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Gilhooley SK, Bauman WA, La Fountaine MF, Cross GT, Kirshblum SC, Spungen AM, Cirnigliaro CM. Cardiometabolic risk factor clustering in persons with spinal cord injury: A principal component analysis approach. J Spinal Cord Med 2023:1-13. [PMID: 37695205 DOI: 10.1080/10790268.2023.2215998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
CONTEXT/OBJECTIVE To identify cardiometabolic (CM) measurements that cluster to confer increased cardiovascular disease (CVD) risk using principal component analysis (PCA) in a cohort of chronic spinal cord injury (SCI) and healthy non-SCI individuals. APPROACH A cross-sectional study was performed in ninety-eight non-ambulatory men with chronic SCI and fifty-one healthy non-SCI individuals (ambulatory comparison group). Fasting blood samples were obtained for the following CM biomarkers: lipid, lipoprotein particle, fasting glucose and insulin concentrations, leptin, adiponectin, and markers of inflammation. Total and central adiposity [total body fat (TBF) percent and visceral adipose tissue (VAT) percent, respectively] were obtained by dual x-ray absorptiometry (DXA). A PCA was used to identify the CM outcome measurements that cluster to confer CVD risk in SCI and non-SCI cohorts. RESULTS Using PCA, six factor-components (FC) were extracted, explaining 77% and 82% of the total variance in the SCI and non-SCI cohorts, respectively. In both groups, FC-1 was primarily composed of lipoprotein particle concentration variables. TBF and VAT were included in FC-2 in the SCI group, but not the non-SCI group. In the SCI cohort, logistic regression analysis results revealed that for every unit increase in the FC-1 standardized score generated from the statistical software during the PCA, there is a 216% increased risk of MetS (P = 0.001), a 209% increased risk of a 10-yr. FRS ≥ 10% (P = 0.001), and a 92% increase in the risk of HOMA2-IR ≥ 2.05 (P = 0.01). CONCLUSION Application of PCA identified 6-FC models for the SCI and non-SCI groups. The clustering of variables into the respective models varied considerably between the cohorts, indicating that CM outcomes may play a differential role on their conferring CVD-risk in individuals with chronic SCI.
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Affiliation(s)
- Shawn K Gilhooley
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - William A Bauman
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
- Medical Service, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
- Departments of Medicine and Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael F La Fountaine
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
- Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, South Orange, New Jersey, USA
- Departments of Medical Sciences and Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, New Jersey, USA
| | - Gregory T Cross
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Steven C Kirshblum
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Ann M Spungen
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
- Medical Service, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
- Departments of Medicine and Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christopher M Cirnigliaro
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
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Chalermsri C, Ziaei S, Ekström EC, Muangpaisan W, Aekplakorn W, Satheannopakao W, Rahman SM. Dietary diversity associated with risk of cardiovascular diseases among community-dwelling older people: A national health examination survey from Thailand. Front Nutr 2022; 9:1002066. [PMID: 36159494 PMCID: PMC9493071 DOI: 10.3389/fnut.2022.1002066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundCardiovascular diseases (CVD) are the common comorbidities in older people. Healthy diet is an essential strategy to alleviate the risk of developing CVD. Dietary diversity (DD) is an indicator of diet quality. Currently, limited research exists regarding DD and CVD in older people in developing countries, such as Thailand, despite rapid growth of older population. Therefore, this study aims to determine associations of DD with the risk of CVD and the cardiometabolic risk factors among Thai older people.MethodsThis cross-sectional study used the sub-sample of the fifth Thai National Health Examination Survey conducted from 2013 to 2015. A total of 6,956 older people aged 60 years and older and no pre-existing CVD were included.Dietary diversity score (DDS) was assessed the consumption of eight food groups using food frequency questionnaires. Each food group was scored from 0 to 4. The DDS was calculated as the sum of the scores (0–32). The risk of CVD was calculated by using a Thai cardiovascular (CV) risk score. The cardiometabolic risk factors included hypertension, diabetes mellitus (DM), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels. Data were adjusted for a complex survey design and analysed using linear and logistic regression models.ResultsIn the adjusted model, DDS had a significant negative association with log-Thai CV risk score, with adjusted β (95% CI) values of −0.01 (−0.01, −0.01). Regarding the cardiometabolic risk factors, DDS had a significant negative association with hypertension, DM and log-TG levels, with adjusted OR (95% CI) values of 0.97 (95% CI 0.97, 0.98) for hypertension, 0.94 (0.93, 0.95) for DM, and adjusted β (95% CI) values of −0.002 (−0.004, −0.001) for log-TG level. DDS was positively associated with TC and LDL-C, with adjusted β (95% CI) values of 0.59 (0.38, 0.80) for TC and 0.59 (0.38, 0.79) for LDL-C levels, while DDS was not associated with HDL-C level.ConclusionHigher DD was associated with a lower risk of CVD among Thai older people. The nutritional policies or interventions should encourage a diverse food intake for the prevention of CVD in this population.
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Affiliation(s)
- Chalobol Chalermsri
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- *Correspondence: Chalobol Chalermsri
| | - Shirin Ziaei
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Weerasak Muangpaisan
- Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Thompson HJ, Neil ES, McGinley JN, Fitzgerald VK, El Bayoumy K, Manni A. Building a Foundation for Precision Onco-Nutrition: Docosahexaenoic Acid and Breast Cancer. Cancers (Basel) 2021; 14:cancers14010157. [PMID: 35008321 PMCID: PMC8750666 DOI: 10.3390/cancers14010157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Precision onco-nutrition (PON) is the use of specific nutrients and dietary factors to enhance cancer treatment efficacy and to improve the prognosis for long-term survival. PON requires integration of an understanding of nutrient metabolism with knowledge of the signaling pathways characteristic of each molecular subtype of cancer which can be targeted to improve treatment and control efficacies. Herein we report differences among n-3 fatty acids on the growth and survival of established breast cancer cell lines. Docosahexaenoic acid (DHA) is shown to have greater anticancer activity than eicosapentaenoic acid (EPA). Moreover, we show that a penultimate metabolite of one pathway by which DHA is metabolized inhibited the growth of common molecular subtypes of breast cancer via differential effects on identified canonical signaling pathways and the functions within the cell that they regulate. These findings provide a knowledge base for juxtaposing molecular subtype targeted treatment strategies with the adjuvant use of specific n-3 fatty acid metabolites as an example of precision onco-nutrition for the management and control of breast cancer. Abstract In vivo evidence of heterogeneous effects of n-3 fatty acids (N3FA) on cell signaling pathways associated with the reduced growth of breast cancer has been reported and is consistent with the expectation that N3FA will not exert uniform effects on all molecular subtypes of the disease. Similarly, available evidence indicates that many metabolites of N3FA are synthesized by mammalian cells and that they exert metabolite-specific biological activities. To begin to unravel the complex relationships among molecular subtypes and effects exerted by specific N3FA metabolites on those pathways, proof-of-concept experiments were conducted using cell lines representative of common molecular subtypes of human breast cancer. N3FA differed in anticancer activity with docosahexaenoic acid (DHA) having greater anticancer activity than eicosapentaenoic acid. 4-oxo-docosahexaenoic (4-oxo-DHA), a penultimate metabolite of 5-lipoxygenase mediated DHA metabolism, induced dose-dependent inhibition of cell number accumulation with apoptosis as a primary effector mechanism. Interrogation of protein expression data using the Ingenuity Pathway Analysis (IPA) bioinformatics platform indicated that 4-oxo-DHA differentially impacted six canonical pathways and the cellular functions they regulate across common molecular subtypes of breast cancer. This included the endocannabinoid pathway for cancer inhibition that has not been previously reported. These findings provide a rationale for juxtaposing molecular subtype targeted treatment strategies with the adjuvant use of specific N3FA metabolites as an example of precision onco-nutrition (PON) for the management and control of breast cancer.
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Affiliation(s)
- Henry J. Thompson
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523, USA; (E.S.N.); (J.N.M.); (V.K.F.)
- Correspondence: ; Tel.: +1-970-491-7748; Fax: +1-970-491-3542
| | - Elizabeth S. Neil
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523, USA; (E.S.N.); (J.N.M.); (V.K.F.)
| | - John N. McGinley
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523, USA; (E.S.N.); (J.N.M.); (V.K.F.)
| | - Vanessa K. Fitzgerald
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523, USA; (E.S.N.); (J.N.M.); (V.K.F.)
| | - Karam El Bayoumy
- College of Medicine, Penn State University, Hershey, PA 17033, USA; (K.E.B.); (A.M.)
| | - Andrea Manni
- College of Medicine, Penn State University, Hershey, PA 17033, USA; (K.E.B.); (A.M.)
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Thompson HJ, Levitt JO, McGinley JN, Chandler P, Guenther PM, Huybrechts I, Playdon MC. Measuring Dietary Botanical Diversity as a Proxy for Phytochemical Exposure. Nutrients 2021; 13:1295. [PMID: 33919845 PMCID: PMC8070776 DOI: 10.3390/nu13041295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/31/2021] [Accepted: 04/08/2021] [Indexed: 01/04/2023] Open
Abstract
The study of natural plant molecules and their medicinal properties, pharmacognosy, provides a taxonomy for botanical families that represent diverse chemical groupings with potentially distinct functions in relation to human health. Yet, this reservoir of knowledge has not been systematically applied to elucidating the role of patterns of plant food consumption on gut microbial ecology and function. All chemical classes of dietary phytochemicals can affect the composition of the microbes that colonize the gut and their function. In turn, the gut microbiome affects the host via multiple mechanisms including gut barrier function, immune function, satiety and taste regulation and the activity of biological signaling pathways that influence health and disease. Herein, we report the development of a botanical diversity index (BDI) to evaluate plant food consumption as a novel metric for identifying and quantifying phytochemicals to which an individual is exposed. A rationale is advanced for using the BDI to investigate how plant food diversity impacts gut microbial ecology and functionality.
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Affiliation(s)
- Henry J. Thompson
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523, USA;
| | - Jack O. Levitt
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA; (J.O.L.); (P.M.G.)
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
| | - John N. McGinley
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523, USA;
| | - Paulette Chandler
- Department of Medicine, Harvard Medical School & Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - Patricia M. Guenther
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA; (J.O.L.); (P.M.G.)
| | - Inge Huybrechts
- Nutritional Epidemiology Group, International Agency for Research on Cancer, World Health Organization, CEDEX 08, 69372 Lyon, France;
| | - Mary C. Playdon
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA; (J.O.L.); (P.M.G.)
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
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Zhang J, Liang D, Zhao A. Dietary Diversity and the Risk of Fracture in Adults: A Prospective Study. Nutrients 2020; 12:E3655. [PMID: 33261013 PMCID: PMC7761242 DOI: 10.3390/nu12123655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 02/07/2023] Open
Abstract
Nutrition plays an important and modifiable role in bone health. This study aimed to investigate the effect of dietary diversity on the risk of any type of fracture in adults. Data from the China Health and Nutrition Survey collected between waves 1997 and 2015 were used. A total of 10,192 adults aged 40 years and older were included in the analysis. Both dietary diversity score (DDS) based on Chinese dietary guidelines (DDS-CDG) and minimum dietary diversity for women (DDS-MDD-W) were computed. Cox proportional hazards regression models were conducted to determine the association. Stratified analyses were conducted in women by the age of fracture using the case-control study approach. In men, higher scores in both the DDS-CDG (hazard ratio (HR) 0.70, 95% CI 0.56-0.88) and DDS-MDD-W (HR 0.67, 95% CI 0.54-0.82) were associated with decreased risk of fracture, however, the associations were not significant in women (DDS-CDG: HR 0.94, 95% CI 0.79-1.12; DDS-MDD-W: HR 0.93, 95% CI 0.79-1.09). In the stratified analyses, higher DDS-CDG (odds ratio (OR) 0.74, 95% CI 0.58-0.95) and higher DDS-MDD-W (OR 0.76, 95% CI 0.60-0.95) were associated with lower risks of fracture in women aged 40 to 60 years; in women aged over 60 years, no association was observed (DDS-CDG: OR 1.10, 95% CI 0.83-1.46; DDS-MDD-W: OR 1.00, 95% CI 0.79-1.27). In summary, higher dietary diversity was associated with decreased risk of fracture in men and middle-aged women, but not in women aged over 60 years.
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Affiliation(s)
- Jian Zhang
- Vanke School of Public Health, Tsinghua University, Beijing 100091, China;
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Dong Liang
- China National Center for Food Safety Risk Assessment, Beijing 100021, China;
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing 100091, China;
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Zhang J, Zhao A, Wu W, Yang C, Ren Z, Wang M, Wang P, Zhang Y. Dietary Diversity Is Associated With Memory Status in Chinese Adults: A Prospective Study. Front Aging Neurosci 2020; 12:580760. [PMID: 33117146 PMCID: PMC7494158 DOI: 10.3389/fnagi.2020.580760] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/12/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND AIM Subjective memory complaints are common in elderly people. Nutrition plays an important role in keeping brain health, however, the evidence on dietary diversity and subjective memory status is limited. This study aimed to investigate the effect of dietary diversity score (DDS) on memory status in Chinese adults in a prospective cohort study. METHODS Data of the China Health and Nutrition Survey was used in this study. A total of 4356 participants aged 50 years or older were enrolled in the analysis. DDS was calculated based on the dietary recall data collected in the wave of 2011. Information on self-report memory status (OK, good, or bad) and memory change in the past 12 months (stayed the same, improved, or deteriorated) were obtained from the wave of 2015. A memory score was calculated based on a subset of items of the Telephone Interview for Cognitive Status-modified. Multinomial logistic regression models were used to estimate the associations of DDS with memory status and memory change, and linear regression models were carried out to estimate the association between DDS and memory score. RESULTS In the study population, the percentages of participants who thought their memory was OK, bad, and good were 43.3, 24.3, and 32.4%, respectively. There were 1.4% of participants reported memory improvement in the past 12 months and 47.2% reported memory decline. Average memory score among participants was 12.8 ± 6.1. Compared with participants who thought their memory was OK, a higher DDS was associated with self-reported good memory (Odds Ratio [OR] 1.15, 95%CI 1.07-1.24) and inversely associated with bad memory (OR 0.82, 95%CI 0.75-0.89). In subgroup analysis, however, in participants aged 65 years and above, the association between DDS and self-reported good memory was insignificant (OR 1.09, 95%CI 0.94-1.25). Compared with participants whose memory stayed the same, higher DDS was inversely associated with memory decline (OR 0.85, 95%CI 0.80-0.91). Besides, higher DDS was associated with higher memory score (β 0.74, 95%CI 0.56-0.91). CONCLUSION This study revealed that higher DDS was associated with better memory status and was inversely associated with self-reported memory decline in Chinese adults.
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Affiliation(s)
- Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Wei Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Chenlu Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Zhongxia Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Meichen Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Peiyu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
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Balasubramanian GV, Chuah KA, Khor BH, Sualeheen A, Yeak ZW, Chinna K, Sundram K, Karupaiah T. Associations of Eating Mode Defined by Dietary Patterns with Cardiometabolic Risk Factors in the Malaysia Lipid Study Population. Nutrients 2020; 12:nu12072080. [PMID: 32674327 PMCID: PMC7400910 DOI: 10.3390/nu12072080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/09/2020] [Indexed: 12/16/2022] Open
Abstract
Cardiometabolic risk is scarcely explored related to dietary patterns (DPs) in Asian populations. Dietary data (n = 562) from the cross-sectional Malaysia Lipid Study were used to derive DPs through principal component analysis. Associations of DPs were examined with metabolic syndrome (MetS), atherogenic, inflammation and insulinemic status. Four DPs with distinctive eating modes were Home meal (HM), Chinese traditional (CT), Plant foods (PF) and Sugar-sweetened beverages (SSB). Within DP tertiles (T3 vs. T1), the significantly lowest risk was associated with CT for hsCRP (AOR = 0.44, 95% CI 0.28, 0.70, p < 0.001) levels. However, SSB was associated with the significantly highest risks for BMI (AOR = 2.01, 95% CI 1.28, 3.17, p = 0.003), waist circumference (AOR = 1.81, 95% CI 1.14, 2.87, p = 0.013), small LDL-C particles (AOR= 1.69, 95% CI 1.02, 2.79, p = 0.043), HOMA2-IR (AOR = 2.63, 95% CI 1.25, 5.57, p = 0.011), hsCRP (AOR = 2.21, 95% CI 1.40, 3.50, p = 0.001), and MetS (AOR = 2.78, 95% CI 1.49, 5.22, p = 0.001). Adherence behaviors to SSBs (T3) included consuming coffee/tea with condensed milk (29%) or plain with sugar (20.7%) and eating out (12 ± 8 times/week, p < 0.001). Overall, the SSB pattern with a highest frequency of eating out was detrimentally associated with cardiometabolic risks.
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Affiliation(s)
- Gaiyal Viliy Balasubramanian
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (G.V.B.); (A.S.)
| | - Khun-Aik Chuah
- Nutrition Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (K.-A.C.); (Z.-W.Y.)
| | - Ban-Hock Khor
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia;
| | - Ayesha Sualeheen
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (G.V.B.); (A.S.)
| | - Zu-Wei Yeak
- Nutrition Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (K.-A.C.); (Z.-W.Y.)
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor 47500, Malaysia;
| | - Kalyana Sundram
- Malaysian Palm Oil Council, Menara Axis, Petaling Jaya, Selangor 46100, Malaysia;
| | - Tilakavati Karupaiah
- School of BioSciences, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor 47500, Malaysia
- Correspondence: ; Tel.: +60-192-731-400
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Gribble MO, Head JR, Prabhakaran D, Kapoor D, Garg V, Mohan D, Anjana RM, Mohan V, Vasudevan S, Kadir MM, Tandon N, Narayan KMV, Patel SA, Jaacks LM. Potentially Heterogeneous Cross-Sectional Associations of Seafood Consumption with Diabetes and Glycemia in Urban South Asia. Int J Environ Res Public Health 2020; 17:E459. [PMID: 31936772 DOI: 10.3390/ijerph17020459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/01/2020] [Accepted: 01/07/2020] [Indexed: 11/16/2022]
Abstract
Aims: In this study, we aimed to estimate cross-sectional associations of fish or shellfish consumption with diabetes and glycemia in three South Asian mega-cities. Methods: We analyzed baseline data from 2010-2011 of a cohort (n = 16,287) representing the population ≥20 years old that was neither pregnant nor on bedrest from Karachi (unweighted n = 4017), Delhi (unweighted n = 5364), and Chennai (unweighted n = 6906). Diabetes was defined as self-reported physician-diagnosed diabetes, fasting plasma glucose ≥126 mg/dL (7.0 mmol/L), or glycated hemoglobin A1c (HbA1c) ≥6.5% (48 mmol/mol). We estimated adjusted and unadjusted odds ratios for diabetes using survey estimation logistic regression for each city, and differences in glucose and HbA1c using survey estimation linear regression for each city. Adjusted models controlled for age, gender, body mass index, waist-height ratio, sedentary lifestyle, educational attainment, tobacco use, an unhealthy diet index score, income, self-reported physician diagnosis of high blood pressure, and self-reported physician diagnosis of high cholesterol. Results: The prevalence of diabetes was 26.7% (95% confidence interval: 24.8, 28.6) in Chennai, 36.7% (32.9, 40.5) in Delhi, and 24.3% (22.0, 26.6) in Karachi. Fish and shellfish were consumed more frequently in Chennai than in the other two cities. In Chennai, the adjusted odds ratio for diabetes, comparing more than weekly vs. less than weekly fish consumption, was 0.81 (0.61, 1.08); in Delhi, it was 1.18 (0.87, 1.58), and, in Karachi, it was 1.30 (0.94, 1.80). In Chennai, the adjusted odds ratio of prevalent diabetes among persons consuming shellfish more than weekly versus less than weekly was 1.08 (95% CI: 0.90, 1.30); in Delhi, it was 1.35 (0.90, 2.01), and, in Karachi, it was 1.68 (0.98, 2.86). Conclusions: Both the direction and the magnitude of association between seafood consumption and glycemia may vary by city. Further investigation into specific locally consumed seafoods and their prospective associations with incident diabetes and related pathophysiology are warranted.
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