Author
LIU, ENJU - TUFTS UNIVERSITY | |
MCKEOWN, NICOLA - JM USDA HNRCA @ TUFTS | |
NEWBY, PK - BOSTON UNIVERSITY | |
MEIGS, JAMES - MASS GENERAL HOSPITAL | |
VASAN, RAMACHANDRAN - BOSTON UNIVERSITY | |
D'AGOSTINO, RALPH - BOSTON UNIVERSITY | |
QUATROMONI, PA - SARGET COLLEGE | |
Jacques, Paul |
Submitted to: British Journal of Nutrition
Publication Type: Peer Reviewed Journal Publication Acceptance Date: 12/10/2008 Publication Date: 2/16/2009 Citation: Liu, E., Mckeown, N.M., Newby, P., Meigs, J.B., Vasan, R.S., D'Agostino, R.B., Quatromoni, P., Jacques, P. 2009. Cross-sectional association of dietary patterns with insulin resistance phenotypes among adults without diabets in the Framingham Offspring Study. British Journal of Nutrition. 16:1-8. Interpretive Summary: In nutritional epidemiology, the use of dietary patterns to capture the overall dietary habits of populations has received much attention in recent years. Unlike the traditional nutritional epidemiology method, which is focused on the effect of individual nutrients or foods, dietary patterns capture the overall variance in dietary intake. In 2875 non-diabetic adults, we looked to see if dietary pattern was associated with insulin resistance. Four dietary patterns were identified using cluster analysis: Healthy, Western, Beer, and Soda. We found that compared to individuals in the Healthy pattern, those in the Soda pattern had greater degree of insulin resistance, while those in the Alcohol pattern had lower degree of insulin resistance. The Soda pattern is characterized by higher consumption of sugar-sweetened soft drinks. High intake of added sugars from beverage requires greater insulin release from pancreatic beta cell, and hyperinsulinemia itself may cause insulin resistance. Although this study showed that the Beer pattern is favorably associated with insulin resistance, it has significantly lower dietary guideline adherence index compared to the Healthy pattern. According to the current dietary recommendations sugar-sweetened soft drinks and alcoholic beverages are considered discretionary calories that should be consumed in moderation. Technical Abstract: Several studies have linked dietary patterns which derived by cluster analysis with metabolic syndrome. Insulin resistance and hyperinsulinemia are key metabolic abnormalities which drive the metabolic syndrome. However, whether dietary patterns identified by cluster analysis are also associated with insulin resistance and its phenotypes is unknown. The objective of this study is to examine the relationship between dietary patterns identified by cluster analysis and surrogate markers of insulin resistance and insulin resistance-related phenotypes among 2875 non-diabetic adults in the Framingham Offspring Study at exam 5 (1991-1995). The outcome variables include waist circumference, body mass index, fasting and 2-hour post-challenge insulin, insulin sensitivity index, HDL cholesterol, triacylglcerol, systolic and diastolic blood pressure. Four dietary patterns were identified (Healthy, Western, Beer, and Soda). Compared to the Healthy pattern, the Soda pattern had significantly (P<0.05) higher fasting insulin (31.3 versus 28.0 µU/mL) and 2-hour post-challenge insulin concentration (100.4 versus 87.3µU/mL) , the Beer pattern had significantly higher HDL cholesterol concentration (56.2 versus 50.6 mg/dL) after adjusting for multiple comparisons and potential confounders. Although the Beer pattern appear to be favorably associated with insulin resistance, like the Soda pattern it had significantly lower dietary guideline adherence index (DGAI) than the Healthy pattern (8,0 versus 11.1). No significant associations were found between dietary pattern and waist circumference, BMI, Insulin sensitivity index (ISI 0,120), triacylglycerol, or systolic and diastolic blood pressure. Our study findings support current recommendations that sugar-sweetened soft drinks and alcohol beverages are considered discretionary calories that should be consumed in moderation. |