Dietary Pattern Low in Fruits Explains Variations in Inflammation and in Biomarkers of Cardiovascular Disease in Latinos Diagnosed with Type-2 Diabetes
Mariana C. Calle *
Department of Health Sciences, Worcester State University, USA and Department of Nutritional Sciences, University of Connecticut, USA and Connecticut NIH EXPORT Center for Eliminating Health Disparities among Latinos, USA.
Sonia Vega-López
Connecticut NIH EXPORT Center for Eliminating Health Disparities among Latinos, USA and Arizona State University, USA.
Sofia Segura-Pérez
Connecticut NIH EXPORT Center for Eliminating Health Disparities among Latinos, USA and Hispanic Health Council, USA.
Rafael Pérez-Escamilla
Department of Nutritional Sciences, University of Connecticut, USA and Connecticut NIH EXPORT Center for Eliminating Health Disparities among Latinos, USA and School of Public Health, Yale University, USA.
Maria Luz Fernandez
Department of Nutritional Sciences, University of Connecticut, USA and Connecticut NIH EXPORT Center for Eliminating Health Disparities among Latinos, USA.
*Author to whom correspondence should be addressed.
Abstract
Aims: 1) To identify a dietary pattern associated with plasma interleukin-6 (IL-6), tumor necrosis factor alpha (TNFα) and monocyte chemotactic protein-1 (MCP-1) in Latinos diagnosed with T2D. 2) To examine whether the “pro-inflammation” dietary pattern obtained is associated with additional cardiovascular disease risk in this Latino population.
Methodology: Reduced rank regression was used to determine the cross-sectional relationship between food patterns and plasma inflammatory biomarkers in Latinos (26 men/77 women, 32-76 y) diagnosed with type-2 diabetes (T2D). Reduced rank regression was used to create 3 dietary patterns from 33 food groups. We included IL-6, TNFα, and MCP-1 as response variables to derive 3 dietary patterns.
Study Design: Cross-sectional.
Place and Duration of Study: University of Connecticut, Hartford Hospital, and the Hispanic Health Council, between January 2010 and May 2011.
Results: The first dietary pattern characterized by low intake of fruits and yellow vegetables and high intake of refined grains and sugar-free beverages explained the largest proportion of variance in inflammation markers. After adjusting for confounding factors including energy intake, statin treatment, waist circumference, glycosylated hemoglobin and blood pressure, IL-6 (P< 0.0001) and TNFα (P =0.0004) were positively associated with the first dietary pattern. Food groups that were negatively associated with inflammation markers were fruits and dark yellow vegetables, explaining 10.2% and 4.6% of the variance, respectively. This dietary pattern was also significantly associated with higher number of large VLDL particles (P < 0.05) after adjusting for WC, statins use and systolic blood pressure as well as higher concentrations of apolipoprotein A-2 after adjusting for WC and energy (P< 0.05).
Conclusion: This dietary pattern may increase heart disease risk in this already challenged population.
Keywords: Dietary pattern, latinos, type-2 diabetes, cardiovascular disease risk, TNFα, inflammation.