Abstract
Blood lipids play a critical role in the pathogenesis of type 2 diabetes, and they are closely related to dietary factors. However, the associations between blood lipids-related dietary patterns and risk of type 2 diabetes are controversial and not fully clear. In this study, we aimed to derive dietary patterns that explained variation in blood lipids and to investigate their associations with incident type 2 diabetes. The analysis was based on 39,000 women and 25,777 men participating in the Lifelines cohort study (aged 18-65 years, mean 43.2 years for women and 43.5 years for men). Dietary intake was measured using a 110-item semi-quantitative food frequency questionnaire. Reduced rank regression was used to derive dietary patterns with blood lipids (HDL-cholesterol, LDL-cholesterol, triglycerides, total cholesterol, and total cholesterol:HDL-cholesterol ratio) as response variables for women and men separately. The first dietary pattern identified for each sex was selected because they explained the largest variance in blood lipids. The associations between the identified dietary patterns and incident type 2 diabetes were subsequently investigated using multivariate logistic regression models. All analyses were performed separately for women and men. During an average follow-up of 43 months, 479 new cases (incidence 0.74%) of type 2 diabetes were identified. Using reduced rank regression, we identified two sex-specific blood lipids-associated dietary patterns characterized by high intake of sugary beverages, added sugar, and low intake of vegetables, fruits, tea, and nuts/seeds. These two sex-specific dietary patterns were similar in food groups but differed in factor loadings. High dietary pattern scores were associated with increased risk of type 2 diabetes after adjustment for age, total energy intake, body mass index, waist-hip ratio, and blood pressure (ORs for the fifth quintile [Q5] using the first quintile [Q1] as reference, 1.87 [95% CI 1.23, 2.83] for women [P-trend<0.001], and 1.72 [95% CI 1.11, 2.66] for men [P-trend=0.018]). The associations were attenuated but remained significant after further adjustment for lifestyle and socio-economic factors. Dietary patterns associated with adverse blood lipids are associated with incidence of type 2 diabetes. The present study provides new insights in optimizing blood lipids for the prevention of type 2 diabetes through dietary approaches.
Highlights
Using rank regression (RRR), we derived two sex-specific simplified dietary pattern scores that were negatively associated with HDLcholesterol, but positively associated with LDL-cholesterol, triglycerides, total cholesterol, and total cholesterol:HDL-cholesterol ratio
We identified two sex-specific dietary patterns that explained the variation in blood lipids and were significantly associated with incident type 2 diabetes in a large population-based sample
We identified dietary patterns characterized by high intake of sugary beverages, added sugar, and juice; and low intake of fruits, vegetables, nuts/seeds, cereals, and tea
Summary
May be prioritized as a better intervention target Several dietary factors, such as saturated fatty acids and simple carbohydrates, have been found to have long-term detrimental effects on blood lipid profiles, independent of weight change [13,14]. We identified two sex-specific blood lipids-associated dietary patterns characterized by high intake of sugary beverages, added sugar, and low intake of vegetables, fruits, tea, and nuts/seeds. These two sex-specific dietary patterns were similar in food groups but differed in factor loadings.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
