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Healthful eating patterns, serum metabolite profile and risk of diabetes in a population-based prospective study of US Hispanics/Latinos

Abstract

Aims/hypothesis

We aimed to evaluate associations of multiple recommended dietary patterns (i.e. the alternate Mediterranean diet [aMED], the Healthy Eating Index [HEI]-2015 and the healthful Plant-based Diet Index [hPDI]) with serum metabolite profile, and to examine dietary-pattern-associated metabolites in relation to incident diabetes.

Methods

We included 2842 adult participants free from diabetes, CVD and cancer during baseline recruitment of the Hispanic Community Health Study/Study of Latinos. Metabolomics profiling of fasting serum was performed using an untargeted approach. Dietary pattern scores were derived using information collected by two 24 h dietary recalls. Dietary-pattern-associated metabolites were identified using multivariable survey linear regressions and their associations with incident diabetes were assessed using multivariable survey Poisson regressions with adjustment for traditional risk factors.

Results

We identified eight metabolites (mannose, γ/β-tocopherol, N1-methylinosine, pyrraline and four amino acids) that were inversely associated with all dietary scores. These metabolites were detrimentally associated with various cardiometabolic risk traits, especially insulin resistance. A score comprised of these metabolites was associated with elevated risk of diabetes (RRper SD 1.54 [95% CI 1.29, 1.83]), and this detrimental association appeared to be attenuated or eliminated by having a higher score for aMED (pinteraction = 0.0001), HEI-2015 (pinteraction = 0.020) or hPDI (pinteraction = 0.023). For example, RR (95% CI) of diabetes for each SD increment in the metabolite score was 1.99 (1.44, 2.37), 1.67 (1.17, 2.38) and 1.08 (0.86, 1.34) across the lowest to the highest tertile of aMED score, respectively.

Conclusions/interpretation

Various recommended dietary patterns were inversely related to a group of metabolites that were associated with elevated risk of diabetes. Adhering to a healthful eating pattern may attenuate or eliminate the detrimental association between metabolically unhealthy serum metabolites and risk of diabetes.

Graphical abstract

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Data availability

The datasets analysed during the current study are available from the corresponding author based upon reasonable request in addition to a Data and Materials Distribution Agreement to protect the confidentiality and privacy of the participants and their families. Alternatively, de-identified data are publicly available at BioLINCC (https://biolincc.nhlbi.nih.gov/home/) and dbGaP (https://www.ncbi.nlm.nih.gov/gap/) for the subset of the study cohort that authorised general use of their data at the time of informed consent.

Abbreviations

aMED:

Alternate Mediterranean diet

DBP:

Diastolic BP

DHA:

Docosahexaenoic acid

FDR:

False discovery rate

FPG:

Fasting plasma glucose

HCHS/SOL:

Hispanic Community Health Study/Study of Latinos

HEI:

Healthy Eating Index

hPDI:

Healthful Plant-based Diet Index

PC:

Principal component

SBP:

Systolic BP

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Acknowledgements

The authors thank the staff and participants of HCHS/SOL for their important contributions. A complete list of HCHS/SOL staff and investigators can be found in Lavange et al [58] or at http://sites.cscc.unc.edu/hchs/.

Authors’ relationships and activities

QQ is a member of the Editorial Board of Diabetologia. The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.

Contribution statement

G-CC, FBH and QQ designed the research. RCK, FBH and QQ directed the study. G-CC and JCC developed the analytical plan, performed the statistical analyses and prepared tables and figures G-CC drafted the manuscript. All authors contributed to the interpretation of data, critically reviewed and revised the manuscript and approved the final manuscript. QQ is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Funding

The HCHS/SOL is a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (HHSN268201300001I / N01-HC-65233), University of Miami (HHSN268201300004I / N01-HC-65234), Albert Einstein College of Medicine (HHSN268201300002I / N01-HC-65235), University of Illinois at Chicago (HHSN268201300003I), Northwestern University (N01-HC-65236) and San Diego State University (HHSN268201300005I / N01-HC-65237). The following institutes/centres/offices have contributed to the HCHS/SOL through a transfer of funds to the NHLBI: National Institute on Minority Health and Health Disparities; National Institute on Deafness and Other Communication Disorders; National Institute of Dental and Craniofacial Research; National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); National Institute of Neurological Disorders and Stroke; and NIH Institution-Office of Dietary Supplements.

This work is supported by the NHLBI R01HL060712 and NIDDK R01DK119268. Other funding sources for this study include: UM1 HG008898 from the National Human Genome Research Institute; K01HL129892, R01HL060712, R01HL140976 and R01HL136266 from the NHLBI; and R01DK112940, R01DK120870, P30DK046200 and the New York Regional Center for Diabetes Translation Research (P30 DK111022) from the NIDDK.

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Correspondence to Qibin Qi.

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Chen, GC., Chai, J.C., Xing, J. et al. Healthful eating patterns, serum metabolite profile and risk of diabetes in a population-based prospective study of US Hispanics/Latinos. Diabetologia 65, 1133–1144 (2022). https://doi.org/10.1007/s00125-022-05690-w

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Keywords

  • Diabetes
  • Dietary guidelines
  • Dietary patterns
  • Metabolomics