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Tag: diabetes

Dairy Intake Linked to Decreased Diabetes, Hypertension Risk 

Characterized by elevated blood pressure, abdominal obesity, elevated triglycerides, low high density lipoprotein cholesterol, and elevated blood glucose, metabolic syndrome (MetS) has been associated with an increased risk of cardiometabolic diseases. Researchers continue to evaluate the role of nutritional behaviors in the development of these conditions, including cardiovascular disease and type 2 diabetes. In particular, diary intake has been studied for its impact on lipid levels, blood pressure, and other risk factors as emerging evidence suggests whole fat and fermented dairy products may influence diverse metabolic pathways.

Although prior research implicates that dairy consumption is associated with a decreased risk of MetS, diabetes, and hypertension, the majority of these studies have been conducted in North American and European populations, limiting the generalizability of their findings. A new international study published online in BMJ Open Diabetes Research & Care reports that a diary-rich diet has the potential to reduce the risk of certain cardiometabolic conditions – including diabetes and high blood pressure – along with several cardiovascular disease risk factors.

Association of Dairy Consumption with Cardiometabolic Conditions

The most recent trial evaluated 147,812 participants aged between 35 and 70 from 21 countries, to verify the generalizability of prior findings and ascertain whether the associations between diary consumption and reduced cardiometabolic disease risk can be found on an international scale. As part of the Prospective Urban Rural Epidemiology (PURE) study, investigators assessed the association between dairy intake and MetS prevalence as well as its components over a median follow-up period of 9.1 years. This included the incidence of hypertension and diabetes in the cohort.

Dietary dairy intake was assessed using Food Frequency Questionnaires and evaluated whether participants consumed milk, yogurt, yogurt drinks, cheese, and dishes prepared with dairy products classified as either full or low fat. The average daily total dairy intake was 179 grams, this included 124.5 grams of full fat and 65 grams of low fat products.

Additionally, the research team collected data on individual personal medical history, prescription medicine use, educational level, smoking status, weight and height measurements, blood pressure, and fasting blood glucose.

Reduced Incidence of Metabolic Syndrome Components

After an average of 9 years of follow-up, 13,640 participants developed hypertension while 5,351 developed diabetes. Over 46,660 subjects had metabolic syndrome, defined as at least 3 of the 5 components. The team’s findings reveal that total dairy and full fat – but not low fat – dairy intakes were associated with a decreased prevalence of most components of metabolic syndrome, especially in countries with typically lower daily dairy consumption.

Compared with participants who did not consume dairy, those who had an intake of at least 2 servings of dairy a day experienced a 24% reduction in metabolic syndrome risk. The risk reduction grew to 28% in participants who consumed full fat dairy products. Similarly, at least 2 servings a day of total dairy were linked to a 12% reduction in the risk of both hypertension and diabetes, while 3 servings contributed to a 13-14% lower risk.

The latest findings indicate the potential benefits of increasing whole fat dairy intake for the reduction of MetS risk and its component factors, as well as for lowering the incidence of hypertension and diabetes. While the recent study proves that prior findings linking dairy consumption to cardiometabolic health implications are generalizable across an international population, further large-scale randomized trials need to be conducted to ascertain the connection between whole fat dairy products and decreased risk of MetS, hypertension, and diabetes.

 

The Impact of Major Depressive Disorder on Cardiometabolic Disease Risk

Driven by a widespread change in lifestyle factors, such as dietary patterns and physical activity levels, as well as heightened stress levels, the global prevalence of cardiometabolic disease continues to rise. A burgeoning body of evidence suggests the potential impact of mental health factors, specifically the presence of major depressive disorder (MDD) on the development of cardiometabolic conditions. Affecting an estimated 322 million people, MDD has a high comorbidity rate with other medical disorders and in particular, type 2 diabetes. Although the mechanisms underlying the potential causal associations between the two are unknown, both cardiometabolic disease and major depressive disorder place a significant burden on population health.

Past observational studies have reported an association between MDD and an increased risk for type 2 diabetes, caused by biological alterations – such as elevated counter-regulatory hormone release and activity – as well as poor lifestyle factors, including smoking and alcohol consumption. Research has shown that brain regions involved in mood regulation also control metabolism, hypothalamic-pituitary-adrenal (HPA) axis, inflammatory responses, and autonomic nervous system (ANS) thus, controlling heart rate and blood pressure. These factors may influence the relationship between MDD and certain cardiometabolic conditions, however, evidence remains limited.

Adding to the growing body of evidence, a recent bidirectional Mendelian randomization study published in Diabetologia aimed to assess the causal relationships between major depressive disorder, type 2 diabetes, coronary artery disease, and heart failure to further elucidate the connections.

MDD and Cardiometabolic Disease

A team of researchers utilized the Mendelian randomization method – used for assessing causal inference of exposures on outcomes based on genetic variants as instrumental variables for exposures – to diminish chances of residual confounding and eliminate reverse causality due to the fixed nature of genetic variants regardless of disease progression or development.

In conducting their investigation, researchers extracted summary-level data for MDD, T2D, CAD, and heart failure from corresponding large genome-wide association studies; they used 96 single-nucleotide polymorphisms (SNPs) for MDD, 202 SNPs for type 2 diabetes, 44 SNPs for CAD, and 12 SNPs for heart failure. To perform their main analyses, the random-effects inverse-variance weighted method used.

Impact of MDD on Cardiometabolic Risk

Overall, the study’s authors found that the genetic liability to MDD was significantly associated with type 2 diabetes and coronary artery disease; they also found a suggestive association between MDD and heart failure. In examining the causal relationship, the research team found limited evidence in support of the causal effects of cardiometabolic disease on MDD risk, indicating that the presence of these conditions may not increase the likelihood of major depressive disorder.

However, meta-analyses did prove that the presence of MDD had an impact on type 2 diabetes development with the potential to increase risk by up to 60%. Additionally, the team found evidence of MDD having a causal association with the risk of CAD and HF. As diabetes and CAD have been known risk factors for HF and CAD may explain over 60% of heart failure cases, the relationship between major depressive disorder and heart failure may possibly be mediated via type 2 diabetes and coronary artery disease.

The latest findings further validate previous evidence that MDD is a potential risk factor for both type 2 diabetes and CAD, however, additional research needs to be conducted to determine whether MDD is causally related to heart failure. Future studies are likely to continue investigating the correlation to determine the significance of the impact of MDD on cardiometabolic health as well as to assess potential therapeutic interventions.

Due to the high disease burden related to causal association, the study’s authors recommend “that MDD prevention, management, and treatment should be enhanced for type 2 diabetes prevention.” Implications for the clinical practice may include more targeted strategies for the prevention and treatment of cardiometabolic diseases in the future with an increased focus on the mental health of patients.