Abstract
Background: Although daily total dietary nutrient intakes were potentially important factors in maintaining glycemic balance, their overall effect on glycemic control was still unclear among American adults. Objectives: We aimed to examine the association between daily total dietary nutrient intake and recent glycemic control status (RGCS). Methods: This cohort was composed of 41,302 individuals from the National Health and Nutrition Examination Survey (NHANES). The daily total intake of dietary nutrients and RGCS were independent and dependent variables, respectively. To evaluate their association, we carried out binary logistic regression, model fitting, linear discriminant analysis, and the receiver operator characteristic (ROC) analysis. Results: The result of robust check model showed that only the daily total dietary vitamin B6 intake (adjusted OR = 0.848; 95% CI: 0.738, 0.973; p-value = 0.019) was significantly negatively correlated with RGCS. When daily total dietary vitamin B6 intake and glycosylated hemoglobin (HbA1c) were used as independent variables and dependent variables, respectively, to fit the curves and lines, the established robust check model could distinguish American adults with different RGCS well. Moreover, the robust check model results of ROC analysis indicated that daily total dietary vitamin B6 intake might be a potential predictor for RGCS (AUC = 0.977; 95% CI: 0.974, 0.980; p-value < 0.001). Conclusions: This study showed that only daily total dietary vitamin B6 intake was a beneficial factor in RGCS, but it might need further multicenter or prospective studies to verify whether vitamin B6 had biological implications and public health meaning for glycemic control among American adults (specifically referred to non-pregnant participants over 20 years old).
Highlights
Dietary nutrients play an important role in maintaining the balance of blood glucose as a necessary substance to regulate the normal physiological function of the body, being roughly divided into macronutrients [1,2,3], dietary fiber [4,5,6], minerals [7,8,9], and vitamins [10,11,12,13]
All details about the database could be efficiently acquired at http://www.cdc.gov/nchs/nhanes/, including relevant information such as strict quality control measures for the questionnaire data undertaken by National Health and Nutrition Examination Survey (NHANES)
We performed model fitting with the glycosylated hemoglobin (HbA1c) index as the dependent variable, and receiver operator characteristic (ROC) analysis was performed to calculate the area under the curve (AUC)
Summary
Dietary nutrients play an important role in maintaining the balance of blood glucose as a necessary substance to regulate the normal physiological function of the body, being roughly divided into macronutrients [1,2,3], dietary fiber (as an independent factor that distinguishes carbohydrates, included in this study) [4,5,6], minerals [7,8,9], and vitamins [10,11,12,13]. Most of the research conclusions on the association between daily total nutrient intake and RGCS have been one-sided. They did not analyze the overall effect of various nutrients on RGCS but analyzed minerals, vitamins, and macronutrients separately, which was not complete and systematic, and might have even led to obtaining inconsistent conclusions [23,24]. Findings on the association between daily total dietary nutrient intake and RGCS were inconsistent and not enough to prove the relationship, these results, to a certain extent, could supply research hypotheses for future large-scale prospective or multi-center verification. We conducted the follow-up sampling survey study to estimate the association between daily total nutrient intake and RGCS among non-pregnant adults 20+ years old using a large-scale database from National Health and Nutrition Examination Survey (NHANES 1999–2018, except for 2003–2004)
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