Consumption of Monounsaturated Fat from Plant Sources is Associated with an Elevated Risk of Type 2 Diabetes: Findings from Oriental Population-Based Nationwide Cohort

Abstract

Background: Although high dietary intake of monounsaturated fatty acids (MUFAs) has been shown to improve glycemic control and lipid profiles, whether MUFA consumption from different sources is linked to type 2 diabetes (T2D) development remains unclear. Methods: A total of 15,022 healthy Chinese adults, aged ≥20 y, from China Health and Nutrition Survey (CHNS) at entry in 1997, 2000, 2004, 2006 or 2009 round were followed up until the year 2011. Consumption of MUFA from plant and animal sources was assessed using 3-day 24-hr recalls in each survey and cumulative average of intake was calculated. Findings: During a median of 14 years of follow-up, 1,014 incident T2D cases were documented. Intake of plant-derived MUFA (P-MUFA) was associated with a higher risk of T2D [HR Q4 vs Q1 (95% CI): 1.50 (1.18, 1.90); P-trend=0.0013], whereas animal-derived MUFA (A-MUFA) showed no significant association with T2D risk (P-trend=0.30). For individual MUFAs, plant-derived oleic acid (P-OA) and palmitoleic acid (P-PA) intakes were positively related to T2D risk [HR Q4 vs Q1 (95% CI): 1.56 (1.20, 2.02) and 1.58 (1.23, 2.03) for P-OA and P-PA, respectively]. In contrast, PA from animal sources had a strong inverse association with T2D risk (P-trend<0.0001). Isocalorically replacing the sum of saturated fat and A-MUFAs with P-MUFAs (5% of energy) was related to a 26% higher T2D risk. Interpretation: Intake of MUFAs from plant sources, including OA and PA, may elevate T2D risk in Chinese population. Funding Statement: This work was supported by the National Natural Science Foundation of China (grant no. 81773419). Declaration of Interests: There is no conflict of interest to be declared for all authors. Ethics Approval Statement: The survey was approved by the institutional review committees of the University of North Carolina and the National Institute of Nutrition and Food Safety at Chinese Center for Disease Control and Prevention. Informed consent was obtained from all the participants.