scholarly journals Intake of whole grain foods and risk of type 2 diabetes: results from three prospective cohort studies

BMJ ◽  
2020 ◽  
pp. m2206 ◽  
Author(s):  
Yang Hu ◽  
Ming Ding ◽  
Laura Sampson ◽  
Walter C Willett ◽  
JoAnn E Manson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Brown Rice ◽  
Whole Grains ◽  
Health Study ◽  
Whole Grain ◽  
Breakfast Cereal ◽  
Hazard Ratios ◽  
Grain Foods

Abstract Objective To examine the associations between the intake of total and individual whole grain foods and the risk of type 2 diabetes. Design Prospective cohort studies. Setting Nurses’ Health Study (1984-2014), Nurses’ Health Study II (1991-2017), and Health Professionals Follow-Up Study (1986-2016), United States. Participants 158 259 women and 36 525 men who did not have type 2 diabetes, cardiovascular disease, or cancer at baseline. Main outcome measures Self-reports of incident type 2 diabetes by participants identified through follow-up questionnaires and confirmed by a validated supplementary questionnaire. Results During 4 618 796 person years of follow-up, 18 629 participants with type 2 diabetes were identified. Total whole grain consumption was categorized into five equal groups of servings a day for the three cohorts. After adjusting for lifestyle and dietary risk factors for diabetes, participants in the highest category for total whole grain consumption had a 29% (95% confidence interval 26% to 33%) lower rate of type 2 diabetes compared with those in the lowest category. For individual whole grain foods, pooled hazard ratios (95% confidence intervals) for type 2 diabetes in participants consuming one or more servings a day compared with those consuming less than one serving a month were 0.81 (0.77 to 0.86) for whole grain cold breakfast cereal, 0.79 (0.75 to 0.83) for dark bread, and 1.08 (1.00 to 1.17) for popcorn. For other individual whole grains with lower average intake levels, comparing consumption of two or more servings a week with less than one serving a month, the pooled hazard ratios (95% confidence intervals) were 0.79 (0.75 to 0.83) for oatmeal, 0.88 (0.82 to 0.94) for brown rice, 0.85 (0.80 to 0.90) for added bran, and 0.88 (0.78 to 0.98) for wheat germ. Spline regression showed a non-linear dose-response association between total whole grain intake and the risk of type 2 diabetes where the rate reduction slightly plateaued at more than two servings a day (P<0.001 for curvature). For whole grain cold breakfast cereal and dark bread, the rate reduction plateaued at about 0.5 servings a day. For consumption of popcorn, a J shaped association was found where the rate of type 2 diabetes was not significantly raised until consumption exceeded about one serving a day. The association between higher total whole grain intake and lower risk of type 2 diabetes was stronger in individuals who were lean than in those who were overweight or obese (P=0.003 for interaction), and the associations did not vary significantly across levels of physical activity, family history of diabetes, or smoking status. Conclusion Higher consumption of total whole grains and several commonly eaten whole grain foods, including whole grain breakfast cereal, oatmeal, dark bread, brown rice, added bran, and wheat germ, was significantly associated with a lower risk of type 2 diabetes. These findings provide further support for the current recommendations of increasing whole grain consumption as part of a healthy diet for the prevention of type 2 diabetes.

scholarly journals Carbohydrate Quantity and Quality and Risk of Type 2 Diabetes: Results from Three Large Prospective US Cohorts

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1380-1380
Author(s):  
Kim Braun ◽  
Marta Liu Guasch-Ferré ◽  
Vasanti Malik ◽  
Hala Alessa ◽  
Walter Willett ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Saturated Fat ◽  
Whole Grains ◽  
Health Study ◽  
Monounsaturated Fat ◽  
Funding Sources ◽  
Cox Proportional Hazard Regression ◽  
Time Varying Covariates

Abstract Objectives Carbohydrate intake has been reported to be associated with higher type 2 diabetes (T2D) risk, but high and low quality of carbohydrate may have different effects. Furthermore, these effects may differ depending on overall macronutrient composition. We aimed to examine associations of isocalorically substituting high quality carbohydrates (HQC) and low quality carbohydrates (LQC) with other macronutrients on T2D risk. Methods We included 69,949 women from the Nurses’ Health Study, 90,239 women from the Nurses’ Health Study 2, and 40,539 men from the Health Professionals Follow-up Study. Dietary data were collected every 2–4 years using a semi-quantitative food frequency questionnaire, from which dietary intake of LQC and HQC were calculated. LQC was defined as the percentage of energy (E%) from carbohydrates from refined grains, sugary foods, and potatoes, and HQC as E% from carbohydrate from whole grains. Hazard ratios were estimated using Cox proportional hazard regression analyses with time-varying covariates. Results During 4389,996 years of follow-up, we documented 11,872 T2D cases. In pooled multivariable-adjusted analyses, substituting 5E% from saturated fat with 5E% from LQC was associated with a higher T2D (HR[95% CI] = 1.05[1.00–1.09]) while substitution with HQC was associated with a lower T2D risk (HR[95% CI] = 0.93[0.87–0.99]). Isocaloric substitution of other macronutrients with LQC was not associated with T2D risk. On the other hand, isocaloric substitution of HQC was associated with lower T2D risk when the replacement nutrient was monounsaturated fat (HR[95% CI] = 0.88[0.83–0.94]), polyunsaturated fat (HR[95% CI] = 0.92[0.86–0.98]), trans fat (HR[95% CI] = 0.90[0.85–0.97]), animal protein (HR[95% CI] = 0.88[0.83–0.93]), and vegetable protein (HR[95% CI] = 0.90[0.84–0.96]). Conclusions Our study suggests that higher intake of HQC, especially from whole grains, is associated with a lower T2D risk, irrespective of the macronutrient it replaces. In contrast, a higher intake of LQC is associated with a higher risk of type 2 diabetes, but only when it replaces saturated fat. Our findings highlight the importance of making a distinction between carbohydrate from high and low quality sources and taking into account different substitutions when examining macronutrients. Funding Sources National Institutes of Health.

scholarly journals Dairy fat intake and risk of type 2 diabetes in 3 cohorts of US men and women

2019 ◽  
Vol 110 (5) ◽  
pp. 1192-1200 ◽  
Author(s):  
Andres V Ardisson Korat ◽  
Yanping Li ◽  
Frank Sacks ◽  
Bernard Rosner ◽  
Walter C Willett ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Dairy Products ◽  
Lower Risk ◽  
Whole Grains ◽  
Health Study ◽  
Fat Intake ◽  
Men And Women ◽  
Dairy Fat

ABSTRACT Background Previous studies have examined dairy products with various fat contents in relation to type 2 diabetes (T2D) risk, although data regarding dairy fat intake per se are sparse. Objectives We aimed to evaluate the association between dairy fat intake and risk of T2D in 3 prospective cohorts. We also examined associations for isocalorically replacing dairy fat with other macronutrients. Methods We prospectively followed 41,808 men in the Health Professionals Follow-Up Study (HPFS; 1986–2012), 65,929 women in the Nurses’ Health Study (NHS; 1984–2012), and 89,565 women in the NHS II (1991–2013). Diet was assessed quadrennially using validated FFQs. Fat intake from dairy products and other relevant sources was expressed as percentage of total energy. Self-reported incident T2D cases were confirmed using validated supplementary questionnaires. Time-dependent Cox proportional hazards regression was used to estimate the HR for dairy fat intake and T2D risk. Results During 4,219,457 person-years of follow-up, we documented 16,511 incident T2D cases. Dairy fat was not associated with risk of T2D when compared with calories from carbohydrates (HR for extreme quintiles: 0.98; 95% CI: 0.95, 1.02). Replacing 5% of calories from dairy fat with other sources of animal fat or carbohydrate from refined grains was associated with a 17% (HR: 1.17; 95% CI: 1.13, 1.21) and a 4% (HR: 1.04; 95% CI: 1.00, 1.08) higher risk of T2D, respectively. Conversely, a 5% calorie replacement with carbohydrate from whole grains was associated with a 7% lower risk of T2D (HR: 0.93; 95% CI: 0.88, 0.98). Conclusions Dairy fat intake was not associated with T2D risk in these cohort studies of US men and women when compared with calories from carbohydrate. Replacing dairy fat with carbohydrates from whole grains was associated with lower risk of T2D. Replacement with other animal fats or refined carbohydrates was associated with higher risk.

scholarly journals Epidemiological support for the protection of whole grains against diabetes

2003 ◽  
Vol 62 (1) ◽  
pp. 143-149 ◽  
Author(s):  
Maureen A. Murtaugh ◽  
David R. Jacobs ◽  
Brenda Jacob ◽  
Lyn M. Steffen ◽  
Leonard Marquart
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Control ◽  
Whole Grains ◽  
Overweight And Obesity ◽  
Whole Grain ◽  
Incident Type ◽  
Fibre Intake ◽  
Incident Type 2 Diabetes ◽  
Grain Foods

The epidemic of type 2 diabetes among children, adolescents and adults is increasing along with the increasing prevalence of overweight and obesity. Overweight is the most powerful modifiable risk factor for type 2 diabetes. Intake of whole-grain foods may reduce diabetes risk. Three prospective studies in 160 000 men and women examined the relationship of whole-grain or cereal-fibre intake with the risk of type 2 diabetes. Each study used a mailed Willett food-frequency questionnaire and similar methods of quantifying whole-grain foods and cereal fibre. The self-reported incident diabetes outcome was more reliably determined in the two studies of health-care professionals than in the study of Iowa women. Risk for incident type 2 diabetes was 21–27% lower for those in the highest quintile of whole-grain intake, and 30–36% lower in the highest quintile of cereal-fibre intake, each compared with the lowest quintile. Risk reduction persisted after adjustment for the healthier lifestyle found among habitual whole-grain consumers. Observations in non-diabetic individuals support an inverse relationship between whole-grain consumption and fasting insulin levels. In feeding studies in non-diabetic individuals insulin resistance was reduced using whole grains or diets rich in whole grains. Glucose control improved with diets rich in whole grains in feeding studies of subjects with type 2 diabetes. There is accumulating evidence to support the hypothesis that whole-grain consumption is associated with a reduced risk of incident type 2 diabetes; it may also improve glucose control in diabetic individuals.

scholarly journals Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
You-Bin Lee ◽  
Kyungdo Han ◽  
Bongsung Kim ◽  
Seung-Eun Lee ◽  
Ji Eun Jun ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Cox Regression ◽  
Early Mortality ◽  
Hazard Ratios ◽  
Epidemiological Characteristics

Abstract Background Both type 1 and type 2 diabetes are well-established risk factors for cardiovascular disease and early mortality. However, few studies have directly compared the hazards of cardiovascular outcomes and premature death among people with type 1 diabetes to those among people with type 2 diabetes and subjects without diabetes. Furthermore, information about the hazard of cardiovascular disease and early mortality among Asians with type 1 diabetes is sparse, although the clinical and epidemiological characteristics of Asians with type 1 diabetes are unlike those of Europeans. We estimated the hazard of myocardial infarction (MI), hospitalization for heart failure (HF), atrial fibrillation (AF), and mortality during follow-up in Korean adults with type 1 diabetes compared with those without diabetes and those with type 2 diabetes. Methods We used Korean National Health Insurance Service datasets of preventive health check-ups from 2009 to 2016 in this retrospective longitudinal study. The hazard ratios of MI, HF, AF, and mortality during follow-up were analyzed using the Cox regression analyses according to the presence and type of diabetes in ≥ 20-year-old individuals without baseline cardiovascular disease (N = 20,423,051). The presence and type of diabetes was determined based on the presence of type 1 or type 2 diabetes at baseline. Results During more than 93,300,000 person-years of follow-up, there were 116,649 MIs, 135,532 AF cases, 125,997 hospitalizations for HF, and 344,516 deaths. The fully-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident MI, hospitalized HF, AF, and all-cause death within the mean follow-up of 4.6 years were higher in the type 1 diabetes group than the type 2 diabetes [HR (95% CI) 1.679 (1.490–1.893) for MI; 2.105 (1.901–2.330) for HF; 1.608 (1.411–1.833) for AF; 1.884 (1.762–2.013) for death] and non-diabetes groups [HR (95% CI) 2.411 (2.138–2.718) for MI; 3.024 (2.730–3.350) for HF; 1.748 (1.534–1.993) for AF; 2.874 (2.689–3.073) for death]. Conclusions In Korea, the presence of diabetes was associated with a higher hazard of cardiovascular disease and all-cause death. Specifically, people with type 1 diabetes had a higher hazard of cardiovascular disease and all-cause mortality compared to people with type 2 diabetes.

scholarly journals Whole grain consumption has a modest effect on the development of diabetes in the Goto–Kakisaki rat

2011 ◽  
Vol 107 (2) ◽  
pp. 192-201 ◽  
Author(s):  
Moonyeon Youn ◽  
A. Saari Csallany ◽  
Daniel D. Gallaher
Keyword(s):  
Oxidative Stress ◽  
Type 2 Diabetes ◽  
Cell Mass ◽  
Thiobarbituric Acid ◽  
Basal Diet ◽  
Whole Grains ◽  
Whole Grain ◽  
Wheat Group ◽  
Basal Group

Epidemiological evidence suggests that whole grain intake is associated with reduced risk of type 2 diabetes. However, studies of individual whole grains on the prevention of type 2 diabetes are lacking. The objective of the present study was to examine the effect of different whole grains on type 2 diabetes in an animal model of type 2 diabetes, the Goto–Kakisaki (GK) rat. GK rats were fed either a basal diet or a whole grain-containing diet for 5 months. Whole grain diets contained 65 % whole grain flours of wheat, barley, oats or maize. After 2 months of feeding, fasting plasma glucose concentrations were lower in the wheat, barley and oats groups, compared with the basal group, whereas glycated Hb was significantly greater in the wheat group compared with other groups. Feeding of whole barley and maize increased plasma C-peptide concentrations compared with whole wheat at 2 months. There was a trend in the improvement of insulin resistance with a consumption of barley and oats diets at 2 months (P = 0·06) compared with the basal diet. Oxidative stress markers, urinary thiobarbituric acid-reactive substances and 8-isoprostane, did not improve with whole grain intake at 2 months. At 5 months, whole grain diets did not differ from the basal diet in glycaemic control, insulin secretion, oxidative stress and preservation of pancreatic β-cell mass. These results suggest that the consumption of whole grains may offer modest benefit early in the development of type 2 diabetes, but this benefit is lost with further development of the disease.

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 &gt;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 &lt;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 May the Mediterranean diet attenuate the risk of type 2 diabetes associated with obesity: the Seguimiento Universidad de Navarra (SUN) cohort

2017 ◽  
Vol 117 (10) ◽  
pp. 1478-1485 ◽  
Author(s):  
Sonia Eguaras ◽  
Maira Bes-Rastrollo ◽  
Miguel Ruiz-Canela ◽  
Silvia Carlos ◽  
Pedro de la Rosa ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Adverse Effects ◽  
Mediterranean Diet ◽  
Weight Changes ◽  
Product Term ◽  
Hazard Ratios ◽  
The Mediterranean ◽  
Incident Cases

AbstractIt is likely that the Mediterranean diet (MedDiet) may mitigate the adverse effects of obesity on the incidence of type 2 diabetes mellitus (T2DM). We assessed this hypothesis in a cohort of 18 225 participants initially free of diabetes (mean age: 38 years, 61 % women). A validated semi-quantitative 136-item FFQ was used to assess dietary intake and to build a 0–9 score of adherence to MedDiet. After a median of 9·5-year follow-up, 136 incident cases of T2DM were confirmed during 173 591 person-years follow-up. When MedDiet adherence was low (≤4 points), the multivariable-adjusted hazard ratios (HR) were 4·07 (95 % CI 1·58, 10·50) for participants with BMI 25–29·99 kg/m2 and 17·70 (95 % CI 6·29, 49·78) kg/m2 for participants with BMI≥30 kg/m2, (v.<25 kg/m2). In the group with better adherence to the MedDiet (>4 points), these multivariable-adjusted HR were 3·13 (95 % CI 1·63, 6·01) and 10·70 (95 % CI 4·98, 22·99) for BMI 25–30 and ≥30 kg/m2, respectively. The P value for the interaction was statistically significant (P=0·002). When we assessed both variables (BMI and MedDiet) as continuous, the P value for their interaction product-term was marginally significant (P=0·051) in fully adjusted models. This effect modification was not explained by weight changes during follow-up. Our results suggest that the MedDiet may attenuate the adverse effects of obesity on the risk of T2DM.

scholarly journals Sudomotor dysfunction independently predicts incident cardiovascular–renal events and all-cause death in type 2 diabetes: the Joint Asia Diabetes Evaluation register

2018 ◽  
Vol 34 (8) ◽  
pp. 1320-1328 ◽  
Author(s):  
Lee Ling Lim ◽  
Amy W C Fu ◽  
Eric S H Lau ◽  
Risa Ozaki ◽  
Kitty K T Cheung ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Screening Strategy ◽  
Composite Score ◽  
Risk Markers ◽  
Chinese Adults ◽  
Non Invasive ◽  
Hazard Ratios ◽  
Never Smokers

AbstractBackgroundEarly detection and risk factor control prevent chronic kidney disease (CKD) progression. Evaluation of peripheral autonomic dysfunction may detect incident cardiovascular–renal events in type 2 diabetes (T2D).MethodsSUDOSCAN, a non-invasive tool, provides an age-adjusted electrochemical skin conductance (ESC) composite score incorporating hands/feet ESC measurements, with a score ≤53 indicating sudomotor dysfunction. A consecutive cohort of 2833 Chinese adults underwent structured diabetes assessment in 2012–13; 2028 participants without preexisting cardiovascular disease (CVD) and CKD were monitored for incident cardiovascular–renal events until 2015.ResultsIn this prospective cohort {mean age 57.0 [standard deviation (SD) 10.0] years; median T2D duration 7.0 [interquartile range (IQR) 3.0–13.0] years; 56.1% men; 72.5% never-smokers; baseline ESC composite score 60.7 (SD 14.5)}, 163 (8.0%) and 25 (1.2%) participants developed incident CKD and CVD, respectively, after 2.3 years of follow-up. The adjusted hazard ratios (aHRs) per 1-unit decrease in the ESC composite score for incident CKD, CVD and all-cause death were 1.02 [95% confidence interval (CI) 1.01–1.04], 1.04 (1.00–1.07) and 1.04 (1.00–1.08), respectively. Compared with participants with an ESC composite score >53, those with a score ≤53 had an aHR of 1.56 (95% CI 1.09–2.23) for CKD and 3.11 (95% CI 1.27–7.62) for CVD, independent of common risk markers. When added to clinical variables (sex and duration of diabetes), the ESC composite score improved discrimination of all outcomes with appropriate reclassification of CKD risk.ConclusionsA low ESC composite score independently predicts incident cardiovascular–renal events and death in T2D, which may improve the screening strategy for early intervention.

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