Fat consumption and HbA(1c) levels: the EPIC-Norfolk study

Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
Diabetes Care (Impact Factor: 8.42). 12/2001; 24(11):1911-6.
Source: PubMed

ABSTRACT To describe the relationship between total dietary fat and the pattern of fat intake and HbA(1c).
In this cross-sectional study, 2,759 men and 3,464 women (40-78 years of age) without a previous diagnosis of type 2 diabetes were recruited from a population-based sampling frame. Diet was assessed using a self-reported semiquantitative food frequency questionnaire.
The HbA(1c) level was negatively associated with the polyunsaturated fat-to-saturated fat ratio (P:S ratio) of the diet (beta = -0.0338 HbA(1c)% per SD change in P:S ratio; P < 0.001) and positively associated with the total level of fat intake (beta = 0.0620 HbA(1c)% per SD change in total fat intake; P < 0.001), adjusted for age and total energy intake. The associations remained significant when adjusted for each other and for total energy, protein, age, sex, family history of diabetes, BMI, waist-to-hip ratio, physical activity, and smoking (for P:S ratio, beta = -0.0200 HbA(1c)% per SD change in P:S ratio, P = 0.013; for total fat, beta = 0.420% HbA(1c)% per SD change in total fat intake, P < 0.001). The benefits from a high P:S ratio were attributed to a lower saturated fat intake.
These findings demonstrate independent associations between HbA(1c) concentration across the normal range of HbA(1c) and both total fat intake and the pattern of dietary fat intake. They provide further support to efforts promoting modifications in the intake of dietary fat.

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Available from: Ailsa A Welch, Sep 27, 2015
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    • "In a population-based study on non-diabetic persons, total dietary fat and saturated fat were positively associated with HbA1c; but the association of PUFA and MUFA was not statistically significant [32]. Several studies have indicated beneficial effect of high MUFA diets, for example Mediterranean diet in prevention and managing diabetes [9,33-35]. "
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    ABSTRACT: Since both dietary carbohydrate and fatty acids separately affect carbohydrate metabolism, how dietary macronutrients distribution may have different effects on carbohydrate metabolism pathways and regulation of blood glucose especially in diabetic patients. In this cross-sectional study 750 type 2 diabetic patients (261 men and 489 women, aged 35–65 years),who at least two years were followed in Diabetes and Metabolic disease Clinic of Tehran University of Medical Sciences, were recruited according to inclusion and exclusion criteria by simple sampling. Dietary data were collected by a validated food frequency questionnaire. Other variables were anthropometric measurements, Stress, physical activity level, Biochemical analyses including fasting and postprandial plasma glucose, Glycated hemoglobin, total cholesterol, low and high density lipoproteins, triglycerides and 25-hydoxy D3. Linear regression models were used to assess the association of covariates with the mean concentrations of HbA1C in quintiles and multivariate linear regression model was used to distinguish the impacts of dietary macronutrient composition of the diet. Carbohydrate and dietary fiber intakes were inversely (P: < 0.0001 and 0.003 respectively) and dietary amount and proportion of saturated, mono-unsaturated and poly-unsaturated fatty were positively (P: < 0.0001, 0.03, 0.01 and 0.01 respectively) associated with HbA1C concentrations. Multivariate linear regression macronutrient density model that controlled for age, sex, diabetes duration and calorie intake showed that carbohydrate was inversely associated with HbA1C (P < 0.0001, R2 = 15%). Results were also the same in the other three models adjusted for stress and exercise levels in model 2, waist circumference and sum of meals in model 3 and serum triglyceride and 25-hydroxy vitamin D in model 4(P < .0001, <.0001 and 0.0003 respectively). Calorie intake of 25 Kcal/body weight was identified as a cut of point of the negative effect of dietary carbohydrate and 30 for the positive effect of fat on HbA1c respectively (P = 0.04 and 0.03). Moreover, carbohydrate intake was positively (β = 0.08, P = 0.01) and protein (β = −0.04, P < 0.0001), SAFA (β = −0.04, P < 0.0001) and MUFA (β = −0.02, 0.07) proportion were negatively associated with increment in calorie intake. This study showed that the substitution of fat for carbohydrate is associated with low concentrations of HbA1c in high calorie consuming type 2 diabetic patients.
    Journal of Diabetes and Metabolic Disorders 06/2013; 12(1):27. DOI:10.1186/2251-6581-12-27
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    • "An association between macronutrient intake and glycemic control in Western countries has been conclusively established [11-23]. Total energy intake and total fat intake are closely related with glycemic control [11,12,22,23]. However, the association between carbohydrate intake and glycemic control is unclear [13-21]. "
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    ABSTRACT: Major macronutrients for energy intake vary among countries and cultures. Carbohydrates, including rice, are the major component of daily energy intake in Korea. The aim of this study was to examine the association of daily energy intake or each proportion of macronutrients, especially carbohydrates, with glycemic control in diabetic Koreans. A total of 334 individuals with diabetes (175 men, age 57.4±0.8 years; 159 women, age 60.9±0.9 years) who participated in the 2005 Korean National Health and Nutrition Examination Survey were examined. Glycemic control was categorized based on concentration of glycated hemoglobin (HbA1c; HbA1c ≤6.5%; 6.6% to 8.0%; ≥8.1%). Dietary intake was assessed by using a 24-recall item questionnaire. High total energy intake was associated with poor glycemic control (HbA1c ≤6.5%, 1,824±75 kcal; 6.6% to 8.0%, 1,990±57 kcal; ≥8.1%, 2,144±73 kcal; P value for trend=0.002). Each proportion of protein, fat, or carbohydrate was not associated with glycemic control. Even after adjusting for several parameters, the association of daily energy intake with glycemic control still persisted. Total energy intake may be more closely related to glycemic control than each proportionof macronutrients in Korean diabetics.
    Diabetes & metabolism journal 08/2012; 36(4):300-6. DOI:10.4093/dmj.2012.36.4.300
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    • "The majority of epidemiologic studies have indicated that saturated fat or meat intake are associated with markers of insulin resistance (Mayer et al., 1993; Marshall et al., 1994 and Feskens et al., 1994) or glucose intolerance/ type 2 diabetes (Van Dam et al., 2002 and Harding et al., 2001). The majority of these studies also find that PUFA (or vegetable fat) intake is significantly associated with improved insulin sensitivity or glucose tolerance (Lovejoy, 2002). "
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