Impact of dietary fat composition on prediabetes: a 12-year follow-up study

Abstract

Objective: Dietary fatty acid composition likely affects prediabetic conditions such as isolated impaired fasting glucose (IFG) or impaired glucose tolerance (IGT); however, this risk has not been evaluated in a large population nor has it been followed prospectively. Design: Diet, physical activity, anthropometric, socio-economic and blood glucose data from the Atherosclerosis Risk in Communities (ARIC) study were obtained from BioLINCC. Cox proportional hazards regression models were used to evaluate associations of dietary SFA, MUFA, PUFA, n-3 fatty acid (FA) and n-6 FA intakes with incidence of one (isolated IFG) or two (IFG with IGT) prediabetic conditions at the end of 12-year follow-up. Setting: Study volunteers were from counties in North Carolina, Mississippi, Minnesota and Maryland, USA. Subjects: Data from 5288 volunteers who participated in the ARIC study were used for all analyses reported herein. Results: The study population was 62 % male and 84 % white, mean age 53·5 (SD 5·7) years and mean BMI 26·2 (SD 4·6) kg/m 2 . A moderately high intake of dietary MUFA (10-15 % of total daily energy) was associated with a 10 % reduced risk of isolated IFG incidence, while a high intake of n-3 FA (>0·15 % of total daily energy) was associated with a 10 % increase in risk. Curiously, moderately high intake of n-6 PUFA (4-5 % of total daily energy) was associated with a 12 % reduction in IFG and IGT incidence. Conclusions: MUFA, n-3 and n-6 FA contribute differently to the development of isolated IFG v. IFG with IGT; and their mechanism may be more complex than originally proposed. . T2DM is a chronic disease that is characterized by high levels of blood glucose (fasting >126 mg/dl and/or postprandial >200 mg/dl). Impaired glucose tolerance (IGT; 2 h postprandial blood glucose between 140 and 199 mg/dl, but fasting glucose <126 mg/dl) and impaired fasting glucose (IFG; fasting glucose between 100 and 126 mg/dl) are prediabetic conditions (2) . The transition from IFG and IGT to overt T2DM appears to be relative to other confounding factors, with 25 % progressing, while another 50 % remain in the impaired glycaemic state and the remaining 25 % revert back to normoglycaemic conditions (3,4) . Having both prediabetic conditions (IFG and IGT) puts a person at higher risk than having just one of the two (5,6) . Further, the dietary modifications required to manage one v. both may be quite different, based on their pathophysiology. IFG is characterized by basal and firstphase glucose-induced insulin response loss, but without differences in second-phase insulin release or insulin resistance (7) . IGT, on the other hand, is associated with defects in oral glucose-induced insulin response, but an even stronger deficit in late-phase insulin secretion, and reduced hepatic as well as skeletal muscle insulin resistance (7) . Since insulin resistance is closely associated with dietary fat intake (8) , dietary risk factors contributing to isolated IFG (only one prediabetic condition) v. both IFG and IGT (two prediabe...

Polyunsaturated fatty acids as modulators of fat mass and lean mass in human body composition regulation and cardiometabolic health

“…34 By contrast, epidemiological evidence highlights an inverse association between circulating ALA, but not marinederived n-3 PUFA, and type 2 diabetes, 35 while a 12-year follow-up study of 5,288 individuals found a moderately high intake of LA to be associated with a 12% reduced incidence of impaired fasting glucose and impaired glucose tolerance. 36 Most strikingly, a recent pooled analysis involving 20 prospective cohort studies from around the world revealed that high LA biomarker (i.e., LA levels being measured in adipose tissue, cholesterol ester, erythrocyte, or plasma phospholipids and/or total plasma; which reflect long-term dietary intake), is associated with dose-dependent decreases in the incidence of type 2 diabetes. 37 These findings corroborate earlier cross-sectional and intervention studies showing that biomarkers of LA and ALA intake, but not marine-derived n-3 PUFA, are associated with better glycemic control and/or insulin sensitivity and reduced risk of type 2 diabetes.…”

Effects of nut and seed consumption on markers of glucose metabolism in adults with prediabetes: a systematic review of randomised controlled trials

“…Evidence also suggests that dietary fat quality is more important than dietary fat quantity in relation to T2D prevention, and a diet that emphasises fat from plant sources over animal sources is considered favourable for the prevention of diabetes (47,48) . In addition, energy intake from SFA was positively associated with measures of IFG and IGT (49) , whereas a moderately high dietary intake of MUFA (10-15 % of total daily energy) and PUFA (4-5 % of total daily energy) was associated with a reduced risk of incident IFG and IGT (50) . Finally, nut and seed consumption has been associated with increased dietary intake of several vitamins (e.g.…”

Association between fatty acids and the risk of impaired glucose tolerance and type 2 diabetes mellitus in American adults: NHANES 2005−2016

“…In several prospective studies, the total MUFA and PUFA intakes were inversely associated with the odds of T2DM [ 19 – 21 ]. The sheltering effect of FAs on metabolic diseases is partly owing to the regulation of microRNAs by modulating gene expression [ 22 ].…”