scholarly journals Enhanced Eating Competence Is Associated with Improved Diet Quality and Cardiometabolic Profile in Finnish Adults with Increased Risk of Type 2 Diabetes

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4030
Author(s):  
Kirsikka Aittola ◽  
Leila Karhunen ◽  
Reija Männikkö ◽  
Elina Järvelä-Reijonen ◽  
Santtu Mikkonen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Intervention ◽  
Diet Quality ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Eating Attitudes ◽  
Cardiometabolic Health ◽  
Increased Risk ◽  
Eating Competence

Eating competence (EC) is characterized by positive attitudes towards food and eating, having regular meals, eating a variety of foods, and internally regulated eating. We investigated the associations of changes in EC with changes in lifestyle, anthropometrics and biomarkers of glucose and lipid metabolism in 2291 adults at increased risk of type 2 diabetes as part of the StopDia study conducted in primary healthcare. EC and diet quality were assessed with validated digital questionnaires. During the intervention, the participants received either (1) the digital lifestyle intervention, (2) the combined digital and face-to-face group-based lifestyle intervention, or (3) standard care. EC increased among the participants independent of the intervention type. Increase in EC was associated with an increase in diet quality, high-density lipoprotein (HDL) cholesterol, and with a decrease in body mass index and waist circumference, regardless of baseline EC. Of the subdomains of EC, the contextual skills, food acceptance and eating attitudes were associated with various of these changes. Our results thus suggest that EC could be a potential target in lifestyle interventions aiming to improve the cardiometabolic health of people at type 2 diabetes risk.

The Role of Disordered Eating in Type 2 Diabetes: A Pilot Study

2021 ◽  
pp. 155982762110024
Author(s):  
Alyssa M. Vela ◽  
Brooke Palmer ◽  
Virginia Gil-Rivas ◽  
Fary Cachelin
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Disordered Eating ◽  
Lifestyle Intervention ◽  
Eating Behaviors ◽  
Diabetes Management ◽  
Behavioral Therapy ◽  
Exercise Stress ◽  
Increased Risk

Rates of type 2 diabetes mellitus continue to rise around the world, largely due to lifestyle factors such as poor diet, overeating, and lack of physical activity. Diet and eating is often the most challenging aspect of management and, when disordered, has been associated with increased risk for diabetes-related complications. Thus, there is a clear need for accessible and evidence-based interventions that address the complex lifestyle behaviors that influence diabetes management. The current study sought to assess the efficacy and acceptability of a pilot lifestyle intervention for women with type 2 diabetes and disordered eating. The intervention followed a cognitive behavioral therapy guided-self-help (CBTgsh) model and included several pillars of lifestyle medicine, including: diet, exercise, stress, and relationships. Ten women completed the 12-week intervention that provided social support, encouraged physical activity, and addressed eating behaviors and cognitions. Results indicate the lifestyle intervention was a feasible treatment for disordered eating behaviors among women with type 2 diabetes and was also associated with improved diabetes-related quality of life. The intervention was also acceptable to participants who reported satisfaction with the program. The current CBTgsh lifestyle intervention is a promising treatment option to reduce disordered eating and improve diabetes management.

scholarly journals Associations of Diet Quality and All-Cause Mortality Across Levels of Cardiometabolic Health and Disease: A 7.6-Year Prospective Analysis From the Dutch Lifelines Cohort

2021 ◽  
Author(s):  
Petra C Vinke ◽  
Gerjan Navis ◽  
Daan Kromhout ◽  
Eva Corpeleijn
Keyword(s):  
Type 2 Diabetes ◽  
Diet Quality ◽  
Total Population ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Dietary Guidelines ◽  
Cardiometabolic Health ◽  
Ageing Population ◽  
All Cause Mortality

<b>Objective: </b>To simultaneously investigate the association of diet quality and all-cause mortality in groups with varying cardiometabolic diseases (CMDs) at baseline.<br><p> <b>Design:</b> From the population-based Lifelines cohort, 40,892 non-underweight participants aged ≥50 years with data on diet quality and confounding factors were included (enrollment 2006-2013). From food frequency questionnaire data, tertiles of the Lifelines diet score were calculated (T1 = poorest, T3 = best diet quality). Four CMD categories were defined: 1) CMD-free, 2) type 2 diabetes, 3) one cardiovascular disease (CVD), 4) two or more CMDs. Months when deaths occurred were obtained from municipal registries up until November 2019. Multivariable Cox proportional hazards models were applied for the total population and stratified by CMD categories.<br> <b>Results</b>: After a median follow-up of 7.6 years, 1,438 participants died. Diet quality and CMD categories were independently associated with all-cause mortality in crude and adjusted models (p < 0.001). A dose-response relationship of diet quality with all-cause mortality was observed in the total population (P for trend < 0.001, T2 vs. T3 = 1.22 (1.07-1.41), T1 vs. T3 = 1.57 (1.37-1.80)). In stratified analyses, the association was significant for CMD-free individuals (T1 vs. T3 = 1.63 (1.38-1.93)) and for type 2 diabetes patients (1.87 (1.17-3.00)), but not for patients with one CVD (1.39 (0.93-2.08)) or multiple CMDs (1.19 (0.80-1.76)).<br> <b>Conclusions</b>: A high-quality diet can potentially lower all-cause mortality risk in the majority of the ageing population. Its effect may be greatest for CMD-free individuals and patients with type 2 diabetes. Tailored dietary guidelines may be required for patients with extensive histories of CMDs. </p>

Abstract 17285: Metabolite-Derived Network Reveals Cluster of Acylcholine Metabolites Associated With Better Diet Quality and Lower Prevalence of Type 2 Diabetes: Findings From the Boston Puerto Rican Health Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Danielle E Haslam ◽  
Dong Wang ◽  
Liming Liang ◽  
Rachel S Kelly ◽  
Clemens Wittenbecher ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Puerto Rican ◽  
Diet Quality ◽  
Tca Cycle ◽  
Dietary Factors ◽  
Health Study ◽  
Plasma Metabolites ◽  
Cluster Score ◽  
Increased Risk

Introduction: Puerto Rican (PR) adults living on the US mainland are at high risk for developing type 2 diabetes (T2D), and dietary factors may contribute to this increased risk. Network analysis is a data-reduction tool that can identify correlated clusters of co-regulated metabolites that reflect mechanisms underlying diet-T2D associations. Hypothesis: Diet quality will associate with T2D-associated metabolite clusters among PR adults. Methods: We used LC/MS to measure fasting plasma metabolites (>700) among Boston PR Health Study participants, aged 45-75 years, with (n=258) and without (n=421) T2D. We applied an unsupervised correlation network-based method to identify metabolite clusters within a global metabolite network and calculated a score for each cluster using a weighted sum of metabolite concentrations. To estimate diet quality, we calculated a modified version of a previously validated American Heart Association diet score (AHA-DS). Logistic regression was used to assess cross-sectional associations between metabolite clusters and prevalent T2D, and linear regression was used to assess associations between the continuous AHA-DS and T2D-associated metabolite clusters among controls, adjusting for potential confounders and correcting for multiple testing. Results: We identified 7 metabolite clusters that were associated with prevalent T2D ( p <0.05). For every 1-standard deviation (SD) increase in cluster score, the odds ratios for prevalent T2D and 95% confidence intervals were as the follows: acylcholines [0.40 (0.31, 0.50)], aromatic hydrocarbon derivatives [0.33 (0.22, 0.47)], sphingolipids [0.46 (0.33, 0.64)], tricarboxylic acid (TCA) cycle amino acids/peptides [0.39 (0.25, 0.62)], branched-chain amino acid metabolites [4.1 (2.9, 6.0)], acylcarnitines [1.8 (1.3, 2.5)], and TCA cycle/energy metabolites [2.0 (1.4, 3.0)]. The AHA-DS was only significantly associated with the acylcholine metabolites cluster [β (standard error) = 0.01 (0.004) SD increase in cluster score, p=0.02]. Conclusions: In individuals of PR descent, we identified a cluster of acylcholine metabolites where concentrations are higher among those with better diet quality and lower among those with prevalent T2D.

Abstract P462: Myosteatosis: Differences in Association With Type 2 Diabetes by Anatomical Location

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Curtis Tilves ◽  
Allison Kuipers ◽  
Joseph Zmuda ◽  
J. J Carr ◽  
James G Terry ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
African Ancestry ◽  
Lifestyle Factor ◽  
Cardiometabolic Health ◽  
Anatomical Location ◽  
Quantitative Ct ◽  
Muscle Area ◽  
Cross Sectional ◽  
Increased Risk

Background: CT-derived muscle density (MD) reflects the degree of adiposity in muscle (i.e., myosteatosis) with lower MD indicating greater adiposity. Previous research indicates lower MD is associated with increased risk of type 2 diabetes (T2D). However, few studies have compared the association of simultaneously measured MD by anatomic location. The relationship between myosteatosis and cardiometabolic health may differ by body site and influence which location(s) is most useful for risk assessment. We investigated potential differential relationships between T2D and MD of the locomotor muscles of the abdomen (psoas), thigh, and calf among 539 African Caribbean men from Tobago. Methods: Men were aged 50-91 years (mean 64.4 years, mean BMI 27.5 kg/m 2 ). Calf MD was measured at 66% of calf length using peripheral quantitative CT; calf MD was defined as the ratio of muscle mass to cross-sectional muscle area. Psoas MD was measured in the abdomen (between L3/L4) and thigh MD was measured in the mid-thigh using CT; for these, MD was defined as the average muscle attenuation across each site. MDs were converted to per-SD units for comparability. T2D was defined as a fasting serum glucose level of ≥126 mg/dL or currently taking antidiabetic medication. Results: Psoas and thigh MDs were more highly correlated (r = 0.70) than psoas and calf (r = 0.33) or thigh and calf (r = 0.53) MDs, and calf MD was moderately correlated with BMI (r = -0.38) compared to lower BMI correlations for thigh (r = -0.18) or psoas (r = -0.16) MDs (all significant p < 0.05). After age and lifestyle factor adjustment (Table), a 1-SD lower MD of the thigh or calf was significantly associated with higher odds of T2D. Additional adjustment for BMI completely attenuated the association with T2D for thigh MD, but not calf MD. Conclusion: In our study of African Ancestry men, only calf MD was associated with higher odds of T2D independent of BMI and other muscle groups. Longitudinal studies are needed to better characterize specific muscle myosteatosis and metabolic abnormalities.

scholarly journals Low-cost exercise interventions improve long-term cardiometabolic health independently of a family history of type 2 diabetes: a randomized parallel group trial

2020 ◽  
Vol 8 (2) ◽  
pp. e001377
Author(s):  
Niko S Wasenius ◽  
Bo A Isomaa ◽  
Bjarne Östman ◽  
Johan Söderström ◽  
Björn Forsén ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Exercise Prescription ◽  
Low Cost ◽  
Density Lipoprotein ◽  
Cardiometabolic Health ◽  
Supervised Exercise ◽  
History Of

IntroductionTo investigate the effect of an exercise prescription and a 1-year supervised exercise intervention, and the modifying effect of the family history of type 2 diabetes (FH), on long-term cardiometabolic health.Research design and methodsFor this prospective randomized trial, we recruited non-diabetic participants with poor fitness (n=1072, 30–70 years). Participants were randomly assigned with stratification for FH either in the exercise prescription group (PG, n=144) or the supervised exercise group (EG, n=146) group and compared with a matched control group from the same population study (CON, n=782). The PG and EG received exercise prescriptions. In addition, the EG attended supervised exercise sessions two times a week for 60 min for 12 months. Cardiometabolic risk factors were measured at baseline, 1 year, 5 years, and 6 years. The CON group received no intervention and was measured at baseline and 6 years.ResultsThe EG reduced their body weight, waist circumference, diastolic blood pressure, and low-density lipoprotein-cholesterol (LDL-C) but not physical fitness (p=0.074) or insulin or glucose regulation (p>0.1) compared with the PG at 1 year and 5 years (p≤0.011). The observed differences were attenuated at 6 years; however, participants in the both intervention groups significantly improved their blood pressure, high-density lipoprotein-cholesterol, and insulin sensitivity compared with the population controls (p≤0.003). FH modified LDL-C and waist circumference responses to exercise at 1 year and 5 years.ConclusionsLow-cost physical activity programs have long-term beneficial effects on cardiometabolic health regardless of the FH of diabetes. Given the feasibility and low cost of these programs, they should be advocated to promote cardiometabolic health.Trial registration numberClinicalTrials.gov identifier NCT02131701.

scholarly journals The Effect of Replacing Carbohydrate-based Breakfast Foods with Eggs on Cardiometabolic Risk Factors in Adults at Risk for Type 2 Diabetes (P08-045-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kevin Maki ◽  
Orsolya Palacios ◽  
Mary Buggia ◽  
Mary Dicklin ◽  
Marjorie Bell ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
At Risk ◽  
Risk Factor ◽  
Insulin Sensitivity ◽  
Cardiometabolic Risk ◽  
Dietary Intervention ◽  
Density Lipoprotein ◽  
Cardiometabolic Health ◽  
Cardiometabolic Risk Factor

Abstract Objectives To assess the effect of breakfast egg intake, vs. energy-matched carbohydrate (CHO)-based foods, on insulin sensitivity and markers of cardiometabolic health in adults at-risk for type 2 diabetes. Methods Overweight or obese adults with prediabetes and/or metabolic syndrome were included in this randomized crossover study consisting of two 4-wk dietary intervention periods, separated by a ≥4 wk washout. During each intervention, subjects consumed study products containing either 2 eggs/d for 6 d/wk (12 eggs/wk) or energy-matched CHO-based foods for breakfast. Percent changes from baseline were assessed for insulin sensitivity; CHO metabolism; lipid metabolism, including lipoprotein lipids, subfactions and particle sizes; high-sensitivity C-reactive protein (hs-CRP); and blood pressures (BP). Results Overall, 30 subjects (11 male; 19 female) with mean age of 53.5 ± 1.9 y and body mass index (BMI) of 31.9 ± 0.7 kg/m2 provided evaluable data. Median low-density lipoprotein cholesterol (LDL-C) decreased by 6.0% from a baseline of 119 mg/dL after 4-wk intake of the CHO breakfast foods, which was larger than the 2.9% reduction during the egg condition (P = 0.023 between diets). Mean systolic blood pressure was reduced significantly more during the egg condition vs. the CHO condition (2.7% vs. 0.0%, respectively, P = 0.018) from a baseline value of 127 mmHg. None of the other cardiometabolic risk factor parameters showed significant differences in response between diet conditions. Conclusions Intake of 12 eggs/wk for breakfast, vs. energy matched CHO-based foods, did not adversely affect the cardiometabolic risk factor profile in men and women at risk for diabetes. Funding Sources American Egg Board/Egg Nutrition Center, Park Ridge, IL Supporting Tables, Images and/or Graphs

scholarly journals Potential Impact on Lipoprotein Subfractions in Type 2 Diabetes

2019 ◽  
Vol 12 ◽  
pp. 117955141986681 ◽  
Author(s):  
Yuka Kamijo ◽  
Hideto Ishii ◽  
Tomohiko Yamamoto ◽  
Kunihisa Kobayashi ◽  
Hiroyuki Asano ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Sglt2 Inhibitor ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Sglt2 Inhibitors ◽  
Diabetic Patients ◽  
Lipoprotein Subfractions ◽  
Cholesterol Levels

Introduction: Recently, the sodium-glucose cotransporter2 (SGLT2) inhibitor empagliflozin has been shown to lower cardiovascular risk among diabetic patients. It is intriguing that some SGLT2 inhibitors have been found to increase low-density lipoprotein (LDL) cholesterol levels, while the relevance to high-density lipoprotein (HDL) cholesterol is unknown. Although the inhibitory effect of SGLT2 inhibitors on glucose reabsorption may accelerate compensatory lipid metabolism and subsequently reduce body weight and affect the lipid profile, much remains unclear about this mechanism. Therefore, we conducted this study to investigate in detail how canagliflozin affects lipoprotein fractions including LDL and HDL subclasses. Materials and Methods: This study is a multicenter prospective study. The participants were patients with 22 type 2 diabetes (60.7 ± 11.6 years, 59.1% of men) who had HbA1c ⩾ 7.0% and consented to participate in the study. They were administered 100 mg canagliflozin orally once per day. Biochemistry test and cholesterol levels of 20 lipoprotein fractions (G1-G20) using high performance liquid chromatography methods were examined before and after 12 weeks of treatment period. Results: Significant decreases were observed in the participants’ body weight (69.7 to 67.9 kg, P < .001), systolic blood pressure (129.3 to 119.5 mm Hg, P < .01), and HbA1c (8.5% to 7.4%, P < .001). Cholesterol levels in the 20 lipoprotein fractions increased for very large HDL (G14, G15) and large HDL (G16) ( P < .05). Conclusions: Reduction in body weight, improvement of blood glucose levels, and increases in very large HDL and large HDL subclasses were observed after canagliflozin treatment. These beneficial changes might contribute to subsequent suppression of cardiovascular outcomes.

scholarly journals Adverse differences in cardiometabolic risk factor levels between individuals with pre-diabetes and normal glucose metabolism are more pronounced in women than in men: the Maastricht Study

2019 ◽  
Vol 7 (1) ◽  
pp. e000787 ◽  
Author(s):  
Rianneke de Ritter ◽  
Simone J S Sep ◽  
Carla J H van der Kallen ◽  
Miranda T Schram ◽  
Annemarie Koster ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Pressure Difference ◽  
Cardiometabolic Risk ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Cardiometabolic Risk Factors ◽  
Blood Pressure Difference

ObjectiveTo investigate whether adverse differences in levels of cardiovascular risk factors in women than men, already established when comparing individuals with and without diabetes, are also present before type 2 diabetes onset.Research design and methodsIn a population-based cohort study of individuals aged 40-75 years (n=3410; 49% women, 29% type 2 diabetes (oversampled by design)), we estimated associations with cardiometabolic and lifestyle risk factors of (1) pre-diabetes and type 2 diabetes (reference category: normal glucose metabolism) and (2) among non-diabetic individuals, of continuous levels of hemoglobin A1c (HbA1c). Age-adjusted sex differences were analyzed using linear and logistic regression models with sex interaction terms.ResultsIn pre-diabetes, adverse differences in cardiometabolic risk factors were greater in women than men for systolic blood pressure (difference, 3.02 mm Hg; 95% CI:−0.26 to 6.30), high-density lipoprotein (HDL) cholesterol (difference, −0.10 mmol/L; 95% CI: −0.18 to −0.02), total-to-HDL cholesterol ratio (difference, 0.22; 95% CI: −0.01 to 0.44), triglycerides (ratio: 1.11; 95% CI: 1.01 to 1.22), and inflammation markers Z-score (ratio: 1.18; 95% CI: 0.98 to 1.41). In type 2 diabetes, these sex differences were similar in direction, and of greater magnitude. Additionally, HbA1c among non-diabetic individuals was more strongly associated with several cardiometabolic risk factors in women than men: per one per cent point increase, systolic blood pressure (difference, 3.58 mm Hg; 95% CI: −0.03 to 7.19), diastolic blood pressure (difference, 2.10 mm Hg; 95% CI: −0.02 to 4.23), HDL cholesterol (difference, −0.09 mmol/L; 95% CI: −0.19 to 0.00), and low-density lipoprotein cholesterol (difference, 0.26 mmol/L; 95% CI: 0.05 to 0.47). With regard to lifestyle risk factors, no consistent pattern was observed.ConclusionOur results are consistent with the concept that the more adverse changes in cardiometabolic risk factors in women (than men) arise as a continuous process before the onset of type 2 diabetes.

Plasma Trimethylamine N-Oxide and Risk of Cardiovascular Events in Patients With Type 2 Diabetes

2020 ◽  
Vol 105 (7) ◽  
pp. 2371-2380 ◽  
Author(s):  
Mikael Croyal ◽  
Pierre-Jean Saulnier ◽  
Audrey Aguesse ◽  
Elise Gand ◽  
Stéphanie Ragot ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Events ◽  
Tumor Necrosis Factor Receptor ◽  
Density Lipoprotein ◽  
Major Adverse Cardiovascular Events ◽  
Cox Models ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Design And Methods

Abstract Objective Even though trimethylamine N-oxide (TMAO) has been demonstrated to interfere with atherosclerosis and diabetes pathophysiology, the association between TMAO and major adverse cardiovascular events (MACE) has not been specifically established in type 2 diabetes (T2D). Research Design and Methods We examined the association of plasma TMAO concentrations with MACE and all-cause mortality in a single-center prospective cohort of consecutively recruited patients with T2D. Results The study population consisted in 1463 SURDIENE participants (58% men), aged 65 ± 10 years. TMAO concentrations were significantly associated with diabetes duration, renal function, high-density lipoprotein cholesterol, soluble tumor necrosis factor receptor 1 (sTNFR1) concentrations (R2 = 0.27) and were significantly higher in patients on metformin, even after adjustment for estimated glomerular filtration rate (eGFR): 6.7 (8.5) vs 8.5 (13.6) µmol/L, respectively (PeGFR-adjusted = 0.0207). During follow-up (median duration [interquartile range], 85 [75] months), 403 MACE and 538 deaths were registered. MACE-free survival and all-cause mortality were significantly associated with the quartile distribution of TMAO concentrations, patients with the highest TMAO levels displaying the greatest risk of outcomes (P &lt; 0.0001). In multivariate Cox models, compared with patients from the first 3 quartiles, those from the fourth quartile of TMAO concentration had an independently increased risk for MACE: adjusted hazard ratio (adjHR) 1.32 (1.02-1.70); P = 0.0325. Similarly, TMAO was significantly associated with mortality in multivariate analysis: adjHR 1.75 (1.17-2.09); P = 0.0124, but not when sTNFR1 and angiopoietin like 2 were considered: adjHR 1.16 (0.95-1.42); P = 0.1514. Conclusions We revealed an association between higher TMAO concentrations and increased risk of MACE and all-cause mortality, thereby opening some avenues on the role of dysbiosis in cardiovascular risk, in T2D patients.

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