scholarly journals Mushroom consumption, biomarkers, and risk of cardiovascular disease and type 2 diabetes: a prospective cohort study of US women and men

2019 ◽  
Vol 110 (3) ◽  
pp. 666-674 ◽  
Author(s):  
Dong Hoon Lee ◽  
Meng Yang ◽  
Edward L Giovannucci ◽  
Qi Sun ◽  
Jorge E Chavarro
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Chronic Diseases ◽  
Prospective Cohort ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Potential Health ◽  
Cardiometabolic Diseases

ABSTRACT Background Mushrooms are good dietary sources of important vitamins, minerals, and bioactive compounds which may be important in the prevention of chronic diseases. However, studies have not prospectively evaluated the potential health effects of mushrooms with respect to major cardiometabolic diseases. Objectives The aim of this study was to examine the association of mushroom consumption with major cardiometabolic diseases and mediating biomarkers in 2 large prospective US cohorts. Methods We followed 67,139 women from the Nurses’ Health Study (1986–2012) and 43,541 men from the Health Professionals Follow-up Study (1986–2012) who were free of chronic diseases. Mushroom consumption was assessed at baseline through the use of a food-frequency questionnaire. Cardiometabolic biomarkers were collected in subpopulations of the 2 cohorts. Cox proportional hazards models were used to estimate HRs and 95% CIs of cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke, and type 2 diabetes (T2D), associated with mushroom consumption. Results We identified total 11,894 CVD (7,616 CHD; 4,278 stroke), and 10,206 T2D cases in >2 million person-years of follow-up. In the pooled multivariable-adjusted analysis, participants who consumed ≥5 servings of mushrooms per week had no significantly different risk of total CVD (HR: 1.02; 95% CI: 0.91, 1.14), CHD (HR: 1.00; 95% CI: 0.87, 1.16), stroke (HR: 1.05; 95% CI: 0.87, 1.25), or T2D (HR: 1.04; 95% CI: 0.93, 1.16) than participants who consumed mushrooms <1 time/mo. We consistently found no association between mushroom consumption and the aforementioned cardiometabolic diseases, in subgroups of sex, lifestyle factors, and medical conditions. Moreover, mushroom consumption was not associated with plasma biomarkers of lipids, insulin, and inflammation. Conclusions We found no association of mushroom consumption with biomarkers and risks of CVD and T2D in US adults. More large prospective cohort studies are warranted to investigate this association in other racial/ethnic groups.

scholarly journals Restricted AccessChanges in Plant-Based Diet Indices and Subsequent Risk of Type 2 Diabetes in Women and Men: Three U.S. Prospective Cohorts

2021 ◽  
Author(s):  
Zhangling Chen ◽  
Jean-Philippe Drouin-Chartier ◽  
Yanping Li ◽  
Megu Y. Baden ◽  
JoAnn E. Manson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Diabetes Risk ◽  
Health Study ◽  
Weight Changes ◽  
Subsequent Risk

<b>Objective</b> <p>We evaluated the associations between changes in plant-based diets and subsequent risk of type 2 diabetes.</p> <p><b>Methods</b></p> <p>We prospectively followed 76,530 women in the Nurses’ Health Study (NHS, 1986-2012), 81,569 women in NHS II (1991-2017), and 34,468 men in the Health Professionals’ Follow-up Study (1986-2016). Adherence to plant-based diets was assessed every 4 years using the overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI). We used multivariable Cox proportional hazards models to estimate hazard ratios (HRs). Results of the three cohorts were pooled using meta-analysis.</p> <p><b>Results</b></p> <p>We documented 12,627 cases of type 2 diabetes during 2,955,350 person-years of follow-up. <a>After adjustment for initial BMI, initial and 4-year changes in alcohol intake, smoking, physical activity, and other factors, </a><a>compared with participants whose indices remained relatively stable (±3%), </a><a>participants with the largest decrease (>10%) in PDI and hPDI over 4 years had a 12%-23% higher diabetes risk in the subsequent 4 years (pooled HR: PDI, 1.12 (95% CI 1.05, 1.20), hPDI, 1.23 (1.16, 1.31)). </a>Each 10% increment in PDI and hPDI over 4 years was associated with a 7%-9% lower risk (PDI, 0.93 (0.91, 0.95), hPDI, 0.91 (0.87, 0.95)). Changes in uPDI were not associated with diabetes risk. Weight changes accounted for 6.0%-35.6% of the associations between changes in PDI and hPDI and diabetes risk. </p> <p><b>Conclusions</b></p> <p>Improving adherence to overall and healthful plant-based diets was associated with a lower risk of type 2 diabetes, whereas decreased adherence to such diets was associated with a higher risk. </p>

scholarly journals Dietary glucosinolates and risk of type 2 diabetes in 3 prospective cohort studies

2018 ◽  
Vol 107 (4) ◽  
pp. 617-625 ◽  
Author(s):  
Le Ma ◽  
Gang Liu ◽  
Laura Sampson ◽  
Walter C Willett ◽  
Frank B Hu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Prospective Cohort ◽  
Vegetable Consumption ◽  
Dietary Factors ◽  
Health Study ◽  
Cruciferous Vegetable ◽  
Dietary Risk Factors ◽  
Incident Cases

ABSTRACTBackgroundGlucosinolates are a group of phytochemicals that are abundant in cruciferous vegetables and precursors of the potentially chemopreventive isothiocyanates. Isothiocyanates may reduce oxidative stress and inflammation, but little is known regarding the association between glucosinolate intake and risk of type 2 diabetes (T2D).ObjectiveTo evaluate the association between the intake of glucosinolates and the incidence of T2D in US men and women.DesignThis prospective cohort study investigated 200,907 women and men [71,256 women from the Nurses’ Health Study (NHS; 1984–2012), 88,293 women from the NHS II (1991–2013), and 41,358 men from the Health Professionals Follow-Up Study (1986–2012)] who were free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed using validated semiquantitative food frequency questionnaires. Self-reported T2D incidence was confirmed by a supplementary questionnaire.ResultsDuring follow-up in the 3 cohorts, we accumulated 4,303,750 person-years and 16,567 incident cases of T2D. After adjustment for major lifestyle and dietary risk factors for T2D, participants in the highest quintile of total glucosinolate intake had a 19% higher risk (95% CI: 13%, 25%; Ptrend < 0.001) of T2D than did those in the lowest quintile. The intake of 3 major glucosinolate subtypes was consistently and significantly associated with T2D risk, with pooled HRs ranging from 1.13 to 1.18 (all Ptrend < 0.001). A significant association was also observed between total cruciferous vegetable consumption and T2D (HR: 1.16; 95% CI :1.07, 1.25; Ptrend < 0.001). These associations persisted in subgroups defined by demographic, lifestyle, and other dietary factors.ConclusionsDietary glucosinolate intake was associated with a moderately higher risk of T2D in US adults. These results need to be replicated in further investigations, including biomarker-based studies. Mechanistic research is also needed to understand the relation between exposures to glucosinolates, isothiocyanates, and other metabolites with T2D risk. This trial was registered at clinicaltrials.gov as NCT03366532.

scholarly journals Changes in Plant Based Diets and Subsequent Risk of Type 2 Diabetes: Results from 3 Large US Cohorts

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1387-1387
Author(s):  
Zhangling Cheng ◽  
Jean-Philippe Drouin-Chartier ◽  
Yanping Li ◽  
Megu Baden ◽  
JoAnn Manson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Proportional Hazards ◽  
Meta Analysis ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Weight Changes ◽  
Cox Proportional Hazards Models

Abstract Objectives Plant-based diets may lower type 2 diabetes (T2D) risk. Whether changes in adherence to plant-based diets are associated with subsequent T2D risk remains unknown. We aimed to evaluate the associations between 4 year changes in plant based diets and subsequent 4 year risk of T2D. Methods We prospectively followed 76,530 women in the Nurses’ Health Study (NHS, 1986–2012), 81,586 women in NHS II (1991–2017), and 34,468 men in the Health Professionals’ Follow-up Study (1986–2016). Diet was assessed every 4 years using validated food-frequency questionnaires. Adherence to plant-based diets was assessed using previously developed indices – the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI). Self reported T2D cases were validated by supplementary questionnaires. We used multivariable time dependent Cox proportional hazards models to estimate hazard ratios (HR) and 95% CIs for T2D associated with 4 year changes in adherence to plant based diets. Results of the three cohorts were pooled using an inverse variance-weighted meta-analysis. Results We documented 12,016 cases of T2D during 2818,485 person-years of follow-up. After adjustment for initial BMI, initial and 4-year changes in lifestyle and other factors, compared with participants whose indices remained relatively stable (±3%), participants with the largest 4-year decrease (&gt;10%) in PDI and hPDI had a 12%-23% higher T2D risk in the subsequent 4 years (HR for PDI, 1.12 (95% CI 1.05, 1.20), HR for hPDI, 1.23 (1.16, 1.31)). Conversely, each 10% incremental increase in PDI and hPDI over 4 years was associated with a 7%–9% lower T2D risk in subsequent 4 years (HR for PDI, 0.93 (0.90, 0.95), HR for hPDI, 0.91 (0.87, 0.95)). Changes in uPDI were not associated with T2D risk. Further adjustment for concurrent changes in body weight, a potential mediator, modestly attenuated the associations but results remained significant. We estimated that body weight changes explained 6.0%–36% of the associations between 4 year changes in PDI and hPDI and subsequent T2D risk. Conclusions Improving adherence to overall and healthful plant based diets over a 4 year period was associated with a lower T2D risk, whereas decreased adherence to overall and healthful plant based diets was associated with a higher T2D risk. Funding Sources Nutricia Research Foundation/NIH.

Abstract MP91: History of Infertility and Risk of Type 2 Diabetes Mellitus in Women

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Deirdre K Tobias ◽  
Frank B Hu ◽  
Stacey A Missmer ◽  
JoAnn E Manson ◽  
Jorge Chavarro
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Diseases ◽  
Effect Modification ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Male Factor ◽  
Tubal Blockage ◽  
History Of

Background: Increasing evidence supports a biologically plausible association between delayed conception and metabolic dysfunction, including insulin resistance and inflammation; however, few studies have assessed whether infertility is associated with metabolic diseases such as type 2 diabetes (T2D) later in life. Objective: We prospectively evaluated the association between a history of infertility and T2D risk in a large cohort of women. Methods: Participants of the Nurses’ Health Study II self-reported their infertility status (>12 months attempting a pregnancy), lifestyle characteristics, and several health-related outcomes, via biennial questionnaires (1989-2011). Those reporting infertility were asked to cite the clinical reason(s), if known. Exposure status was updated every two years and carried forward to represent “ever”. Cox proportional hazards models estimated the relative risk (HR) and 95% confidence interval (CI) comparing participants with a history of infertility versus none. Multivariable models adjusted for age, body mass index (BMI), physical activity, healthful dietary pattern score, smoking, alcohol consumption, and several other lifestyle factors. Results: Participants (N=115,750) were on average 35 years old (range 25-44) with a BMI of 24.1 (SD=5.0) at baseline, with 91.7% Caucasian. Twenty-one percent (n=24,118) reported a history of infertility at baseline or follow-up. Incident T2D was reported in 5,414 participants during follow-up (2.6 cases/1,000 person-years). Women with a history of infertility had a significant 21% greater risk of T2D compared to women without infertility after adjusting for several T2D risk factors (multivariable HR=1.21, CI=1.14, 1.29). Infertility due to ovulation disorders was associated with a 47% greater risk of T2D (HR=1.47, CI=1.33, 1.64), and tubal blockage with a 32% greater risk (HR=1.32, CI=1.09, 1.61), compared to no infertility. Other reasons for infertility were not associated with T2D risk, including cervical mucus disorder (HR=1.09, CI=0.80, 1.48), male factor (HR=1.13, CI=0.96, 1.32), and “other” (HR=1.08, CI=0.90, 1.28). Tests for interaction did not indicate significant effect modification across BMI categories for total infertility (BMI<25: HR=1.34, CI=1.03, 1.74; BMI 25-29: HR=1.38, CI=1.18, 1.60; BMI 30+: HR=1.15, CI=1.07, 1.34; p-interaction=0.13). Effect modification by BMI category was suggested for infertility due to ovulation disorders (BMI<25: HR=2.14, CI=1.58, 3.67; BMI 25-29: HR=1.43, CI=1.08, 1.89; BMI 30+: HR=1.35, CI=1.20, 1.52; p-interaction=0.06). Conclusions: Among women, a history of infertility is significantly associated with T2D later in life, specifically infertility due to ovulation disorders and tubal blockage.

scholarly journals Restricted AccessChanges in Plant-Based Diet Indices and Subsequent Risk of Type 2 Diabetes in Women and Men: Three U.S. Prospective Cohorts

2021 ◽  
Author(s):  
Zhangling Chen ◽  
Jean-Philippe Drouin-Chartier ◽  
Yanping Li ◽  
Megu Y. Baden ◽  
JoAnn E. Manson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Diabetes Risk ◽  
Health Study ◽  
Weight Changes ◽  
Subsequent Risk

<b>Objective</b> <p>We evaluated the associations between changes in plant-based diets and subsequent risk of type 2 diabetes.</p> <p><b>Methods</b></p> <p>We prospectively followed 76,530 women in the Nurses’ Health Study (NHS, 1986-2012), 81,569 women in NHS II (1991-2017), and 34,468 men in the Health Professionals’ Follow-up Study (1986-2016). Adherence to plant-based diets was assessed every 4 years using the overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI). We used multivariable Cox proportional hazards models to estimate hazard ratios (HRs). Results of the three cohorts were pooled using meta-analysis.</p> <p><b>Results</b></p> <p>We documented 12,627 cases of type 2 diabetes during 2,955,350 person-years of follow-up. <a>After adjustment for initial BMI, initial and 4-year changes in alcohol intake, smoking, physical activity, and other factors, </a><a>compared with participants whose indices remained relatively stable (±3%), </a><a>participants with the largest decrease (>10%) in PDI and hPDI over 4 years had a 12%-23% higher diabetes risk in the subsequent 4 years (pooled HR: PDI, 1.12 (95% CI 1.05, 1.20), hPDI, 1.23 (1.16, 1.31)). </a>Each 10% increment in PDI and hPDI over 4 years was associated with a 7%-9% lower risk (PDI, 0.93 (0.91, 0.95), hPDI, 0.91 (0.87, 0.95)). Changes in uPDI were not associated with diabetes risk. Weight changes accounted for 6.0%-35.6% of the associations between changes in PDI and hPDI and diabetes risk. </p> <p><b>Conclusions</b></p> <p>Improving adherence to overall and healthful plant-based diets was associated with a lower risk of type 2 diabetes, whereas decreased adherence to such diets was associated with a higher risk. </p>

scholarly journals Skin autofluorescence predicts new cardiovascular disease and mortality in people with type 2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Henderikus E. Boersma ◽  
Robert P. van Waateringe ◽  
Melanie M. van der Klauw ◽  
Reindert Graaff ◽  
Andrew D. Paterson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Fasting Blood Glucose ◽  
Multivariable Analysis ◽  
Oral Glucose ◽  
Skin Autofluorescence ◽  
Z Score

Abstract Background Skin autofluorescence (SAF) is a non-invasive marker of tissue accumulation of advanced glycation endproducts (AGE). Recently, we demonstrated in the general population that elevated SAF levels predict the development of type 2 diabetes (T2D), cardiovascular disease (CVD) and mortality. We evaluated whether elevated SAF may predict the development of CVD and mortality in individuals with T2D. Methods We included 2349 people with T2D, available baseline SAF measurements (measured with the AGE reader) and follow-up data from the Lifelines Cohort Study. Of them, 2071 had no clinical CVD at baseline. 60% were already diagnosed with diabetes (median duration 5, IQR 2–9 years), while 40% were detected during the baseline examination by elevated fasting blood glucose ≥7.0 mmol/l) and/or HbA1c ≥6.5% (48 mmol/mol). Results Mean (±SD) age was 57 ± 12 yrs., BMI 30.2 ± 5.4 kg/m2. 11% of participants with known T2D were treated with diet, the others used oral glucose-lowering medication, with or without insulin; 6% was using insulin alone. Participants with known T2D had higher SAF than those with newly-detected T2D (SAF Z-score 0.56 ± 0.99 vs 0.34 ± 0.89 AU, p < 0.001), which reflects a longer duration of hyperglycaemia in the former group. Participants with existing CVD and T2D had the highest SAF Z-score: 0.78 ± 1.25 AU. During a median follow-up of 3.7 yrs., 195 (7.6%) developed an atherosclerotic CVD event, while 137 (5.4%) died. SAF was strongly associated with the combined outcome of a new CVD event or mortality (OR 2.59, 95% CI 2.10–3.20, p < 0.001), as well as incidence of CVD (OR 2.05, 95% CI 1.61–2.61, p < 0.001) and death (OR 2.98, 2.25–3.94, p < 0.001) as a single outcome. In multivariable analysis for the combined endpoint, SAF retained its significance when sex, systolic blood pressure, HbA1c, total cholesterol, eGFR, as well as antihypertensive and statin medication were included. In a similar multivariable model, SAF was independently associated with mortality as a single outcome, but not with incident CVD. Conclusions Measuring SAF can assist in prediction of incident cardiovascular disease and mortality in individuals with T2D. SAF showed a stronger association with future CVD events and mortality than cholesterol or blood pressure levels.

Physical activity less than the recommended amount may prevent the onset of major biological risk factors for cardiovascular disease: a cohort study of 198 919 adults

2018 ◽  
Vol 54 (4) ◽  
pp. 238-244 ◽  
Author(s):  
David Martinez-Gomez ◽  
Irene Esteban-Cornejo ◽  
Esther Lopez-Garcia ◽  
Esther García-Esquinas ◽  
Kabir P Sadarangani ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Highly Active ◽  
Atherogenic Dyslipidaemia

ObjectivesWe examined the dose–response relationship between physical activity (PA) and incidence of cardiovascular disease (CVD) risk factors in adults in Taiwan.MethodsThis study included 1 98 919 participants, aged 18–97 years, free of CVD, cancer and diabetes at baseline (1997–2013), who were followed until 2016. At baseline, participants were classified into five PA levels: inactive’ (0 metabolic equivalent of task (MET)-h/week), ‘lower insufficiently active’ (0.1–3.75 MET-h/week), ‘upper insufficiently active’ (3.75–7.49 MET-h/week), ‘active’ (7.5–14.99 MET-h/week) and ‘highly active’ (≥15 MET-h/week]. CVD risk factors were assessed at baseline and at follow-up by physical examination and laboratory tests. Analyses were performed with Cox regression and adjusted for the main confounders.ResultsDuring a mean follow-up of 6.0±4.5 years (range 0.5–19 years), 20 447 individuals developed obesity, 19 619 hypertension, 21 592 hypercholesterolaemia, 14 164 atherogenic dyslipidaemia, 24 275 metabolic syndrome and 8548 type 2 diabetes. Compared with inactive participants, those in the upper insufficiently active (but not active) category had a lower risk of obesity (HR 0.92; 95% CI 0.88 to 0.95), atherogenic dyslipidaemia (0.96; 0.90 to 0.99), metabolic syndrome (0.95; 0.92 to 0.99) and type 2 diabetes (0.91; 0.86 to 0.97). Only highly active individuals showed a lower incidence of CVD risk factors than their upper insufficiently active counterparts.ConclusionCompared with being inactive, doing half the recommended amount of PA is associated with a lower incidence of several common biological CVD risk factors. Given these benefits, half the recommended amount of PA is an evidence based target for inactive adults.

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