Circulating very-long-chain saturated fatty acids (VLCSFAs) may play an active role in the origin of cardiometabolic diseases.
We measured 3 VLCSFAs (C20:0, C22:0, and C24:0) in plasma and ...erythrocytes using gas-liquid chromatography among 794 incident coronary heart disease (CHD) cases who were prospectively identified and confirmed among women in the Nurses' Health Study (NHS; 1990-2006) and among men in the Health Professionals Follow-Up Study (HPFS; 1994-2008). A total of 1233 CHD-free controls were randomly selected and matched to cases in these 2 cohorts. Conditional logistic regression was used to estimate hazard ratios and 95% confidence intervals. Plasma VLCSFAs were correlated with favorable profiles of blood lipids, C-reactive protein, and adiponectin in the NHS and HPFS and with fasting insulin and C-peptide levels in a nationally representative US comparison population. After multivariate adjustment for lifestyle factors, body mass index, diet, and long-chain n-3 and trans fatty acids, total VLCSFAs in plasma were associated with a 52% decreased risk of CHD (pooled hazard ratio, 0.48; 95% confidence interval, 0.32-0.72, comparing extreme quintiles; Ptrend<0.0001). For VLCSFAs in erythrocytes, a nonsignificant inverse trend with CHD risk was observed (pooled hazard ratio, 0.66; 95% confidence interval, 0.41-1.06, comparing extreme quintiles; Ptrend=0.16).
In US men and women, plasma VLCSFAs were independently associated with favorable profiles of blood lipids and other cardiovascular disease risk markers and a lower risk of CHD. Erythrocyte VLCSFAs were associated with nonsignificant trends of lower CHD risk. Future studies are warranted to elucidate the underlying biological mechanisms.
Inconsistent data suggest that endogenous sex hormones may have a role in sex-dependent etiologies of type 2 diabetes, such that hyperandrogenism may increase risk in women while decreasing risk in ...men.
To systematically assess studies evaluating the association of plasma levels of testosterone, sex hormone-binding globulin (SHBG), and estradiol with risk of type 2 diabetes.
Systematic search of EMBASE and MEDLINE (1966-June 2005) for English-language articles using the keywords diabetes, testosterone, sex-hormone-binding-globulin, and estradiol; references of retrieved articles; and direct author contact.
From 80 retrieved articles, 43 prospective and cross-sectional studies were identified, comprising 6974 women and 6427 men and presenting relative risks (RRs) or hormone levels for cases and controls.
Information on study design, participant characteristics, hormone levels, and risk estimates were independently extracted by 2 investigators using a standardized protocol.
Results were pooled using random effects and meta-regressions. Cross-sectional studies indicated that testosterone level was significantly lower in men with type 2 diabetes (mean difference, -76.6 ng/dL; 95% confidence interval CI, -99.4 to -53.6) and higher in women with type 2 diabetes compared with controls (mean difference, 6.1 ng/dL; 95% CI, 2.3 to 10.1) (P<.001 for sex difference). Similarly, prospective studies showed that men with higher testosterone levels (range, 449.6-605.2 ng/dL) had a 42% lower risk of type 2 diabetes (RR, 0.58; 95% CI, 0.39 to 0.87), while there was suggestion that testosterone increased risk in women (P = .06 for sex difference). Cross-sectional and prospective studies both found that SHBG was more protective in women than in men (P< or =.01 for sex difference for both), with prospective studies indicating that women with higher SHBG levels (>60 vs < or =60 nmol/L) had an 80% lower risk of type 2 diabetes (RR, 0.20; 95% CI, 0.12 to 0.30), while men with higher SHBG levels (>28.3 vs < or =28.3 nmol/L) had a 52% lower risk (RR, 0.48; 95% CI, 0.33 to 0.69). Estradiol levels were elevated among men and postmenopausal women with diabetes compared with controls (P = .007).
This systematic review indicates that endogenous sex hormones may differentially modulate glycemic status and risk of type 2 diabetes in men and women. High testosterone levels are associated with higher risk of type 2 diabetes in women but with lower risk in men; the inverse association of SHBG with risk was stronger in women than in men.
Epidemiological evidence supports an association between sugar-sweetened soda consumption and diabetes. However, evidence regarding this association is limited in countries that have recently ...undergone a nutritional transition.
We estimated the association between sugar-sweetened soda consumption and incident diabetes. We also determined if the association between sugar-sweetened soda and diabetes differs as a result of
We used data from the Mexican Teachers’ Cohort including 72,667 women aged ≥25 y, free of diabetes, cardiovascular disease, and cancer at baseline. We assessed sugar-sweetened soda consumption using a validated food frequency questionnaire (FFQ) at baseline. Diabetes was self-reported. We used Cox proportional hazard regression models to estimate the association between quintiles of sugar-sweetend soda and diabetes. We also estimated the associaiton by increasing one serving per day (355 mL) of sugar-sweetened soda.We conducted prespecified subgroup analysis by potential effect modifiers, namely markers of energy balance of early life factors, family history of diabetes, and Amerindian admixture.
During a median follow-up of 2.16 y (IQR 0.75–4.50) we identified 3,155 incident cases of diabetes. The median consumption of sugar-sweetened soda was 1.17 servings per day (IQR 0.47– 4.00). In multivariable analyses, comparing extreme quintiles showed that higher sugar-sweetened soda consumption was associated with diabetes incidence (HR = 1.32; 95% CI: 1.17, 1.49), and each additional serving per day of sugar-sweetened soda was associated with an increase of 27% in diabetes incidence (HR = 1.27; 95% CI: 1.16, 1.38). The soda–diabetes association was stronger among women who experienced intrauterine and childhood over-nutrition (high birth weight, no short stature, higher adiposity in premenarche, and higher adiposity at age 18–20 y old).
Sugar-sweetened soda consumption is associated with an increased risk of diabetes among Mexican women in a magnitude similar to that reported in other populations. The stronger association among individuals with markers of early life over-nutrition reinforce the need for early life interventions.
A combination of healthy lifestyle behaviours (i.e., regular physical activity, nutritious diet, no smoking, moderate alcohol, and healthy body mass) has been consistently associated with beneficial ...health outcomes including reduced risk of cardiometabolic diseases. Metabolomic profiles, characterized by distinct sets of biomarkers, have been described for healthy lifestyle behaviours individually and in combination. However, recent literature calls for systematic evaluation of these heterogenous data to identify potential clinical biomarkers relating to a combined healthy lifestyle. The objective was to systematically review existing literature on the metabolomic profile of combined healthy lifestyle behaviours. MEDLINE, EMBASE and Cochrane databases were searched through March 2022. Studies in humans outlining the metabolomic profile of a combination of two or more healthy lifestyle behaviours were included. Collectively, the metabolomic profile following regular adherence to combined healthy lifestyle behaviours points to a positive association with beneficial fatty acids and phosphocreatine, and inverse associations with triglycerides, trimethylamine N‐oxide, and acylcarnitines. The findings suggest that a unique metabolomic profile is associated with combined healthy lifestyle behaviours. Additional research is warranted to further describe this metabolomic profile using targeted and untargeted metabolomic approaches along with uniform definitions of combined healthy lifestyle variables across populations.
Adverse associations of low- and no-calorie sweetened beverages (LNCSB) with cardiometabolic outcomes in observational studies may be explained by reverse causality and residual confounding.
To ...address these limitations we used change analyses of repeated measures of intake and substitution analyses to synthesize the association of LNCSB with cardiometabolic outcomes.
MEDLINE, Embase, and the Cochrane Library were searched up to 10 June 2021 for prospective cohort studies with ≥1 year of follow-up duration in adults.
Outcomes included changes in clinical measures of adiposity, risk of overweight/obesity, metabolic syndrome, type 2 diabetes (T2D), cardiovascular disease, and total mortality.
Two independent reviewers extracted data, assessed study quality, and assessed certainty of evidence using GRADE. Data were pooled with a random-effects model and expressed as mean difference (MD) or risk ratio (RR) and 95% CI.
A total of 14 cohorts (416,830 participants) met the eligibility criteria. Increase in LNCSB intake was associated with lower weight (5 cohorts, 130,020 participants; MD -0.008 kg/year 95% CI -0.014, -0.002). Substitution of LNCSB for sugar-sweetened beverages (SSB) was associated with lower weight (three cohorts, 165,579 participants; MD, -0.12 -0.14, -0.10, kg/y) and lower incidence of obesity (OB) (one cohort, 15,765 participants; RR 0.88 95% CI 0.88, 0.89), coronary heart disease (six cohorts, 233,676 participants; 0.89 0.81, 0.98), cardiovascular disease mortality (one cohort, 118,363 participants; 0.95 0.90, 0.99), and total mortality (one cohort, 118,363 participants; 0.96 0.94, 0.98) with no adverse associations across other outcomes. Substitution of water for SSB showed lower weight (three cohorts, 165,579 participants; MD -0.10 kg/year -0.13, -0.06), lower waist circumference (one cohort, 173 participants; -2.71 cm/year -4.27, -1.15) and percent body fat (one cohort, 173 participants; -1.51% per year -2.61, -0.42), and lower incidence of OB (one cohort, 15,765 participants; RR 0.85 0.75, 0.97) and T2D (three cohorts, 281,855 participants; 0.96 0.94, 0.98). Substitution of LNCSB for water showed no adverse associations.
The evidence was low to very low certainty owing to downgrades for imprecision, indirectness, and/or inconsistency.
LNCSB were not associated with cardiometabolic harm in analyses that model the exposure as change or substitutions. The available evidence provides some indication that LNCSB in their intended substitution for SSB may be associated with cardiometabolic benefit, comparable with the standard of care, water.
Background: Consumption of caffeinated beverages such as coffee and tea has been associated with a lower risk of type 2 diabetes (T2D). Paradoxically, short-term metabolic studies have shown that ...caffeine impairs postprandial glycemic control.Objective: The objective was to prospectively examine the association of caffeinated compared with caffeine-free beverages, including coffee, tea, sugar-sweetened beverages (SSBs), and carbonated artificially sweetened beverages (ASBs), with T2D risk.Design: We prospectively observed 74,749 women from the Nurses’ Health Study (NHS, 1984–2008) and 39,059 men from the Health Professionals Follow-Up Study (HPFS, 1986–2008) who were free of diabetes, cardiovascular diseases, and cancer at baseline.Results: We documented 7370 incident cases of T2D during 24 y of follow-up in the NHS and 2865 new cases during 22 y of follow-up in the HPFS. After major lifestyle and dietary risk factors were controlled for, caffeinated and caffeine-free SSB intake was significantly associated with a higher risk of T2D in the NHS (RR per serving: 13% for caffeinated SSBs, 11% for caffeine-free SSBs; P < 0.05) and in the HPFS (RR per serving: 16% for caffeinated SSBs, 23% for caffeine-free SSBs; P < 0.01). Only caffeine-free ASB intake in NHS participants was associated with a higher risk of T2D (RR: 6% per serving; P < 0.001). Conversely, the consumption of caffeinated and decaffeinated coffee was associated with a lower risk of T2D RR per serving: 8% for both caffeinated and decaffeinated coffee in the NHS (P < 0.0001) and 4% for caffeinated and 7% for decaffeinated coffee in the HPFS (P < 0.01). Only caffeinated tea was associated with a lower T2D risk among NHS participants (RR per serving: 5%; P < 0.0001).Conclusion: Irrespective of the caffeine content, SSB intake was associated with a higher risk of T2D, and coffee intake was associated with a lower risk of T2D.
The replacement of caloric beverages such as sugar-sweetened beverages (SSBs) and fruit juices with noncaloric beverages such as plain water has been recommended for diabetes prevention.
We evaluated ...the relation of plain-water intake and the substitution of plain water for SSBs and fruit juices with incident type 2 diabetes (T2D) in US women.
We prospectively followed 82,902 women in the Nurses' Health Study II who were free of diabetes, cardiovascular disease, or cancer at baseline. Diet, including various beverages, was assessed by using validated food-frequency questionnaires and updated every 4 y. Incident T2D was confirmed by using a validated supplementary questionnaire. We used a 4-y lagged analysis to minimize reverse causation (ie, increased water consumption that was due to early stage of diabetes).
During 1,115,427 person-years of follow-up, we documented 2718 incident T2D cases. Plain-water intake was not associated with T2D risk in the multivariable-adjusted model that included age, BMI, diet, and lifestyle factors; RRs (95% CIs) across categories (<1, 1, 2-3, 4-5, and ≥6 cups/d) were 1.00, 0.93 (0.82, 1.05), 0.93 (0.83, 1.05), 1.09 (0.96, 1.24), and 1.06 (0.91, 1.23), respectively (P-trend = 0.15). We estimated that the replacement of 1 serving SSBs and fruit juices/d by 1 cup plain water/d was associated with 7% (3%, 11%) and 8% (2%, 13%) lower risk of T2D, respectively.
Plain-water intake, per se, was not significantly associated with risk of T2D. However, substitution of plain water for SSBs or fruit juices was estimated to be associated with modestly lower risk of T2D.
Healthful dietary patterns have been associated with lower risks of type 2 diabetes and coronary artery disease, but their relations with intermediate markers of cardiometabolic and endocrine health ...are less established.
We evaluated the Dietary Approaches to Stop Hypertension (DASH), the alternate Mediterranean diet (aMED), and the Alternate Healthy Eating Index (aHEI) diet-quality scores with cardiometabolic and endocrine plasma biomarkers in US women.
The trial was a cross-sectional analysis of 775 healthy women in the Women's Lifestyle Validation Study that was conducted within the NHS (Nurses' Health Study) and NHS II longitudinal cohorts. Multiple linear regression models adjusted for potential confounders were used to estimate associations between quartiles of dietary pattern-adherence scores that were derived from a food-frequency questionnaire and plasma biomarker concentrations that were collected simultaneously.
In multivariable models in which highest and lowest quartiles of dietary pattern scores were compared, 1) DASH was significantly associated with higher concentrations of high-density lipoprotein (9%) and sex-hormone binding globulin (SHBG) (21%), and lower concentrations of leptin (28%), triglycerides (19%), and C-peptide (4%) (all P-trend ≤ 0.04); 2) the aMED was associated with 19% higher SHBG and 16% lower triglycerides (P-trend = 0.02 and 0.003, respectively); and 3) the aHEI was associated with significantly higher concentrations of insulin (16%) and SHBG (19%) and lower concentrations of leptin (18%) (all P-trend ≤ 0.02). Further adjustment for body mass index (BMI) attenuated these associations but remained significant for 1) DASH with leptin and triglycerides and 2) the aMED with triglycerides (all P-trend ≤ 0.03).
Adherence to healthful dietary patterns is associated with favorable concentrations of many cardiometabolic and endocrine biomarkers. These relations are mediated in part by BMI.
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