A Snack Dietary Pattern Increases the Risk of Hypercholesterolemia in Northern Chinese Adults: A Prospective Cohort Study

<div><p>The evidence about the effect of dietary patterns on blood cholesterol from cohort studies was very scarce. The study was to identify the association of dietary patterns with lipid profile, especially cholesterol, in a cohort in north China. Using a 1-year food frequency questionnaire, we assessed the dietary intake of 4515 adults from the Harbin People’s Health Study in 2008, aged 20-74 years. Principle component analysis was used to identify dietary patterns. The follow-up was completed in 2012. Fasting blood samples were collected for the determination of blood lipid concentrations. Logistic regression models were used to evaluate the association of dietary patterns with the incidence of hypercholesterolemia, hypertriglyceridemia, and low-HDL cholesterolemia. Five dietary patterns were identified (“staple food”, “vegetable, fruit and milk”, “potato, soybean and egg”, “snack”, and “meat”). The relative risk (RR) between the extreme tertiles of the snack dietary pattern scores was 1.72 (95% CI = 1.14, 2.59, <i>P</i> = 0.004) for hypercholesterolemia, 1.39 (1.13, 1.75, <i>P</i> = 0.036) for hypertriglyceridemia, after adjustment for age, sex, education, body mass index, smoking, alcohol consumption, energy intake, exercise and baseline lipid concentrations. There was a significant positive association between the snack dietary pattern scores and fasting serum total cholesterol (SRC (standardized regression coefficient) = 0.262, <i>P</i> = 0.025), LDL-c (SRC = 0.324, <i>P</i> = 0.002) and triglycerides (SRC = 0.253, <i>P</i> = 0.035), after adjustment for the multiple variables above. Moreover, the adjusted RR of hypertriglyceridemia between the extreme tertiles was 0.73 (0.56, 0.94, <i>P</i> = 0.025) for the vegetable, fruit and milk dietary pattern, and 1.86 (1.33, 2.41, <i>P</i> = 0.005) for the meat dietary pattern. The snack dietary pattern was a newly emerged dietary pattern in northern Chinese adults. It appears conceivable that the risk of hypercholesterolemia can be reduced by changing the snack dietary pattern.</p></div

RR (95% CI) of hypercholesterolemia on tertiles of energy-adjusted dietary pattern scores in the study.

<p>Abbreviations: CI, confidence interval; RR, relative risk.</p><p>Model 1 was adjusted for age, sex; Model 2 was adjusted for the baseline values of age, sex, education, body mass index, smoking, alcohol consumption, energy intake, exercise and blood lipid concentrations.</p

HepG2 cells were incubated with 0.2 mmol/L OA only or with different concentrations of mangiferin (12.5, 25, 50, 100 µmol/L) simultaneously for 24 h.

<p>Proteins were isolated from the cell lysates and analyzed by western blot analysis for AMPK (A), CD36 (B), CPT1 (C), ACC (D) and DGAT (E) expressions. The experiments were repeated 3 times. Data are presented as means ± SD (n = 3). ^*<i>P</i><0.05 compared with only OA stimulation group.</p

Dietary Vitamin C Intake Reduces the Risk of Type 2 Diabetes in Chinese Adults: HOMA-IR and T-AOC as Potential Mediators

<div><p>Despite growing interest in the protective role that dietary antioxidant vitamins may have in the development of type 2 diabetes (T2D), little epidemiological evidence is available in non-Western populations especially about the possible mediators underlying in this role. The present study aimed to investigate the association of vitamin C and vitamin E intakes with T2D risk in Chinese adults and examine the potential mediators. 178 incident T2D cases among 3483 participants in the Harbin People Health Study (HPHS), and 522 newly diagnosed T2D among 7595 participants in the Harbin Cohort Study on Diet, Nutrition and Chronic Non-communicable Diseases (HDNNCDS) were studied. In the multivariable-adjusted logistics regression model, the relative risks (RRs) were 1.00, 0.75, and 0.76 (<i>P</i>_trend = 0.003) across tertiles of vitamin C intake in the HDNNCDS, and this association was validated in the HPHS with RRs of 1.00, 0.47, and 0.46 (<i>P</i>_trend = 0.002). The RRs were 1.00, 0.72, and 0.76 (<i>P</i>_trend = 0.039) when T2D diagnosed by haemoglobin A_1c in the HDNNCDS. The mediation analysis discovered that insulin resistance (indicated by homeostasis model assessment) and oxidative stress (indicated by plasma total antioxidative capacity) partly mediated this association. But no association was evident between vitamin E intake and T2D. In conclusion, our research adds further support to the role of vitamin C intake in reducing the development of T2D in the broader population studied. The results also suggested that this association was partly mediated by inhibiting or ameliorating oxidative stress and insulin resistance.</p></div

Baseline characteristics and nutrient intakes according to tertile scores of the snack dietary in the study.

<p>Abbreviations: BMI, body mass index.</p><p>^a Difference among tertiles were analyze by using ANCOVA with age, sex, BMI, smoking, alcohol consumption and exercise as covariants.</p><p>^b Difference among tertiles were analyze by using ANCOVA with age, sex, BMI, smoking, alcohol consumption, exercise and energy intake as covariants.</p><p>Data are means (SD) or n (%). Difference among tertiles were analyze by using ANOVA or χ2 test.</p

The association between the snack pattern scores and serum cholesterol levels at follow-up using multiple linear regression analysis.

<p>Abbreviations: SRCs, standardized regression coefficients.</p><p>^a SRCs were adjusted for age and sex;</p><p>^b SRCs were adjusted for the baseline values of age, sex, education, body mass index, smoking, alcohol consumption, energy intake, exercise and blood lipid concentrations.</p><p>The association between the snack pattern scores and serum cholesterol levels at follow-up using multiple linear regression analysis.</p

Effects of mangiferin on the ratio of AMP to ATP and LKB1 protein expression in HepG2 cells.

<p>HepG2 cells were incubated to 0.2 mmol/L oleic acid only or with different concentrations of mangiferin (12.5, 25, 50, 100 µmol/L) simultaneously for 24 h. The ratio of AMP to ATP was detected by HPLC (A). The LKB1 protein expression was carried out by western blot analysis (B). The experiments were repeated 3 times. Data are presented as means ± SD (n = 3). ^*<i>P</i><0.05 compared with only OA stimulation group.</p

The flow chart of the participants.

<p>The flow chart of the participants.</p

Dietary Information Improves Model Performance and Predictive Ability of a Noninvasive Type 2 Diabetes Risk Model

<div><p>There is no diabetes risk model that includes dietary predictors in Asia. We sought to develop a diet-containing noninvasive diabetes risk model in Northern China and to evaluate whether dietary predictors can improve model performance and predictive ability. Cross-sectional data for 9,734 adults aged 20–74 years old were used as the derivation data, and results obtained for a cohort of 4,515 adults with 4.2 years of follow-up were used as the validation data. We used a logistic regression model to develop a diet-containing noninvasive risk model. Akaike’s information criterion (AIC), area under curve (AUC), integrated discrimination improvements (IDI), net classification improvement (NRI) and calibration statistics were calculated to explicitly assess the effect of dietary predictors on a diabetes risk model. A diet-containing type 2 diabetes risk model was developed. The significant dietary predictors including the consumption of staple foods, livestock, eggs, potato, dairy products, fresh fruit and vegetables were included in the risk model. Dietary predictors improved the noninvasive diabetes risk model with a significant increase in the AUC (delta AUC = 0.03, <i>P</i><0.001), an increase in relative IDI (24.6%, <i>P</i>-value for IDI <0.001), an increase in NRI (category-free NRI = 0.155, <i>P</i><0.001), an increase in sensitivity of the model with 7.3% and a decrease in AIC (delta AIC = 199.5). The results of the validation data were similar to the derivation data. The calibration of the diet-containing diabetes risk model was better than that of the risk model without dietary predictors in the validation data. Dietary information improves model performance and predictive ability of noninvasive type 2 diabetes risk model based on classic risk factors. Dietary information may be useful for developing a noninvasive diabetes risk model.</p></div

Effect of mangiferin on fasting metabolic variables at 6 weeks in hyperlipemic rats.

<p>Data are means ± SD (n = 10),</p>#<p><i>P</i><0.05</p>##<p><i>P</i><0.01 indicate statistically significant differences when compared with control group.</p><p>*<i>P</i><0.05 and</p><p>**<i>P</i><0.01 indicate statistically significant differences when compared with hyperlipidemia group.</p