Feskens E J, Virtanen S M, Räsänen L, Tuomilehto J, Stengård J, Pekkanen J, Nissinen A, Kromhout D
Department of Chronic Diseases and Environmental Epidemiology, National Institute of Public Health and Environmental Protection, Bilthoven, The Netherlands.
Diabetes Care. 1995 Aug;18(8):1104-12. doi: 10.2337/diacare.18.8.1104.
To investigate the role of diet as a predictor of glucose intolerance and non-insulin-dependent diabetes mellitus (NIDDM).
At the 30-year follow-up survey of the Dutch and Finnish cohorts of the Seven Countries Study, in 1989/1990, men were examined according to a standardized protocol including a 2-h oral glucose tolerance test. Information on habitual food consumption was obtained using the cross-check dietary history method. Those 338 men in whom information on habitual diet was also available 20 years earlier were included in this study. Subjects known as having diabetes in 1989/1990 were excluded from the analyses.
Adjusting for age and cohort, the intake of total, saturated, and monounsaturated fatty acids and dietary cholesterol 20 years before diagnosis was higher in men with newly diagnosed diabetes in the survey than in men with normal or impaired glucose tolerance. After adjustment for cohort, age, past body mass index, and past energy intake, the past intake of total fat was positively associated with 2-h postload glucose level (P < 0.05). An independent inverse association with the past intake of vitamin C was observed (P < 0.05). These associations were independent of changes in the intake of fat and vitamin C during the 20-year follow-up. An increase in the consumption of vegetables and legumes, potatoes, and fish during the 20-year follow-up was inversely related with 2-h glucose level (P < 0.05).
Although the regression coefficients were in general not very large, these results indicate that a high intake of fat, especially that of saturated fatty acids, contributes to the risk of glucose intolerance and NIDDM. Foods such as fish, potatoes, vegetables, and legumes may have a protective effect. In addition, the observed inverse association between vitamin C and glucose intolerance suggests that antioxidants may also play a role in the development of derangements in glucose metabolism.
研究饮食作为葡萄糖耐量异常和非胰岛素依赖型糖尿病（NIDDM）预测指标的作用。
在七国研究的荷兰和芬兰队列的30年随访调查中，于1989/1990年按照标准化方案对男性进行检查，包括2小时口服葡萄糖耐量试验。使用交叉核对饮食史方法获取习惯性食物消费信息。本研究纳入了20年前也有习惯性饮食信息的338名男性。1989/1990年已知患有糖尿病的受试者被排除在分析之外。
在调整年龄和队列后，调查中新诊断糖尿病的男性在诊断前20年的总脂肪酸、饱和脂肪酸、单不饱和脂肪酸和膳食胆固醇摄入量高于葡萄糖耐量正常或受损的男性。在调整队列、年龄、既往体重指数和既往能量摄入量后，既往总脂肪摄入量与负荷后2小时血糖水平呈正相关（P<0.05）。观察到与既往维生素C摄入量呈独立负相关（P<0.05）。这些关联独立于20年随访期间脂肪和维生素C摄入量的变化。20年随访期间蔬菜、豆类、土豆和鱼类消费量的增加与2小时血糖水平呈负相关（P<0.05）。
尽管回归系数一般不是很大，但这些结果表明，高脂肪摄入，尤其是饱和脂肪酸摄入，会增加葡萄糖耐量异常和NIDDM的风险。鱼类、土豆、蔬菜和豆类等食物可能具有保护作用。此外，观察到的维生素C与葡萄糖耐量异常之间的负相关表明，抗氧化剂可能也在葡萄糖代谢紊乱的发生中起作用。
