- CHU de Québec-Université Laval Research Center, Québec City, Québec, Canada
| | - Line Guénette
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
- CHU de Québec-Université Laval Research Center, Québec City, Québec, Canada
| | - Jacinthe Leclerc
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
- Research Center, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec City, Québec, Canada
| | - Jean Lefebvre
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
| | - Arsène Zongo
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
- CHU de Québec-Université Laval Research Center, Québec City, Québec, Canada
| | - Jean-Philippe Drouin-Chartier
- Nutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, Québec, Canada
- Faculty of Pharmacy, Laval University, Québec City, Québec, Canada
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