Abstract
Previous studies suggested that dietary polyphenols could reduce the incidence and complications of type-2 diabetes (T2D); although the evidence is still limited and inconsistent. This work analyzes whether changing to a diet with a higher polyphenolic content is associated with an improved glucose profile. At baseline, and at 1 year of follow-up visits, 5921 participants (mean age 65.0 ± 4.9, 48.2% women) who had overweight/obesity and metabolic syndrome filled out a validated 143-item semi-quantitative food frequency questionnaire (FFQ), from which polyphenol intakes were calculated. Energy-adjusted total polyphenols and subclasses were categorized in tertiles of changes. Linear mixed-effect models with random intercepts (the recruitment centers) were used to assess associations between changes in polyphenol subclasses intake and 1-year plasma glucose or glycosylated hemoglobin (HbA1c) levels. Increments in total polyphenol intake and some classes were inversely associated with better glucose levels and HbA1c after one year of follow-up. These associations were modified when the analyses were run considering diabetes status separately. To our knowledge, this is the first study to assess the relationship between changes in the intake of all polyphenolic groups and T2D-related parameters in a senior population with T2D or at high-risk of developing T2D.
Highlights
The prevalence of diabetes is experiencing an increasing trend, and in 2019 it was the ninth leading cause of death in the world
No significant differences across tertiles were observed regarding age, educational level, smoking habit, physical activity, diabetes status, glucose and HbA1c levels at baseline, and all groups had lower levels of glucose and HbA1c after one year. This is due to the interventions that all participants received, which were (1) an intensive weight-loss intervention based on an energy-restricted Mediterranean diet, individualized physical activity plan, and behavioral support or (2) an intervention based on the traditional Mediterranean diet and usual health care
Evidence is still limited, it has been suggested that the benefits of dietary polyphenols regarding type-2 diabetes (T2D) may include anti-inflammatory, antioxidant, and glucose metabolism regulatory effects, such as the inhibition of α-amylases and α-glucosidases, protection against glucose toxicity in pancreatic β-cells [17], and modulation of glucose transporter type-4 (GLUT4) receptors
Summary
The prevalence of diabetes is experiencing an increasing trend, and in 2019 it was the ninth leading cause of death in the world. The expectations for the forthcoming years are not encouraging since the prevalence of diabetes has been increasing over the past decades. Type-2 diabetes (T2D), the most prevalent type, can be prevented by modifying harmful behavioral risk factors such as smoking, an unhealthy diet, sedentarism, and alcohol abuse [1]. Healthy plant-based diets are based on the consumption of large amounts of whole grains, fruits, vegetables, legumes, and nuts, as well as healthy fats such as extra virgin olive oil, which are associated with a lower risk of developing cardiovascular disease and In the search for the best dietary pattern to prevent or stop the progression of T2D, plant-based diets such as Mediterranean-style, vegetarian or vegan diets have been studied in several prospective observational studies and clinical trials [2].
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