Postprandial Duration Influences the Association of Insulin-Related Dietary Indexes and Plasma C-peptide Concentrations in Adult Men and Women

ABSTRACT Background The dietary insulin index (II) directly quantifies dietary effects on postprandial insulin secretion, whereas the empirical dietary index for hyperinsulinemia (EDIH), based on fasting C-peptide concentrations, is primarily reflective of insulin resistance. How these scores are related to nonfasting C-peptide in cohort studies has not been examined. Objective We investigated the extent to which EDIH and II scores predict plasma C-peptide concentrations, in cross-sectional analyses by postprandial duration at blood collection from 1 to ≥15 h. Methods Both EDIH and II scores were calculated from food-frequency questionnaire data reported by 3964 men in the Health Professionals Follow-up Study (1993–1995) and 6215 women in the Nurses’ Health Study (1989–1990) who were not diabetic. We constructed 12 multivariable-adjusted linear regression models separately in men and women, by postprandial duration, to calculate relative differences and absolute values of plasma C-peptide concentrations in dietary index quintiles. Results In both men and women, C-peptide concentrations were elevated 1–2 h after eating and declined with increasing postprandial duration. In men, percent differences in C-peptide concentration in the highest compared with lowest dietary index quintile were: EDIH: 0–1 h: 50%; 2 h: 22%; 14 h: 14%; ≥15 h: 30% (all P-trend< 0.05). II: 0–1 h: 19% (P-trend = 0.09); 2 h: 3% (P-trend = 0.09); 14 h: −6% (P-trend = 0.17); ≥15 h: −15% (P-trend = 0.02). Corresponding results among women were: EDIH: 0–1 h: 29% (P-trend = 0.002); 2 h: 33% (P-trend = 0.009); 14 h: 44% (P-trend < 0.0001); ≥15 h: 40% (P-trend < 0.0001). II: 0–1 h: −12% (P-trend = 0.09); 2 h: 17% (P-trend = 0.09); 14 h: −14% (P-trend = 0.009); ≥15 h: −3% (P-trend = 0.37). Conclusion The EDIH was superior to the II in predicting both fasting and nonfasting C-peptide concentrations, suggesting that the EDIH may be better in assessing dietary effects of hyperinsulinemia on disease risk in adult men and women.

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Insulin-related dietary indices predict 24-h urinary C-peptide in adult men

British Journal Of Nutrition ◽

10.1017/s0007114520002184 ◽

2020 ◽

pp. 1-8

Author(s):

Dong Hoon Lee ◽

Edward L. Giovannucci ◽

Fred K. Tabung

Keyword(s):

Insulin Resistance ◽

Insulin Secretion ◽

Positive Association ◽

Significant Positive Association ◽

Cross Sectional ◽

C Peptide ◽

Adult Men ◽

Dietary Index ◽

Sectional Analysis ◽

Dietary Indices

Abstract The dietary insulin index directly estimates the postprandial insulin secretion potential of foods, whereas the empirical dietary index for hyperinsulinaemia (EDIH) assesses the insulinaemic potential of usual diets based on fasting plasma C-peptide, and is primarily reflective of insulin resistance. It is unknown whether these insulin-related indices are predictive of an integrated measure of insulin secretion. We conducted a cross-sectional analysis that included 293 non-diabetic men with 24-h urinary C-peptide data from the Men’s Lifestyle Validation Study. EDIH, dietary insulin index and dietary insulin load were calculated using validated FFQ. We conducted multivariable-adjusted linear regression to estimate relative and absolute concentrations of 24-h urinary C-peptide. In multivariable-adjusted models, we found a significant positive association between all three insulin-related dietary indices and 24-h urinary C-peptide (P < 0·05). Relative concentrations of 24-h urinary C-peptide per 1-sd increase in insulin-related dietary indices were 1·12 (95 % CI 1·02, 1·23) for EDIH, 1·18 (95 % CI 1·07, 1·29) for dietary insulin index and 1·16 (95 % CI 1·06, 1·27) for dietary insulin load. When we further adjusted for BMI, the association was attenuated for EDIH, to 1·07 (95 % CI 0·98, 1·16), and remained unchanged for dietary insulin index and dietary insulin load. In conclusion, EDIH, dietary insulin index and dietary insulin load were predictive of integrated insulin secretion assessed by 24-h urinary C-peptide. Findings after adjustment for BMI appear to confirm the relation of EDIH to insulin resistance and dietary insulin index/load to insulin secretion; the respective constructs of the two dietary indices.

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Development and validation of empirical indices to assess the insulinaemic potential of diet and lifestyle

British Journal Of Nutrition ◽

10.1017/s0007114516003755 ◽

2016 ◽

Vol 116 (10) ◽

pp. 1787-1798 ◽

Cited By ~ 23

Author(s):

Fred K. Tabung ◽

Weike Wang ◽

Teresa T. Fung ◽

Frank B. Hu ◽

Stephanie A. Smith-Warner ◽

...

Keyword(s):

Insulin Resistance ◽

Linear Regression ◽

Insulin Response ◽

Health Study ◽

Food Groups ◽

Linear Regression Models ◽

Long Term Effects ◽

C Peptide ◽

Dietary Index ◽

Resistance Pathway

AbstractThe glycaemic and insulin indices assess postprandial glycaemic and insulin response to foods, respectively, which may not reflect the long-term effects of diet on insulin response. We developed and evaluated the validity of four empirical indices to assess the insulinaemic potential of usual diets and lifestyles, using dietary, lifestyle and biomarker data from the Nurses’ Health Study (NHS, n 5812 for hyperinsulinaemia, n 3929 for insulin resistance). The four indices were as follows: the empirical dietary index for hyperinsulinaemia (EDIH) and the empirical lifestyle index for hyperinsulinaemia (ELIH); the empirical dietary index for insulin resistance (EDIR) and the empirical lifestyle index for insulin resistance (ELIR). We entered thirty-nine FFQ-derived food groups in stepwise linear regression models, and defined indices as patterns most predictive of fasting plasma C-peptide, for the hyperinsulinaemia pathway (EDIH and ELIH), and of theTAG:HDL-cholesterol ratio, for the insulin-resistance pathway (EDIR and ELIR). We evaluated the validity of indices in two independent samples from NHS-II and Health Professionals Follow-up Study (HPFS) using multivariable-adjusted linear regression analyses to calculate relative concentrations of biomarkers. The EDIH is comprised of eighteen food groups; thirteen were positively associated with C-peptide and five were inversely associated. The EDIR is comprised of eighteen food groups; ten were positively associated with TAG:HDL-cholesterol and eight were inversely associated. Lifestyle indices had fewer dietary components, and included BMI and physical activity as components. In the validation samples, all indices significantly predicted biomarker concentrations – for example, the relative concentrations of the corresponding biomarkers comparing extreme index quintiles in the HPFS were EDIH, 1·29 (95 % CI 1·22, 1·37); ELIH, 1·78 (95 % CI 1·68, 1·88); EDIR, 1·44 (95 % CI 1·34, 1·55); and ELIR, 2·03 (95 % CI 1·89, 2·19); all Ptrend<0·0001. The robust associations of these novel hypothesis-driven indices with insulin response biomarker concentrations suggest their usefulness in assessing the ability of whole diets and lifestyles to stimulate and/or sustain insulin secretion.

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Association between egg intake and blood pressure in the USA: the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP)

Public Health Nutrition ◽

10.1017/s1368980021002949 ◽

2021 ◽

pp. 1-9

Author(s):

Thanh-Huyen T Vu ◽

Linda Van Horn ◽

Martha L Daviglus ◽

Queenie Chan ◽

Alan R Dyer ◽

...

Keyword(s):

Blood Pressure ◽

Dietary Cholesterol ◽

International Study ◽

Obese Women ◽

Linear Regression Models ◽

Cross Sectional ◽

Men And Women ◽

The Usa ◽

Underlying Mechanisms

Abstract Objectives: To investigate associations of egg intake with blood pressure (BP) and the role of dietary variables and other macro- and micro-nutrients in the association. Design: We used cross-sectional data for the USA as part of the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). INTERMAP was surveyed between 1996 and 1999, including four 24-h dietary recalls, two 24-h urine collections and eight measurements of systolic BP and diastolic BP (SBP, DBP). Average egg intake (g/d) was calculated. Multivariable linear regression models were used to estimate the association between egg intake (per each 50 g/d or per quintile) and BP. The roles of dietary variables and other macro- and micro-nutrients in this association were also investigated. Setting: In the USA. Participants: In total, 2195 US INTERMAP men and women aged 40–59 years. Results: Participants were 50 % female, 54 % non-Hispanic White and 16 % non-Hispanic Black. Mean egg intake (sd) in men and women was 30·4(29·8) and 21·6(20·5) g/d, respectively. Adjusting for demographics, socio-economics, lifestyle and urinary Na:K excretion ratios, we found non-linear associations with BP in non-obese women (P-quadratic terms: 0·004 for SBP and 0·035 for DBP).The associations remained after adjusting for dietary variables, macro/micro nutrients or minerals. Dietary cholesterol was highly correlated with egg intake and may factor in the association. No association was found in obese women and in obese or non-obese men. Conclusion: Egg intake was non-linearly associated with SBP and DBP in non-obese women, but not in obese women or men. Underlying mechanisms require additional study regarding the role of obesity and sex.

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Socio-economic circumstances and food habits in Eastern, Central and Western European populations

Public Health Nutrition ◽

10.1017/s1368980010002570 ◽

2010 ◽

Vol 14 (4) ◽

pp. 678-687 ◽

Cited By ~ 43

Author(s):

Sinéad Boylan ◽

Tea Lallukka ◽

Eero Lahelma ◽

Hynek Pikhart ◽

Sofia Malyutina ◽

...

Keyword(s):

Food Habits ◽

Western Europe ◽

Healthy Food ◽

Economic Indicators ◽

Health Study ◽

Low Fat ◽

Cross Sectional ◽

Men And Women ◽

Occupational Position ◽

Relative Index

AbstractObjectiveTo assess the relationship between several socio-economic indicators and frequency of consumption of seven predefined healthy foods (consumption of fruit, vegetables, wholegrain bread, vegetable-fat spread, vegetable cooking fat, low-fat milk and low-fat cheese) in populations from Eastern, Central and Western Europe.DesignAnalysis of baseline data collected in two cross-sectional cohort studies between 2000 and 2005: the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study and the Finnish Helsinki Health Study (HHS).SettingUrban populations in the Czech Republic, Russia, Poland and Finland.SubjectsIn the HAPIEE study, random samples of men and women aged 45–69 years were drawn from population registers and electoral lists of selected cities. In the HHS, men and women aged 40–60 years employed by the City of Helsinki were recruited. Data on 21 326 working subjects from both cohorts were analysed.ResultsHealthy food habits were, in general, positively associated with higher education, occupational position and fewer economic difficulties, but there were differences in the strength of the gradient by food and country. Fruit consumption showed the most consistent gradients, especially in relation to socio-economic status among men (country-specific relative index of inequality (RII) = 2·02–5·17) and women (RII = 2·09–3·57).ConclusionsThe associations between socio-economic indicators and healthy food habits showed heterogeneity between countries. Future studies of dietary behaviours should consider multiple measures of socio-economic position.

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Lifestyle correlates of eight breast cancer-related metabolites: a cross-sectional study within the EPIC cohort

BMC Medicine ◽

10.1186/s12916-021-02183-2 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Mathilde His ◽

Vivian Viallon ◽

Laure Dossus ◽

Julie A. Schmidt ◽

Ruth C. Travis ◽

...

Keyword(s):

Breast Cancer ◽

Lower Risk ◽

Positive Association ◽

Blood Collection ◽

Linear Regression Models ◽

Case Control Studies ◽

Cross Sectional ◽

Blood Concentrations ◽

Exogenous Hormones ◽

Negatively Associated

Abstract Background Metabolomics is a promising molecular tool for identifying novel etiological pathways leading to cancer. In an earlier prospective study among pre- and postmenopausal women not using exogenous hormones, we observed a higher risk of breast cancer associated with higher blood concentrations of one metabolite (acetylcarnitine) and a lower risk associated with higher blood concentrations of seven others (arginine, asparagine, phosphatidylcholines (PCs) aa C36:3, ae C34:2, ae C36:2, ae C36:3, and ae C38:2). Methods To identify determinants of these breast cancer-related metabolites, we conducted a cross-sectional analysis to identify their lifestyle and anthropometric correlates in 2358 women, who were previously included as controls in case-control studies nested within the European Prospective Investigation into Cancer and Nutrition cohort and not using exogenous hormones at blood collection. Associations of each metabolite concentration with 42 variables were assessed using linear regression models in a discovery set of 1572 participants. Significant associations were evaluated in a validation set (n = 786). Results For the metabolites previously associated with a lower risk of breast cancer, concentrations of PCs ae C34:2, C36:2, C36:3, and C38:2 were negatively associated with adiposity and positively associated with total and saturated fat intakes. PC ae C36:2 was also negatively associated with alcohol consumption and positively associated with two scores reflecting adherence to a healthy lifestyle. Asparagine concentration was negatively associated with adiposity. Arginine and PC aa C36:3 concentrations were not associated to any of the factors examined. For the metabolite previously associated with a higher risk of breast cancer, acetylcarnitine, a positive association with age was observed. Conclusions These associations may indicate possible mechanisms underlying associations between lifestyle and anthropometric factors, and risk of breast cancer. Further research is needed to identify potential non-lifestyle correlates of the metabolites investigated.

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Association of the Insulinemic Potential of Diet and Lifestyle With Risk of Digestive System Cancers in Men and Women

JNCI Cancer Spectrum ◽

10.1093/jncics/pky080 ◽

2018 ◽

Vol 2 (4) ◽

Cited By ~ 8

Author(s):

Weike Wang ◽

Teresa T Fung ◽

Molin Wang ◽

Stephanie A Smith-Warner ◽

Edward L Giovannucci ◽

...

Keyword(s):

Digestive Tract ◽

Digestive System ◽

Cox Regression ◽

Health Study ◽

Men And Women ◽

Dietary Index ◽

Hazard Ratios ◽

Incident Cancer ◽

Men Health ◽

Diet And Lifestyle

Abstract Background We examined the role of the insulinemic potential of diet and lifestyle in the development of cancers of the digestive system, using two plasma C-peptide-based indices: the empirical dietary index for hyperinsulinemia (EDIH) and empirical lifestyle index for hyperinsulinemia (ELIH). Methods We used Cox regression to analyze data on 45 816 men (Health Professionals Follow-up Study, 1986–2012) and 74 191 women (Nurses’ Health Study, 1984–2012) to examine associations between EDIH and ELIH scores and digestive system cancers. We computed the diet-only score (EDIH) from food-frequency questionnaires administered every 4 years. The lifestyle score (ELIH) included diet, body mass index, and physical activity. Outcomes included incident cancer of the digestive system (mouth, throat, esophagus, stomach, small intestine, and colorectum) and its accessory organs (pancreas, gallbladder, and liver). P values were two-sided. Results We found direct associations between higher insulinemic potential of diet or lifestyle and risk of developing digestive system cancers in both men and women. The pooled multivariable hazard ratios (HRs) for participants comparing the highest to lowest EDIH quintile were: HR = 1.27, 95% confidence interval (CI) = 1.15 to 1.40, Ptrend < .001 for digestive system cancers; HR = 1.30, 95% CI = 1.17 to 1.45, Ptrend < .001 for digestive tract cancers (excluding accessory organs); and HR = 1.15, 95% CI = 0.93 to 1.41, Ptrend = .48 for digestive accessory organ cancers. The same associations were stronger with the lifestyle score: HR = 1.47, 95% CI = 1.23 to 1.76, Ptrend < .001 for digestive system cancers; HR = 1.49, 95% CI = 1.14 to 1.95, Ptrend = .001 for digestive tract cancers; and HR = 1.43, 95% CI = 1.17 to 1.73, Ptrend < .001 for digestive accessory organ cancers. Conclusions The findings suggest that interventions to reduce the insulinemic potential of diet and lifestyle may be a means of preventing digestive system cancer.

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Psychiatric Disorders and Alcohol Consumption Among Low-Income African Americans:Gender Differences

Brain Sciences ◽

10.3390/brainsci9040086 ◽

2019 ◽

Vol 9 (4) ◽

pp. 86 ◽

Cited By ~ 1

Author(s):

Sharon Cobb ◽

Shervin Assari

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Linear Regression ◽

Low Income ◽

Regression Models ◽

Future Research ◽

Linear Regression Models ◽

Cross Sectional ◽

Men And Women ◽

Compulsive Disorder

Background: Although cooccurrence of nonsubstance use disorders (non-SUDs) and substance use is well-established in the literature, most of what we know in this regard is derived from studies that have recruited predominantly White sample populations. As a result, there is a gap in knowledge on this link among low-income African Americans (AAs). There is also a need to understand how low-income AA men and women differ in these associations. Objective: To study whether there is an association between number of non-SUDs and amount of alcohol consumption by AA adults, and whether this association varies between AA men and women. Methods: This cross-sectional study recruited a nonrandom sample of 150 AA adults with non-SUDs (i.e., major depression, bipolar disorders, obsessive–compulsive disorder, paranoid disorder, panic disorder, posttraumatic stress disorder (PTSD), and schizoaffective disorder). The independent variable was the number of non-SUDs. The dependent variable was the amount of alcohol consumption. Age, socioeconomic status (educational attainment and household income), and self-rated health were covariates. Gender was the moderator. Linear regression models were used to analyze the data. Results: A higher number of non-SUDs was not associated with a higher amount of alcohol use in the pooled sample of AA adults. We, however, found a significant interaction between gender and number of non-SUDs on the amount of alcohol use, suggesting a stronger effect of non-SUDs on alcohol consumption in AA men than in AA women. Gender-stratified linear regression models showed a positive association between number of non-SUDs and amount of alcohol consumption in AA men but not in AA women. Conclusion: Non-SUDs impact alcohol use of AA men but not women. Future research should test whether AA men may have a higher tendency to turn to alcohol to regulate their emotions and cope with psychological pain due to multiple non-SUDs. The results also suggest that integration of services for SUDs and non-SUDs may be more relevant to provision of mental health services for AA men than AA women.

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Serum 25-hydroxyvitamin D levels and lung function in adults with asthma: the HUNT Study

European Respiratory Journal ◽

10.1183/09031936.00069714 ◽

2014 ◽

Vol 45 (4) ◽

pp. 1019-1026 ◽

Cited By ~ 15

Author(s):

Tricia L. Larose ◽

Arnulf Langhammer ◽

Yue Chen ◽

Carlos A. Camargo ◽

Pål Romundstad ◽

...

Keyword(s):

Allergic Rhinitis ◽

Lung Function ◽

Vital Capacity ◽

Forced Expiratory Volume ◽

Health Study ◽

Linear Regression Models ◽

Cross Sectional ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Hunt Study

The association between vitamin D status and lung function in adults with asthma remains unclear.We studied this cross-sectional association and possible modification by sex and allergic rhinitis in 760 adults (aged 19–55 years) with self-reported asthma in the Nord-Trøndelag Health Study. Serum 25-hydroxyvitamin D (25(OH)D) level <50 nmol·L−1was considered deficient. Lung function measurements included forced expiratory volume in 1 s (FEV1) % predicted, forced vital capacity (FVC) % predicted and FEV1/FVC ratio. Multiple linear regression models were used to estimate adjusted regression coefficients (β) and 95% confidence intervals.44% of asthma adults had serum 25(OH)D levels <50 nmol·L−1. Its associations with lung function measures seemed to be modified by sex and allergic rhinitis (p<0.03 for three-way interaction term). Overall, a serum 25(OH)D level <50 nmol·L−1was not associated with lung function measurements in subjects with allergic rhinitis in this asthma cohort. In men with asthma but without allergic rhinitis, however, a serum 25(OH)D level <50 nmol·L−1was significantly associated with lower FEV1/FVC ratio (β=−8.60%; 95% CI: −16.95%– −0.25%).Low serum 25(OH)D level was not associated with airway obstruction in most asthma adults with the exception of men with asthma but without allergic rhinitis.

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