Dietary Intake Association with IFG and Responses of a Lifestyle Changing Protocol in a Community-B based Adult Cohort

Abstract

Objective: Investigate the association of diet on Impaired Fasting Glucose (IFG) and response of a lifestyle changing protocol (LISC) on a community sample of adults. Methods:A cross sectional study of LISC was conducted with 1004 subjects. From those, 264 adults individuals participated in a 20-week intervention based on physical exercises and dietary counseling and were divided in three groups, normoglycemic, IFG, and T2DM. Evaluations were done at baseline (M0) and after a 20-week intervention (M1). The analyses were performed by using SAS, version 9.2., and results were discussed based on the level of significance of p<0.05.Results: At baseline, the three groups differed for plasma triglycerides, and number of altered metabolic syndrome (MetS) components. T2DM differed from normoglicemic by presenting higher intake of meat, lower of sugar, and less dietary variety, along with higher plasma levels of uric acid. After 20-week intervention, normoglicemics, IFG and T2DM responded similarly to LISC. Both genders increased body fatness. Men increased fasting plasma insulin, saturated fatty acid intake, along with a decrease of vegetable oil intake while women showed a significant increase in HEI and dietary fiber intake and a trend to higher sugar and protein intake and lower vegetable oil intake. Overall T2DM decreased 68% from M0 (9.5%) to M1 (6.4%) of LISC. Conclusion:Our data showed a significant difference in food composition on altered plasma glucose, and its further normalization with lifestyle intervention was independent of significant body weight and body fat changes.

Understanding contemporary diseases under evolutionary medicine view

“…Then, hormones (see item 3.1) and other circulating factors provide cues that allow cellular behavior to be matched to organismal goals. For energy saving and energy-yielding substrate distribution, fat storage and insulin resistance can be seen as thriftiness in situation such as famine (19,20). Similarly, sodium preservation during water privation (21) and inflammation in situations of infection (22).…”

“…In ancient time, food supply was never consistent then, it is contended that the human ancestors had cycles of feast and famine, punctuated with obligate periods of famine, and certain genes evolved to regulate efficient intake and utilization of fuel stores (19). During famines, individuals with the thrifty genotype would have a survival advantage because they relied on larger, previously stored energy to maintain homeostasis (87,88).…”

“…(223), insulin resistance (224,225) diabetes (226,227) plasma cholesterol, triglycerides markers of inflammation and CVD (65). Additionally, there is a close correlation between nutrition and the recent exponential increase in the conditions of obesity (19), dyslipidemia (86), diabetes (57), hypertension (21), metabolic syndrome (35) and cardiovascular disease, as seen in nations who adopted the "western lifestyle". Thus, as our civilization evolved, a sedentary lifestyle and sodium-and energy-rich diet, the thrifty genotype is no longer advantageous, and may be maladaptive to disease phenotype, such as hypertension, obesity and insulin resistance syndrome (117).…”

“…Hence obesity would be consequence of an adaptive response to our thrifty genes selected naturally from adverse ancestral scenarios. This genotype is turning pathological in the modern urban environment selectively affecting individuals with the gene(s) (19).…”

“…For example undernutrition in utero increases the risk of NCDs in adulthood (80,81). In fact, these (mis)adaptations can lead to the post natal development of obesity, T2DM, blood hypertension, dyslipidemia and metabolic syndrome in conditions of adequate nutrition or overnutrition (18)(19)(20). Many epidemiologic studies in populations worldwide have robustly supported the initial findings that poor fetal growth resulting in low birth weight increases the risk of developing diseases in adulthood (230).…”