scholarly journals A Shift Toward a Plant-Centered Diet from Young to Middle Adulthood and Subsequent Risk of Type 2 Diabetes and Weight Gain: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Author(s):  
Yuni Choi ◽  
Nicole Larson ◽  
Daniel D. Gallaher ◽  
Andrew O. Odegaard ◽  
Jamal S. Rana ◽  
...  

<b>OBJECTIVE: </b>To examine the associations between change in plant-centered diet quality and type 2 diabetes risk and change in body size. <p><b>RESEARCH DESIGN AND METHODS: </b>A<b> </b>prospective study conducted in the US enrolled adults ages 18–30 years in 1985–1986 (exam year [Y0]) and followed them through 2015–2016. <a>We analyzed the associations between change in plant-centered diet quality over 20 years (Y0–Y20) and diabetes (Y20–30, n=2,534) and change (Y0–Y20 and Y20–30) in body mass index (BMI), waist circumference (WC), and weight (n > 2,434). </a>Plant-centered diet quality was measured using the A Priori Diet Quality Score (APDQS); a higher score favors nutritionally-rich plant foods. Cox regression models were used to assess diabetes risk and linear regression models were used to examine change in body size.</p> <p><b>RESULTS: </b>During mean follow-up of 9.3 (±1.7) years, 206 incident diabetes cases occurred. In multivariable analysis, participants with the largest increase in APDQS over 20 years had a 48% (95% CI: 0.31–0.85; P-trend < 0.001) lower risk of diabetes over the subsequent 10–years compared with participants whose score remained stable. <a>Each 1–SD increment in APDQS over 20 years was associated with lower gains in BMI (-0.39 kg/m<sup>2</sup>, SE: 0.14; P=0.004), WC (-0.90 cm, SE: 0.27; P < 0.001), and weight (-1.14 kg, SE: 0.33; P < 0.001) during the same period, but not with subsequent changes.</a></p> <p><b>CONCLUSIONS: </b>Young adults who increased plant-centered diet quality had a lower diabetes risk and gained less weight by middle adulthood.<b></b></p>

2020 ◽  
Author(s):  
Yuni Choi ◽  
Nicole Larson ◽  
Daniel D. Gallaher ◽  
Andrew O. Odegaard ◽  
Jamal S. Rana ◽  
...  

<b>OBJECTIVE: </b>To examine the associations between change in plant-centered diet quality and type 2 diabetes risk and change in body size. <p><b>RESEARCH DESIGN AND METHODS: </b>A<b> </b>prospective study conducted in the US enrolled adults ages 18–30 years in 1985–1986 (exam year [Y0]) and followed them through 2015–2016. <a>We analyzed the associations between change in plant-centered diet quality over 20 years (Y0–Y20) and diabetes (Y20–30, n=2,534) and change (Y0–Y20 and Y20–30) in body mass index (BMI), waist circumference (WC), and weight (n > 2,434). </a>Plant-centered diet quality was measured using the A Priori Diet Quality Score (APDQS); a higher score favors nutritionally-rich plant foods. Cox regression models were used to assess diabetes risk and linear regression models were used to examine change in body size.</p> <p><b>RESULTS: </b>During mean follow-up of 9.3 (±1.7) years, 206 incident diabetes cases occurred. In multivariable analysis, participants with the largest increase in APDQS over 20 years had a 48% (95% CI: 0.31–0.85; P-trend < 0.001) lower risk of diabetes over the subsequent 10–years compared with participants whose score remained stable. <a>Each 1–SD increment in APDQS over 20 years was associated with lower gains in BMI (-0.39 kg/m<sup>2</sup>, SE: 0.14; P=0.004), WC (-0.90 cm, SE: 0.27; P < 0.001), and weight (-1.14 kg, SE: 0.33; P < 0.001) during the same period, but not with subsequent changes.</a></p> <p><b>CONCLUSIONS: </b>Young adults who increased plant-centered diet quality had a lower diabetes risk and gained less weight by middle adulthood.<b></b></p>


Diabetologia ◽  
2019 ◽  
Vol 62 (12) ◽  
pp. 2298-2309 ◽  
Author(s):  
Ari V. Ahola-Olli ◽  
Linda Mustelin ◽  
Maria Kalimeri ◽  
Johannes Kettunen ◽  
Jari Jokelainen ◽  
...  

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.


2020 ◽  
Vol 150 (6) ◽  
pp. 1470-1477 ◽  
Author(s):  
Floor R Scheffers ◽  
Alet H Wijga ◽  
W M Monique Verschuren ◽  
Yvonne T van der Schouw ◽  
Ivonne Sluijs ◽  
...  

ABSTRACT Background Dietary guidelines on pure fruit juice consumption vary from country to country regarding the inclusion of pure fruit juice in the recommendations as an acceptable alternative for fruit. Current epidemiological evidence on the association between pure fruit juice consumption and diabetes risk is scarce. Objective We studied the association of both pure fruit juice and fruit consumption with diabetes risk and investigated the differences between low and high fruit consumers in the association of pure fruit juice consumption with diabetes risk. Methods This prospective cohort study included 36,147 participants in the European Prospective Investigation into Cancer and Nutrition–Netherlands (EPIC-NL) Study aged 20–69 y at baseline. Fruit juice and fruit consumption were assessed using a validated food-frequency questionnaire; amounts of consumption were divided into 5 categories and quintiles, respectively. Incident type 2 diabetes cases were mainly self-reported and verified against medical records. Cox regression was used to estimate adjusted HRs and 95% CIs. Results After an average follow-up of 14.6 y, 1477 verified incident cases of type 2 diabetes were documented. Compared with no consumption, pure fruit juice consumption was not significantly associated with type 2 diabetes, with adjusted HRs ranging from 0.92 (95% CI: 0.79, 1.09) to 1.03 (95% CI: 0.83, 1.26). The associations did not differ between participants with low and high fruit consumption. None of the categories of fruit consumption were associated with type 2 diabetes (lowest quintile as reference). Adjusted HRs ranged between 0.93 (95% CI: 0.78, 1.10) and 1.00 (95% CI: 0.84, 1.19). Adjustment for the Dutch Healthy Diet Index, as an overall measure of dietary quality, strongly attenuated the observed associations of type 2 diabetes with both fruit juice and fruit consumption. Conclusions We found no evidence for associations between pure fruit juice and fruit consumption and diabetes risk after adjustment for overall dietary quality for participants in the EPIC-NL study. This trial was registered at https://www.trialregister.nl/trial/6939 as NL6939.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Hyunju Kim ◽  
Dan Wang ◽  
John Chalmers ◽  
Mark Woodward ◽  
Elizabeth Selvin ◽  
...  

Introduction: Creatinine-based estimated glomerular filtration rate (eGFR) is biased in the setting of obesity and other conditions. Alternative kidney filtration markers may be particularly useful in adults with diabetes, but few studies examined the risk of clinical outcomes associated with filtration markers in adults with type 2 diabetes. Objective: We evaluated whether baseline levels and change in eGFR based on creatinine (Cr), cystatin C (Cys), and B 2 -microglobulin (B2M) were associated with the risk of clinical outcomes among individuals with type 2 diabetes. Methods: In the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial, Cr, Cys, and B2M were measured in 7,217 participants at baseline and a random sample of 640 participants at the 1 year visit. We categorized baseline eGFR Cr , eGFR Cys , eGFR B2M , and the average across the 3 eGFR estimates (eGFR avg ) into quarters, and examined associations with major macrovascular and microvascular events together, and separately, and all-cause mortality using Cox regression models, adjusting for established risk factors. We also examined associations with continuous eGFR decline and increase (per 30%). Results: Over a median follow-up of 5 years, 1,313 combined major macrovascular (n=748) and microvascular events (n=637), and 743 deaths occurred. Lower levels of eGFR based on all three filtration markers individually and combined were associated with 1.5 to 2.2 times higher risk of combined major macrovascular and microvascular events, with similar patterns for other outcomes ( Table ). Per 30% decline in eGFR Cys and eGFR avg were associated with a >2-fold higher risk of all clinical outcomes, after additional adjustment of baseline eGFR. Conclusions: In adults with type 2 diabetes, baseline levels of eGFR based on alternative filtration markers and per 30% decline in eGFR Cys and eGFR avg were consistently associated with all clinical outcomes.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Yuni Choi ◽  
David Jacobs ◽  
Kristin Hirahatake ◽  
Nicole Larson ◽  
Andrew Odegaard ◽  
...  

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


2019 ◽  
Vol 2 (4) ◽  
Author(s):  
Rebeca Eriksen ◽  
Rachel Gibson ◽  
Maria Aresu ◽  
Andy Heard ◽  
Queenie Chan ◽  
...  

Diabetes Care ◽  
2020 ◽  
Vol 43 (11) ◽  
pp. 2796-2803
Author(s):  
Yuni Choi ◽  
Nicole Larson ◽  
Daniel D. Gallaher ◽  
Andrew O. Odegaard ◽  
Jamal S. Rana ◽  
...  

2014 ◽  
Vol 112 (6) ◽  
pp. 945-951 ◽  
Author(s):  
Amani Alhazmi ◽  
Elizabeth Stojanovski ◽  
Mark McEvoy ◽  
Wendy Brown ◽  
Manohar L. Garg

The present study aimed to determine the ability of two diet quality scores to predict the incidence of type 2 diabetes in women. The study population comprised a nationally representative sample of 8370 Australian middle-aged (45–50 years) women participating in the ALSWH (Australian Longitudinal Study on Women's Health), who were free of diabetes and completed FFQ at baseline. The associations between the Australian Recommended Food Score (ARFS) and Dietary Guideline Index (DGI) with type 2 diabetes risk were assessed using multiple logistic regression models, adjusting for sociodemographic characteristics, lifestyle factors and energy intake. During 6 years of follow-up, 311 incident cases of type 2 diabetes were reported. The DGI score was inversely associated with type 2 diabetes risk (OR comparing the highest with the lowest quintile of DGI was 0·51; 95 % CI 0·35, 0·76; P for trend = 0·01). There was no statistically significant association between the ARFS and type 2 diabetes risk (OR comparing the highest with the lowest quintile of ARFS was 0·99; 95 % CI 0·68, 1·43; P for trend = 0·42). The results of the present prospective study indicate that the DGI score, which assesses compliance with established dietary guidelines, is predictive of type 2 diabetes risk in Australian women. The risk of type 2 diabetes among women in the highest quintile of DGI was approximately 50 % lower than that in women in the lowest quintile. The ARFS was not significantly predictive of type 2 diabetes.


Obesity Facts ◽  
2021 ◽  
pp. 1-10
Author(s):  
Britt W. Jensen ◽  
Charlotte Watson ◽  
Nophar Geifman ◽  
Jennifer L. Baker ◽  
Ellena Badrick ◽  
...  

<b><i>Introduction:</i></b> Body mass index (BMI) is often elevated at type 2 diabetes (T2D) diagnosis. Using latent class trajectory modelling (LCTM) of BMI, we examined whether weight loss after diagnosis influenced cancer incidence and all-cause mortality. <b><i>Methods:</i></b> From 1995 to 2010, we identified 7,708 patients with T2D from the Salford Integrated Record database (UK) and linked to the cancer registry for information on obesity-related cancer (ORC), non-ORC; and all-cause mortality. Repeated BMIs were used to construct sex-specific latent class trajectories. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models. <b><i>Results:</i></b> Four sex-specific BMI classes were identified; stable-overweight, stable-obese, obese-slightly-decreasing, and obese-steeply-decreasing; comprising 41%, 45%, 13%, and 1% of women, and 45%, 37%, 17%, and 1% of men, respectively. In women, the stable-obese class had similar ORC risks as the obese-slightly-decreasing class, whereas the stable-overweight class had lower risks. In men, the obese-slightly-decreasing class had higher risks of ORC (HR = 1.86, 95% CI: 1.05–3.32) than the stable-obese class, while the stable-overweight class had similar risks No associations were observed for non-ORC. Compared to the stable-obese class, women (HR = 1.60, 95% CI: 0.99–2.58) and men (HR = 2.37, 95% CI: 1.66–3.39) in the obese-slightly-decreasing class had elevated mortality. No associations were observed for the stable-overweight classes. <b><i>Conclusion:</i></b> Patients who lost weight after T2D diagnosis had higher risks for ORC (in men) and higher all-cause mortality (both genders) than patients with stable obesity.


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