Metabolomic profiling of the Dietary Approaches to Stop Hypertension diet provides novel insights for the nutritional epidemiology of type 2 diabetes mellitus

Abstract

Adherence to the DASH diet is inversely associated with T2DM risk. Metabolic changes due to DASH adherence and their potential relationship with incident T2DM have not been described. The objective is to determine metabolite clusters associated with adherence to a DASH-like diet in the Insulin Resistance Atherosclerosis Study (IRAS) cohort and explore if the clusters predicted 5-year incidence of T2DM. The current study included the 570 non-diabetic multi-ethnic participants aged 40 - 69 years. Adherence to a DASH-like diet was determined a priori through an 80-point scale for absolute intakes of the eight DASH food groups. Quantitative measurements of 87 metabolites (acylcarnitines, amino acids, bile acids, sterols, and fatty acids) were obtained at baseline. Metabolite clusters related to DASH adherence were determined through partial least squares (PLS) analysis using R. Multivariable-adjusted logistic regression (MLR) was used to explore the associations between metabolite clusters and incident T2DM. A group of acylcarnitines and fatty acids loaded strongly on the two components retained under PLS. Among strongly loading metabolites, a select group of acylcarnitines had over 50% of their individual variance explained by the PLS model. Component 2 was inversely associated with incident T2DM (Odds ratio (OR): 0.89; 95% Confidence interval (CI) 0.80-0.99, p-value = 0.043) after adjustment for demographic and metabolic covariates. Component 1 was not associated with T2DM risk (OR: 1.02; 95% CI 0.88-1.19, p-value = 0.74). Adherence to a DASH-type diet may contribute to reduced T2DM risk in part through modulations in acylcarnitine and fatty acid physiology.

Association between a priori and a posteriori dietary patterns and the risk of type 2 diabetes: a representative cohort study in Taiwan

“…Fourth, two main components, nuts and sodium, were not assessed in our study. This may change the metabolite clusters in the DASH pattern in our study and may affect the physiological mechanism of T2DM prevention ( 41 ) . For the PCA-derived prudent pattern in our study, a high intake of healthy foods like in the Mediterranean diet including fish, vegetables and legumes, along with a high intake of unhealthy foods such as meat may invalidate the benefits of the former.…”

Insulin Resistance and Vitamin D Deficiency: A Link Beyond the Appearances

“…The energy-restricted dietary regimens such as the Mediterranean diet, the Dietary Approaches to Stop Hypertension (DASH) diet, the plant-based diets were reported to ameliorate insulin sensitivity and reduce the incidence of T2D ( 166 ). In particular, in a post-hoc analysis of the Insulin Resistance Atherosclerosis Study cohort, an inverse association between the adherence to the DASH diet and the risk of T2D has been reported ( 167 ). Similar results were documented for MS; in this case, the adherence to the DASH diet was associated with a 64% lower risk to develop MS in healthy children and adolescents ( 168 ).…”

Metabolomic Biomarkers of Dietary Approaches to Stop Hypertension (DASH) Dietary Patterns in Pregnant Women

“…To date, the most rigorous investigations that identified DASH-related metabolomic markers were studies utilizing data from randomized controlled feeding studies, including the DASH trial [ 12 ] and DASH Mechanism Study [ 26 ]. Several observational studies also identified circulating metabolomic markers for DASH dietary patterns in general populations, including the Cancer Prevention Study (CPS)-II Nutrition Cohort among postmenopausal women [ 27 ], the Framingham Offspring Study [ 28 ], the Atherosclerosis Risk in Communities Study (ARIC) [ 29 ], the Chronic Renal Insufficiency Cohort (CRIC) study [ 30 ], and the Insulin Resistance Atherosclerosis Study (IRAS) [ 31 ]. Although most DASH-related metabolites are lipids and lipid-like molecules, among these studies conducted with general populations, only a few metabolites were replicated.…”