Dietary Patterns and Cardiometabolic Outcomes in Diabetes: A Summary of Systematic Reviews and Meta-Analyses

The Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD) conducted a review of existing systematic reviews and meta-analyses to explain the relationship between different dietary patterns and patient-important cardiometabolic outcomes. To update the clinical practice guidelines for nutrition therapy in the prevention and management of diabetes, we summarize the evidence from these evidence syntheses for the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), Portfolio, Nordic, liquid meal replacement, and vegetarian dietary patterns. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. We summarized the evidence for disease incidence outcomes and risk factor outcomes using risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs), respectively. The Mediterranean diet showed a cardiovascular disease (CVD) incidence (RR: 0.62; 95%CI, 0.50, 0.78), and non-significant CVD mortality (RR: 0.67; 95%CI, 0.45, 1.00) benefit. The DASH dietary pattern improved cardiometabolic risk factors (P < 0.05) and was associated with the decreased incidence of CVD (RR, 0.80; 95%CI, 0.76, 0.85). Vegetarian dietary patterns were associated with improved cardiometabolic risk factors (P < 0.05) and the reduced incidence (0.72; 95%CI: 0.61, 0.85) and mortality (RR, 0.78; 95%CI, 0.69, 0.88) of coronary heart disease. The Portfolio dietary pattern improved cardiometabolic risk factors and reduced estimated 10-year coronary heart disease (CHD) risk by 13% (−1.34% (95%CI, −2.19 to −0.49)). The Nordic dietary pattern was correlated with decreased CVD (0.93 (95%CI, 0.88, 0.99)) and stroke incidence (0.87 (95%CI, 0.77, 0.97)) and, along with liquid meal replacements, improved cardiometabolic risk factors (P < 0.05). The evidence was assessed as low to moderate certainty for most dietary patterns and outcome pairs. Current evidence suggests that the Mediterranean, DASH, Portfolio, Nordic, liquid meal replacement and vegetarian dietary patterns have cardiometabolic advantages in populations inclusive of diabetes.

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Association between vitamin D status and cardiometabolic risk factors in Saudi adults with or without coronary heart disease

Journal of Nutrition & Intermediary Metabolism ◽

10.1016/j.jnim.2017.04.132 ◽

2017 ◽

Vol 8 ◽

pp. 95

Author(s):

N. Aljefree ◽

P. Lee ◽

F. Ahmed ◽

J. Al Saqqaf

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Vitamin D Status

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Saturated Fat and Cardiometabolic Risk Factors, Coronary Heart Disease, Stroke, and Diabetes: a Fresh Look at the Evidence

Lipids ◽

10.1007/s11745-010-3393-4 ◽

2010 ◽

Vol 45 (10) ◽

pp. 893-905 ◽

Cited By ~ 276

Author(s):

Renata Micha ◽

Dariush Mozaffarian

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cardiometabolic Risk ◽

Saturated Fat ◽

Cardiometabolic Risk Factors

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Chronic consumption of a low-fat diet improves cardiometabolic risk factors according to theCLOCKgene in patients with coronary heart disease

Molecular Nutrition & Food Research ◽

10.1002/mnfr.201500375 ◽

2015 ◽

Vol 59 (12) ◽

pp. 2556-2564 ◽

Cited By ~ 14

Author(s):

Francisco Gomez-Delgado ◽

Antonio Garcia-Rios ◽

Juan Francisco Alcala-Diaz ◽

Oriol Rangel-Zuñiga ◽

Javier Delgado-Lista ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Low Fat ◽

Low Fat Diet

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Associations between empirically derived dietary patterns and cardiovascular risk factors among older adult men

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000725 ◽

2021 ◽

Author(s):

Hadis Mozaffari ◽

Yahya Jalilpiran ◽

Katherine Suitor ◽

Nick Bellissimo ◽

Leila Azadbakht

Keyword(s):

Risk Factors ◽

Older Adults ◽

Dietary Patterns ◽

Dietary Pattern ◽

Cardiometabolic Risk ◽

High Serum ◽

Cardiometabolic Risk Factors ◽

Anthropometric Measures ◽

Public Health Burden ◽

Unhealthy Diet

Abstract. Cardiovascular disease (CVD) remains the leading cause of death globally, and epidemiological studies have suggested a link between diet and cardiometabolic risk. Currently, the prevalence of CVD is rapidly increasing with an aging population and continues to contribute to the growing economic and public health burden. However, there is limited evidence available regarding dietary patterns and cardiometabolic risk factors in older adults. We conducted a cross-sectional study to assess dietary patterns and cardiometabolic risk factors in males ≥60 years. Factor analysis identified a “healthy” diet and an “unhealthy” diet as the two primary dietary patterns. Multivariable logistic regression was used for estimating the associations of identified dietary patterns and cardiometabolic risk factors including anthropometric measures, blood pressure, glycemic biomarkers, lipid profile, and inflammatory biomarkers. A healthy dietary pattern was significantly associated with decreased odds of high serum fasting blood sugar (FBS) (OR: 0.32; 95% CI: 0.15–0.67; Ptrend=0.002), but increased odds of high serum low-density lipoprotein cholesterol (LDL-C) (OR: 1.82; 95% CI: 1.02–3.24; Ptrend=0.04). In comparison, an unhealthy diet was associated with increased odds of obesity (OR: 2.33; 95% CI: 1.31–4.15; Ptrend=0.004) and high LDL-C (OR: 2.00; 95% CI: 1.10–2.61; Ptrend=0.02). Thus, in older adults, adherence to an unhealthy dietary pattern has a significant impact on clinically relevant risk factors for cardiometabolic risk.

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Effects of the Mediterranean Diet or Nut Consumption On Gut Microbiota Composition and Fecal Metabolites and their Relationship With Cardiometabolic Risk Factors

Molecular Nutrition & Food Research ◽

10.1002/mnfr.202000982 ◽

2021 ◽

pp. 2000982

Author(s):

Serena Galié ◽

Jesús‐García Gavilán ◽

Lucía Camacho‐Barcía ◽

Alessandro Atzeni ◽

Jananee Muralidharan ◽

...

Keyword(s):

Risk Factors ◽

Gut Microbiota ◽

Mediterranean Diet ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Microbiota Composition ◽

The Mediterranean ◽

Gut Microbiota Composition

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Abstract MP67: Lactation Duration and Subsequent Intima Media Thickness in Women During Midlife Controlling for Pre-pregnancy Cardiometabolic Risk Factors: The CARDIA Study

Circulation ◽

10.1161/circ.129.suppl_1.mp67 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Erica P Gunderson ◽

Cora E. Lewis ◽

Xian Ning ◽

Mark Pletcher ◽

David Jacobs ◽

...

Keyword(s):

Risk Factors ◽

Heart Disease ◽

Weight Gain ◽

Cardiometabolic Risk ◽

Intima Media Thickness ◽

Cardiometabolic Risk Factors ◽

Inverse Association ◽

Media Thickness ◽

The Metabolic Syndrome ◽

Lactation Duration

Background: Greater lactation duration has been associated with lower incidence of the metabolic syndrome, and self-reported type 2 diabetes and heart disease in women later in life. Two retrospective studies reported higher carotid artery intima-media thickness among parous women who never or inconsistently breastfed, but no clear association with duration. However, lactation history was recalled many years later and heart disease risk factors were not measured before pregnancy. We hypothesized that lactation duration has a graded inverse association with subclinical atherosclerosis in women during mid-life independent of pre-pregnancy cardiometabolic risk factors. Methods: We examined 846 women (46% Black), aged 18-30 years at enrollment in 1985-1986 (baseline) in the biracial Coronary Artery Risk Development in Young Adults (CARDIA) study. Women included delivered 1 or more live births from 1986-2005, had no history of heart disease or diabetes before pregnancies, and had maximum common carotid intima media thickness (ccIMT, mm) measured in 2005-2006 at ages 38-50 years. Lactation duration was recalled within 1 to 4 years of delivery. We categorized women into four lactation groups according to cumulative duration for all post-baseline births; 0-<1 month (n=262), 1-<6 months (n=210), 6-10 months (n=169) and >10 months (n=205). Multiple linear regression models estimated mean ccIMT (95% CI) among lactation categories adjusted for pre-pregnancy cardiometabolic risk factors [BMI, systolic blood pressure (SBP), HDL-C, HOMA-IR], parity, socio-demographics (age, race, education), and smoking. We also assessed weight gain and change in SBP as mediators of the lactation and ccIMT association. Results: Increasing lactation duration showed a graded inverse association with mean ccIMT; differences between >10 months vs. 0<1 month groups ranged from -0.062 from the unadjusted model (p<0.001) and -0.029 from adjusted models (p=0.046) that included pre-pregnancy risk factors and other covariates. Weight gain and SBP change during the 20-year follow up slightly attenuated (~10%) the ccIMT-association with increased lactation duration. Conclusions: Greater lactation duration is associated with lower mean ccIMT independent of cardiometabolic risk factors measured before pregnancy, parity, socio-demographics and smoking. Lactation may have lasting favorable effects on cardiometabolic risk factors for heart disease.

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