Dietary Fat Quality and Pre‑diabetes: A Case‑control Study

Maryam Abshirini, Behzad Mahaki, Fariba Bagheri, Fereydoun Siassi, Fariba Koohdani, Mostafa Qorbani, Parvaneh Yavari, Gity Sotoudeh

Abstract


Background: The relationship between dietary fat quality (DFQ) indices and pre‑diabetes has not been well studied. This study aimed to determine the association of DFQ indices and fatty acid intake with pre‑diabetes.

Methods: This case‑control study included 150 subjects with normal fasting blood glucose (FBG) and 147 pre‑diabetic subjects. Dietary intake was assessed by a validated food‑frequency questionnaire. DFQ indices including atherogenicity (AI) and thrombogenicity (TI), the ratios of hypo‑ and hypercholesterolemic (h:H), polyunsaturated:saturated (P:S) and n‑3:n‑6 polyunsaturated fatty acids were calculated. FBG test and 2‑hour oral glucose tolerance test (OGTT) were measured.

Results: After adjustment for some confounding variables, a positive association was found between intake of total saturated fatty acids (SFA), myristic acid, palmitic acid, and pre‑diabetes, and a negative association was observed among n‑3 polyunsaturated fatty acids, eicosapentaenoic, docosahexaenoic and arachidonic acids intake and pre‑diabetes. AI was found to be positively associated with pre‑diabetes (OR 6.68, 95% CI 2.57‑17.34). An inverse relationship was observed between n‑3:n‑6 (OR 0.37, 95% CI 0.14‑0.93) and h:H (OR 0.20, 95% CI 0.07‑0.52) ratios with pre‑diabetes.

Conclusions: Higher intake of dietary n‑3 fatty acids was adversely, whereas SFA intake was positively related to pre‑diabetes morbidity. DFQ indices may be a useful measure to investigate fat intakes and blood glucose disturbances.


Keywords


Dietary fat quality; fatty acids; polyunsaturated fatty acids; pre‑diabetes

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References


Rydén L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N,

et al. ESC Guidelines on diabetes, pre‑diabetes, and cardiovascular

diseases developed in collaboration with the EASD: The Task

Force on diabetes, pre‑diabetes, and cardiovascular diseases of

the European Society of Cardiology (ESC) and developed in

collaboration with the European Association for the Study of

Diabetes (EASD). Eur Heart J 2013;34:3035‑87.

Derosa G, Cicero AF, D’angelo A, Borghi C, Maffioli P. Effects

of n-3 pufas on fasting plasma glucose and insulin resistance

in patients with impaired fasting glucose or impaired glucose

tolerance. Biofactors 2016;42:316‑22.

Wu JH, Micha R, Imamura F, Pan A, Biggs ML, Ajaz O, et al.

Omega‑3 fatty acids and incident type 2 diabetes: A systematic

review and meta‑analysis. Br J Nutr 2012;107:214‑27.

Krishnan S, Steffen LM, Paton CM, Cooper JA. Impact of

dietary fat composition on prediabetes: A 12‑year follow‑up

study. Public Health Nutr 2017;20:1617‑26.

Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H,

Ilanne‑Parikka P, et al. Prevention of type 2 diabetes mellitus

by changes in lifestyle among subjects with impaired glucose

tolerance. N Engl J Med 2001;344:1343‑50.

Vessby B. Dietary fat and insulin action in humans. Br J Nutr

;83:91‑6.

Ulbricht T, Southgate D. Coronary heart disease: Seven dietary

factors. Lancet 1991;338:985‑92.

Santos‑Silva J, Mendes I, Bessa R. The effect of genotype,

feeding system and slaughter weight on the quality of light

lambs: 1. Growth, carcass composition and meat quality. Livest

Prod Sci 2002;76:17‑25.

Barbieiri P, Nunes JC, Torres AG, Nishimura RY, Zuccolotto DC,

Crivellenti LC, et al. Indices of dietary fat quality during

midpregnancy is associated with gestational diabetes. Nutrition

;32:656‑61.

Bagheri F, Siassi F, Koohdani F, Mahaki B, Qorbani M, Yavari P,

et al. Healthy and unhealthy dietary patterns are related to prediabetes: A case–control study. Br J Nutr 2016;116:874-81.

Moghaddam MHB, Aghdam FB, Jafarabadi MA,

Allahverdipour H, Nikookheslat SD, Safarpour S. The Iranian

Version of International Physical Activity Questionnaire (IPAQ)

in Iran: Content and construct validity, factor structure, internal

consistency and stability. World Appl Sci 2012;18:1073‑80.

Bankar SB, Bule MV, Singhal RS, Ananthanarayan L. Glucose

oxidase—An overview. Biotechnol Adv 2009;27:489‑501.

Esmaillzadeh A, Mirmiran P, Azizi F. Whole‑grain intake and the

prevalence of hypertriglyceridemic waist phenotype in Tehranian

adults. Am J Clin Nutr 2005;81:55‑63.

Overview & Background of The Healthy Eating Index.

Available form: https://epi.grants.cancer.gov/hei/. [Last accessed

on 2019 Apr 17].

Willett WC, Howe GR, Kushi LH. Adjustment for total energy

intake in epidemiologic studies. Am J Clin Nutr 1997;65:1220‑8.

Hunnicutt JW, Hardy RW, Williford J, McDonald JM. Saturated

fatty acid‑induced insulin resistance in rat adipocytes. Diabetes

;43:540‑5.

Koska J, Ozias MK, Deer J, Kurtz J, Salbe AD, Harman SM,

et al. A human model of dietary saturated fatty acid induced

insulin resistance. Metabolism 2016;65:1621‑8.

Kennedy A, Martinez K, Chuang C‑C, LaPoint K, McIntosh M.

Saturated fatty acid‑mediated inflammation and insulin resistance

in adipose tissue: Mechanisms of action and implications. ‎J Nutr

;139:1‑4.

Van der Kolk BW, Goossens GH, Jocken JW, Blaak EE. Altered

skeletal muscle fatty acid handling is associated with the

degree of insulin resistance in overweight and obese humans.

Diabetologia 2016;59:2686‑96.

Villegas R, Xiang Y‑B, Elasy T, Li H‑L, Yang G, Cai H, et al.

Fish, shellfish, and long‑chain n − 3 fatty acid consumption and

risk of incident type 2 diabetes in middle‑aged Chinese men and

women. Am J Clin Nutr 2011;94:543‑51.

Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F,

Giugliano G, et al. Effect of a Mediterranean‑style diet on

endothelial dysfunction and markers of vascular inflammation in the

metabolic syndrome: A randomized trial. JAMA 2004;292:1440‑6.

Liu H‑Q, Qiu Y, Mu Y, Zhang X‑J, Liu L, Hou X‑H, et al.

A high ratio of dietary n‑3/n‑6 polyunsaturated fatty acids

improves obesity‑linked inflammation and insulin resistance

through suppressing activation of TLR4 in SD rats. Nutr Res

;33:849‑58.

Simopoulos AP. An increase in the omega‑6/omega‑3 fatty acid

ratio increases the risk for obesity. Nutrients 2016;8:128.

Buckley JD, Howe P. Anti-obesity effects of long-chain omega-3

polyunsaturated fatty acids. Obes Rev 2009;10:648‑59.

Pischon T, Hankinson SE, Hotamisligil GS, Rifai N, Willett WC,

Rimm EB. Habitual dietary intake of n‑3 and n‑6 fatty acids in

relation to inflammatory markers among US men and women.

Circulation 2003;108:155‑60.