Abstract
Identification of diet and lifestyle risk factors for prevention of type 2 diabetes mellitus (T2DM) is of great importance. The specific role of dietary cholesterol (DC) in T2DM risk is unclear. This study uses data from 2192 Framingham Offspring Study subjects to estimate the effects of DC alone and in combination with markers of a healthy diet and other lifestyle factors on fasting glucose and risk of T2DM or impaired fasting glucose (IFG) over 20 years of follow-up. Dietary data were derived from two sets of three-day food records. Statistical methods included mixed linear regression and Cox proportional hazard’s modeling to adjust for confounding. There were no statistically significant differences in glucose levels over 20 years of follow-up across DC intake categories (<200, 200–<300, and ≥300 mg/day) and no increased risk of T2DM/IFG associated with higher intakes. The HR for T2DM/IFG associated with consumption of ≥300 mg/day of DC was 0.87 (95% CI: 0.68–1.10). In contrast, subjects with lower intakes of fish, whole grains, and fiber had higher T2DM/IFG risk. DC consumption was not associated with fasting glucose levels or risk of T2DM/IFG over 20 years of follow-up.
Highlights
Fasting blood glucose levels in healthy individuals are maintained within a relatively narrow physiological range
While evidence suggests that healthy dietary factors including fruits and vegetables, whole grains, fiber, and fish seem to lower the risk of type 2 diabetes mellitus (T2DM) and Impaired fasting glucose (IFG) [6,7], other factors such as the macronutrient composition of the diet [8,9,10,11] and dietary cholesterol (DC) are less well understood
The current study aims to examine the effects of DC on glucose levels and the risk of IFG and
Summary
Fasting blood glucose levels in healthy individuals are maintained within a relatively narrow physiological range. Beginning in the 1960s, United States Dietary Guidelines recommended limiting intake of DC to no more than 300 mg per day for the prevention of cardiovascular disease [16,17] These restrictions were removed in the 2015 Guidelines, some questions remain about the effects of DC on glucose regulation [18]. Some earlier studies have suggested that excess DC intake among individuals with prevalent diabetes may have adverse effects on both lipids and glucose [19,20] while an analysis of healthy subjects in the Iowa Women’s Health Study found that higher DC intake was linked with a higher risk of T2DM [21]. Potential modification by selected markers of a healthy diet and lifestyle factors such as physical activity is explored
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