Healthy dietary pattern is associated with lower glycemia independently of the genetic risk of type 2 diabetes: a cross-sectional study in Finnish men

Abstract

Purpose: Hyperglycemia is affected by lifestyle and genetic factors. We investigated if dietary patterns associate with glycemia in individuals with high or low genetic risk for type 2 diabetes (T2D).

Methods: Men (n = 1577, 51-81 years) without T2D from the Metabolic Syndrome in Men (METSIM) cohort filled a food-frequency questionnaire and participated in a 2-hour oral glucose tolerance test. Polygenetic risk score (PRS) including 76 genetic variants was used to stratify participants into low or high T2D risk groups. We established two data-driven dietary patterns, termed healthy and unhealthy, and investigated their association with plasma glucose concentrations and hyperglycemia risk.

Results: Healthy dietary pattern was associated with lower fasting and 2-hour plasma glucose, glucose area under the curve, and better insulin sensitivity (Matsuda insulin sensitivity index) and insulin secretion (disposition index) in unadjusted and adjusted models, whereas the unhealthy pattern was not. No interaction was observed between the patterns and PRS on glycemic measures. Healthy dietary pattern was negatively associated with the risk for hyperglycemia in an adjusted model (OR 0.69, 95% CI 0.51-0.95, in the highest tertile), whereas unhealthy pattern was not (OR 1.08, 95% CI 0.79-1.47, in the highest tertile). No interaction was found between diet and PRS on the risk for hyperglycemia (p = 0.69 for healthy diet, p = 0.54 for unhealthy diet).

Conclusion: Our findings suggest that healthy diet is associated with lower glucose concentrations and lower risk for hyperglycemia in men with no interaction with the genetic risk.

Keywords: Diabetes; Diet; Gene; Glucose; Glycemia; Human.

Fig. 1

Participant flow

Fig. 2

The interaction between dietary patterns (consumption tertiles) and polygenetic risk score (PRS, low and high groups) on glucose variables (means), p-values for interaction from two-way between groups ANOVA. P-values < 0.05 are considered statistically significant. PRS polygenic risk score; Glucose AUC glucose area under the curve; Matsuda ISI Matsuda insulin sensitivity index. ¹ High in fresh salad, fresh vegetables; fresh or frozen berries; boiled side vegetables; fruits; oil-based salad dressing or oil with vegetables; fish and fish dishes; chicken, turkey and chicken dishes; unsweetened or artificially sweetened yoghurt (including dairy-, oat-, soy- and rice-based products), quark, Nordic sour milk, or skyr (≤ 1% fat); vegetable dishes; whole grain porridges; whole grain pasta or rice; low-fat cheeses (fat ≤ 17%); boiled or mashed potatoes. ² High in fried potatoes or French fries; sausage dishes, sausages; hamburgers; pizza; refined pasta or rice; other sweet pastries; sausage cutleries; other candy; savory pies and pastries; savory snacks; ice cream or puddings; French roll, baquette, or other white bread; sweet cookies, biscuits; meat dishes; ready-meals; other cheeses; sweetened yoghurt (including dairy-, oat-, soy- and rice-based products), quark, or Nordic sour milk (> 1% fat); sour cream based salad dressing

Fig. 3

Dietary patterns and the risk of hyperglycemia (= prediabetes or newly diagnosed type 2 diabetes) in all participants. Model 1 = unadjusted values, Model 2 = adjusted with BMI, Model 3 = adjusted with BMI, age, leisure time exercise, smoking, and total alcohol consumption. P-values < 0.05 are considered statistically significant. ¹ High in fresh salad, fresh vegetables; fresh or frozen berries; boiled side vegetables; fruits; oil-based salad dressing or oil with vegetables; fish and fish dishes; chicken, turkey and chicken dishes; unsweetened or artificially sweetened yoghurt (including dairy-, oat-, soy- and rice-based products), quark, Nordic sour milk, or skyr (≤ 1% fat); vegetable dishes; whole grain porridges; whole grain pasta or rice; low-fat cheeses (fat ≤ 17%); boiled or mashed potatoes. ² High in fried potatoes or French fries; sausage dishes, sausages; hamburgers; pizza; refined pasta or rice; other sweet pastries; sausage cutleries; other candy; savory pies and pastries; savory snacks; ice cream or puddings; French roll, baquette, or other white bread; sweet cookies, biscuits; meat dishes; ready-meals; other cheeses; sweetened yoghurt (including dairy-, oat-, soy- and rice-based products), quark, or Nordic sour milk (> 1% fat); sour cream based salad dressing

Fig. 4

Risk for hyperglycemia in low and high polygenetic risk score (PRS) group in the highest dietary pattern tertiles. Model 1 = unadjusted values, Model 2 = adjusted with BMI, Model 3 = adjusted with BMI, age, leisure time exercise, smoking, and total alcohol consumption. P-values < 0.05 are considered statistically significant. PRS polygenic risk score. ¹ High in fresh salad, fresh vegetables; fresh or frozen berries; boiled side vegetables; fruits; oil-based salad dressing or oil with vegetables; fish and fish dishes; chicken, turkey and chicken dishes; unsweetened or artificially sweetened yoghurt (including dairy-, oat-, soy- and rice-based products), quark, Nordic sour milk, or skyr (≤ 1% fat); vegetable dishes; whole grain porridges; whole grain pasta or rice; low-fat cheeses (fat ≤ 17%); boiled or mashed potatoes. ² High in fried potatoes or French fries; sausage dishes, sausages; hamburgers; pizza; refined pasta or rice; other sweet pastries; sausage cutleries; other candy; savory pies and pastries; savory snacks; ice cream or puddings; French roll, baquette, or other white bread; sweet cookies, biscuits; meat dishes; ready-meals; other cheeses; sweetened yoghurt (including dairy-, oat-, soy- and rice-based products), quark, or Nordic sour milk (> 1% fat); sour cream based salad dressing