Life Course Change Towards a Plant-Centered Diet and Incidence of Type 2 Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study (OR33-03-19)

Abstract Objectives There has been limited study of long-term change towards a plant-centered diet in relation to incident type 2 diabetes (T2DM). We examined this question in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. Methods Analyses included 2717 participants in CARDIA, a US multicenter, community-based prospective cohort study, currently with 30 years of follow-up. Participants were free of diabetes through year 20, with follow-up for incident T2DM through year 30. Dietary intake at years 0 and 20 was assessed by interviewer-administered diet history; overall dietary quality was assessed using a hypothesis-driven index based on 46 food groups, the A Priori Diet Quality Score (APDQS). The APDQS has possible scores 0 to 132 and increasing score is largely led by consumption of nutritionally rich plant foods–fruits and vegetables and plant-derived fats (e.g., seeds, nut, vegetable oils) and proteins (e.g., avocado, legume, soy). Change in diet quality (year 20 – year 0) and its quintiles were calculated. Diagnosis of T2DM was based on self-reported use of antidiabetic medication treatment or lab tests (fasting glucose, 2-hour glucose, or glycated hemoglobin). In proportional hazards regression, covariates included sociodemographics, baseline APDQS, and time-varying energy intake, smoking, and physical activity. Results Mean baseline age was 25.0 ± 3.6y, 43% were black, and 58% were women. During 10 years of follow-up after year 20, 206 cases of incident T2DM occurred. Mean year 0 APDQS was 64 ± 13 points and mean 20-year changes in APDQS was 7 ± 11. In multivariable-adjusted analysis, we found that the greatest increase in dietary quality over 20 years (median APDQS increased by 22 points) was associated with a 60% decrease in risk of T2DM as compared to a small decrease in diet quality (median APDQS decreased by 8 points); HRQ5 vs. Q1: 0.40; 95% CI:0.24–0.67). For every 10-point increase in APDQS over 20 years, there was a 23% decrease in risk of T2DM (95% CI: 0.67–0.88, P-trend = 0.0009). The pattern of findings persisted within below median and within above median year 0 APDQS. Conclusions Our finding suggests that young adults would benefit from improving diet quality by shifting toward a more plant-centered diet over time for the prevention of T2DM. Funding Sources This research was funded by an NHLBI contract and the University of Minnesota Healthy Food, Healthy Lives Institute. Supporting Tables, Images and/or Graphs

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Cumulative intake of artificially sweetened and sugar-sweetened beverages and risk of incident type 2 diabetes in young adults: the Coronary Artery Risk Development In Young Adults (CARDIA) Study

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz154 ◽

2019 ◽

Vol 110 (3) ◽

pp. 733-741 ◽

Cited By ~ 8

Author(s):

Kristin M Hirahatake ◽

David R Jacobs ◽

James M Shikany ◽

Luohua Jiang ◽

Nathan D Wong ◽

...

Keyword(s):

Type 2 Diabetes ◽

Young Adults ◽

Coronary Artery ◽

Weight Change ◽

Lifestyle Factors ◽

Sweetened Beverage ◽

Dieting Behavior ◽

Baseline Bmi

ABSTRACT Background Epidemiological evidence has demonstrated a positive association between artificially sweetened beverage (ASB) and sugar-sweetened beverage (SSB) consumption and type 2 diabetes (T2D) risk. However, research informing this topic in young adults is limited. Objective This study examined the association between ASB, SSB, and total sweetened beverage (TSB; combined ASB and SSB) consumption and T2D risk in young adults. Methods A prospective analysis of 4719 Black and White men and women aged 18–30 y at baseline was conducted from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Each participant's beverage intake was assessed using the CARDIA Diet History at baseline and at study Years 7 and 20. Multivariable Cox proportional hazards regression models were used to examine cumulative average ASB, SSB, and TSB intakes and risk of T2D. Results During the 30-y follow-up period, 680 participants developed T2D. ASB consumption was associated with a 12% greater risk of T2D per serving/day (HR 1.12, 95% CI 1.04–1.20) in a model adjusted for lifestyle factors, diet quality, and dieting behavior. Further adjustments for baseline BMI (HR 1.07, 95% CI 0.99–1.14) and weight change during follow-up (HR 1.04, 95% CI 0.97–1.12) attenuated the association. SSB and TSB consumption as continuous variables per 1 serving/day of intake were associated with 6% and 5% increased risks of T2D, respectively (HRSSB 1.06, 95% CI 1.01–1.10; HRTSB 1.05, 95% CI 1.01–1.09), in the model accounting for lifestyle factors, dieting behavior, baseline BMI, and weight change. Results were consistent when the exposures were modeled in categories of consumption and quintiles. Conclusions In young adults, long-term ASB, SSB, and TSB consumption were associated with increased risks of T2D. However, the estimates for ASB were attenuated when accounting for weight changes.

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Potassium intake and risk of incident type 2 diabetes mellitus: the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Diabetologia ◽

10.1007/s00125-012-2487-3 ◽

2012 ◽

Vol 55 (5) ◽

pp. 1295-1303 ◽

Cited By ~ 39

Author(s):

R. Chatterjee ◽

L. A. Colangelo ◽

H. C. Yeh ◽

C. A. Anderson ◽

M. L. Daviglus ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Young Adults ◽

Coronary Artery ◽

Incident Type ◽

Potassium Intake ◽

Incident Type 2 Diabetes

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Association of 20-Year Changes in Cardiorespiratory Fitness With Incident Type 2 Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) fitness study

Diabetes Care ◽

10.2337/dc08-1971 ◽

2009 ◽

Vol 32 (7) ◽

pp. 1284-1288 ◽

Cited By ~ 60

Author(s):

M. R. Carnethon ◽

B. Sternfeld ◽

P. J. Schreiner ◽

D. R. Jacobs ◽

C. E. Lewis ◽

...

Keyword(s):

Type 2 Diabetes ◽

Young Adults ◽

Coronary Artery ◽

Cardiorespiratory Fitness ◽

Incident Type ◽

Incident Type 2 Diabetes

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Association of Alcohol Drinking With Incident Type 2 Diabetes and Pre-diabetes: the Guangzhou Biobank Cohort Study

10.21203/rs.3.rs-955149/v1 ◽

2021 ◽

Author(s):

Mei Jiao Li ◽

Jing Ren ◽

Wei Sen Zhang ◽

Chao Qiang Jiang ◽

Ya Li Jin ◽

...

Keyword(s):

Type 2 Diabetes ◽

Genetic Polymorphisms ◽

Impaired Fasting Glucose ◽

Alcohol Drinking ◽

Fasting Glucose ◽

Heavy Alcohol ◽

Incident Type ◽

Incident Type 2 Diabetes

Abstract Background To examine associations of baseline alcohol drinking with incident type 2 diabetes or impaired fasting glucose, and explore whether the associations were modified by genetic polymorphisms of aldehyde dehydrogenase-2 (ALDH2) and alcohol dehydrogenase-1B (ADH1B).Methods Information of alcohol consumption was collected at baseline from 2003 to 2008. Incident type 2 diabetes was defined as fasting glucose ≥7.0 mmol/l or post-load glucose ≥11.1 mmol/l at follow-up examination (2008-2012), self-reported type 2 diabetes and/or initiation of hypoglycemia medication or insulin during follow-up. Impaired fasting glucose was defined as fasting glucose ≥5.6 mmol/l and <7 mmol/l. Results Of 15,716 participants without diabetes and 11,232 participants without diabetes and impaired fasting glucose at baseline, 1,624 (10.33%) developed incident type 2 diabetes, and 1,004 (8.94%) developed incident impaired fasting glucose during average 4 years of follow-up. After adjusting for sex, age, education, occupation, personal annual income, smoking, physical activity, body mass index, waist/hip ratio, health status, family history of diabetes, compared with never drinking, occasional or moderate alcohol drinking was not associated with risk of incident type 2 diabetes+impaired fasting glucose (odds ratio (OR) 1.08, 95% confidence interval (CI) 0.94-1.25, and 0.89 (0.68-1.16), respectively), but heavy alcohol drinking was associated with a higher risk of incident type 2 diabetes+impaired fasting glucose (1.83, 1.25-2.69). No interactions of sex, overweight/obesity and genetic polymorphisms of ADH1B or ALDH2 genes with alcohol drinking on incident type 2 diabetes and/or impaired fasting glucose were found (p for interaction from 0.12 to 0.81). Conclusions Our results support a detrimental effect of heavy alcohol use on impaired fasting glucose and type 2 diabetes. No protective effect was found for those carrying lower risk alleles for ADH1B and ALDH2 genes.

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Associations of Diet Quality and All-Cause Mortality Across Levels of Cardiometabolic Health and Disease: A 7.6-Year Prospective Analysis From the Dutch Lifelines Cohort

10.2337/figshare.13964039 ◽

2021 ◽

Author(s):

Petra C Vinke ◽

Gerjan Navis ◽

Daan Kromhout ◽

Eva Corpeleijn

Keyword(s):

Type 2 Diabetes ◽

Diet Quality ◽

Total Population ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Dietary Guidelines ◽

Cardiometabolic Health ◽

Ageing Population ◽

All Cause Mortality

Objective: To simultaneously investigate the association of diet quality and all-cause mortality in groups with varying cardiometabolic diseases (CMDs) at baseline. Design: From the population-based Lifelines cohort, 40,892 non-underweight participants aged ≥50 years with data on diet quality and confounding factors were included (enrollment 2006-2013). From food frequency questionnaire data, tertiles of the Lifelines diet score were calculated (T1 = poorest, T3 = best diet quality). Four CMD categories were defined: 1) CMD-free, 2) type 2 diabetes, 3) one cardiovascular disease (CVD), 4) two or more CMDs. Months when deaths occurred were obtained from municipal registries up until November 2019. Multivariable Cox proportional hazards models were applied for the total population and stratified by CMD categories. Results: After a median follow-up of 7.6 years, 1,438 participants died. Diet quality and CMD categories were independently associated with all-cause mortality in crude and adjusted models (p < 0.001). A dose-response relationship of diet quality with all-cause mortality was observed in the total population (P for trend < 0.001, T2 vs. T3 = 1.22 (1.07-1.41), T1 vs. T3 = 1.57 (1.37-1.80)). In stratified analyses, the association was significant for CMD-free individuals (T1 vs. T3 = 1.63 (1.38-1.93)) and for type 2 diabetes patients (1.87 (1.17-3.00)), but not for patients with one CVD (1.39 (0.93-2.08)) or multiple CMDs (1.19 (0.80-1.76)). Conclusions: A high-quality diet can potentially lower all-cause mortality risk in the majority of the ageing population. Its effect may be greatest for CMD-free individuals and patients with type 2 diabetes. Tailored dietary guidelines may be required for patients with extensive histories of CMDs.

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Natriuretic peptides and risk of type 2 diabetes: Results from the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium

10.2337/figshare.15173301.v1 ◽

2021 ◽

Author(s):

Chaterina Sujana ◽

Veikko Salomaa ◽

Frank Kee ◽

Simona Costanzo ◽

Stefan Söderberg ◽

...

Keyword(s):

Type 2 Diabetes ◽

Risk Assessment ◽

Cardiovascular Risk ◽

Inverse Association ◽

Cardiovascular Risk Assessment ◽

Multiplicative Interaction ◽

Incident Type ◽

Incident Type 2 Diabetes

Objective: Natriuretic peptide (NP) concentrations are increased in cardiovascular diseases (CVD) but are associated with a lower diabetes risk. We investigated associations of N-terminal pro-B-type NP (NT-proBNP) and mid-regional pro-atrial NP (MR-proANP) with incident type 2 diabetes stratified by the presence of CVD. Research Design and Methods: Based on the Biomarkers for Cardiovascular Risk Assessment in Europe-(BiomarCaRE) Consortium, we included 45,477 participants with NT-proBNP measurements (1,707 developed type 2 diabetes over 6.5 years of median follow-up; among these, 209 had CVD at baseline) and 11,537 participants with MR-proANP measurements (857 developed type 2 diabetes over 13.8 years of median follow-up; among these, 106 had CVD at baseline). The associations were estimated using multivariable Cox regression models. Results: Both NPs were inversely associated with incident type 2 diabetes (hazard ratios [95%CI] per 1-standard deviation increase of log NP: 0.84 [0.79; 0.89] for NT-proBNP and 0.77 [0.71; 0.83] for MR-proANP). The inverse association between NT-proBNP and type 2 diabetes was significant in individuals without, but not in individuals with CVD (0.81 [0.76; 0.86] vs 1.04 [0.90; 1.19]; P-multiplicative interaction= 0.001). There was no significant difference in the association of MR-proANP with type 2 diabetes between individuals without and with CVD (0.75 [0.69; 0.82] vs 0.81 [0.66; 0.99]; P-multiplicative interaction= 0.236). Conclusions: NT-proBNP and MR-proANP are inversely associated with incident type 2 diabetes. However, the inverse association of NT-proBNP seems to be modified by the presence of CVD. Further investigations are warranted to confirm our findings and to investigate the underlying mechanisms.

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Abstract MP05: Leisure-Time Running and Incident Type 2 Diabetes

Circulation ◽

10.1161/circ.131.suppl_1.mp05 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Duck-chul Lee ◽

Carl J. Lavie ◽

Timothy S. Church ◽

Xuemei Sui ◽

Steven N. Blair

Keyword(s):

Type 2 Diabetes ◽

Lower Risk ◽

Leisure Time ◽

Cox Regression ◽

Smoking Status ◽

Physical Activities ◽

Incident Type ◽

Incident Type 2 Diabetes

Introduction: There is still little evidence on the dose-response relation between leisure-time running and incident type 2 diabetes (T2D). Hypothesis: We examined the hypothesis that running reduces the risk of developing T2D. Methods: Participants were 19,347 adults aged 18 to 100 years (mean age, 44) who received an extensive preventive medical examination during 1974-2006 in the Aerobics Center Longitudinal Study. Participants were free of cardiovascular disease, cancer, and T2D at baseline. Running and other physical activities were assessed on the medical history questionnaire by self-reported leisure-time activities during the past 3 months. We defined T2D as fasting glucose ≥126 mg/dl, insulin use, or physician-diagnosis during follow-up medical examinations. Cox regression was used to quantify the association between running and T2D after adjusting for baseline age, sex, examination year, body mass index, smoking status, heavy alcohol drinking, abnormal electrocardiogram, hypertension, hypercholesterolemia, and levels of other physical activities. Results: During an average follow-up of 6.5 years, 1,015 adults developed T2D. Approximately 30% of adults participated in leisure-time running. Runners had a 29% lower risk of developing T2D compared with non-runners. The hazard ratios (95% confidence intervals) of T2D were 0.97 (0.74-1.27), 0.66 (0.49-0.89), 0.62 (0.45-0.85), 0.78 (0.58-1.03), and 0.57 (0.42-0.79) across quintiles (Q) of running time (minutes/week); 0.99 (0.76-1.30), 0.60 (0.44-0.82), 0.72 (0.55-0.94), 0.65 (0.47-0.90), and 0.63 (0.47-0.86) across Q of running distance (miles/week); 1.08 (0.83-1.40), 0.67 (0.50-0.90), 0.70 (0.53-0.93), 0.61 (0.45-0.83), and 0.53 (0.36-0.76) across Q of running frequency (times/week); 0.95 (0.73-1.24), 0.70 (0.52-0.94), 0.62 (0.45-0.84), 0.73 (0.55-0.97), and 0.58 (0.42-0.80) across Q of total amount of running (MET-minutes/week); and 0.95 (0.71-1.28), 0.76 (0.59-0.99), 0.59 (0.42-0.83), 0.66 (0.51-0.85), and 0.62 (0.43-0.90) across Q of running speed (mph), respectively, compared with no running after adjusting for confounders including levels of other physical activities. Conclusions: Participating in leisure-time running is associated with markedly lower risk of developing T2D in adults. Except for those in the very lowest Q for running doses, even relatively low running doses (starting with Q 2) were associated with marked reductions in T2D risk over time, supporting the prescription of running to reduce T2D.

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Circulating metabolites and the risk of type 2 diabetes: a prospective study of 11,896 young adults from four Finnish cohorts

Diabetologia ◽

10.1007/s00125-019-05001-w ◽

2019 ◽

Vol 62 (12) ◽

pp. 2298-2309 ◽

Cited By ~ 16

Author(s):

Ari V. Ahola-Olli ◽

Linda Mustelin ◽

Maria Kalimeri ◽

Johannes Kettunen ◽

Jari Jokelainen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Young Adults ◽

Fasting Glucose ◽

Diabetes Risk ◽

Increased Risk ◽

Metabolic Biomarkers ◽

Incident Cases ◽

Future Diabetes

Abstract Aims/hypothesis Metabolomics technologies have identified numerous blood biomarkers for type 2 diabetes risk in case−control studies of middle-aged and older individuals. We aimed to validate existing and identify novel metabolic biomarkers predictive of future diabetes in large cohorts of young adults. Methods NMR metabolomics was used to quantify 229 circulating metabolic measures in 11,896 individuals from four Finnish observational cohorts (baseline age 24–45 years). Associations between baseline metabolites and risk of developing diabetes during 8–15 years of follow-up (392 incident cases) were adjusted for sex, age, BMI and fasting glucose. Prospective metabolite associations were also tested with fasting glucose, 2 h glucose and HOMA-IR at follow-up. Results Out of 229 metabolic measures, 113 were associated with incident type 2 diabetes in meta-analysis of the four cohorts (ORs per 1 SD: 0.59–1.50; p< 0.0009). Among the strongest biomarkers of diabetes risk were branched-chain and aromatic amino acids (OR 1.31–1.33) and triacylglycerol within VLDL particles (OR 1.33–1.50), as well as linoleic n-6 fatty acid (OR 0.75) and non-esterified cholesterol in large HDL particles (OR 0.59). The metabolic biomarkers were more strongly associated with deterioration in post-load glucose and insulin resistance than with future fasting hyperglycaemia. A multi-metabolite score comprised of phenylalanine, non-esterified cholesterol in large HDL and the ratio of cholesteryl ester to total lipid in large VLDL was associated with future diabetes risk (OR 10.1 comparing individuals in upper vs lower fifth of the multi-metabolite score) in one of the cohorts (mean age 31 years). Conclusions/interpretation Metabolic biomarkers across multiple molecular pathways are already predictive of the long-term risk of diabetes in young adults. Comprehensive metabolic profiling may help to target preventive interventions for young asymptomatic individuals at increased risk.

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Variability in estimated glomerular filtration rate and the incidence of type 2 diabetes: a nationwide population-based study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001187 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001187

Author(s):

You-Bin Lee ◽

Da Hye Kim ◽

Eun Roh ◽

So-Hyeon Hong ◽

Jung A Kim ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Diabetes Risk ◽

Incident Type ◽

Incident Type 2 Diabetes

ObjectiveVariability in estimated glomerular filtration rate (eGFR) has been associated with adverse outcomes in patients with diabetes or chronic kidney disease (CKD). However, no previous study has explored the relationship between eGFR variability and type 2 diabetes incidence.Research design and methodsIn this nationwide, longitudinal, cohort study, we investigated the association between eGFR variability and type 2 diabetes risk using the Korean National Health Insurance Service datasets from 2002 to 2017. eGFR variability was calculated using the variability independent of the mean (eGFR-VIM), coefficient of variation (eGFR-CV), standard deviation (eGFR-SD) and average real variability (eGFR-ARV).ResultsWithin 7 673 905.58 person-years of follow-up (mean follow-up: 3.19 years; n=2 402 668), 11 981 cases of incident type 2 diabetes were reported. The HRs and 95% CIs for incident type 2 diabetes increased according to advance in quartiles of eGFR-VIM (HR (95% CI): Q2, 1.068 (1.009 to 1.130); Q3, 1.077 (1.018 to 1.138); Q4, 1.203 (1.139 to 1.270)) even after adjusting for confounding factors including mean eGFR and mean fasting plasma glucose levels. The subgroup analyses according to risk factors as well as analyses using eGFR-CV, eGFR-SD and eGFR-ARV showed consistent results. The association between increased eGFR variability and type 2 diabetes risk was more prominent in men, individuals with dyslipidemia and those with CKD as shown in the subgroup analysis (p for interaction <0.001).ConclusionsIncreased eGFR variability may be an independent predictor of type 2 diabetes and might be useful for risk stratification of individuals without diabetes.

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