Association between dietary patterns and prediabetes, undetected diabetes or clinically diagnosed diabetes: results from the KORA FF4 study

Abstract

Purpose Diet is one of the most important modifiable risk factors for the development of type 2 diabetes. Here, we aim to identify dietary patterns and to investigate their association with prediabetes, undetected diabetes and prevalent diabetes. Methods The present study included 1305 participants of the cross-sectional population-based KORA FF4 study. Oral glucose tolerance test (OGTT) measurements together with a physician-confirmed diagnosis allowed for an accurate categorization of the participants according to their glucose tolerance status into normal glucose tolerance (n = 698), prediabetes (n = 459), undetected diabetes (n = 49), and prevalent diabetes (n = 99). Dietary patterns were identified through principal component analysis followed by hierarchical clustering. The association between dietary patterns and glucose tolerance status was investigated using multinomial logistic regression models. Results A Prudent pattern, characterized by high consumption of vegetables, fruits, wholegrains and dairy products, and a Western pattern, characterized by high consumption of red and processed meat, alcoholic beverages, refined grains and sugar-sweetened beverages, were identified. Participants following the Western pattern had significantly higher chances of having prediabetes (odds ratio [OR] 1.92; 95% confidence interval [CI] 1.35, 2.73), undetected diabetes (OR 10.12; 95% CI 4.19, 24.43) or prevalent diabetes (OR 3.51; 95% CI 1.85, 6.67), compared to participants following the Prudent pattern. Conclusion To our knowledge, the present study is one of the few investigating the association between dietary patterns and prediabetes or undetected diabetes. The use of a reference group exclusively including participants with normal glucose tolerance might explain the strong associations observed in our study. These results suggest a very important role of dietary habits in the prevention of prediabetes and type 2 diabetes.

Association between dietary patterns and stroke in patients with type 2 diabetes mellitus in China: a propensity score-matched analysis

“…The results showed that there were differences in dietary patterns among patients with T2DM. The typical dietary characteristics of two dietary patterns in T2DM patients contained a variety of foods rich in quality protein such as soyabean products or whole grains and fewer intake of fruits and rice, which may be due to the transition to a low glycaemic index diet after diabetes considering their state of health, especially the reduction in the intake of foods that are likely to contribute to poor control of glycaemia (35,36) . Participants exhibiting adherence to the balanced pattern consumed moderate amounts of beneficial foods such as white meat, eggs, soyabean products and fresh vegetables tended to a Mediterranean diet, which was beneficial to stroke prevention (21)(22)(23)37) .…”

Association between Habitual Diet and the Postprandial Glucose Response—An Enable Study

“…Some publications on German cohorts have equally demonstrated, that older adults are more likely to follow a healthier diet, characterized by lower consumption of meat or soft drinks and the highest intake of fish, vegetables, fruits, or whole grains in comparison with younger participants. [ 17,12 ]…”

“…Finally, it should be mentioned that food groups are not consumed individually and do not reflect an individual's food choices. [ 12 ] Consequently, a breakdown of the main food groups into their subcategories would give more insights into which food components have higher health implications and are possibly associated with changes in the glycemic response.…”

“…Furthermore, studies have shown that a diet characterized by high consumption of red and processed meat, alcoholic beverages, refined grains, sugar‐sweetened beverages, as well as a low intake of fruits is positively associated with a higher risk for diabetes, based on the glucose tolerance after an OGTT. [ 12,13 ] These findings indicate that there is an interplay between diet, the postprandial response, and health. However, there is limited knowledge on whether dietary patterns have long‐term effects on the postprandial response and whether there are age‐specific differences in the postprandial response.…”

Role of Fluid Milk in Attenuating Postprandial Hyperglycemia and Hypertriglyceridemia

“…Both epidemiological and prospective studies indicate that chronic consumption of dairy exhibits a protective effect in preclinical populations. A diet including high consumption of dairy products show lower chances of having prediabetes, undetected diabetes, or prevalent diabetes, compared with a Western diet [ 70 ]. For individuals with prediabetes, a diet that includes dairy decreases postprandial glucose, insulin, and triglyceride response compared with a red meat/refined carbohydrate diet [ 71 ].…”