A combination of plasma phospholipid fatty acids and its association with incidence of type 2 diabetes: The EPIC-InterAct case-cohort study.

BACKGROUND: Combinations of multiple fatty acids may influence cardiometabolic risk more than single fatty acids. The association of a combination of fatty acids with incident type 2 diabetes (T2D) has not been evaluated. METHODS AND FINDINGS: We measured plasma phospholipid fatty acids by gas chromatography in 27,296 adults, including 12,132 incident cases of T2D, over the follow-up period between baseline (1991-1998) and 31 December 2007 in 8 European countries in EPIC-InterAct, a nested case-cohort study. The first principal component derived by principal component analysis of 27 individual fatty acids (mole percentage) was the main exposure (subsequently called the fatty acid pattern score [FA-pattern score]). The FA-pattern score was partly characterised by high concentrations of linoleic acid, stearic acid, odd-chain fatty acids, and very-long-chain saturated fatty acids and low concentrations of γ-linolenic acid, palmitic acid, and long-chain monounsaturated fatty acids, and it explained 16.1% of the overall variability of the 27 fatty acids. Based on country-specific Prentice-weighted Cox regression and random-effects meta-analysis, the FA-pattern score was associated with lower incident T2D. Comparing the top to the bottom fifth of the score, the hazard ratio of incident T2D was 0.23 (95% CI 0.19-0.29) adjusted for potential confounders and 0.37 (95% CI 0.27-0.50) further adjusted for metabolic risk factors. The association changed little after adjustment for individual fatty acids or fatty acid subclasses. In cross-sectional analyses relating the FA-pattern score to metabolic, genetic, and dietary factors, the FA-pattern score was inversely associated with adiposity, triglycerides, liver enzymes, C-reactive protein, a genetic score representing insulin resistance, and dietary intakes of soft drinks and alcohol and was positively associated with high-density-lipoprotein cholesterol and intakes of polyunsaturated fat, dietary fibre, and coffee (p < 0.05 each). Limitations include potential measurement error in the fatty acids and other model covariates and possible residual confounding. CONCLUSIONS: A combination of individual fatty acids, characterised by high concentrations of linoleic acid, odd-chain fatty acids, and very long-chain fatty acids, was associated with lower incidence of T2D. The specific fatty acid pattern may be influenced by metabolic, genetic, and dietary factors

The relation of CUN-BAE index and BMI with body fat, cardiovascular events and diabetes during a 6-year follow-up: the Hordaland Health Study

Kathrine J Vinknes,1 Eha Nurk,1,2 Grethe S Tell,3 Gerhard Sulo,3 Helga Refsum,1,4 Amany K Elshorbagy4,5 1Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway; 2Department of Surveillance and Evaluation, National Institute for Health Development, Tallinn, Estonia; 3Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; 4Department of Pharmacology, University of Oxford, Oxford, UK; 5Department of Physiology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt Objective: We compared Cl&iacute;nica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and body mass index (BMI) as correlates of body fat percent (BF%) and the association with future risk of cardiovascular disease (CVD) and type 2 diabetes in a Caucasian population. Methods: We used data from 6796 individuals (born 1925&ndash;27 and 1950&ndash;52) from the Hordaland Health Study, a prospective cohort study in Norway. The study was conducted in 1992&ndash;1993 and 1997&ndash;1999. Cross-sectional analyses were conducted with data from 1997/99, including BF% measured by dual-energy X-ray absorptiometry. Longitudinal analyses included BMI and CUN-BAE calculated in 1992/93, and self-reported information on CVD events and diabetes in 1997/99. Results: The correlation between CUN-BAE and BF% (r=0.88) was stronger than between BMI and BF% (r=0.56). In sex-stratified analyses, CUN-BAE and BMI correlated similarly with BF% in men (r=0.77 and r=0.76, respectively) and women (r=0.82 and r=0.81, respectively). In longitudinal analyses, the odds ratio (per 1 SD increase) of CVD and type 2 diabetes was higher for BMI (ORCVD =1.23 [95% CI: 1.11&ndash;1.36]; ORdiabetes =2.11 [1.82&ndash;2.45]) than for CUN-BAE (ORCVD =1.15 [1.04&ndash;1.27]; ORdiabetes =2.06 [1.72&ndash;2.47]) in the total population. In sex-stratified analyses, CUN-BAE showed higher CVD and diabetes risk than BMI: in men BMI ORCVD =1.22 (1.04&ndash;1.44), ORdiabetes =2.13 (1.64&ndash;2.83); CUN-BAE ORCVD =1.93 (1.54&ndash;2.43), ORdiabetes =4.33 (2.80&ndash;6.71); and in women BMI ORCVD =1.22 (1.07&ndash;1.39), ORdiabetes =2.11 (1.76&ndash;2.53); CUN-BAE ORCVD =2.06 (1.69&ndash;2.51), ORdiabetes =5.45 (3.87&ndash;7.67). Conclusion: CUN-BAE is more strongly associated with future risk of type 2 diabetes and CVD compared with BMI in analysis stratified by sex. As a measure of adiposity in men and women separately, CUN-BAE has no advantage over BMI, except when the value of estimated BF% itself is of interest. Keywords: anthropometry, body composition, body fat, body mass index, cardiovascular disease risk, diabetes ris

The independent associations of protein consumption with body fat and glycaemic control in adult Chinese

Purpose High-protein diets were popular in weight control. However, the role of protein intake in adiposity and related metabolic conditions among general populations is not clear. We aimed to evaluate the associations of protein intake with adiposity and glycaemic control among adult Chinese in a nationwide population-based survey. Methods The data were from China Health and Nutrition Survey 2009. A total of 9360 men and women aged 18 years or older were included. Body fat percentage was calculated using validated Chinese-specific equations. Dietary intake levels of macronutrients were evaluated by food-weighing approach combined with a 3-day food intake recall. Results Averagely, our participants have 12.5% energy intake from dietary protein. With multivariate adjustment including total energy intake, the odds ratios (95% CIs) of excessive adiposity (body fat percentage ≥ 20/30% for men/women), and central obesity (waist circumference ≥ 90/80 cm for men/women) were 1.51 (1.30, 1.75) and 1.40 (1.21, 1.62), respectively, comparing extreme quintiles of relative protein intake, while fat and carbohydrate were not associated with adiposity indices. Moreover, higher relative protein intake was associated with elevated concentration of fasting glucose (β ± SE: 1.233 ± 0.583), fasting insulin (23.211 ± 9.191), glycated hemoglobin (1.057 ± 0.369), and insulin resistance indicated by homeostasis model assessment of insulin resistance (7.558 ± 2.928) (all P < 0.05). Further adjusting for body mass index attenuated the associations. Conclusion In Chinese adults, higher habitual protein consumption may be associated with higher adiposity and worse glycaemic control, independent of total energy intake