Associations between Dietary Polyphenols and Type 2 Diabetes in a Cross-Sectional Analysis of the PREDIMED-Plus Trial: Role of Body Mass Index and Sex - PubMed (original) (raw)

doi: 10.3390/antiox8110537.

Anna Tresserra-Rimbau 1 2 3 4, Facundo Vitelli-Storelli 6, Nerea Becerra-Tomas 1 2 3 4, Zenaida Vázquez-Ruiz 1 7, Andrés Díaz-López 1 2 3 4, Dolores Corella 1 8, Olga Castañer 1 9, Dora Romaguera 1 10, Jesús Vioque 11 12, Ángel María Alonso-Gómez 1 13, Julia Wärnberg 1 14, José Alfredo Martínez 1 7 15 16, Lluís Serra-Majem 1 17, Ramon Estruch 1 18, Francisco José Tinahones 1 19, José Lapetra 1 20, Xavier Pintó 1 21, Josep Antoni Tur 1 10 22, José López-Miranda 1 23, Laura García-Molina 11 24, Miguel Delgado-Rodríguez 11 25, Pilar Matía-Martín 26, Lidia Daimiel 16, María Rubín-García 6, Josep Vidal 27 28, Alba Galdon 29, Emilio Ros 1 30, Francisco Javier Basterra-Gortari 1 7 31, Nancy Babio 1 2 3 4, José Vicente Sorlí 1 8, Álvaro Hernáez 1 18, Jadwiga Konieczna 1 10, Leyre Notario-Barandiaran 12, Lucas Tojal-Sierra 1 13, Jessica Pérez-López 14, Itziar Abete 1 15 16, Jacqueline Álvarez-Pérez 1 17, José Carlos Fernández-García 1 19, José Manuel Santos-Lozano 1 20, Ana Galera-Cusí 1 21, Alicia Julibert 1 10 22, Miguel Ruiz-Canela 1 7, Raul Martinez-Lacruz 1 8, Karla-Alejandra Pérez-Vega 9, Aina María Galmes-Panades 1 10, Concepción Pastor-Polo 32, Anai Moreno-Rodriguez 1 13, Alfredo Gea 1 7, Montserrat Fitó 1 9, Rosa María Lamuela-Raventós 1 33, Jordi Salas-Salvadó 1 2 3 4

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Associations between Dietary Polyphenols and Type 2 Diabetes in a Cross-Sectional Analysis of the PREDIMED-Plus Trial: Role of Body Mass Index and Sex

Anna Tresserra-Rimbau et al. Antioxidants (Basel). 2019.

Abstract

Overweight and obesity are important risk factors for type 2 diabetes (T2D). Moving towards healthier diets, namely, diets rich in bioactive compounds, could decrease the odds of suffering T2D. However, those individuals with high body mass index (BMI) may have altered absorption or metabolism of some nutrients and dietary components, including polyphenols. Therefore, we aimed to assess whether high intakes of some classes of polyphenols are associated with T2D in a population with metabolic syndrome and how these associations depend on BMI and sex. This baseline cross-sectional analysis includes 6633 participants from the PREDIMED-Plus trial. Polyphenol intakes were calculated from food frequency questionnaires (FFQ). Cox regression models with constant time at risk and robust variance estimators were used to estimate the prevalence ratios (PRs) for polyphenol intake and T2D prevalence using the lowest quartile as the reference group. Analyses were stratified by sex and BMI groups (overweight and obese) to evaluate potential effect modification. Catechins, proanthocyanidins, hydroxybenzoic acids, and lignans were inversely associated with T2D. Hydroxycinnamic acids were directly related in men. These associations were different depending on sex and BMI, that is, women and overweight obtained stronger inverse associations.

Keywords: catechins; diet; flavonoids; hydroxybenzoic acids; hydroxycinnamic acids; lignans; obesity; phenolic acids; proanthocyanidins.

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Conflict of interest statement

R.E. reports grants from Cerveza y Salud, Spain, and Fundacion Dieta Mediterranea, Spain. Additionally, personal fees for given lectures from Brewers of Europe, Belgium; Fundacion Cerveza y Salud, Spain; Pernod Ricard, Mexico; Instituto Cervantes, Albuquerque, NM, USA; Instituto Cervantes, Milan, Italy; Instituto Cervantes, Tokyo, Japan; Lilly Laboratories, Spain; and Wine and Culinary International Forum, Spain; and non-financial support to organize a National Congress on Nutrition. R.M.L.-R. reports personal fees from Cerveceros de España, personal fees and other from Adventia, other from Ecoveritas, S.A., outside the submitted work. The rest of the authors have declared that no competing interests exist. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. E.R. reports grants, personal fees, non-financial support and other from California Walnut Commission, during the conduct of the study; grants, personal fees, non-financial support and other from Alexion, grants, personal fees and other from Sanofi Aventis, personal fees, non-financial support and other from Ferrer International, personal fees, non-financial support and other from Danone, personal fees and non-financial support from Merck Sharp Dohme, personal fees and other from Amarin, outside the submitted work.

Figures

Figure 1

Figure 1

Cox proportional models for polyphenol groups and type 2 diabetes (T2D) by sex, comparing quartile 4 (Q4) vs. quartile 1 (Q1) and adjusted for age, education (basic studies, medium, high), body mass index (BMI) (overweight, obese), smoking (never, former, smoker), physical activity (quintiles), energy, consumption of refined cereals and animal products (from 17-point questionnaire) and of distilled beverages and liquors, sugar, soft drinks, cookies, and pastries (g/day), and stratified by recruitment center.

Figure 2

Figure 2

Cox proportional models for polyphenol groups and T2D by BMI groups, comparing Q4 vs. Q1 and adjusted for sex, age, education (basic studies, medium, high), smoking (never, former, smoker), physical activity (quintiles), energy, consumption of refined cereals and animal products (from 17-point questionnaire) and of distilled beverages and liquors, sugar, soft drinks, cookies, and pastries (g/day), and stratified by recruitment center.

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