Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-27T14:02:15.075Z Has data issue: false hasContentIssue false
  • English
  • Français

A cross-sectional study of dietary patterns with glucose intolerance and other features of the metabolic syndrome

Published online by Cambridge University Press:  09 March 2007

Desmond E. M. Williams ,
A. Toby Prevost ,
Margaret J. Whichelow ,
Brian D. Cox ,
Nicholas E. Day  and
Nicholas J. Wareham
Desmond E. M. Williams
Affiliation:
Department of Community Medicine, University of Cambridge, Institute of Public Health, Robinson Way, Cambridge, CB2 2SR, UK
A. Toby Prevost
Affiliation:
Department of Community Medicine, University of Cambridge, Institute of Public Health, Robinson Way, Cambridge, CB2 2SR, UK
Margaret J. Whichelow
Affiliation:
Department of Community Medicine, University of Cambridge, Institute of Public Health, Robinson Way, Cambridge, CB2 2SR, UK
Brian D. Cox
Affiliation:
Department of Community Medicine, University of Cambridge, Institute of Public Health, Robinson Way, Cambridge, CB2 2SR, UK
Nicholas E. Day
Affiliation:
Department of Community Medicine, University of Cambridge, Institute of Public Health, Robinson Way, Cambridge, CB2 2SR, UK
Nicholas J. Wareham*
Affiliation:
Department of Community Medicine, University of Cambridge, Institute of Public Health, Robinson Way, Cambridge, CB2 2SR, UK
*
*Corresponding author: Dr N. J. Wareham, fax +44 (0)1223 330330, email njw1004@medschl.cam.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Previous epidemiological studies have demonstrated relationships between individual nutrients and glucose intolerance and type 2 diabetes, but the association with the overall pattern of dietary intake has not previously been described. In order to characterize this association, 802 subjects aged 40–65 years were randomly selected from a population-based sampling frame and underwent a 75 g oral glucose-tolerance test. Principal component analysis was used to identify four dietary patterns explaining 31·7 % of the dietary variation in the study cohort. These dietary patterns were associated with other lifestyle factors including socio-economic group, smoking, alcohol intake and physical activity. Component 1 was characterized by a healthy balanced diet with a frequent intake of raw and salad vegetables, fruits in both summer and winter, fish, pasta and rice and low intake of fried foods, sausages, fried fish, and potatoes. This component was negatively correlated with central obesity, fasting plasma glucose, 120 min non-esterified fatty acid and triacylglycerol, and positively correlated with HDL-cholesterol. It therefore appears to be protective for the metabolic syndrome. Component 1 was negatively associated with the risk of having undiagnosed diabetes, and this association was independent of age, sex, smoking and obesity. The findings support the hypothesis that dietary patterns are associated with other lifestyle factors and with glucose intolerance and other features of the metabolic syndrome. The results provide further evidence for the recommendation of a healthy balanced diet as one of the main components of chronic disease prevention.

Keywords

Type 2 diabetesDietary patternsPrincipal component analysis
Type
Research Article
Information
British Journal of Nutrition , Volume 83 , Issue 3 , March 2000 , pp. 257 - 266
Copyright
Copyright © The Nutrition Society 2000

References

Ainsworth, BE, Haskell, WL, Leon, AS, Jacobs, DR, Montoye, HJ, Sallis, JF and Paffenbarger, RS (1993) Compendium of physical activities: Classification of energy costs of human physical activities. Medicine and Science in Sports and Exercise 25, 71–80.CrossRefGoogle ScholarPubMed
Barker, ME, McClean, SI, Strain, JJ and Thompson, KA (1992) Dietary behaviour and health in Northern Ireland: an exploration of biochemical and haematological associations. Journal of Epidemiology and Community Health 46, 151–156.CrossRefGoogle ScholarPubMed
Barker, ME, McClean, SI, Thompson, KA and Reid, NG (1990) Dietary behaviours and sociocultural demographics in Northern Ireland. British Journal of Nutrition 64, 319–329.CrossRefGoogle ScholarPubMed
Bull, NL (1965) Dietary habits of 15 to 25 year olds. Human Nutrition: Applied Nutrition 38, 1–68.Google Scholar
Cattell, RB (1965) Factor analysis: An introduction to essentials. Biometrics 21, 190–215.CrossRefGoogle ScholarPubMed
Cattell, RB (1966) The Scree Test for the number of factors. Multivariate Behavioral Research 1, 245–276.CrossRefGoogle ScholarPubMed
Cox, BDB, laxter, M, Buckle, ALJ, Fenner, NP, Golding, JF, Gore, M, Huppert, FA, Nickson, J, Roth, M, Stark, J, Wadsworth, MEJ & Whichelow, M (1987) The Health and Lifestyle Survey: Preliminary Report. Cambridge: Health Promotion Research Trust.Google Scholar
Daly, ME, Vale, C, Walker, M, Alberti, KG and Mathers, JC (1997) Dietary carbohydrates and insulin sensitivity: a review of the evidence and clinical implications. American Journal of Clinical Nutrition 66, 1072–1085.CrossRefGoogle ScholarPubMed
Friedewald, WT, Levy, RI and Fredrickson, DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical Chemistry 18, 499–502.CrossRefGoogle ScholarPubMed
Gittelsohn, J, Wolever, TMS, Harris, SB, Harris-Giraldo R, Hanley, AJG and Zinman, B (1998) Specific patterns of food consumption and preparation are associated with diabetes and obesity in a Native Canadian community. Journal of Nutrition 128, 541–547.CrossRefGoogle Scholar
Gregory, J, Foster, K, Tyler, H & Wiseman, M (1990) The Dietary and Nutritional Survey of British Adults. London: H.M. Stationery Office.Google Scholar
Haffner, SM, Valdez, RA, Hazuda, HP, Mitchell, BD, Morales, PA and Stern, MP (1992) Prospective analysis of the insulin-resistance syndrome (Syndrome X). Diabetes 41, 715–722.CrossRefGoogle ScholarPubMed
Hamman, RF (1992) Genetic and environmental determinants of non-insulin-dependent diabetes mellitus (NIDDM). Diabetes/Metabolism Reviews 8, 287–338.CrossRefGoogle ScholarPubMed
Huijbregts, PPCW, Feskens, EJM and Kromhout, D (1995) Dietary patterns and cardiovascular risk factors in elderly men: The Zutphen Elderly Study. International Journal of Epidemiology 24, 313–320.CrossRefGoogle ScholarPubMed
Johnson, MF, Nichols, JF, Sallis, JF, Calfas, KJ and Hovel, MF (1998) Interrelationships between physical activity and other health behaviors among University women and men. Preventive Medicine 27, 536–544.CrossRefGoogle ScholarPubMed
Kant, AK, Schatzkin, A and Ziegler, RG (1995) Dietary diversity and subsequent cause-specific mortality in the NHANES I epidemiologic follow-up study. Journal of the American College of Nutrition 14, 233–238.CrossRefGoogle ScholarPubMed
King, H and Rewers, M (1993) Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults. WHO ad hoc Diabetes Reporting Group. Diabetes Care 16, 157–177.CrossRefGoogle ScholarPubMed
Kunst, A, Draeger, B & Ziegenhon, J (1983) UV-methods with hexokinase and glucose-6-phosphate dehydrogenase. In Methods of Enzymatic Analysis, pp. 163–172 [Bergmeyer, HU, editor]. Deerfield, IL: Weinheim Verlag Chemie.Google Scholar
Mardia, KV, Kent, JT & Bibby, JM (1979) Multivariate Analysis. London: Academic Press.Google Scholar
Margetts, BM and Jackson, AA (1993) Interactions between people's diet and their smoking habits: The dietary and nutritional survey of British adults. British Medical Journal 307, 1381–1384.CrossRefGoogle ScholarPubMed
Meigs, JB, D'Agostino RB, Wilson, PWF, Cupples, LA, Nathan, DM and Singer, DE (1997) Risk variable clustering in the insulin resistance syndrome: The Framingham Offspring Study. Diabetes 46, 1594–1600.CrossRefGoogle ScholarPubMed
Paffenbarger, RS, Blair, SN, Lee, I and Hyde, RT (1993) Measurement of physical activity to assess health effects in free-living populations. Medicine and Science in Sports and Exercise 25, 60–70.CrossRefGoogle ScholarPubMed
Prevost, AT, Whichelow, MJ and Cox, BD (1997) Longitudinal dietary changes between 1984–5 and 1991–2 in British adults: associations with socio-demographic, lifestyle and health factors. British Journal of Nutrition 78, 873–888.CrossRefGoogle ScholarPubMed
Purnell, JQ and Brunzell, JD (1997) The central role of dietary fat, not carbohydrate, in the insulin resistance syndrome. Current Opinion in Lipidology 8, 17–22.CrossRefGoogle Scholar
Reaven, GM (1988) Role of insulin resistance in human disease. Diabetes 37, 1595–1607.CrossRefGoogle ScholarPubMed
Registrar General (1980) Classification of Occupations. London: H.M. Stationery Office.Google Scholar
Wareham, NJ, Hennings, SJ, Byrne, CD, Hales, CN and Day, NE (1998) A quantitative analysis of the relationship between habitual energy expenditure, fitness and the metabolic cardiovascular syndrome. British Journal of Nutrition 80, 235–241.CrossRefGoogle ScholarPubMed
Wareham, NJ, Ness, EM, Byrne, CD, Cox, BD, Day, NE and Hales, CN (1996) Cigarette smoking is not associated with hyperinsulinemia: Evidence against a causal relationship between smoking and insulin resistance. Metabolism: Clinical and Experimental 45, 1551–1556.CrossRefGoogle Scholar
Whichelow, MJ, Erzinclioglu, SW and Cox, BD (1991) Some regional variations in dietary patterns in a random sample of British adults. European Journal of Clinical Nutrition 45, 253–262.Google Scholar
Whichelow, MJ, Erzinclioglu, SW and Cox, BD (1991) A comparison of the diets of non-smokers and smokers. British Journal of Addiction to Alcohol and Other Drugs 86, 71–81.Google ScholarPubMed
Whichelow, MJ and Prevost, AT (1996) Dietary patterns and their associations with demographic, lifestyle and health variables in a random sample of British adults. British Journal of Nutrition 76, 17–30.CrossRefGoogle Scholar
Williams, DRR, Wareham, NJ, Brown, DC, Byrne, CD, Clark, PMS, Cox, BD, Cox, LJ, Day, NE, Hales, CN, Palmer, CR, Shackleton, JR and Wang, TWM (1995) Undiagnosed glucose intolerance in the community: The Isle of Ely Diabetes Project. Diabetic Medicine 12, 30–35.CrossRefGoogle ScholarPubMed
Williams, DE, Wareham, NJ, Cox, BD, Byrne, CD, Hales, CN and Day, NE (1999) Frequent salad vegetable consumption is associated with a reduction in the risk of diabetes mellitus. Journal of Clinical Epidemiology 52, 329–335.CrossRefGoogle ScholarPubMed
World Health Organization (1985) Diabetes Mellitus: Report of a WHO Study Group, Technical Report Series no. 727. Geneva: WHO.Google Scholar
Yarnell, JWG, Fehily, AM, Milbank, JE, Sweetnam, PM and Walker, CL (1983) A short dietary questionnaire for use in an epidemiological survey: Comparison with weighed dietary records. Human Nutrition: Applied Nutrition 37, 103–112.Google Scholar