Abstract

BackgroundMetabolic alterations correlate with adverse outcomes in type 2 diabetes. Dietary modification serves as an integral part in its treatment.ObjectiveWe examined the relationships among dietary patterns, dietary biomarkers, and metabolic indicators in type 2 diabetes (n = 871).DesignDiabetic patients (n = 871) who provided complete clinical and dietary data in both 2008 and 2009 were selected from a cohort participating in a diabetic control study in Taiwan. Dietary data were obtained using a short, semiquantitative food frequency questionnaires, and dietary pattern identified by factor analysis. Multiple linear regressions were used to analyze the association between dietary biomarkers (ferritin, folate, and erythrocyte n-3 polyunsaturated fatty acids [n-3 PUFAs]) and metabolic control upon adjusting for confounders.ResultsThree dietary patterns (high-fat meat, traditional Chinese food–snack, and fish–vegetable) were identified. Ferritin correlated positively with high-fat meat factor scores (P for trend <0.001). Erythrocyte n-3 PUFAs (eicosapentaenoic acid [EPA] + docosahexaenoic acid [DHA], n-3/n-6 PUFA ratio) correlated positively with fish–vegetable factor scores (all P for trends <0.001). Multiple linear regressions revealed a positive relationship between ferritin concentrations and fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and triglycerides, but a negative relationship with high-density lipoprotein cholesterol (HDL-C). Erythrocyte n-3 PUFA, EPA+DHA, and n-3/n-6 PUFA ratio were negatively linked to FPG, HbA1c, and triglycerides (all P < 0.05) and positively with HDL-C (though n-3/n-6 ratio marginally correlated).ConclusionsFerritin and n-3 PUFA can serve as valid biomarkers for high-fat meat and fish–vegetable dietary patterns. Unlike ferritin, erythrocyte n-3 PUFA status was related to better glycemic and blood lipid profiles. Our results suggest that habitual consumption of diet pattern rich in fish and vegetables may contribute in part to a healthier metabolic profile in type 2 diabetes.

Highlights

  • Metabolic alterations correlate with adverse outcomes in type 2 diabetes

  • This study was aimed to investigate the relationships between various dietary patterns, the dietary biomarkers, and measurement of glycemic control and lipid control (­triglyceride and high-density lipoprotein cholesterol (HDL-C)) in patients with type 2 diabetes in Taiwan

  • The high-fat meat dietary pattern scores were positively correlated with diastolic blood pressure (DBP), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), ferritin, n-3 PUFAs, eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA), and n-3/n-6 PUFA ratio, and negatively correlated with HDL-C and folate in a dose responsive manner

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Summary

Introduction

Metabolic alterations correlate with adverse outcomes in type 2 diabetes. Dietary modification serves as an integral part in its treatment. Multiple linear regressions were used to analyze the association between dietary biomarkers (ferritin, folate, and erythrocyte n-3 polyunsaturated fatty acids [n-3 PUFAs]) and metabolic control upon adjusting for confounders. Results: Three dietary patterns (high-fat meat, traditional Chinese food–snack, and fish–vegetable) were identified. Ferritin correlated positively with high-fat meat factor scores (P for trend

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