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Epidemiology

Diet pattern may affect fasting insulin in a large sample of black and white adults

European Journal of Clinical Nutrition volume 75, pages 628–635 (2021)Cite this article

Subjects

Abstract

Objective

Dietary modification of insulin resistance may be a strategy for reducing chronic disease. For this study, we tested the hypothesis that higher fasting insulin, a marker for insulin resistance, would be related to diet patterns with a high proportion of carbohydrates, those with a high glycemic index, and those characterized by added sugar and processed starches.

Study design

Data were analyzed on 13,528 nondiabetic participants of the REasons for Geographic and Ethnic Differences in Stroke (REGARDS), an observational study of adults aged ≥45 years residing in 1855 counties across the continental USA. Information on habitual diet was collected using the Block 98 Food Frequency Questionnaire. Percent energy from carbohydrate, glycemic index, and glycemic load were determined for each participant, as well as adherence to five established diet patterns. Logistic regression was used to examine associations of baseline diet characteristics with odds for high fasting insulin [quartiles 3 and 4 (median = 98.9 pmol/L) vs. quartile 1], after adjusting for covariates.

Result

Greater percent carbohydrate, glycemic index, and glycemic load, and adherence to sweets/fat and southern diet patterns, was associated with greater odds for high insulin (P for trend <0.05 to <0.0001), whereas adherence to the plant-based and alcohol/salad patterns was associated with lower odds for high insulin (P for linear trend <0.0001).

Conclusion

In conclusion, diet pattern is associated with fasting insulin. Future studies are needed to determine if diet interventions designed to lower insulin, perhaps based on the patterns identified in this study, can improve risk for chronic disease.

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Fig. 1: Adjusted odds ratios (95% CI) for high fasting insulin by quintile of %CHO, GI, GL, and diet pattern.

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Acknowledgements

The REGARDS research project is supported by a cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke or the National Institutes of Health. Representatives of the funding agency have been involved in the review of the paper but not directly involved in the collection, management, analysis or interpretation of the data. Additional support was provided by General Mills for coding of the Block Food Frequency Questionnaire. The authors thank the other investigators, the staff, and the participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions can be found at http://www.regardsstudy.org.

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Author notes

  1. Keith Pearson

    Present address: Department of Nutrition and Dietetics, Samford University, Birmingham, AL, USA

Authors and Affiliations

  1. Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, AL, USA

    Barbara A. Gower, Keith Pearson, Nikki Bush & Caroline W. Cohen

  2. Department of Preventive Medicine, UAB, Birmingham, AL, USA

    James M. Shikany

  3. Department of Epidemiology, UAB, Birmingham, AL, USA

    Virginia J. Howard

  4. Department of Biostatistics, UAB, Birmingham, AL, USA

    Stephanie E. Tison, George Howard & Suzanne Judd

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Gower, B.A., Pearson, K., Bush, N. et al. Diet pattern may affect fasting insulin in a large sample of black and white adults. Eur J Clin Nutr 75, 628–635 (2021). https://doi.org/10.1038/s41430-020-00762-9

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