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Diets with higher insulinaemic potential are associated with increased risk of overall and cardiovascular disease-specific mortality

Published online by Cambridge University Press:  06 December 2021

Yingying Wang
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, People’s Republic of China NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, People’s Republic of China Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical UniversityHefei, Anhui, People’s Republic of China
Bo Chen
Affiliation:
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui230032, People’s Republic of China
Jiawei Zhang
Affiliation:
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui230032, People’s Republic of China
Hairong Li
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Xufen Zeng
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Zhuang Zhang
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Yu Zhu
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Xiude Li
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Anla Hu
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Qihong Zhao
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Wanshui Yang*
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, People’s Republic of China NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, People’s Republic of China Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical UniversityHefei, Anhui, People’s Republic of China
*
*Corresponding author: Dr W. Yang, email wanshuiyang@gmail.com

Abstract

Hyperinsulinaemia and insulin resistance have been proposed to be associated with mortality risk, and diet can modulate insulin response. However, whether dietary patterns with high insulinaemic potential are associated with mortality remains unknown. We prospectively examined the associations between hyperinsulinaemic diets and the risk of total and cause-specific mortality in a large nationally representative population. Dietary factors were assessed by 24-h recalls. Two empirical dietary indices for hyperinsulinaemia (EDIH) and insulin resistance (EDIR) were developed to identify food groups most predictive of biomarkers for hyperinsulinaemia (C-peptide and insulin) and insulin resistance (homoeostatic model assessment for insulin resistance), respectively. Deaths from date of the first dietary interview until 31 December 2015 were identified by the National Death Index. Multivariable hazard ratios (HR) and 95 % CI were calculated using Cox regression models. During a median follow-up of 7·8 years, 4904 deaths were documented among 40 074 participants. For EDIH, the multivariable-adjusted HR (comparing extreme quintiles) were 1·20 (95 % CI 1·09, 1·32, P-trend<0·001) for overall mortality and 1·41 (95 % CI 1·15, 1·74, P-trend = 0·002) for CVD mortality. Similar associations were observed for EDIR with HR of 1·18 (95 % CI 1·07, 1·29, P-trend < 0·001) for total and 1·35 (95 % CI 1·09, 1·67, P-trend = 0·005) for CVD mortality. After further adjustments for BMI and diabetes, these positive associations were somewhat attenuated. Our findings suggested that diets with higher insulinaemic potential are associated with increased risk of overall and CVD-specific mortality.

Type
Full Papers
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society

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Footnotes

These authors contributed equally as co-first authors for this article

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