Low-Carbohydrate, High-Protein, High-Fat Diets Rich in Livestock, Poultry and Their Products Predict Impending Risk of Type 2 Diabetes in Chinese Individuals that Exceed Their Calculated Caloric Requirement

Abstract

The evidence on the association between long-term low-carbohydrate, high-fat and high-protein diets and type 2 diabetes (T2D) is controversial. Until now, data is limited for Chinese populations, especially in considering the influence of extra energy intake. In this paper, we aimed to investigate the association of low-carbohydrate, high-fat and high-protein diets with type 2 diabetes (T2D) risk in populations consuming extra calories and those with normal caloric intake, We also determined whether the association is mediated by insulin resistance (IR) or β-cell dysfunction. A total of 3644 subjects in the Harbin People’s Health Study (Cohort 1, 2008–2012) and 7111 subjects in the Harbin Cohort Study on Diet, Nutrition and Chronic Non-Communicable Diseases (Cohort 2, 2010–2015) were analyzed, with a median follow-up of 4.2 and 5.3 years, respectively. Multivariate relative risks (RRs) and their 95% confidence intervals (95% CIs) were calculated to estimate the association between low-carbohydrate, high-fat and high-protein diet and T2D in logistic regression models. The multivariate RRs (95% CIs) were 1.00, 2.24 (1.07, 4.72) and 2.29 (1.07, 4.88) (Ptrend = 0.04), and 1.00, 1.45 (0.91, 2.31) and 1.64 (1.03, 2.61) (Ptrend = 0.04) across tertiles of low-carbohydrate, high-fat and high-protein diet scores in the population consuming extra calories in Cohort 1 and Cohort 2, respectively. The association was no longer significant after adjustment for livestock and its products, or poultry and its products. The mediation analysis discovered that this association in the population consuming extra calories was insulin resistance mediated, in both Cohort 1 and Cohort 2. However, the association was not significant among participants overall and participants with normal caloric intake. Our results indicated that long-term low-carbohydrate, high-fat and high-protein diets were associated with increased T2D risk among the population consuming extra calories, which may be caused by higher intake of animal-origin fat and protein as well as lower intake of vegetables, fruit and fiber. Additionally, the association was mediated by IR. In the population consuming extra calories, reducing the intake of livestock, poultry and their products and increasing the intake of vegetables, fruit and fiber might protect this population from developing T2D.

Dietary Protein Consumption and the Risk of Type 2 Diabetes: ADose-Response Meta-Analysis of Prospective Studies

“…To the best of our knowledge, our study is the first meta-analysis to identify an association of poultry intake with the risk of T2D. The subgroup analysis and a recent study both showed a protective effect of poultry intake on the development of T2D in China [84]. Regional differences in the relationship between white meat intake and diabetes may be related to the distinct in cooking styles between China and Europe, particularly in regard to frying versus boiled or steamed meat.…”

Ten SNPs May Affect Type 2 Diabetes Risk in Interaction with Prenatal Exposure to Chinese Famine

“…A validated semi-quantitative food frequency questionnaire and 24 h recall method for the last three consecutive days (two weekdays and one weekend day) were used to collect data regarding dietary intake. In the present study, we only considered the intake of cereals and beans, and the intake of meat and poultry as confounders, as they have been found to be associated with type 2 diabetes [ 20 , 21 ]. The Chinese Dietary Guideline recommends that the reference intake of meat and poultry is between 40 g and 75 g, and the reference intake of cereals and beans is between 50 g and 150 g [ 22 ].…”

Genetic predisposition to impaired metabolism of the branched chain amino acids, dietary intakes, and risk of type 2 diabetes

“…Family history of diabetes was defined as those whose first-degree relatives suffered from diabetes. The presence of coronary heart disease at baseline was collected by using a structured questionnaire [17].…”