Background: Cardiovascular disease (CVD) is one of the leading causes of death worldwide, driven by various metabolic risk factors and diabetes. Diet is a key modifiable component in the development of these risk factors. This study aimed to investigate cardio-metabolic risk factors associated with diet. Secondly, dietary interaction with genetic risk of diabetes. Methods: A cross-sectional analysis was conducted on 5,864 participants’ baseline data from the Airwave Health Monitoring Study. Participants completed a 7-day food diary and a health screening including blood sample, blood pressure and anthropometrics. Diet quality was assessed according to UK Dietary Reference Values (DRV) using the novel DRV index and the established UK nutrient profile model. The nutritional genomic association with diabetes and HbA1c% was studied using a polygenetic risk score (GRS). Results: A higher DRV score was associated with a lower waist circumference ( -0.56 p < 0.0001), total cholesterol ( -0.06, p < 0.0001) and glycated haemoglobin A1c ( -0.02, p=0.003). Individuals with a higher DRV score (top quartile vs bottom quartile) were less likely to have diabetes (OR 0.75, p=0.04), elevated blood sugar (OR 0.80, p=0.01) and abdominal obesity (OR 0.64, p < 0.0001). GRS was associated with a higher HbA1c ( 0.03, p < 0.0001) and higher risk of diabetes (OR 1.13, 95%CI 1.04-1.24). Interactions between GRS and higher diet quality modified the genetic effect on HbA1c (-0.017, pinteraction=0.02) in high-risk individuals. High alcohol intake (>16g/day) modified the genetic effect on HbA1c ( 1.22, p=0.002). Obesity (BMI >30kg/m2) increased the effect on HbA1c by =1.90 pinteraction =0.0006. Conclusion: Individuals consuming a high quality diet (high in complex carbohydrates, fibre, fruit and vegetables and wholegrain) aligned with the UK guidelines were associated with fewer metabolic risk factors for CVD and diabetes. A high quality diet also reduced the genetic effect on HbA1c and diabetes in high-risk individuals. These findings support the importance of encouraging a healthy diet, along with moderate alcohol consumption, as part of public health advice for a lower risk of CVD and diabetes, especially in high genetic risk groups.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:754697 |
| Date | January 2017 |
| Creators | Eriksen, Rebeca |
| Contributors | Frost, Gary ; Elliott, Paul ; Chan, Queenie |
| Publisher | Imperial College London |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://hdl.handle.net/10044/1/61394 |
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