Quality and quantity of macronutrients, and their joint associations with the incidence of type 2 diabetes over a nine-year follow-up.

IF 4.4 2区医学 Q1 NUTRITION & DIETETICS Nutrition Journal Pub Date : 2024-08-30 DOI:10.1186/s12937-024-01003-6

Nazanin Moslehi, Zahra Kamali, Zahra Bahadoran, Parvin Mirmiran, Fereidoun Azizi

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Abstract

Background: The association between macronutrient consumption and the risk of type 2 diabetes (T2D) remains equivocal. Here, we investigated whether the quantity and quality of macronutrient intake are associated with T2D incidence in a West Asian population.

Methods: T2D-free adults (n = 2457, mean age 38.5 ± 13.6 years, 54.2% women) who participated in the third examination cycle (2005-2008) of the Tehran Lipid and Glucose Study were followed for a median of 8.6 years. We estimated the macronutrient quality index (MQI), its individual sub-indices (carbohydrate quality index (CQI), fat quality index (FQI), and healthy plate protein quality index (HPPQI)), as well as the macronutrient quantity. The risk of T2D in relation to macronutrient quantity, quality, and their combined effects was examined using Cox proportional hazard models adjusted for known risk factors for T2D.

Results: During the study follow-up, 257 incident cases of T2D were documented. Individuals in the highest tertiles of MQI and CQI had a 27% (HR = 0.73, 95% CI = 0.54, 0.98) and 29% (HR = 0.71, 95% CI = 0.51-0.99) lower T2D risk than those in the lowest tertiles. The T2D incidence was 35% lower in the middle HPPQI tertile than in the lowest (HR = 0.65, 95% CI = 0.47, 0.89). The multivariable adjusted model showed that individuals in the middle and highest tertiles of carbohydrate intake had 32% (HR = 0.68, 95% CI = 0.49-0.95) and 26% (HR = 0.74, 95% CI = 0.55-1.00) lower risks of T2D than individuals in the lowest tertile. A high-quantity, high-quality carbohydrate diet (≥ 58.5% of energy from carbohydrate with a CQI ≥ 13) and a low-glycemic index (GI), high-fiber diet (GI < 55 and fiber ≥ 25 g/d) were related to a reduced risk of T2D by 34% (HR = 0.66, 95% CI = 0.47, 0.93) and 42% (HR = 0.58, 95% CI = 0.38, 0.90), respectively.

Conclusion: A diet with a higher carbohydrate quality may be associated with a lower T2D incidence, particularly when the carbohydrate quantity is also high.

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宏量营养素的质量和数量及其与九年随访期间 2 型糖尿病发病率的共同关系。

背景：常量营养素摄入量与 2 型糖尿病（T2D）发病风险之间的关系仍不明确。在此，我们研究了在西亚人群中，宏量营养素摄入的数量和质量是否与 2 型糖尿病发病率有关：方法：我们对参加德黑兰血脂和血糖研究第三个检查周期（2005-2008 年）的无 T2D 的成年人（n = 2457，平均年龄为 38.5 ± 13.6 岁，54.2% 为女性）进行了中位数为 8.6 年的跟踪调查。我们估算了宏量营养素质量指数（MQI）、其各个子指数（碳水化合物质量指数（CQI）、脂肪质量指数（FQI）和健康平板蛋白质量指数（HPPQI））以及宏量营养素数量。在对已知的 T2D 风险因素进行调整后，研究人员使用 Cox 比例危险模型检测了 T2D 风险与常量营养素数量、质量及其综合影响的关系：在研究跟踪期间，共记录了257例T2D病例。MQI和CQI最高三分位数人群的T2D风险分别比最低三分位数人群低27%（HR = 0.73，95% CI = 0.54，0.98）和29%（HR = 0.71，95% CI = 0.51-0.99）。HPPQI中间三分位数的T2D发病率比最低三分位数低35%（HR = 0.65, 95% CI = 0.47, 0.89）。多变量调整模型显示，与最低三分位数的人相比，碳水化合物摄入量居中和最高三分位数的人患 T2D 的风险分别低 32%（HR = 0.68，95% CI = 0.49-0.95）和 26%（HR = 0.74，95% CI = 0.55-1.00）。高数量、高质量的碳水化合物饮食（≥58.5% 的能量来自碳水化合物，CQI ≥13）和低血糖生成指数（GI）、高纤维饮食（GI 结论：低血糖生成指数（GI）、高纤维饮食（GI 结论：低血糖生成指数（GI）、高纤维饮食（GI 结论：低血糖生成指数（GI）、高血糖生成指数（GI碳水化合物质量较高的饮食可能会降低 T2D 的发病率，尤其是当碳水化合物的数量也较高时。

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来源期刊

Nutrition Journal NUTRITION & DIETETICS-

CiteScore

9.80

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered. Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies. In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.