The association of insulinemic potential of diet and lifestyle with the risk of insulin-related disorders: a prospective cohort study among participants of Tehran Lipid and Glucose Study

Abstract

Background We aim to assess the association of empirical dietary (EDIH) and lifestyle (ELIH) index for hyperinsulinemia with the risk of insulin resistance, hyperinsulinemia, insulin sensitivity, and β-cell dysfunction in Iranian adults. Methods In this prospective study, a total of 1244 men and women aged ≥ 20 years were selected among participants of the Tehran lipid and glucose study and followed for 3.2 years. Dietary intakes were assessed using a valid semi-quantitative food frequency questionnaire. Dietary and lifestyle insulinemic potential indices were calculated using dietary intake, body mass index, and physical activity information. Multivariable logistic regression was used to estimate the associated risk of a 3-year incidence of insulin-related disorders. Results The mean ± SD age and BMI of all eligible participants (42.7% males) were 43.0 ± 13.0 and 27.4 ± 4.9 in the study's baseline. After adjusting for all potential confounders, participants in the highest tertile of ELIH score had a greater risk of developing hyperinsulinemia (OR:2.42, 95%CI:1.52–3.86, P for trend = < 0.001), insulin resistance (OR:2.71, 95%CI:1.75–4.18, P for trend = < 0.001) and insulin insensitivity (OR:2.65, 95%CI: 1.72–4.10, P for trend = < 0.001) compared with those in the lowest tertile. However, the risk of incident β-cell dysfunction was lower in individuals with a higher score of ELIH in comparison to those with the lowest score (OR:0.30, 95%CI:0.19–0.45, P for trend = < 0.001). Conclusions Empirical lifestyle index for hyperinsulinemia was directly associated with insulin resistance, insulin insensitivity, and hyperinsulinemia and was inversely associated with β-cells dysfunction.

Dietary and lifestyle indices for hyperinsulinemia with the risk of obesity phenotypes: a prospective cohort study among Iranian adult population

“…In the current study, we showed that higher ELIH score, determined by the combination of insulinemic potential of diet, physical activity, and BMI, are strongly associated with increased risk of two abnormal types of phenotypes, including MHO and MUO. Our results are in agreement with the findings of other studies that investigated the association of insulinemic potential of lifestyle with metabolic disorders [ 18 ]. Farhadnejad et al have shown that a higher score of ELIH was related to an increased risk of diabetes by 89% [ 18 ].…”

“…Our results are in agreement with the findings of other studies that investigated the association of insulinemic potential of lifestyle with metabolic disorders [ 18 ]. Farhadnejad et al have shown that a higher score of ELIH was related to an increased risk of diabetes by 89% [ 18 ]. Also, it has previously been reported that adherence to a lifestyle with a higher score of ELIH may be associated with an increased risk of insulin metabolism-related disorders, including IR, insulin insensitivity, and hyperinsulinemia [ 18 ].…”

“…Although this study firstly assessed the association of EDIH and ELIH with the risk of obesity phenotypes, our results are comparable with previous investigations conducted on the role of the insulinemic potential of diet and lifestyle with weight gain and metabolic disorders [ 16 , 18 ]. Tabung et al revealed that the high insulinemic potential of the diet was associated with a higher risk of long-term weight gain and obesity in adults [ 16 ], however, contrary to the results of the above-mentioned study, in our study, no significant association was observed between the higher score of EDIH and MHO risk.…”

“…Tabung et al revealed that the high insulinemic potential of the diet was associated with a higher risk of long-term weight gain and obesity in adults [ 16 ], however, contrary to the results of the above-mentioned study, in our study, no significant association was observed between the higher score of EDIH and MHO risk. In this study, we indicated that adherence to a dietary pattern with higher score of EDIH may increase the risk of obesity with metabolic disorders (MUO phenotypes risk), however, other studies conducted on the Iranian population did not show a strong significant relationship between higher EDIH score and the risk of metabolic disorders, including IR [ 18 ] and T2D [ 17 ]. Also, our findings on the unhealthy characteristics of the EDIH or ELIH are comparable with the adverse effects of these insulinemic indices in increasing the risk of chronic diseases in other studies.…”

“…Tabung et al observed that a high EDIH score was associated with long-term weight gain in adults [ 16 ]. Also, the positive linkage between these dietary insulinemic indices and risk of IR [ 17 ] and T2D [ 18 ] has previously been reported.…”