scholarly journals The Prospective Association of Dietary Sugar Intake in Adolescence With Risk Markers of Type 2 Diabetes in Young Adulthood

2021 ◽  
Vol 7 ◽  
Author(s):  
Karen A. Della Corte ◽  
Katharina Penczynski ◽  
Gunter Kuhnle ◽  
Ines Perrar ◽  
Christian Herder ◽  
...  

Purpose: To examine the prospective relevance of dietary sugar intake (based on dietary data as well as urinary excretion data) in adolescent years for insulin sensitivity and biomarkers of inflammation in young adulthood.Methods: Overall 254 participants of the DONALD study who had at least two 3-day weighed dietary records for calculating intakes of fructose, glucose, sucrose, total, free, added sugars, total sugars from sugar-sweetened beverages (SSB), juice, and sweets/sugar or at least two complete 24 h urine samples (n = 221) for calculating sugar excretion (urinary fructose and urinary fructose + sucrose) in adolescence (females: 9–15 years, males: 10–16 years) and a fasting blood sample in adulthood (18–36 years), were included in multivariable linear regression analyses assessing their prospective associations with adult homeostasis model assessment insulin sensitivity (HOMA2-%S) and a pro-inflammatory score (based on CRP, IL-6, IL-18, leptin, chemerin, adiponectin).Results: On the dietary intake level, no prospective associations were observed between adolescent fructose, sucrose, glucose, added, free, total sugar, or total sugar from SSB, juice or sweets/sugar intake and adult HOMA2-%S (p > 0.01). On the urinary level, however, higher excreted fructose levels were associated with improved adult HOMA2-%S (p = 0.008) among females only. No associations were observed between dietary or urinary sugars and the adult pro-inflammatory score (p > 0.01).Conclusion: The present study did not provide support that dietary sugar consumed in adolescence is associated with adult insulin sensitivity. The one potential exception was the moderate dietary consumption of fructose, which showed a beneficial association with adult fasting insulin and insulin sensitivity.

Author(s):  
Ballesteros JM ◽  
◽  
Struijk E ◽  
Machado-Fragua MD ◽  
Ortolá R ◽  
...  

Background: Added sugar intake is a key contributor to the development of several chronic diseases. We aimed to investigate the prospective association between added sugar intake and the risk of falling among older men and women. Methods: We analyzed data from 2,154 Spanish adults aged ≥65 years from the Seniors-ENRICA cohort. Baseline food consumption was collected in 2008-2010 with a validated diet history, in which 155 foods were identified to contain added sugar. The occurrence of falls was ascertained up to 2015. Analyses were conducted with Cox models adjusted for potential confounders, including nutritional status, chronic diseases and sleeping medication. Results: Over 7.2y of follow-up, 605 participants experienced ≥1 fall and 527 suffered injurious falls. The hazard ratios (95% confidence interval) for ≥1 fall across quintiles of added sugar intake were: 1.0, 1.09 (0.83-1.42), 1.07 (0.82-1.40), 1.15 (0.88-1.52), and 1.48 (1.12-1.96); p-trend 0.03. The corresponding figures for injurious falls were: 1.0, 1.17 (0.88-1.56), 1.06 (0.79- 1.41), 1.13 (0.84-1.52), and 1.40 (1.03-1.90); p-trend 0.10. These associations did not vary over strata of age, protein, calcium or vitamin intake, diet quality, physical activity or alcohol consumption. No differences were found when solid and liquid sources of added sugars were examined separately. Conclusions: Intake of added sugars was associated with a higher risk of falling in older people. This adds to the evidence to support interventions to reduce added sugar intake.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Ines Perrar ◽  
Gunter K. Kuhnle ◽  
Thomas Remer ◽  
Anette E. Buyken ◽  
Ute Alexy

AbstractA high sugar intake is increasingly discussed to affect health. Preceding analyses based on dietary records, collected between 1985–2016, suggest a decreasing time trend in total [TS], added [AS] and free [FS] sugar intake (calculated as % of energy intake [%E]) since 2005 - most notably from 2010 onwards - among children and adolescents in Germany. While TS [%E] intake decreased with age, the youngest children had the lowest AS [%E] intake and the oldest children had the lowest FS [%E] intake, with minor differences in the other age groups. However, self-reported data is likely introducing bias due to selective underreporting, especially of sugar-rich foods, which can distort results. Therefore, we analysed time and age trends in dietary sugar intake using urinary biomarkers.Urinary fructose excretion (FE), sucrose excretion (SE) and the sum of both (FE + SE) as predictive biomarkers for sugar intake was measured by UPLC-MS/MS in 997 24-h urine samples from the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study cohort collected from 8.5–16.5-year-olds (239 boys, 253 girls) between 1990–2016. Time and age trends of log-transformed FE, SE and FE + SE were analyzed using polynomial mixed-effects regression models. Sex, creatinine and urea excretion, urine volume, total daily energy intake, overweight status, type of weekday, maternal overweight and educational status as well as maternal employment were considered as potentially confounding factors.The mean (± SD) FE was 26.1 ± 20.9 mg/d, SE 33.4 ± 38.3 mg/d, and FE + SE 59.6 ± 49.1 mg/d. While FE increased significantly with age (linear trend: p = 0.0147), there were no significant age trends for SE and FE + SE in adjusted models. Between 1990–2016 FE as well as FE + SE decreased significantly (linear trend: p = 0.0280 and p < 0.0001, respectively). SE showed a tendency towards a negative quadratic time trend (p = 0.0574).The decreasing time trend of urinary sugar excretion supports our previous observed time trends in dietary sugar intake based on dietary records among children and adolescents. In contrast, the observed age trend in dietary sugar was not confirmed by the biomarker trend analysis, suggesting increasing underreporting with age during adolescence. Although predictive biomarkers do not allow conclusions on the amount of the respective dietary intake, the combination of biomarker and dietary record data points towards the need of further public health measures to support the observed decline in sugar intake among children and adolescents in Germany.The project is funded by the German Federal Ministry of Food and Agriculture.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Stefanie Hinkle ◽  
Mengying Li ◽  
Jagteshwar Grewal ◽  
Katherine Grantz ◽  
Samrawit Yisahak ◽  
...  

Abstract Objectives Women diagnosed with gestational diabetes (GDM) are usually advised to reduce carbohydrate intake and increase physical activity (PA). There is limited longitudinal population-based evidence on whether these women change their diet and PA after diagnosis. Our aim was to examine if women with GDM do in fact alter their diet and PA post diagnosis and identify characteristics of women with favorable changes. Methods This study included 1735 women from the NICHD Fetal Growth Studies-Singletons (2009–2013) who completed an Automated Self-Administered 24-Hour dietary recall and a Pregnancy PA Questionnaire at 16–22, 24–29, 30–33, 34–37, and 38–41 (PA only) gestational weeks (GW). GDM was ascertained by medical records (n = 85; 4.9%), diagnosed at a mean of 27.7 GW (S.D. 4.7). We used adjusted linear mixed models with random effects to estimate changes in diet/PA post-GDM screening (non-GDM)/diagnosis (GDM) and tested for differences by GDM status. For factors that changed among women with GDM, we tested for differences by covariates. Results Women with GDM significantly reduced total sugar intake after diagnosis by 27.9 g/d (95% confidence interval −41.5, −14.3), while it increased in women without GDM by 3.7 g/d (0.7, 6.7) after screening (Figure). Specifically, women with GDM reduced added sugars [−12.0 g/d (−22.0, −2.0)] and fruit juice [−0.4 serving/d (−0.6, −0.2)], and increased artificially sweetened beverage intake [0.2 servings/d (0.1, 0.3)]. The significant reduction in total sugar persisted in all women except Hispanics [−9.0 g/d (−27.2, 9.3); P-interaction = 0.08] and non-nulliparous women [−10.7 g/d (−25.5, 4.2); P-interaction = 0.001]. Women with GDM performed less moderate intensity PA [−30.6 MET-hr/wk (−43.2, −18.0)] after diagnosis than before, which was less than women without GDM [−17.1 (−19.9, −14.3)]. Conclusions Majority of women with GDM undergoing usual care substantially decreased their overall sugar intake after diagnosis primarily by reducing added sugars and fruit juice, and increasing artificially sweetened beverages. Greater dietary counseling efforts may be needed among Hispanic and multiparous women, and for PA in all women with GDM. Funding Sources This research was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Supporting Tables, Images and/or Graphs


Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4152
Author(s):  
Mericarmen Peralta ◽  
Celine Heskey ◽  
David Shavlik ◽  
Synnove Knutsen ◽  
Andrew Mashchak ◽  
...  

Sugar intake is a potentially important aspect of diet which has not previously been validated in the Adventist Health Study-2 (AHS-2). We sought to validate the food frequency questionnaire (FFQ) measurement of total sugars, added sugars, sucrose, and fructose against multiple 24-h dietary recalls (recalls) in AHS-2 participants. Food consumption data from a self-administered FFQ and six recalls from 904 participants were combined with nutrient profile data to estimate daily sugar intake. Validity was evaluated among all participants and by race. FFQ and recall means were compared and correlation coefficients (Spearman’s, energy-adjusted log-transformed Pearson’s, deattenuated Pearson’s) were calculated. Mean total energy, total sugars, and fructose intake were higher in the FFQ, whereas added sugars and sucrose were higher in recalls. The energy-adjusted (log-transformed) deattenuated correlations among all participants were: total sugars (r = 0.42, 95% CI 0.32–0.52), added sugars (r = 0.50, 95% CI 0.36–0.59), sucrose (r = 0.32, 95% CI 0.23–0.42), and fructose (r = 0.50, 95% CI 0.40–0.59). We observed moderate validity for added sugars and fructose and low-moderate validity for total sugars and sucrose measured by the AHS-2 FFQ in this population. Dietary sugar estimates from this FFQ may be useful in assessing possible associations of sugars intake with health outcomes.


2019 ◽  
Vol 31 (3) ◽  
pp. 212-218

Both insulin and leptin are major contributors for the body energy balance. Obesity is a state of energy imbalance and is also associated with changes in both insulin sensitivity and leptin sensitivity. The aim of this study was to find out the relationship between insulin sensitivity and body fat composition, and leptin sensitivity in non-obese and obese adults. A total of 86 adults participated: 42 non-obese and 44 over-weight/obese. Body fat (BF) percent was determined by skinfold method. Fasting plasma glucose was analyzed by glucose oxidase-phenol and 4 aminophenazone (GOD-PAP) method using spectro-photometer, fasting serum insulin and leptin concentrations by direct sandwich ELISA method and resting energy expenditure (REE) by indirect calorimetry. Leptin sensitivity index and insulin sensitivity were expressed as REE : Leptin ratio and homeostatic model assessment-insulin resistance (HOMA-IR), respectively. It was found that median value of HOMA-IR was significantly higher [2.93 vs 1.72, p<0.01] and leptin sensitivity was significantly lower [116.76 vs 265.66, p<0.001] in the overweight/obese adults than the non-obese adults, indicating that insulin sensitivity and leptin sensitivity were markedly reduced in overweight/obese adults in compare to non-obese adults. There was a moderate degree of positive relationship between HOMA-IR and BF only in the overweight/obese (ρ=0.509, n=44, p<0.001) and all adults (ρ=0.39, n=86, p<0.001). Similarly, a weak negative relationship between leptin sensitivity index and HOMA-IR was found in the overweight/obese (ρ=-0.328, n=44, p<0.05) and all adults (ρ=-0.35, n=86, p<0.01). It can be concluded that the insulin sensitivity was adiposity dependent, but, it did not depend on leptin sensitivity.


2021 ◽  
pp. 1-9
Author(s):  
Narges Ghorbani Bavani ◽  
Parvane Saneei ◽  
Ammar Hassanzadeh Keshteli ◽  
Ahmadreza Yazdannik ◽  
Ebrahim Falahi ◽  
...  

Abstract Objective: We investigated the association of dietary Mg intake with insulin resistance and markers of endothelial function among Iranian women. Design: A cross-sectional study. Setting: Usual dietary intakes were assessed using a validated FFQ. Dietary Mg intake was calculated by summing up the amount of Mg in all foods. A fasting blood sample was taken to measure serum concentrations of glycemic indices (fasting plasma glucose and insulin) and endothelial function markers (E-selectin, soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1). Insulin resistance and sensitivity were estimated using the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), Homeostasis Model Assessment β-cell function (HOMA-β) and quantitative insulin sensitivity check index (QUICKI). Participants: Iranian female nurses (n 345) selected by a multistage cluster random sampling method. Results: The Mg intake across energy-adjusted quartiles was 205 (se 7), 221·4 (se 8), 254·3 (se 7) and 355·2 (se 9) mg/d, respectively. After adjustments for potential confounders, QUICKI level was significantly different across quartiles of Mg intake (Q1: 0·34 (se 0·02), Q2: 0·36 (se 0·01), Q3: 0·40 (se 0·01), and Q4: 0·39 (se 0·02), P = 0·02); however, this association disappeared after considering markers of endothelial function, indicating that this relation might be mediated through endothelial dysfunction. After controlling for all potential confounders, Mg intake was inversely, but not significantly, associated with serum concentrations of sICAM (Q1: 239 (se 17), Q2: 214 (se 12), Q3: 196 (se 12), and Q4: 195 (se 17), P = 0·29). There was no other significant association between dietary Mg intake and other indicators of glucose homoeostasis or endothelial markers. Conclusions: Higher dietary Mg intake was associated with better insulin sensitivity in Iranian females. This linkage was mediated through reduced endothelial dysfunction.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 989.3-989
Author(s):  
A. Jitaru ◽  
C. Pomirleanu ◽  
M. M. Leon-Constantin ◽  
F. Mitu ◽  
C. Ancuta

Background:Rheumatoid arthritis (RA) is associated with an increased cardiovascular (CV) risk, due not only to the traditional risk factors (hypertension, insulin resistance/diabetes, obesity, smoking), but to the inflammatory status as well. The blockade of interleukin-6 (IL-6) can regulate the glucose metabolism, reducing the glucose level and insulin resistance (IR). This beneficial effect is seen more in patients with normal values of body mass index (BMI), compared to the obese population.Objectives:Given the mentioned existing data, we aim to demonstrate the positive effect of IL-6 inhibitors in active RA patients with normal or increased BMI.Methods:We recruited 56 consecutive patients with definite and active RA, non-responders/partial responders to conventional synthetic Drug Modifying Anti-Rheumatic Drugs (csDMARDs)/biological therapy. For a period of 52 weeks, patients received subcutaneous Tocilizumab (TCZ) in a dose of 162mg once a week, according to European League Anti Rheumatism (EULAR) recommendation and National Protocol. We assessed demographics, RA-related parameters (clinical, inflammatory and immune) and metabolic markers, as well as the peripheral response to insulin, quantified by Homeostasis Model Assessment for insulin resistance (HOMA-IR) and the Quantitative Insulin Sensitivity Check Index (QUICKI). We did not include in the study the patients known with diabetes mellitus (DM) and those undergoing glucocorticoids.Results:After 52 weeks of treatment, most of the patients showed a statistically significant reduction of HOMA-IR (3.61 ± 1.21 at the onset vs. 2.45 ± 1.46 at the end of the study, p<0.001), while QUICKI registered a slight increase (0.32 ± 0.01 at the onset vs. 0.33 ± 0.01 at the end of the study, p<0.001). Also, the decrease in insulin and glucose levels were more obvious in patients with normal BMI, strictly related to disease activity.Conclusion:Long-term administration of TCZ in active RA is associated with a significant reduction of disease activity and IR, especially in normal weight patients. This confirms that obesity, as a CV risk factor, represents one of the main causes of IR.References:[1]Castañeda S, Remuzgo-Martínez S, López-Mejías R et al. Rapid beneficial effect of the IL-6 receptor blockade on insulin resistance and insulin sensitivity in non-diabetic patients with rheumatoid arthritis.Clin Exp Rheumatol. 2019; 37(3):465-473.[2]Lehrskov LL, Christensen RH. The role of interleukin-6 in glucose homeostasis and lipid metabolism.Semin Immunopathol. 2019; 41(4):491-499.[3]Ursini F, Russo E, Ruscitti P, Giacomelli R, De Sarro G. The effect of non-TNF-targeted biologics and small molecules on insulin resistance in inflammatory arthritis.Autoimmun Rev. 2018 Apr;17(4):399-404.Disclosure of Interests:Alexandra Jitaru: None declared, Cristina Pomirleanu: None declared, Maria-Magdalena Leon-Constantin: None declared, Florin Mitu: None declared, CODRINA ANCUTA Consultant of: AbbVie, Pfizer, Roche, Novartis, UCB, Ewopharma, Merck Sharpe and Dohme, and Eli Lilly, Speakers bureau: AbbVie, Pfizer, Roche, Novartis, UCB, Ewopharma, Merck Sharpe and Dohme, and Eli Lilly


2021 ◽  
Vol 9 (1) ◽  
pp. e001975
Author(s):  
Nicolas Quezada ◽  
Ilse Valencia ◽  
Javiera Torres ◽  
Gregorio Maturana ◽  
Jaime Cerda ◽  
...  

IntroductionSystemic chronic low-grade inflammation has been linked to insulin resistance (IR) and non-alcoholic steatohepatitis (NASH). NOD-like receptor protein 3 (NLRP3) inflammasome and its final product, interleukin (IL)-1β, exert detrimental effects on insulin sensitivity and promote liver inflammation in murine models. Evidence linking hepatic NLRP3 inflammasome, systemic IR and NASH has been scarcely explored in humans. Herein, we correlated the hepatic abundance of NLRP3 inflammasome components and IR and NASH in humans.Research design and methodsMetabolically healthy (MH) (n=11) and metabolically unhealthy (MUH) (metabolic syndrome, n=21, and type 2 diabetes, n=14) subjects were recruited. Insulin sensitivity (homeostatic model assessment of IR (HOMA-IR) and Oral Glucose Sensitivity (OGIS120)), glycemic (glycated hemoglobin), and lipid parameters were determined by standard methods. Plasma cytokines were quantified by Magpix. Hepatic NLRP3 inflammasome components were determined at the mRNA and protein levels by reverse transcription–quantitative PCR and western blot, respectively. Liver damage was assessed by histological analysis (Non-alcoholic Fatty Liver Disease Activity Score (NAS) and Steatosis, Inflammatory Activity, and Fibrosis (SAF) scores). IR and liver histopathology were correlated with NLRP3 inflammasome components as well as with liver and plasma IL-1β levels.ResultsBody Mass Index, waist circumference, and arterial hypertension frequency were significantly higher in MUH subjects. These patients also had increased high-sensitivity C reactive protein levels compared with MH subjects. No differences in the plasma levels of IL-1β nor the hepatic content of Nlrp3, apoptosis-associated speck-like (Asc), Caspase-1, and IL-1β were detected between MUH and MH individuals. MUH subjects had significantly higher NAS and SAF scores, indicating more severe liver damage. However, histological severity did not correlate with the hepatic content of NLRP3 inflammasome components nor IL-1β levels.ConclusionOur results suggest that NLRP3 inflammasome activation is linked neither to IR nor to the inflammatory status of the liver in MUH patients.


2020 ◽  
Vol 11 (6) ◽  
pp. 1429-1436
Author(s):  
Jimmy Chun Yu Louie

ABSTRACT Misreporting of added sugar intake has been the major criticism of studies linking high added sugar consumption to adverse health outcomes. Despite the advancement in dietary assessment methodologies, the bias introduced by self-reporting can never be completely eliminated. The search for an objective biomarker for total added sugar intake has therefore been a topic of interest. In this article, the reasons this search may be a wild goose chase will be outlined and discussed. The limitations and inability of the 2 candidate biomarkers, namely urinary sucrose and fructose and δ¹³C isotope, which are based on the 2 only possible ways (i.e., difference in metabolism and plant sources) to identify added sugar based on current knowledge in human physiology and food and nutritional sciences, are discussed in detail. Validation studies have shown that these 2 candidate biomarkers are unlikely to be suitable for use as a predictive or calibration biomarker for total added sugar intake. Unless advancement in our understanding in human physiology and food and nutritional sciences leads to new potential ways to distinguish between naturally occurring and added sugars, it is extremely unlikely that any accurate objective added sugar biomarker could be found. It may be time to stop the futile effort in searching for such a biomarker, and resources may be better spent on further improving and innovating dietary assessment methods to minimize the bias introduced by self-reporting.


2012 ◽  
Vol 17 (1) ◽  
pp. 113-121 ◽  
Author(s):  
Rosangela A Pereira ◽  
Kiyah J Duffey ◽  
Rosely Sichieri ◽  
Barry M Popkin

AbstractObjectiveTo examine the patterns of consumption of foods high in solid fats and added sugars (SoFAS) in Brazil.DesignCross-sectional study; individual dietary intake survey. Food intake was assessed by means of two non-consecutive food records. Foods providing >9·1 % of energy from saturated fat, or >1·3 % of energy from trans fat, or >13 % of energy from added sugars per 100 g were classified as high in SoFAS.SettingBrazilian nationwide survey, 2008–2009.SubjectsIndividuals aged ≥10 years old.ResultsMean daily energy intake was 8037 kJ (1921 kcal), 52 % of energy came from SoFAS foods. Contribution of SoFAS foods to total energy intake was higher among women (52 %) and adolescents (54 %). Participants in rural areas (43 %) and in the lowest quartile of per capita family income (43 %) reported the smallest contribution of SoFAS foods to total energy intake. SoFAS foods were large contributors to total saturated fat (87 %), trans fat (89 %), added sugar (98 %) and total sugar (96 %) consumption. The SoFAS food groups that contributed most to total energy intake were meats and beverages. Top SoFAS foods contributing to saturated fat and trans fat intakes were meats and fats and oils. Most of the added and total sugar in the diet was supplied by SoFAS beverages and sweets and desserts.ConclusionsSoFAS foods play an important role in the Brazilian diet. The study identifies options for improving the Brazilian diet and reducing nutrition-related non-communicable chronic diseases, but also points out some limitations of the nutrient-based criteria.


Sign in / Sign up

Export Citation Format

Share Document