Prospective associations of dietary carbohydrate, fat, and protein intake with \u03b2-cell function in the CODAM study

Louise J C J Den Biggelaar,Ele Ferrannini,Simone J S Sep,Simone J P M Eussen,Ilja C W Arts,Carla J Van Der Kallen,Pieter C Dagnelie,Marleen M Van Greevenbroek,Andrea Mari,Coen D A Stehouwer,Casper G Schalkwijk

doi:10.1007/s00394-018-1644-y

Abstract

PurposeType 2 diabetes mellitus (T2DM) is characterized by both impaired pancreatic β-cell function (BCF) and insulin resistance. In the etiology of T2DM, BCF basically determines whether a person with a certain degree of insulin resistance develops T2DM, as β-cells are able to compensatorily increase insulin secretion. The effects of dietary intake on BCF are largely unknown. Our study aim was to investigate whether dietary macronutrient intake predicts BCF.MethodsProspective data (median follow-up 7 years) of 303 individuals recruited from the CODAM study population (aged 40–70 years, 39% women) were analyzed. BCF was measured by C-peptide deconvolution and physiological modeling of data from a 5-point, 75-g, 2-h oral glucose tolerance test. Macronutrient intake was estimated by a 178-item Food Frequency Questionnaire.ResultsAssociations adjusted for relevant covariates of baseline macronutrient intake with model-derived parameters describing BCF (glucose sensitivity, rate sensitivity or potentiation) or C-peptidogenic index were detected for trans fat [standardized regression coefficient (95%-CI) glucose sensitivity − 0.14 (− 0.26, − 0.01)] per g, cholesterol [potentiation 0.20 (0.02, 0.37)] per 100 mg, dietary fiber [glucose sensitivity 0.21 (0.08, 0.33)] per 10 g, MUFA glucose sensitivity 0.16 (0.02, 0.31) per 10 g, and polysaccharide [potentiation − 0.24 (− 0.43, − 0.05), C-peptidogenic index − 0.16 (− 0.29 − 0.03); odds ratio lowest versus highest tertile (95%-CI) rate sensitivity 1.51 (1.06, 2.15)) per 50 g.ConclusionsIn this population at high risk for developing T2DM, polysaccharide and trans fat intake were associated with worse BCF, whereas increased intake of MUFA, dietary cholesterol, and fiber were associated with better BCF.

Highlights

The number of people with type 2 diabetes mellitus (T2DM) is expected to rise from 366 million worldwide in 2011 to 552 million in 2030 [1]
normal glucose metabolism (NGM), prediabetes, and newly diagnosed T2DM were present in 65.3%, 26.1%, and 8.6% of the final study population, respectively
Results revealed that trans fat and polysaccharide intake were associated with worse BCF, and MUFA, dietary cholesterol and fiber intake with better BCF

Summary

Introduction

The number of people with type 2 diabetes mellitus (T2DM) is expected to rise from 366 million worldwide in 2011 to 552 million in 2030 [1] This enormous rise in T2DM prevalence will most likely be accompanied by an increase in T2DM complications and associated diseases, including cardiovascular disease, neuropathy, nephropathy, and retinopathy, and reduced life expectancy [2–4]. Lifestyle modification, including eating healthier diets, has been suggested to reduce the risk of developing T2DM by 40–70% [5]. A reduced intake of total fat, saturated fat, trans fat, cholesterol, mono- and disaccharides, and an increased intake of fiber, MUFA and PUFA is recommended by several organizations, including the American Diabetes Association [6], Canadian Diabetes Association [7] and Diabetes and Nutrition Study Group of the European Association for the Study of Diabetes [8]

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