Abstract
AimTo investigate the association of major dietary patterns with glucose and insulin homeostasis parameters in a large American sample. The association between dietary patterns (DP) derived via principal components analysis (PCA), with glucose/insulin homeostasis parameters was assessed. The likelihood of insulin resistance (IR) across the DPs quarters was also explored.MethodThe United States National Health and Nutrition Examination Survey (NHANES) participants during 2005–2012 were included if they underwent measurement of dietary intake as well as glucose and insulin homeostasis parameters. Analysis of covariance (ANCOVA) and adjusted logistic and linear regression models were employed to account for the complex survey design and sample weights.ResultsA total of 24,182 participants were included; 48.9% (n = 11,815) were men. Applying PCA revealed three DP (56.8% of variance): the first was comprised mainly of saturated fat (SFA), total fat, mono-unsaturated fatty acids (MUFA) and carbohydrate (CHO); the second is highly enriched with vitamins, trace elements and dietary fiber; and the third was composed of polyunsaturated fatty acids (PUFA), cholesterol and protein. Among the total population, after adjustment for age, sex, race, C-reactive protein, smoking, and physical activity, glucose homeostasis factors, visceral adiposity index and lipid accumulation product improved across the quarters of the first and third DP; and a reverse pattern with the second DP. The same trend was observed for the non-diabetic subjects. Moreover, subjects with higher adherence to the first and third DP had higher likelihood for developing IR, whereas there was a lower likelihood for the second DP.ConclusionThis study shows that the DP heavily loaded with CHO, SFA, PUFA, protein, total fat and MUFA as well as high-cholesterol-load foods is associated with impaired glucose tolerance; in contrast, the healthy pattern which is high in vitamins, minerals and fiber may have favourable effects on insulin sensitivity and glucose tolerance.
Highlights
Background βCell dysfunction and hyperinsulinaemia are involved in the development of diabetes mellitus (DM) [1,2,3]
Applying principal components analysis (PCA) revealed three dietary patterns (DP) (56. 8% of variance): the first was comprised mainly of saturated fat (SFA), total fat, mono-unsaturated fatty acids (MUFA) and carbohydrate (CHO); the second is highly enriched with vitamins, trace elements and dietary fiber; and the third was composed of polyunsaturated fatty acids (PUFA), cholesterol and protein
After adjustment for age, sex, race, C-reactive protein, smoking, and physical activity, glucose homeostasis factors, visceral adiposity index and lipid accumulation product improved across the quarters of the first and third DP; and a reverse pattern with the second DP
Summary
Cell dysfunction and hyperinsulinaemia are involved in the development of diabetes mellitus (DM) [1,2,3]. The triglycerides/glucose index (TyG), a product of triglycerides (TG) and fasting blood glucose (FBG), has been used as an alternative marker of IR among adults [4, 5]. Recent investigation has reported that the TyG index could be a better alternative marker of IR among adolescents compared with the homeostatic model assessment-insulin resistance (HOMA-IR) [5]. There are complex interactions between social, behavioural, cultural, physiological, metabolic and genetic factors that are involved in the development of dysglycaemia and hyperinsulinaemia. It is widely accepted that dietary factors are important in preventing impaired glucose metabolism [6, 7]. Limited nutritional epidemiological research has been conducted to examine long-term effects of diet on glucose and insulin
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