Abstract
Background The overall dietary quality, as well as the dietary total antioxidant capacity (DTAC), deserves central attention in the management of borderline high glucose levels since nonpharmacological strategies are imperative in this regard. Thus, we aimed to investigate the association between prediabetes with dietary quality and DTAC. Methods A case-control study was conducted on 49 patients with prediabetes and 98 controls. Demographics, anthropometric measures, and fasting blood glucose levels of all participants were obtained. Participants completed a validated 80-item food frequency questionnaire (FFQ). DTAC scores were generated using FFQ data, and Healthy Eating Index-2015 (HEI-2015) was used as a diet quality index. The lowest tertile of HEI-2015 and DTAC was considered as the reference category, and logistic regression was used to estimate the relationship between prediabetes with HEI-215 and DTAC. Results Mean age and body mass index of participants were 47.42 ± 15.98 years and 27.90 ± 4.96 kg/m2. Patients with prediabetes had lower DTAC scores when compared to controls (11.86 ± 5.77 and 17.81 ± 12.08, P = 0.01). There was a significant inverse association between the highest tertile of the DTAC score when compared with the lowest tertile in crude (OR = 0.11; 95% CI: 0.03–0.43), age-adjusted (OR = 0.13; 95% CI: 0.03–0.48), and fully adjusted (OR = 0.09; 95% CI: 0.02–0.53) models. In contrast, there was no difference between HEI-2015 in patients with prediabetes when compared to controls (74.41 ± 8.91 and 74.41 ± 9.35, respectively; P = 0.85). Correspondingly, no difference was observed between the highest tertile of the HEI-2015 score when compared with the lowest tertile in crude (OR = 1.23; 95% CI: 0.53–2.86), age-adjusted (OR = 1.17; 95% CI: 0.48–2.82), and fully adjusted (OR = 1.53; 95% CI: 0.56–4.16) models. Conclusion This study demonstrates a clear association between prediabetes with less DTAC, but not with HEI-2015.
Highlights
Oxidative stress plays an substantial role in the pathogenesis of diabetes and its complications, including diabetic neuropathy, nephropathy, retinopathy, and macrovascular complications, among a multitude of related problems [1, 2]
Diabetes remains a burden of public health worldwide; as such, in 2019, almost half a billion people (463 million people) around the world suffered from diabetes, whereas the prevalence is estimated to rise by 25% in 2030 and 51% in 2045 [4]. e prevalence of prediabetes has been increasing with a forecast of >470 million people with prediabetes in 2030 [5]
Cases and controls were classified into tertile categories based on their Healthy Eating Index (HEI)-2015 and dietary total antioxidant capacity (DTAC) scores. e cutoff for each category was as follows: HEI-2015: T1 ≤ 71.23, T2: 71.23–78.21, and T3 > 78.21 and DTAC: T1 ≤ 11.90, T2: 11.90–21.24, and T3 > 21.24. e odds ratios (ORs) for prediabetes based on its association with HEI-2015 and DTAC tertiles are derived in Table 3, with T1 considered as the reference category (i.e., OR 1)
Summary
Oxidative stress plays an substantial role in the pathogenesis of diabetes and its complications, including diabetic neuropathy, nephropathy, retinopathy, and macrovascular complications, among a multitude of related problems [1, 2]. Given the relevance of nonpharmacological strategies against prediabetes, one must be mindful of the need to ameliorate the diet quality based on a constellation of popular food groups alongside the dietary antioxidants as a myriad of essential (e.g., magnesium, zinc, chromium, calcium, potassium, and vitamin D) and functional (e.g., flavonoids and phenolic acids) nutrients can improve glucose metabolism [8,9,10,11,12] or even attenuate glucose absorption, a role played by fiber intake [13]
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