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  • Original Article
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Diet and glycosylated haemoglobin in the 1946 British birth cohort

Abstract

Objectives:

Raised glycosylated haemoglobin (HbA1c) concentration is a recognized risk factor for diabetes, the incidence of which is rising worldwide. The intake of certain foods has been related to HbA1c concentration. The aim of this study was to investigate whether nutrient intake, sourced by these foods, was predictive of raised glycosylated haemoglobin (HbA1c) concentration in a British cohort.

Subjects:

The subjects were 495 men and 570 women who were members of the Medical Research Council National Survey of Health and Development, 1946 birth cohort.Diet was assessed from 5-day records in 1982, 1989 and 1999. HbA1c was measured in blood samples collected in 1999. Individuals in whom concentration of HbA1c was 6.3% were identified as being ‘at risk’ and their nutrient intake was compared with those whose concentration of HbA1c was within the normal range (6.2%).

Results:

Lower intakes of protein, carbohydrate, non-starch polysaccharide, iron, folate, vitamin B12 and a higher percentage energy from fat in 1989 were significantly predictive of high HbA1c status in 1999. In 1999, there were no nutrient intakes that were predictive of HbA1c status. Global tests of whether the intakes of energy, carbohydrate, sodium, iron, riboflavin and vitamin B12 at all three time points were related to HbA1c status in 1999, were significant.

Conclusion:

An increased intake of energy, carbohydrate, sodium, iron, riboflavin and vitamin B12 over 10 years was predictive of raised HbA1c status. Increased energy intake may have resulted in increase in body weight, which is a risk factor for diabetes.

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References

  • Adler AI (2008). UKPDS-modelling of cardiovascular risk assessment and lifetime simulation of outcomes. Diabet Med 25 (Suppl 2), 41–46.

    Article  Google Scholar 

  • Bates CJ, Lean ME, Mansoor MA, Prentice A (2004). Nutrient intakes; biochemical and risk indices associated with Type 2 diabetes and glycosylated haemoglobin, in the British National Diet and Nutrition Survey of people aged 65 years and over. Diabet Med 21, 677–684.

    Article  CAS  Google Scholar 

  • Bazzano LA, Li TY, Joshipura KJ, Hu FB (2008). Intake of fruit, vegetables, and fruit juices and risk of diabetes in women. Diabetes Care 31, 1311–1317.

    Article  CAS  Google Scholar 

  • Bingham SA, Cassidy A, Cole TJ, Welch A, Runswick SA, Black AE et al. (1995). Validation of weighed records and other methods of dietary assessment using the 24 h urine nitrogen technique and other biological markers. Br J Nutr 73, 531–550.

    Article  CAS  Google Scholar 

  • Boeing H, Weisgerber UM, Jeckel A, Rose HJ, Kroke A (2000). Association between glycated hemoglobin and diet and other lifestyle factors in a nondiabetic population: cross-sectional evaluation of data from the Potsdam cohort of the European Prospective Investigation into Cancer and Nutrition Study. Am J Clin Nutr 71, 1115–1122.

    Article  CAS  Google Scholar 

  • Bolton-Smith C, Price RJG, Fenton ST, Harrington DJ, Shearer MJ (2000). Compilation of a provisional UK database for the phylloquinone (vitamin K-1) content of foods. Br J Nutr 83, 389–399.

    CAS  PubMed  Google Scholar 

  • Department for Environment Food and Rural Affairs (2001). National Food Survey 2000. The Stationery Office: London.

  • Diabetes UK (2007). Diabetes in the UK 2007,www.diabetes.org.uk/Professionals/Information_resources/Reports/Diabetes-prevalence-2007/.

  • Food Standards Agency (2002). McCance and Widdowson's The Composition of Foods. Royal Society of Chemistry: Cambridge.

  • Ford ES, Williamson DF, Liu S (1997). Weight change and diabetes incidence: findings from a national cohort of US adults. Am J Epidemiol 146, 214–222.

    Article  CAS  Google Scholar 

  • Fung TT, Schulze M, Manson JE, Willett WC, Hu FB (2004). Dietary patterns, meat intake, and the risk of type 2 diabetes in women. Arch Intern Med 164, 2235–2240.

    Article  Google Scholar 

  • Gulliford MC, Ukoumunne OC (2001). Determinants of glycated haemoglobin in the general population: associations with diet, alcohol and cigarette smoking. Eur J Clin Nutr 55, 615–623.

    Article  CAS  Google Scholar 

  • Harding AH, Day NE, Khaw KT, Bingham SA, Luben RN, Welsh A et al. (2004). Habitual fish consumption and glycated haemoglobin: the EPIC-Norfolk study. Eur J Clin Nutr 58, 277–284.

    Article  CAS  Google Scholar 

  • Harding AH, Sargeant LA, Khaw KT, Welch A, Oakes S, Luben RN et al. (2002). Cross-sectional association between total level and type of alcohol consumption and glycosylated haemoglobin level: the EPIC-Norfolk Study. Eur J Clin Nutr 56, 882–890.

    Article  CAS  Google Scholar 

  • Harding AH, Sargeant LA, Welch A, Oakes S, Luben RN, Bingham S et al. (2001). Fat consumption and HbA(1c) levels: the EPIC-Norfolk study. Diabetes Care 24, 1911–1916.

    Article  CAS  Google Scholar 

  • Harding AH, Wareham NJ, Bingham SA, Khaw K, Luben R, Welch A et al. (2008). Plasma vitamin C level, fruit and vegetable consumption, and the risk of new-onset type 2 diabetes mellitus: the European prospective investigation of cancer—Norfolk prospective study. Arch Intern Med 168, 1493–1499.

    Article  Google Scholar 

  • Holland B, Unwin ID, Buss DH (1988). Cereals and Cereal Products: Third supplement to McCance and Widdowson's The Composition of Foods. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food: Nottingham.

    Google Scholar 

  • Holland B, Unwin ID, Buss DH (1989). Milk and Milk Products: Fourth Supplement to McCance and Widdowson's The Composition of Foods. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food: Cambridge.

    Google Scholar 

  • Khaw KT, Wareham N, Luben R, Bingham S, Oakes S, Welch A et al. (2001). Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European Prospective Investigation of Cancer and Nutrition Study (EPIC-Norfolk). Br Med J 322, 15–18.

    Article  CAS  Google Scholar 

  • Kirk JK, Graves DE, Craven TE, Lipkin EW, Austin M, Margolis KL (2008). Restricted-carbohydrate diets in patients with type 2 diabetes: a meta-analysis. J Am Diet Assoc 108, 91–100.

    Article  CAS  Google Scholar 

  • Lawlor DA, Ebrahim S, Timpson N, Davey Smith G (2005). Avoiding milk is associated with a reduced risk of insulin resistance and the metabolic syndrome: findings from the British Women's Heart and Health Study. Diabet Med 22, 808–811.

    Article  CAS  Google Scholar 

  • Livesey G, Taylor R, Hulshof T, Howlett J (2008). Glycemic response and health—a systematic review and meta-analysis: relations between dietary glycemic properties and health outcomes. Am J Clin Nutr 87, 258S–268S.

    Article  CAS  Google Scholar 

  • Mann JI (2002). Diet and risk of coronary heart disease and type 2 diabetes. Lancet 360, 783–789.

    Article  CAS  Google Scholar 

  • McNaughton SA, Mishra GD, Stephen AM, Wadsworth ME (2007). Dietary patterns throughout adult life are associated with body mass index, waist circumference, blood pressure, and red cell folate. J Nutr 137, 99–105.

    Article  CAS  Google Scholar 

  • Medical Research Council (2002). Current and Future Research on Diabetes. Department of Health: London.

  • Montonen J, Jarvinen R, Heliovaara M, Reunanen A, Aromaa A, Knekt P (2005b). Food consumption and the incidence of type II diabetes mellitus. Eur J Clin Nutr 59, 441–448.

    Article  CAS  Google Scholar 

  • Montonen J, Knekt P, Harkanen T, Jarvinen R, Heliovaara M, Aromaa A et al. (2005a). Dietary patterns and the incidence of type 2 diabetes. Am J Epidemiol 161, 219–227.

    Article  Google Scholar 

  • Papakonstantinou E, Panagiotakos DB, Pitsavos C, Chrysohoou C, Zampelas A, Skoumas Y et al. (2005). Food group consumption and glycemic control in people with and without type 2 diabetes: the ATTICA study. Diabetes Care 28, 2539–2540.

    Article  Google Scholar 

  • Paul A, Southgate D (1978). McCance and Widdowson's The Composition of Foods. HM Stationery Office: London.

    Google Scholar 

  • Prynne CJ, Paul AA, Greenberg D, Mishra GD, Wadsworth MEJ (2005). Changes in intake of key nutrients over 17 years during adult life of a British birth cohort. Brit J Nutr 94, 368–376.

    Article  CAS  Google Scholar 

  • Prynne CJ, Wagemakers J, Stephen A, Wadsworth ME (2009). Meat consumption after disaggregation of meat dishes of a cohort of British adults in 1989 and 1999 and relation to diet quality. Eur J Clin Nutr 63, 660–666.

    Article  CAS  Google Scholar 

  • Sargeant LA, Khaw KT, Bingham S, Day NE, Luben RN, Oakes S et al. (2001). Fruit and vegetable intake and population glycosylated haemoglobin levels: the EPIC-Norfolk Study. Eur J Clin Nutr 55, 342–348.

    Article  CAS  Google Scholar 

  • Sargeant LA, Wareham NJ, Bingham S, Day NE, Luben RN, Oakes S et al. (2000). Vitamin C and hyperglycemia in the European Prospective Investigation into Cancer—Norfolk (EPIC-Norfolk) study: a population-based study. Diabetes Care 23, 726–732.

    Article  CAS  Google Scholar 

  • Schulze MB, Hoffmann K, Manson JE, Willett WC, Meigs JB, Weikert C et al. (2005). Dietary pattern, inflammation, and incidence of type 2 diabetes in women. Am J Clin Nutr 82, 675–684.

    Article  CAS  Google Scholar 

  • Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA et al. (2000). Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. Brit Med J 321, 405–412.

    Article  CAS  Google Scholar 

  • UKPDS (1994). UK Prospective Diabetes Study (UKPDS). XI: Biochemical risk factors in type 2 diabetic patients at diagnosis compared with age-matched normal subjects. Diabetic Medicine 11, 534–544.

    Article  Google Scholar 

  • van Dam RM, Willett WC, Rimm EB, Stampfer MJ, Hu FB (2002). Dietary fat and meat intake in relation to risk of type 2 diabetes in men. Diabetes Care 25, 417–424.

    Article  Google Scholar 

  • Virtanen SM, Knip M (2003). Nutritional risk predictors of beta cell autoimmunity and type 1 diabetes at a young age. Am J Clin Nutr 78, 1053–1067.

    Article  CAS  Google Scholar 

  • Williams DE, Wareham NJ, Cox BD, Byrne CD, Hales CN, Day NE (1999). Frequent salad vegetable consumption is associated with a reduction in the risk of diabetes mellitus. J Clin Epidemiol 52, 329–335.

    Article  CAS  Google Scholar 

  • Wadsworth MEJ, Butterworth SL, Hardy RJ, Kuh DJ, Richards M, Langenberg C et al (2003). The life course prospective design: an example of benefits and problems associated with study longevity. Soc Sci and Med 57, 2193–2205.

    Article  CAS  Google Scholar 

  • Yoshida M, Booth SL, Meigs JB, Saltzman E, Jacques PF (2008). Phylloquinone intake, insulin sensitivity, and glycemic status in men and women. Am J Clin Nutr 88, 210–215.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by the UK Medical Research Council.

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Correspondence to C J Prynne.

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Contributors: CJP and AM were responsible for analysis of the data and preparation of the paper. MEJW was responsible for the cohort study design and data collection and approved the project. AMS provided critical revision of the paper.

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Prynne, C., Mander, A., Wadsworth, M. et al. Diet and glycosylated haemoglobin in the 1946 British birth cohort. Eur J Clin Nutr 63, 1084–1090 (2009). https://doi.org/10.1038/ejcn.2009.43

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