Unique Profiles of Polyphenol Intake Associated with Risk of Type 2 Diabetes

by | Jul 20, 2020 | 2020, Diabetes, Pancreatic Health, Polyphenols

Written by Angeline A. De Leon, Staff Writer. Study results emphasize the importance of a varied diet of polyphenol-rich foods such as nuts, fruits, and vegetables to reduce the risk of type 2 diabetes.

diabetesAlthough type 2 diabetes is a chronic disease with no known cure, research shows that through a healthy lifestyle, one critically involving dietary consumption of inflammation-fighting foods, the disease can be effectively managed, even reversed 1. Diabetes is associated with inflammation and oxidative stress 2, and dietary intake of polyphenols (bioactive compounds found in fruits and vegetables) is known to lower risk of type 2 diabetes 3. Polyphenols exert anti-inflammatory effects by interacting with signaling proteins and blocking the expression of inflammatory cytokines 4. They also show the capacity to improve vascular function through immunomodulatory activity 5 and influence blood glucose levels by modulating liver function 6. Thus, the intake of polyphenol-rich foods (fruits, vegetables, olive oil), as seen in dietary patterns such as the Mediterranean diet, is significantly associated with lower risk of type 2 diabetes 7. In the majority of these types of studies, however, dietary intake of polyphenols has been studied based on total polyphenol intake or specific subclasses of polyphenols. Given that polyphenols are ubiquitous in many different types of foods and beverages and that different subclasses of polyphenols are likely to be consumed concurrently, it is necessary to account for the joint effect of polyphenol intake from multiple polyphenol subclasses. To this end, researchers in France conducted a 2020 cohort study 8 identifying profiles of polyphenol intake associated with type 2 diabetes incidence in a large group of healthy participants.

A prospective cohort study was carried out in a total of 60,586 healthy French women who were monitored from 1993 to 2014. Food intake was assessed using a semi-quantitative food frequency questionnaire, and individual energy-adjusted intakes of 15 subclasses of polyphenols were computed using the PhenolExplorer database. Cases of type 2 diabetes were identified and validated using diabetes-specific follow-up questionnaires. A clustering approach (accounting for highly correlated intakes) was taken to identify 15 distinct clusters with unique polyphenol intake profiles and type 2 diabetes risk.

Over a mean follow-up period of 18.81 years, a total of 2,740 validated cases of type 2 diabetes were identified. When compared to the reference cluster (largest cluster, n = 6,298), the cluster composed of subjects showing high intakes of anthocyanins, dihydroflavonols, catechins, flavonols, hydroxybenzoic acids, lignans, and stilbenes was associated with lower risk of type 2 diabetes (log Hazard Ratio = -0.004, 95% Confidence Interval: -0.002 to –0.007). Relative to the reference cluster, three clusters composed of subjects showing low or medium intakes of the aforementioned polyphenol subclasses were associated with higher risk of type 2 diabetes (logHRs = 0.001 to 0.002). The cluster associated with lower relative risk of type 2 diabetes was characterized by high intake of fruits, vegetables, olive oil, and wine, compared to the 3 high-risk clusters.

Evidence from the current study confirms the importance of consuming a varied range of polyphenol-rich foods to help prevent risk of type 2 diabetes. Data indicated that the cluster with lower relative risk for diabetes consumed a higher ratio of foods typical of the Mediterranean diet, including fruits, vegetables, olive oil, and wine. The unique clustering approach employed by the current study also revealed that certain subclasses of polyphenols exert a more significant influence over the potential development of type 2 diabetes, with disease risk varying as a function of polyphenol intake of these subclasses. Results also speak to the value of assessing diabetes risk based on unique polyphenol intake profiles rather than total polyphenol intake or intakes of select subclasses, as certain profiles of polyphenol intake were seen to be differentially linked to risk of diabetes in the current study. Strengths of the study include a large sample size and long follow-up period, while limitations pertain to the collection of dietary data at baseline only, the use of self-report measures for dietary intake, and the limited generalizability of results, given the enrollment of female-only participants.

Source: Louali N, Berrandou T, Rothwell JA, et al. Profiles of polyphenol intake and type 2 diabetes in 60,586 women followed for 20 years: Results from the E3N cohort study. Nutrients. 2020; 12: 1934. DOI: 10.3390/nu12071934.

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open accessarticle distributed under the terms and conditions of the Creative Commons Attribution(CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Posted July 20, 2020.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

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