Food and drinking patterns as predictors of 6-year BMI-adjusted changes in waist circumference

Few studies have investigated the prospective associations between diet or drinking patterns and abdominal obesity; we therefore investigated whether food and beverage groups or patterns predicted 6-year changes in waist circumference (WC) and whether these associations were independent of concurrent changes in BMI as a measure of general obesity. The subjects were 2300 middle-aged men and women with repeated measurements of dietary intake, BMI and WC from 1982 to 1993. Intakes from ten food groups and from coffee, tea, wine, beer and spirits were assessed; gender-specific food factors were identified by factor analyses. Multiple linear regression analyses were done before and after adjustment for concurrent changes in BMI. A high intake of potatoes seemed to prevent gain in WC for men, while a high intake of refined bread was associated with gain in WC for women. The association persisted for refined bread, but not for potatoes, after adjustment for concurrent BMI changes. Among women, but not men, high intakes of beer and spirits were associated with gain in WC in both models. A high intake of coffee for women and moderate to high intake of tea for men were associated with gain in WC, but the associations were weakened, especially for women, after adjustment for BMI changes. None of the food factors was associated with WC changes. Based on the present study, we conclude that very few food items and no food patterns seem to predict changes in WC, whereas high intakes of beer and spirits among women, and moderate to high tea intake among men, may promote gain in WC.     

The effects of a whole grain-enriched hypocaloric diet on cardiovascular disease risk factors in men and women with metabolic syndrome

BACKGROUND: Whole-grain foods are associated in observational studies with a lower body mass index and lower cardiovascular disease (CVD) risk. However, few clinical trials have tested whether incorporating whole grains into a hypocaloric diet increases weight loss and improves CVD risk factors. OBJECTIVE: The aim of this study was to determine whether including whole-grain foods in a hypocaloric (reduced by 500 kcal/d) diet enhances weight loss and improves CVD risk factors. DESIGN: Obese adults (25 M, 25 F) with metabolic syndrome were randomly assigned to receive dietary advice either to avoid whole-grain foods or to obtain all of their grain servings from whole grains for 12 wk. All participants were given the same dietary advice in other respects for weight loss. RESULTS: Body weight, waist circumference, and percentage body fat decreased significantly (P<0.001) in both groups over the study period, but there was a significantly (P=0.03) greater decrease in percentage body fat in the abdominal region in the whole-grain group than in the refined-grain group. C-reactive protein (CRP) decreased 38% in the whole-grain group independent of weight loss but was unchanged in the refined-grain group (P=0.01 for group x time interaction). Total, LDL, and HDL cholesterol decreased in both diet groups (P<0.05). Dietary fiber and magnesium intakes increased in the whole-grain but not the refined-grain group (P=0.007 and P<0.001, respectively, for group x time interaction). CONCLUSIONS: Both hypocaloric diets were effective means of improving CVD risk factors with moderate weight loss. There were significantly (P<0.05) greater decreases in CRP and percentage body fat in the abdominal region in participants consuming whole grains than in those consuming refined grains.     

Dietary patterns are associated with different indexes of adiposity and obesity in an urban Mexican population

Our objective was to evaluate the relationships between dietary patterns and obesity, abdominal obesity, and high body fat proportion (measured by dual-energy X-ray absorptiometry; >25% in men and >35% in women) in an urban Mexican population. We conducted a cross-sectional analysis with the baseline data from 6070 men and women aged 20-70 y participating in the Health Workers Cohort Study, including information on participants' socio-demographic status and physical activity collected via self-administered questionnaires. Dietary intake was evaluated using a 116-item FFQ. Anthropometric measures were obtained using standardized procedures. We used factor analysis to identify 3 major dietary patterns: prudent, Westernized, and high animal protein/fat. We found that participants in the highest quintile of the prudent pattern were less likely to have high-body fat proportion (OR, 0.82; 95% CI: 0.70-0.98) and that participants in the highest quintile of the Westernized pattern had greater odds for obesity (OR, 1.46; 95% CI: 1.23-1.73), abdominal obesity (OR, 1.64; 95% CI: 1.37-1.96), and high-body fat proportion (OR, 1.17; 95% CI: 1.01-1.35). Additionally, participants in the upper quintile of the high-animal protein/-fat pattern had greater odds of being obese (OR, 1.23; 95% CI: 1.06-1.42). These results indicate that the dietary patterns of Mexican adults are associated with different levels of adiposity and obesity. Further prospective studies are required to confirm these associations.     

The effect of particle size of whole-grain flour on plasma glucose, insulin, glucagon and thyroid-stimulating hormone in humans

OBJECTIVE: Although it is well known that consumption of whole-grain foods with higher fiber content results in beneficial health effects, most Americans usually prefer bread made with white flour. Changes in bread texture and undesirable intestinal responses have been reported as reasons for avoiding consumption of whole-grain foods or high-fiber menus. The purpose of this study was to determine whether consumption of bread made with ultra-fine-ground whole-grain wheat flour retained beneficial effects while reducing undesirable effects. METHODS: Twenty-six men and women, 31 to 55 years of age, consumed glucose solutions or bread made with traditional white, conventional whole-grain wheat (WWF), or ultra-fine whole-grain wheat (UFWF) flour (1 g carbohydrate/kg body weight) in a Latin square design after two days of controlled diet. The effect on glycemic response was determined by comparing blood variables, after a tolerance test with white bread, WWF bread, and UFWF bread, with those after a glucose tolerance test. RESULTS: Men and women had similar responses to all tolerances except postprandial TSH. Glucose and insulin levels one half hour after the glucose load were significantly higher than after any of the bread tolerances. Glucose, but not insulin, areas under the curve were significantly higher after the glucose load than areas after the three breads. Consumption of UFWF resulted in glucose and insulin responses, as well as areas under the curve, similar to those after consumption of conventional whole-wheat bread. CONCLUSION: The particle size of whole grain wheat flour did not substantially affect glycemic responses.     

Alkylresorcinols from whole-grain wheat and rye are transported in human plasma lipoproteins

Alkylresorcinols with alkyl chains C17:0-C25:0 are abundant in whole-grain wheat and rye. Concentrations in human plasma have been suggested to be biomarkers of dietary whole-grain intake. We measured human plasma, erythrocyte, and lipoprotein alkylresorcinol concentrations and alkylresorcinol homolog distribution, and evaluated the use of plasma alkylresorcinol concentration as a dietary biomarker of whole-grain intake compared with serum enterolactone. A total of 15 subjects (8 women) consumed whole-grain wheat or whole-grain rye crisp bread ( approximately 100 g/d) in a crossover design for 1 wk. The test bread periods were preceded by 1-wk periods of consuming refined wheat bread. Plasma, erythrocyte, lipoprotein alkylresorcinol, and serum enterolactone concentrations were measured before and after each period, and plasma alkylresorcinols and serum enterolactone were measured after habitual diet intake before and 1 wk after the trial. Plasma alkylresorcinols are transported in lipoproteins with VLDL and HDL being the main carriers. AR concentrations in plasma, erythrocytes, and lipoproteins were increased (P < 0.05) by whole-grain wheat bread and even more so with rye crisp bread, although interindividual variation was high. The alkylresorcinol homolog C17:0 to C21:0 ratio in plasma was higher after the whole-grain rye diet period compared with the whole-grain wheat diet period (P < 0.05). Serum enterolactone concentrations were increased significantly by whole-grain rye intake only in men. This is the first report to show that alkylresorcinols in human plasma are mainly transported in lipoproteins. The plasma alkylresorcinol C17:0 to C21:0 ratio reflects intake of whole-grain wheat and rye, and the plasma total alkylresorcinol concentration appears to be a useful biomarker of whole-grain cereal intake.     

Whole grain consumption and weight gain: a review of the epidemiological evidence,potential mechanisms and opportunities for future research

The epidemiological data that directly examine whole grain v. refined grain intake in relation to weight gain are sparse. However, recently reported studies offer insight into the potential role that whole grains may play in body-weight regulation due to the effects that the components of whole grains have on hormonal factors, satiety and satiation. In both clinical trials and observational studies the intake of whole-grain foods was inversely associated with plasma biomarkers of obesity, including insulin, C-peptide and leptin concentrations. Whole-grain foods tend to have low glycaemic index values, resulting in lower postprandial glucose responses and insulin demand. High insulin levels may promote obesity by altering adipose tissue physiology and by enhancing appetite. The fibre content of whole grains may also affect the secretion of gut hormones, independent of glycaemic response, that may act as satiety factors. Future studies may examine whether whole grain intake is directly related to body weight, and whether the associations are primarily driven by components of the grain, including dietary fibre, bran or germ.     

Use of the think-aloud method to identify factors influencing purchase of bread and cereals by low-income African American women and implications for whole-grain education

The think-aloud method was used to determine factors influencing bread and cereal purchase by low-income African American women that have implications for whole-grain education. Women (N=70) were audiotaped as they thought aloud while purchasing groceries. Because bread and cereal account for the majority of whole-grain products consumed, transcribed verbalizations regarding purchase of bread and cereals were analyzed using content analysis procedures. Cost, preferences, eating and buying habits, and nutrition were the most important factors that influenced purchase. Nutrition issues included a general desire to eat healthy foods and specific concerns about fat, calcium, and calories, but no mention of wanting to purchase whole-grain products. Whole-grain education should focus on identification of whole-grain products, health benefits, and low-cost and tasty whole-grain options for mothers and children.     

Dietary Patterns and Their Association with Body Composition and Cardiometabolic Markers in Children and Adolescents: Genobox Cohort

Diet is a key factor for obesity development; however, limited data are available on dietary cluster analysis in children with obesity. We aimed to assess the associations between dietary patterns and obesity and several cardiometabolic markers. Anthropometry, bioelectrical impedance, blood pressure and plasma biomarkers of oxidative stress, inflammation and endothelial damage were determined in 674 Caucasian children, aged 5–16, with normal or excess weight. Using a food frequency questionnaire and cluster analysis, two consistent dietary patterns were shown, labeled as health conscious (HC) and sweet and processed (SP). The HC pattern included a greater proportion of participants with overweight/obesity than the SP cluster (80.1% vs. 63.8%). However, children with obesity within the HC cluster, showed less abdominal fat, through waist to hip (0.93 vs. 0.94) and waist to height (0.61 vs. 0.63) indexes (p < 0.01). Univariate general models showed several additional differences in cardiometabolic risk biomarkers in the global and stratified analyses, with a healthier profile being observed mainly in the HC cluster. However, multivariate models questioned these findings and pointed out the need for further studies in this field. Anyhow, our findings support the benefits of a healthy diet and highlight the importance of dietary patterns in the cardiometabolic risk assessment of children with overweight/obesity, beyond weight control.     

The Role of Diet Quality in Mediating the Association between Ultra-Processed Food Intake,Obesity and Health-Related Outcomes: A Review of Prospective Cohort Studies

Prospective cohort studies show that higher intakes of ultra-processed food (UPF) increase the risk of obesity and obesity-related outcomes, including cardiovascular disease, cancer and type 2 diabetes. Whether ultra-processing itself is detrimental, or whether UPFs just have a lower nutritional quality, is debated. Higher UPF intakes are inversely associated with fruit, vegetables, legumes and seafood consumption. Therefore, the association between UPFs and poor health could simply be from excess nutrient intake or from a less healthful dietary pattern. If so, adjustment for dietary quality or pattern should explain or greatly reduce the size of the significant associations between UPFs and health-related outcomes. Here, we provide an overview of the literature and by using a novel approach, review the relative impact of adjusting for diet quality/patterns on the reported associations between UPF intake and health-related outcomes in prospective cohort studies. We find that the majority of the associations between UPFs, obesity and health-related outcomes remain significant and unchanged in magnitude after adjustment for diet quality or pattern. Our findings suggest that the adverse consequences of UPFs are independent of dietary quality or pattern, questioning the utility of reformulation to mitigate against the obesity pandemic and wider negative health outcomes of UPFs.     

Identification of a food pattern characterized by high-fiber and low-fat food choices associated with low prospective weight change in the EPIC-Potsdam cohort

The aim of the study was to identify a dietary pattern predictive of subsequent annual weight change by using dietary composition information. Study subjects were 24,958 middle-aged men and women of the European Prospective Investigation into Cancer and Nutrition-Potsdam cohort. To derive dietary patterns, we used the reduced rank regression method with 3 response variables presumed to affect weight change: fat density, carbohydrate density, and fiber density. Annual weight change was computed by fitting a linear regression line to each person's body weight data (baseline, and 2- and 4-y follow-up) and determining the slope. In linear regression models, the pattern score was related to annual weight change. We identified a food pattern of high consumption of whole-grain bread, fruits, fruit juices, grain flakes/cereals, and raw vegetables, and of low consumption of processed meat, butter, high-fat cheese, margarine, and meat to be predictive of subsequent weight change. Mean annual weight gain gradually decreased with increasing pattern score (P for trend < 0.0001), i.e., subjects scoring high for the pattern maintained their weight or gained significantly less weight over time compared with subjects with an opposite pattern. However, the prediction of annual weight change by the food pattern was significant only in nonobese subjects. In this study population, we identified a food pattern characterized by high-fiber and low-fat food choices that can help to maintain body weight or at least prevent excess body weight gain.     

Suboptimal iron status and associated dietary patterns and practices in premenopausal women living in Auckland, New Zealand

Purpose

To investigate associations between dietary patterns and suboptimal iron status in premenopausal women living in Auckland, New Zealand.

Methods

Premenopausal women (n = 375; 18–44 years) were included in this cross-sectional analysis. Suboptimal iron status was defined as serum ferritin <20 μg/L. Participants completed a 144-item iron food frequency questionnaire (FeFFQ) and a questionnaire on dietary practices to assess dietary intake over the past month. Factor analysis was used to determine dietary patterns from the FeFFQ. Logistic regression was used to determine associations between these dietary patterns and iron status.

Results

Seven dietary patterns were identified: refined carbohydrate and fat; Asian; healthy snacks; meat and vegetable; high tea and coffee; bread and crackers; and milk and yoghurt. Logistic regression suggested that following a “meat and vegetable” dietary pattern reduced the risk of suboptimal iron status by 41 % (95 % CI: 18, 58 %; P = 0.002) and following a “milk and yoghurt” pattern increased the risk of suboptimal iron status by 50 % (95 % CI: 15, 96 %; P = 0.003).

Conclusions

These results suggest that dietary patterns characterized by either a low intake of meat and vegetables or a high intake of milk and yoghurt are associated with an increased risk of suboptimal iron status. Dietary pattern analysis is a novel and potentially powerful tool for investigating the relationship between diet and iron status.     

Country of birth, acculturation status and abdominal obesity in a national sample of Mexican-American women and men

BACKGROUND: Few studies have examined the influence of country of birth and acculturation status on indicators of obesity using national samples of Mexican-American women and men. METHODS: We analysed data for 1387 Mexican-American women and 1404 Mexican- American men, ages 25-64, from the third National Health and Nutrition Examination Survey (1988-1994). We examined whether waist circumference and abdominal obesity varied by country of birth and acculturation status (primary language spoken), and whether among those with abdominal obesity, number of associated cardiovascular disease (CVD) risk factors varied by country of birth and acculturation status. RESULTS: Both country of birth and, to a lesser degree, acculturation status were significantly associated with waist circumference and abdominal obesity. Mexican-born women and men had the smallest waist circumference (90.4 cm, 94.0 cm respectively), US-born English-speaking women and men had intermediate waist circumference (93.6 cm, 97.3 cm), and US-born Spanish-speaking women and men had the largest waist circumference (96.9 cm, 97.7 cm), after accounting for age, education, per cent of energy from dietary fat, leisure-time physical activity, and smoking. All women had high prevalences of abdominal obesity, particularly US-born Spanish-speaking women (68.7%). In addition, US-born Spanish-speaking women with abdominal obesity were significantly more likely than their counterparts to have one or more of the following CVD risk factors: high serum insulin, non-insulin dependent diabetes, high blood lipids, and/or hypertension. CONCLUSIONS: These findings illustrate the heterogeneity of the Mexican-American population and suggest that country of birth and lack of acculturation to the majority culture, as well as secondary lifestyle changes, may explain the significant clinical differences observed in abdominal obesity within Mexican-American population subgroups.     

Dietary patterns and risk factors for type 2 diabetes mellitus in Fijian, Japanese and Vietnamese populations

Diabetes mellitus is now a serious and increasing problem in Asian countries, where dietary patterns have shifted toward Westernized foods and people are becoming more sedentary. In order to elucidate the relationship of dietary habits to the development of diabetic risk factors, the dietary patterns of 200 Fijian, 171 Japanese and 181 Vietnamese women of 30-39 years of age were investigated using 3 day-24 h recall or dietary records. Anthropometric measurements and glycosuria tests were also conducted. The dietary trends of Fijians and Japanese have changed drastically in the past 50 years, while Vietnamese have been minimally influenced by Western dietary habits. The mean 24 h dietary intake showed that Fijians had the highest energy intake. Energy intake from fat was only 13% for Vietnamese, but over 30% for Japanese and Fijians. Percentage of body fat was higher in Vietnamese than in Japanese, though there were no significant differences in body mass index (BMI). In the overweight and obese women, Vietnamese had higher abdominal obesity than Japanese. The prevalence of obesity (BMI > or = 30 kg/m2) was 63.0% for Fijians, 1.8% for Japanese and 1.1% for Vietnamese. Glycosuria testing yielded the most positive cases among Fijians. Dietary transition and dietary excess appear to be potential risk factors for diabetes in Fijian women.     

Consumption of Whole-Grain Bread and Risk of Colorectal Cancer among Norwegian Women (the NOWAC Study)

There is evidence that consumption of foods containing dietary fiber decreases the risk of colorectal cancer (CRC). Whole grains contain dietary fiber, as well as a range of micronutrients and bioactive compounds, but the association between the consumption of whole grains and the risk of CRC remains less studied. The aim of the present study was to investigate the association between whole-grain bread consumption and CRC incidence among Norwegian women, using data from a prospective cohort study (the Norwegian Women and Cancer Study). Dietary intake was estimated from the food-frequency questionnaires of 78,254 women in the cohort (median age: 55 years), and these women were then followed up for CRC incidence. During the 9 years of median follow-up, 795 women were diagnosed with CRC (316 proximal, 193 distal, 218 rectal). Associations between whole-grain bread consumption and the risk of CRC (including colorectal subsites) were investigated using Cox proportional hazards regression models. When compared to the low consumption group, the hazard ratio for CRC was 0.89 (95% confidence interval (CI): 0.72–1.09) for the high consumption group and 0.86 (95% CI: 0.72–1.02) for the medium consumption group in a multivariable model. Overall, no association between whole-grain bread consumption and CRC was found.     

Dietary Pattern Classifications and the Association with General Obesity and Abdominal Obesity in Korean Women

ObjectivesThis study was done to identify dietary patterns and determine relationships between obesity and dietary patterns in Korean women.Subjects/methodsUsing 3,742 cases of baseline data from the Korean Health and Genome Study, dietary patterns were identified using factor analysis of data from a validated food frequency questionnaire. Relationships between dietary patterns and obesity were analyzed.ResultsFour dietary patterns were identified: (a) “animal food” (greater intake of meats and fish), (b) “rice-vegetable” (greater intake of steamed rice, tofu, Kimchi, vegetables, dried anchovy, and seaweeds), (c) “bread-dairy” (greater intake of bread, eggs, milk, and dairy products), and (d) “noodle” (greater intake of ramyun, noodles, and Chajangmyeon). The “animal food,” “bread-dairy,” and “noodle” dietary patterns were preferred by younger people with higher education levels (P<0.01), but the “rice-vegetable” dietary pattern was preferred by older people with lower incomes and education levels (P<0.01). In Korean women, dietary patterns were related to abdominal obesity but not obesity. The “rice-vegetable” and “noodle” dietary patterns were associated with an increased risk of abdominal obesity. However, the “bread-dairy” dietary pattern had an inverse relationship with abdominal obesity.ConclusionIn this study we identified four unique dietary patterns in Korean women that were independently associated with abdominal obesity. Abdominal obesity was positively related to the “rice-vegetable” and “noodle” dietary patterns. These finding may be useful in the development of dietary guidelines and the prevention of abdominal obesity in Korean women.     

Association between major patterns of dietary intake and weight status in adolescents

The relationship between dietary intake and obesity is complex, and dietary pattern analysis may offer new insight. We examined associations between dietary patterns identified in a diverse cohort of adolescents and weight status cross-sectionally and over a 5-year period. Project EAT (Eating Among Teens) (Time 1) collected data on 4746 middle (younger cohort) and high school (older cohort) students in 1998-9. EAT-II (Time 2) resurveyed 2516 of the original cohort in 2003-4. All analyses were run separately by age cohort and sex. The relationship between dietary patterns identified previously (vegetable, fruit, vegetable & fruit, starchy food, sweet & salty snack food, and fast food) and weight status was examined using logistic regression. All analyses were adjusted for socioeconomic status, race/ethnicity and activity level (longitudinal analyses were also adjusted for baseline weight status). In cross-sectional analyses, higher adherence to dietary patterns loading heavily on vegetables was associated with lower risk of overweight/obese weight status in older and younger girls, whereas higher adherence to a 'sweet & salty snack food' pattern was associated with lower risk in older and younger boys. These associations were found prospectively in older boys and girls, but were no longer significant in analyses adjusting for baseline weight status. We did not find consistent or intuitive associations between dietary patterns and weight status. Identified patterns may not capture the elements of diet that are truly important in determining adolescent weight, or diet may not be the primary driver in determining weight status at this age. Methodological difficulties in assessing diet must also be taken into consideration.     

Sugars and obesity: Is it the sugars or the calories?

Sugars containing fructose are emerging as the dominant public health targets for their role in the epidemic of overweight and obesity. This position is largely supported by ecological observations, rodent models of overfeeding and select human trials. Higher level evidence from systematic reviews and meta‐analyses of controlled dietary trials has yet to show convincingly that fructose‐containing sugars behave differently from any other forms of energy (especially refined starch and fat). Prospective cohort studies, which provide the strongest observational evidence, have shown an association between risk of overweight and obesity and fructose‐containing sugars consumed as sugar‐sweetened beverages but not as total sugars or other important sources of added sugars such as cakes, pastries and sweets. Comparative analyses show that high intakes of other highly palatable foods such as refined grains, processed meats, red meats, French fries and potato products, as well as physical inactivity may play an equal or greater role in weight gain and the risk of overweight and obesity. The contributions of these factors are also difficult to disentangle from that of sugar‐sweetened beverages owing to their collinearity with sugar‐sweetened beverages as part of a Western dietary pattern and lifestyle. Attention needs to remain focused on decreasing overconsumption of all foods associated with overweight and obesity. Sugar‐sweetened beverages and foods are certainly an important place to start but should not draw attention away from the issue of overconsumption in general.     

Major dietary patterns and their associations with cardiovascular risk factors among women in West Bengal, India

Few studies have examined dietary patterns in relation to cardiovascular risk factors in Asian populations, particularly in India. The present study was undertaken to explore dietary patterns in a general urban Bengalee population of women in West Bengal, India, and their association with cardiovascular risk factors. We performed a cross-sectional study of 701 women (aged 35 years and above) selected by cluster sampling from twelve different wards of the Kolkata Municipal Corporation (Kolkata, India). The following three major dietary patterns were identified: the 'vegetable, fruits and pulses' pattern (characterised by higher intakes of dark-yellow and green leafy vegetables, sweets, fruits, pulses, nuts, poultry and eggs, and lower intake of mustard oil); the 'hydrogenated and saturated fat and vegetable oil' pattern (characterised by higher intakes of butter, hydrogenated oil, ghee, vegetable oil, mustard oil, condiments, sweets, fish, high-fat dairy and refined grain); the 'red meat and high-fat dairy' pattern (characterised by higher intakes of red meat, high-fat dairy products, whole grain, high-energy drinks and condiments, and lower intakes of fish, refined grain and low-fat dairy products). The vegetable, fruits and pulses pattern was inversely associated with serum total cholesterol (TC), LDL-cholesterol and non-HDL-cholesterol (HDL-C) concentrations (P < 0·05 for all). The hydrogenated and saturated fat and vegetable oil pattern was positively associated with BMI, waist circumference (WC) and HDL-C concentration (P < 0·05 for all). In this Bengalee population, these three major dietary patterns were observed, and the dietary patterns were independently associated with BMI, WC and serum TC concentrations in women.     

Dietary glycemic index and load, measures of glucose metabolism, and body fat distribution in older adults

BACKGROUND: Recent evidence suggests that the rate of carbohydrate digestion and absorption may influence the development of type 2 diabetes. OBJECTIVE: The aim of this study was to examine associations of dietary glycemic index and glycemic load with predictors of type 2 diabetes in older adults. DESIGN: This study evaluated cross-sectional relations of dietary glycemic index and glycemic load with measures of glucose metabolism and body fat distribution in participants of the Health, Aging and Body Composition Study, a prospective cohort study of adults aged 70-80 y (n = 2248). RESULTS: In men, dietary glycemic index was positively associated with 2-h glucose (P for trend = 0.04) and fasting insulin (P for trend = 0.004), inversely associated with thigh intramuscular fat (P for trend = 0.02), and not significantly associated with fasting glucose, glycated hemoglobin, or visceral abdominal fat. Dietary glycemic load was inversely associated in men with visceral abdominal fat (P for trend = 0.02) and not significantly associated with fasting glucose, 2-h glucose, glycated hemoglobin, fasting insulin, or thigh intramuscular fat. In women, although dietary glycemic index and load were not significantly related to any measures of glucose metabolism or body fat distribution, the association between dietary glycemic index and 2-h glucose was nearly significant (P for trend = 0.06). CONCLUSION: The findings of this cross-sectional study indicate an association between dietary glycemic index and selected predictors of type 2 diabetes in older adults, particularly in men.     

Whole-grain intake is inversely associated with the metabolic syndrome and mortality in older adults

BACKGROUND: Whole-grain intake has been inversely associated with the metabolic syndrome in middle-aged populations, but the association has not been investigated in older adults. The metabolic consequence of consuming high whole-grain diets may differ in elderly persons, who are prone to greater insulin resistance and impaired glucose tolerance. OBJECTIVE: The aim of the present study was to examine the cross-sectional association between whole- and refined-grain intake, cardiovascular disease risk factors, prevalence of the metabolic syndrome, and the incidence of cardiovascular disease mortality in the same cohort of older adults. DESIGN: The nutritional status of 535 healthy persons aged 60-98 y was determined from 1981 to 1984. The subjects kept a 3-d food record and had their blood tested for metabolic risk factors. The metabolic syndrome was defined based on criteria set by the third report of the National Cholesterol Education Program. The vital status of the subjects was identified in October 1995. RESULTS: The results showed a significant inverse trend between whole-grain intake and the metabolic syndrome (P for trend = 0.005) and mortality from cardiovascular disease (P for trend = 0.04), independent of demographic, lifestyle, and dietary factors. Fasting glucose concentrations and body mass index decreased across increasing quartile categories of whole-grain intake (P for trend = 0.01 and 0.03, respectively), independent of confounders, whereas intake of refined grain was positively associated with higher fasting glucose concentrations (P for trend = 0.04) and a higher prevalence of the metabolic syndrome (P for trend = 0.01). CONCLUSION: Whole-grain intake is a modifiable dietary risk factor, and older and young adults should be encouraged to increase their daily intake to > or = 3 servings/d.