Insulinemic and inflammatory diets enhance kind 2 diabetes danger for postmenopausal girls

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March 18, 2021

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Postmenopausal women who eat a highly pro-inflammatory or hyperinsulinemic diet are at increased risk of developing type 2 diabetes, according to data on the Women’s Health Initiative published in Diabetes Care.

Fred Tube

“Our results suggest that the nutritional pattern’s ability to raise blood sugar levels may be important in preventing type 2 diabetes. Focusing on foods that contribute to blood sugar levels may not be an optimal approach, however, as there are other foods and beverages that may not add sugar, but can be powerful regulators of inflammation and insulin hypersecretion. ” Fred Tube, PhD, MSPH, an assistant professor at Ohio State University College of Medicine and Comprehensive Cancer Center, said Healio. “Inflammation and insulin responses are normal ways our bodies keep us healthy. However, when these processes get faster, they become harmful to the body. One way they can get into full swing is through a habitual eating pattern that promotes chronic systemic inflammation or insulin hypersecretion. “

High hyperinsulinemic and highly pro-inflammatory diets have been linked to an increased risk of type 2 diabetes in postmenopausal women. The data was provided by Jin Q et al. Diabetes treatment. 2021; doi: 10.2337 / dc20-2216.

Tabung and colleagues analyzed baseline data from 73,495 postmenopausal women aged 50 to 79 years without type 2 diabetes who participated in WHI. Nutritional indices were calculated using basic nutritional data from a self-administered food frequency questionnaire conducted at the start of the study. Hyperinsulinemia index scores were calculated to assess the insulinemic potential of diet and empirical pattern of inflammation scores were calculated to assess inflammatory potential. Women had a higher index of hyperinsulinemia when they consumed more processed and red meat, sugary beverages, fat-free fish, eggs, and poultry, and fewer leafy green vegetables, fruits, high-fat dairy products, coffee, and wine. Highly flammable diets were those with more meat, refined grains, and high-energy drinks, and fewer vegetables, coffee, tea, wine, and beer. The glycemic index and glycemic load were calculated to assess the glycemic potential of a diet based on carbohydrate content. Participants had emerging type 2 diabetes when they reported treatment or hospitalization for diabetes.

Hyperinsulinaemic, pro-inflammatory diets increase the risk of diabetes

During a mean follow-up period of 13.3 years, 11,009 cases of type 2 diabetes were reported in the study cohort. After adjusting for variables, women in the highest hyperinsulinaemic diet quintile had a higher risk of type 2 diabetes than participants in the lowest hyperinsulinaemic diet quintile (adjusted HR = 1.49; 95% CI, 1.32-1.68; P <0.0001 ). Similarly, women in the highest empirical quintile with an inflammatory diet pattern were at higher risk for type 2 diabetes than participants in the lowest quintile (aHR = 1.45; 95% CI, 1.29-1.63; P <0.0001 ). The glycemic index and glycemic load were not associated with type 2 diabetes risk.

Women who consumed a highly hyperinsulinemic diet had 220 cases of type 2 diabetes per 100,000 person-years, and pro-inflammatory diets were associated with 271 cases of type 2 diabetes per 100,000 person-years. Hyperglycemic diets were not associated with cases of excessive type 2 diabetes.

“We expected that there would be a difference between the insulinemic / inflammatory potential of the diet and the glycemic potential of the diet as the glycemic potential of the diet is a narrower concept, especially acute glycemia,” Tabung said. “However, we did not expect that the difference in absolute over-risk that can arise from consuming a hyperinsulinemic or pro-inflammatory diet versus a hyperglycemic diet would be so great.”

In the subgroup analysis, overweight or obese women who were on a highly hyperinsulinaemic or proinflammatory diet had a higher risk of type 2 diabetes than women of normal weight who were on a low hyperinsulinaemic or proinflammatory diet. High hyperinsulinaemic and pro-inflammatory diets were also associated with a higher risk of type 2 diabetes in white and Hispanic women.

New focus on eating habits

According to Tabung, focusing only on glycemic levels in foods to prevent diabetes is not an optimal approach. He said providers should instead study a woman’s overall nutritional behavior and how it could directly affect insulin levels.

“Picking out certain foods and consuming them doesn’t work as well as eating the entire nutritional pattern, except for those foods that some people may be allergic or intolerant to,” Tabung said. “Additionally, targeting specific racial and ethnic sub-groups, such as African American or Hispanic / Latina women, rather than the general population with the same message, can yield a higher return on our efforts to prevent type 2 diabetes.”

For more informations:

Fred Tube, PhD, MSPH, can be reached at fred.tabung@osumc.edu.

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