Intentional weight loss as a predictor of type 2 diabetes occurrence in a general adult population

IntroductionObservational and intervention studies have verified that weight loss predicts a reduced type 2 diabetes (T2D) risk. At the population level, knowledge on the prediction of self-report intentional weight loss (IWL) on T2D incidence is, however, sparse. We studied the prediction of self-report IWL on T2D incidence during a 15-year follow-up in a general adult population.Research design and methodsThe study sample from the representative Finnish Health 2000 Survey comprised 4270 individuals, aged 30–69 years. IWL was determined with questions concerning dieting attempts and weight loss during the year prior to baseline. Incident T2D cases during a 15-year follow-up were drawn from national health registers. The strength of the association between IWL and T2D incidence was estimated with the Cox model.ResultsDuring the follow-up, 417 incident cases of T2D occurred. IWL predicted an increased risk of T2D incidence (HR 1.44; 95% CI 1.11 to 1.87, p=0.008) in a multivariable model. In interaction analyses comparing individuals with and without IWL, a suggestively elevated risk emerged in men, the younger age group, among less-educated people and in individuals with unfavorable values in several lifestyle factors.ConclusionsSelf-report IWL may predict an increased risk of T2D in long-term, probably due to self-implemented IWL tending to fail. The initial prevention of weight gain and support for weight maintenance after weight loss deserve greater emphasis in order to prevent 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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Regular consumption of soft drinks is associated with type 2 diabetes incidence in Mexican adults: findings from a prospective cohort study

Nutrition Journal ◽

10.1186/s12937-020-00642-9 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Leticia Torres-Ibarra ◽

Berenice Rivera-Paredez ◽

Rubí Hernández-López ◽

Francisco Canto-Osorio ◽

Luz María Sánchez-Romero ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Prospective Cohort ◽

Soft Drinks ◽

Self Report ◽

Diabetes Incidence ◽

Increased Risk ◽

Mexican Adults ◽

Incident Cases

Abstract Background Although high consumption of soft drinks has been associated with excess of type 2 diabetes risk, the strength of this association in the Mexican population, where a type 2 diabetes genetic susceptibility has been well established, has been scarcely studied. This study aimed to estimate the risk of type 2 diabetes due to soft drinks consumption in a cohort of Mexicans. Methods We used data on 1445 participants from the Health Workers Cohort Study, a prospective cohort conducted in Cuernavaca, Mexico. Soft drinks consumption was assessed with a semi-quantitative 116-item food frequency questionnaire. Incident type 2 diabetes was defined as self-report of physician-diagnosed type 2 diabetes, fasting glucose > 126 mg/dl, or hypoglycemic medication at any examination. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. Results With a total of 9526.2 person-years of follow-up, 109 incident cases of type 2 diabetes were observed. Type 2 diabetes incidence rate was 7.6, 11.0, and 17.1 per 1000 person-years across levels of soft drinks consumption of < 1, 1–4, and ≥ 5 servings/week, respectively (p < 0.001 for trend). The intake of ≥5 soft drinks/week was significantly associated with an increased risk of type 2 diabetes (HR 1.9 95% CI:1.0–3.5) compared with consumption of < 1/week (p-trend = 0.040). The HR was attenuated by further adjustment for body mass index (HR 1.5 95%CI:0.8–2.8) and abdominal obesity (HR 1.6 95%CI:0.8–3.0). Conclusions The consumption of soft drinks was associated with a higher risk of type 2 diabetes in a cohort of Mexican adults. Our results further support recommendations to limit soft drinks intake to address the growing diabetes epidemic in Mexico.

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Anti-diabetic Treatment in Obese Patients with Type 2 Diabetes Effects of Medication on Body Weight

US Endocrinology ◽

10.17925/use.2006.00.02.1n ◽

2006 ◽

Vol 00 (02) ◽

Author(s):

Andrew J Krentz

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Weight Loss ◽

Vascular Complications ◽

Obese Patients ◽

Intentional Weight Loss ◽

Increased Risk ◽

Potential Benefits ◽

Diabetic Treatment

Obesity is a major risk factor for the development of type 2 diabetes;1–3moreover, the presence of obesity in type 2 diabetes is associated with an increased risk of vascular complications associated with the disorder.4,5The majority of patients are overweight or obese at diagnosis of type2diabetes. Recent clinical trials have demonstrated that progression to diabetes in obese patients with impaired glucose tolerance can be prevented through weight reduction and increased levels of physical activity.6,7For patients who have developed type 2 diabetes, intentional weight loss has many potential benefits including improved metabolic control and a reduced need for antidiabetic medications.8–10

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Abstract 20: Carbohydrate Quality, Measured Using Multiple Carbohydrate Quality Metrics, is Negatively Associated with Risk of Type 2 Diabetes in US Women

Circulation ◽

10.1161/circ.131.suppl_1.20 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Hala AlEssa ◽

Shilpa Bhupathiraju ◽

Vasanti Malik ◽

Nicole Wedick ◽

Hannia Campos ◽

...

Keyword(s):

Type 2 Diabetes ◽

Quality Metrics ◽

Dietary Factors ◽

Increased Risk ◽

Carbohydrate Quality ◽

Cereal Fiber ◽

High Starch ◽

Incident Cases

Background: Carbohydrate quality may be an important determinant of type 2 diabetes (T2D), however, the relationships between various carbohydrate quality metrics and T2D risk have not been systematically investigated. Objective: To prospectively examine the association between carbohydrate, starch, fiber, and different combinations of these nutrients in relation to the risk of T2D in US women. Methods: We prospectively collected information on diet and lifestyle behaviors among 70,041 women from the Nurses Health Study every 2-4 years, after baseline in 1984. These participants were free of diagnosed cardiovascular disease, cancer, or diabetes at baseline. We used Cox proportional hazards regression models to assess the association between dietary factors of interest and incidence of T2D. Results: With 24 years of follow-up we ascertained 6,934 incident cases of T2D during 1,484, 213 person years of follow-up. After adjusting for age, lifestyle and dietary variables, total carbohydrate intake was not associated with T2D (RR=0.98, 95% CI: 0.89 - 1.08, p for trend=0.84), while starch was positively associated with T2D (RR=1.23, 95%CI: 1.12 - 1.35), p for trend <0.0001), comparing the highest to lowest quintile. Total fiber (RR= 0.80, 95%CI: 0.72 - 0.89, p for trend < 0.0001), cereal fiber (RR= 0.71, 95%CI: 0.65 - 0.78, p for trend < 0.0001) and fruit fiber (RR= 0.80, 95%CI: 0.73 - 0.88, p for trend < 0.0001) were all inversely associated with T2D, comparing extreme quintiles. . There was a borderline significant positive association between the ratio of carbohydrate to total fiber intake and risk of T2D (RR= 1.09, 95%CI: 1.00 - 1.20, p for trend = 0.039), and stronger positive associations between the ratios of carbohydrate to cereal fiber (RR= 1.28, 95%CI: 1.17 - 1.39, p for trend < 0.0001), starch to total fiber (RR= 1.12, 95%CI: 1.02 - 1.23, p for trend = 0.030) and starch to cereal fiber (RR= 1.39, 95%CI: 1.27 - 1.53, p for trend < 0.0001) with T2D, comparing extreme quintiles.. Conclusion: Diets with high starch, low fiber and high starch to cereal fiber ratio were associated with increased risk of T2D. Using the starch to cereal fiber ratio of the overall diet is a potentially useful way of assessing carbohydrate quality in relation to T2D.

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Regular use of proton pump inhibitors and risk of type 2 diabetes: results from three prospective cohort studies

Gut ◽

10.1136/gutjnl-2020-322557 ◽

2020 ◽

pp. gutjnl-2020-322557 ◽

Cited By ~ 2

Author(s):

Jinqiu Yuan ◽

Qiangsheng He ◽

Long H Nguyen ◽

Martin C S Wong ◽

Junjie Huang ◽

...

Keyword(s):

Type 2 Diabetes ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Controlled Trial ◽

Health Study ◽

Increased Risk ◽

Randomised Controlled ◽

Incident Cases

ObjectiveThe association between the regular use of proton pump inhibitors (PPIs) and the risk of type 2 diabetes remains unclear, although a recent randomised controlled trial showed a trend towards increased risk. This study was undertaken to evaluate the regular use of PPIs and risk of type 2 diabetes.MethodThis is a prospective analysis of 204 689 participants free of diabetes in the Nurses' Health Study (NHS), NHS II and Health Professionals Follow-up Study (HPFS). Type 2 diabetes was confirmed using American Diabetes Association (ADA) diagnostic criteria. We evaluated hazard ratios (HRs) adjusting for demographic factors, lifestyle habits, the presence of comorbidities, use of other medications and clinical indications.ResultsWe documented 10 105 incident cases of diabetes over 2 127 471 person-years of follow-up. Regular PPI users had a 24% higher risk of diabetes than non-users (HR 1.24, 95% CI 1.17 to 1.31). The risk of diabetes increased with duration of PPI use. Fully adjusted HRs were 1.05 (95% CI 0.93 to 1.19) for participants who used PPIs for >0–2 years and 1.26 (95% CI 1.18 to 1.35) for participants who used PPIs for >2 years compared with non-users.ConclusionsRegular use of PPIs was associated with a higher risk of type 2 diabetes and the risk increased with longer duration of use. Physicians should therefore exercise caution when prescribing PPIs, particularly for long-term use.

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Intentional weight loss as a predictor of type 2 diabetes occurrence in a general population

Proceedings of The Nutrition Society ◽

10.1017/s0029665120001536 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Laura Sares-Jäske ◽

Paul Knekt ◽

Antti Eranti ◽

Satu Männistö ◽

Olavi Lindfors ◽

...

Keyword(s):

Type 2 Diabetes ◽

Weight Loss ◽

Weight Gain ◽

General Population ◽

Population Level ◽

Elevated Risk ◽

Metabolic Health ◽

Intentional Weight Loss

AbstractObesity is a major risk factor of type 2 diabetes (T2D). Accordingly, weight loss is being used to reduce this risk. Intervention studies have shown a T2D risk reduction due to weight loss in populations with an elevated risk. Data on the prediction of intentional weight loss (IWL) on diabetes occurrence at population level is, however, sparse. Since in observational studies IWL has been shown to predict later weight gain, possibly leading to adverse consequences, this study examined the prediction of IWL on T2D occurrence in a general population. Data from the representative Finnish Health 2000 Survey conducted in 2000–2001 was used. The study sample consisted of 1962 men and 2308 women, aged 30–69. Information on IWL during the previous year was collected with a questionnaire. Data for the covariates was collected with a health examination, interviews and questionnaires. Incident T2D cases during a 15-year follow-up were drawn from national health registers covering information on medication use, hospitalization, and cause of death. The Cox model was used to estimate strength of association between IWL and T2D occurrence. During the follow-up, 417 individuals developed a T2D. After adjusting for socio-demographic and lifestyle factors and the components of metabolic syndrome, IWL predicted an increased risk of T2D occurrence (HR 1.44; 95% CI 1.11–1.87) compared to individuals without IWL. Moreover, in interaction analyses, the risk in individuals with IWL compared to those without IWL was pronounced in younger age group and in those with the lowest quality diet. Furthermore, an elevated risk was consistently found in persons with IWL and overweight (BMI ≥ 25 kg/m2), also in combination with different aspects of poor health (i.e. mental health, self-perceived health, metabolic health). In the present cohort, IWL predicted an increased subsequent risk of developing T2D. This may be due to that in long-term at population level IWL causes an elevated risk of T2D e.g. by acting as a promotor for weight gain or by causing weight cycling resulting in unfavorable changes in metabolic health indicators. Alternatively, it cannot be excluded, that individuals reporting IWL already are at a greater risk of T2D and pursue IWL in response to that. Greater emphasis should be put on the initial prevention of weight gain and on the support on the weight maintenance after weight loss. Further cohort studies with repeated measurements on dieting behavior and changes in weight are needed.

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Regular consumption of soft drinks is associated with type 2 diabetes incidence in Mexican adults: findings from a prospective cohort study.

10.21203/rs.3.rs-51105/v2 ◽

2020 ◽

Author(s):

Leticia Torres-Ibarra ◽

Berenice Rivera-Paredez ◽

Rubí Hernández-López ◽

Francisco Canto-Osorio ◽

Luz María Sánchez-Romero ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Prospective Cohort ◽

Soft Drinks ◽

Self Report ◽

Diabetes Incidence ◽

Increased Risk ◽

Mexican Adults ◽

Incident Cases

Abstract Background: Although high consumption of soft drinks has been associated with excess of type 2 diabetes risk, the strength of this association in the Mexican population, where a type 2 diabetes genetic susceptibility has been well established, has been scarcely studied. This study aimed to estimate the risk of type 2 diabetes due to soft drinks consumption in a cohort of Mexicans. Methods: We used data on 1,445 participants from the Health Workers Cohort Study, a prospective cohort conducted in Cuernavaca, Mexico. Soft drinks consumption was assessed with a semi-quantitative 116-item food frequency questionnaire. Incident type 2 diabetes was defined as self-report of physician-diagnosed type 2 diabetes, fasting glucose >126 mg/dl, or hypoglycemic medication at any examination. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models.Results: With a total of 9,526.2 person-years of follow-up, 109 incident cases of type 2 diabetes were observed. Type 2 diabetes incidence rate was 7.6, 11.0, and 17.1 per 1,000 person-years across levels of soft drinks consumption of <1, 1-4, and ³5 servings/week, respectively (p<0.001 for trend). The intake of ≥5 soft drinks/week was significantly associated with an increased risk of type 2 diabetes (HR 1.9 95% CI:1.0-3.5) compared with consumption of <1/week (p-trend=0.040). The HR was attenuated by further adjustment for body mass index (HR 1.5 95%CI:0.8-2.8) and abdominal obesity (HR 1.6 95%CI:0.8-3.0). Conclusions: The consumption of soft drinks was associated with a higher risk of type 2 diabetes in a cohort of Mexican adults. Our results further support recommendations to limit soft drinks intake to address the growing diabetes epidemic in Mexico.

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Depression-related weight change and incident diabetes in a community sample

Scientific Reports ◽

10.1038/s41598-021-92963-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Eva Graham ◽

Tristan Watson ◽

Sonya S. Deschênes ◽

Kristian B. Filion ◽

Mélanie Henderson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Weight Loss ◽

Weight Gain ◽

Weight Change ◽

Short Form ◽

Community Sample ◽

Overweight And Obesity ◽

Community Dwelling ◽

Increased Risk

AbstractThis cohort study aimed to compare the incidence of type 2 diabetes in adults with depression-related weight gain, depression-related weight loss, depression with no weight change, and no depression. The study sample included 59,315 community-dwelling adults in Ontario, Canada. Depression-related weight change in the past 12 months was measured using the Composite International Diagnostic Interview—Short Form. Participants were followed for up to 20 years using administrative health data. Cox proportional hazards models compared the incidence of type 2 diabetes in adults with depression-related weight change and in adults with no depression. Adults with depression-related weight gain had an increased risk of type 2 diabetes compared to adults no depression (HR 1.70, 95% CI 1.32–2.20), adults with depression-related weight loss (HR 1.62, 95% CI 1.09–2.42), and adults with depression with no weight change (HR 1.39, 95% CI 1.03–1.86). Adults with depression with no weight change also had an increased risk of type 2 diabetes compared to those with no depression (HR 1.23, 95% CI 1.04–1.45). Associations were stronger among women and persisted after adjusting for attained overweight and obesity. Identifying symptoms of weight change in depression may aid in identifying adults at higher risk of type 2 diabetes and in developing tailored prevention strategies.

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Life-course trajectories of weight and their impact on the incidence of type 2 diabetes

Scientific Reports ◽

10.1038/s41598-021-91910-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Diego Yacamán-Méndez ◽

Ylva Trolle-Lagerros ◽

Minhao Zhou ◽

Antonio Monteiro Ponce de Leon ◽

Hrafnhildur Gudjonsdottir ◽

...

Keyword(s):

Type 2 Diabetes ◽

Life Course ◽

Risk Ratio ◽

Absolute Risk ◽

Early Adulthood ◽

Normal Weight ◽

Overweight And Obesity ◽

Increased Risk ◽

Incident Cases

AbstractAlthough exposure to overweight and obesity at different ages is associated to a higher risk of type 2 diabetes, the effect of different patterns of exposure through life remains unclear. We aimed to characterize life-course trajectories of weight categories and estimate their impact on the incidence of type 2 diabetes. We categorized the weight of 7203 participants as lean, normal or overweight at five time-points from ages 7–55 using retrospective data. Participants were followed for an average of 19 years for the development of type 2 diabetes. We used latent class analysis to describe distinctive trajectories and estimated the risk ratio, absolute risk difference and population attributable fraction (PAF) associated to different trajectories using Poisson regression. We found five distinctive life-course trajectories. Using the stable-normal weight trajectory as reference, the stable overweight, lean increasing weight, overweight from early adulthood and overweight from late adulthood trajectories were associated to higher risk of type 2 diabetes. The estimated risk ratios and absolute risk differences were statistically significant for all trajectories, except for the risk ratio of the lean increasing trajectory group among men. Of the 981 incident cases of type 2 diabetes, 47.4% among women and 42.9% among men were attributable to exposure to any life-course trajectory different from stable normal weight. Most of the risk was attributable to trajectories including overweight or obesity at any point of life (36.8% of the cases among women and 36.7% among men). The overweight from early adulthood trajectory had the highest impact (PAF: 23.2% for woman and 28.5% for men). We described five distinctive life-course trajectories of weight that were associated to increased risk of type 2 diabetes over 19 years of follow-up. The variability of the effect of exposure to overweight and obesity on the risk of developing type 2 diabetes was largely explained by exposure to the different life-course trajectories of weight.

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Vitamin D status and risk of type 2 diabetes in the Norwegian HUNT cohort study: does family history or genetic predisposition modify the association?

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001948 ◽

2021 ◽

Vol 9 (1) ◽

pp. e001948

Author(s):

Marion Denos ◽

Xiao-Mei Mai ◽

Bjørn Olav Åsvold ◽

Elin Pettersen Sørgjerd ◽

Yue Chen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Family History ◽

Genetic Predisposition ◽

Effect Modification ◽

P Value ◽

Family History Of Diabetes ◽

Increased Risk ◽

History Of

IntroductionWe sought to investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and the risk of type 2 diabetes mellitus (T2DM) in adults who participated in the Trøndelag Health Study (HUNT), and the possible effect modification by family history and genetic predisposition.Research design and methodsThis prospective study included 3574 diabetes-free adults at baseline who participated in the HUNT2 (1995–1997) and HUNT3 (2006–2008) surveys. Serum 25(OH)D levels were determined at baseline and classified as <50 and ≥50 nmol/L. Family history of diabetes was defined as self-reported diabetes among parents and siblings. A Polygenic Risk Score (PRS) for T2DM based on 166 single-nucleotide polymorphisms was generated. Incident T2DM was defined by self-report and/or non-fasting glucose levels greater than 11 mmol/L and serum glutamic acid decarboxylase antibody level of <0.08 antibody index at the follow-up. Multivariable logistic regression models were applied to calculate adjusted ORs with 95% CIs. Effect modification by family history or PRS was assessed by likelihood ratio test (LRT).ResultsOver 11 years of follow-up, 92 (2.6%) participants developed T2DM. A higher risk of incident T2DM was observed in participants with serum 25(OH)D level of<50 nmol/L compared with those of ≥50 nmol/L (OR 1.72, 95% CI 1.03 to 2.86). Level of 25(OH)D<50 nmol/L was associated with an increased risk of T2DM in adults without family history of diabetes (OR 3.87, 95% CI 1.62 to 9.24) but not in those with a family history (OR 0.72, 95% CI 0.32 to 1.62, p value for LRT=0.003). There was no effect modification by PRS (p value for LRT>0.23).ConclusionSerum 25(OH)D<50 nmol/L was associated with an increased risk of T2DM in Norwegian adults. The inverse association was modified by family history of diabetes but not by genetic predisposition to T2DM.

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