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Nut consumption and type 2 diabetes risk: a systematic review and meta-analysis of observational studies.
Becerra-Tomás, N, Paz-Graniel, I, Hernández-Alonso, P, Jenkins, DJA, Kendall, CWC, Sievenpiper, JL, Salas-Salvadó, J
The American journal of clinical nutrition. 2021;(4):960-971
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Abstract
BACKGROUND Previous meta-analyses, with some methodological controversies, have assessed the relation between nut consumption and type 2 diabetes (T2D) risk and pointed to contradictory results, making desirable the performance of an updated meta-analysis. OBJECTIVES We aimed to systematically review and meta-analyze all the published studies investigating the relations of total nuts and different types of nuts-i.e., walnuts, peanuts, peanut butter, and total tree nuts-with the prevalence and incidence of T2D. METHODS A systematic search was conducted in the PubMed and Cochrane databases through 12 August, 2020. The inverse variance method with fixed-effect models was used to pool data across studies, expressed as risk ratios (RRs) or ORs and 95% CIs for prospective cohort and cross-sectional studies, respectively. The Cochran Q test and I2 statistics were used to test and quantify heterogeneity, respectively. Dose-response meta-analysis was also conducted. RESULTS Eight studies (5 prospective and 3 cross-sectional) were included in the quantitative synthesis. Meta-analyses of cross-sectional studies and prospective cohort studies, comparing the highest with the lowest categories, revealed a nonsignificant association between total nut consumption and T2D. Meta-analyses of prospective cohort studies showed an inverse association between peanut butter consumption and T2D incidence (RR: 0.87; 95% CI: 0.77, 0.98; I2 = 50.6%; Pheterogeneity = 0.16), whereas no association was observed between peanuts or tree nuts and T2D. There was no evidence of a linear dose-response or nonlinear dose-response gradient for total nut and peanut consumption in prospective cohort studies. The certainty of the evidence using NutriGrade was very low for all the exposures. CONCLUSIONS Current results do not demonstrate an association of total nut, peanut, or tree nut consumption with T2D. Peanut butter consumption may be inversely associated with this disease.This review protocol was registered at www.crd.york.ac.uk/prospero/ as CRD42020149756.
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Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies.
Livesey, G, Taylor, R, Livesey, HF, Buyken, AE, Jenkins, DJA, Augustin, LSA, Sievenpiper, JL, Barclay, AW, Liu, S, Wolever, TMS, et al
Nutrients. 2019;(6)
Abstract
Published meta-analyses indicate significant but inconsistent incident type-2 diabetes(T2D)-dietary glycemic index (GI) and glycemic load (GL) risk ratios or risk relations (RR). It is nowover a decade ago that a published meta-analysis used a predefined standard to identify validstudies. Considering valid studies only, and using random effects dose-response meta-analysis(DRM) while withdrawing spurious results (p < 0.05), we ascertained whether these relationswould support nutrition guidance, specifically for an RR > 1.20 with a lower 95% confidence limit>1.10 across typical intakes (approximately 10th to 90th percentiles of population intakes). Thecombined T2D-GI RR was 1.27 (1.15-1.40) (p < 0.001, n = 10 studies) per 10 units GI, while that forthe T2D-GL RR was 1.26 (1.15-1.37) (p < 0.001, n = 15) per 80 g/d GL in a 2000 kcal (8400 kJ) diet.The corresponding global DRM using restricted cubic splines were 1.87 (1.56-2.25) (p < 0.001, n =10) and 1.89 (1.66-2.16) (p < 0.001, n = 15) from 47.6 to 76.1 units GI and 73 to 257 g/d GL in a 2000kcal diet, respectively. In conclusion, among adults initially in good health, diets higher in GI or GLwere robustly associated with incident T2D. Together with mechanistic and other data, thissupports that consideration should be given to these dietary risk factors in nutrition advice.Concerning the public health relevance at the global level, our evidence indicates that GI and GLare substantial food markers predicting the development of T2D worldwide, for persons ofEuropean ancestry and of East Asian ancestry.
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Carbohydrate quality and quantity affects the composition of the red blood cell fatty acid membrane in overweight and obese individuals.
Giardina, S, Sala-Vila, A, Hernández-Alonso, P, Calvo, C, Salas-Salvadó, J, Bulló, M
Clinical nutrition (Edinburgh, Scotland). 2018;(2):481-487
Abstract
BACKGROUND Cell membrane fatty acid (FA) composition may play a role in human metabolic diseases. However, the modulatory effect of nutrients other than fat is poorly explored. OBJECTIVE To investigate the effect of moderate-carbohydrate diets with different glycemic indices (GI) and a low-fat diet (LF) on red blood cell (RBC) FA membrane composition. DESIGN The RBC FA profile was measured in 87 subjects from the GLYNDIET study. Participants were randomly assigned to one of the following energy-restricted diet for 6 months: moderate-carbohydrate/low-GI diet (LGI, n = 31), moderate-carbohydrate/high-GI diet (HGI, n = 30) or LF-diet (n = 26). RESULTS We observed a significant increase in C20:0 and decrease in C20:3n-6 in the LGI and HGI groups compared to LF group. Compared to LF-diet, C22:4n-6 was lower after the HGI while C22:6n-3 was higher after LGI diet. Also, a tendency was found for higher concentrations of long-chain omega-3 polyunsaturated fatty acids (LCn-3PUFA) in LGI compared to HGI and LF groups. The intra-group analysis showed significantly increased levels of total monounsaturated fatty acids (MUFA) after LGI and HGI interventions, as well as a significant increase in C22:5n-6 and a decrease in LCn-3PUFA and omega-3-index after the LF diet. The decrease in C20:5n-3 after HGI and LF diets was also significant. CONCLUSION Diets with a moderate amount of carbohydrates and healthy fat, mainly with LGI, modify the RBC fatty acid membrane composition.
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Dietary Inflammatory Index and liver status in subjects with different adiposity levels within the PREDIMED trial.
Cantero, I, Abete, I, Babio, N, Arós, F, Corella, D, Estruch, R, Fitó, M, Hebert, JR, Martínez-González, MÁ, Pintó, X, et al
Clinical nutrition (Edinburgh, Scotland). 2018;(5):1736-1743
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Abstract
BACKGROUND & AIMS To assess the possible association between a validated Dietary Inflammatory Index (DII) and specific dietary components with suitable non-invasive markers of liver status in overweight and obese subjects within the PREDIMED study. METHODS A cross-sectional study encompassing 794 randomized overweight and obese participants (mean ± SD age: 67.0 ± 5.0 y, 55% females) from the PREDIMED (PREvención con DIeta MEDiterránea) trial was conducted. DII is a validated tool evaluating the effect of diet on six inflammatory biomarkers (IL-1b, IL-4, IL-6, IL-10, TNF-α and C-reactive protein). Furthermore, a validated 137-item food-frequency-questionnaire was used to obtain the information about the food intake. In addition, anthropometric measurements and several non-invasive markers of liver status were assessed and the Fatty Liver Index (FLI) score was calculated. RESULTS A higher DII and lower adherence to Mediterranean diet (MeDiet) were associated with a higher degree of liver damage (FLI > 60) in obese as compared to overweight participants. Furthermore, the DII score was positively associated with relevant non-invasive liver markers (ALT, AST, GGT and FLI) and directly affected FLI values. Interestingly, a positive correlation was observed between liver damage (>50th percentile FLI) and nutrients and foods linked to a pro-inflammatory dietary pattern. CONCLUSIONS This study reinforced the concept that obesity is associated with liver damage and revealed that the consumption of a pro-inflammatory dietary pattern might contribute to obesity and fatty liver disease features. These data suggest that a well-designed precision diet including putative anti-inflammatory components could specifically prevent and ameliorate non-alcoholic fatty liver manifestations in addition to obesity.
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A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.
Castro-Quezada, I, Sánchez-Villegas, A, Estruch, R, Salas-Salvadó, J, Corella, D, Schröder, H, Alvarez-Pérez, J, Ruiz-López, MD, Artacho, R, Ros, E, et al
PloS one. 2014;(9):e107968
Abstract
OBJECTIVE Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04); P for trend = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.