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8. Dietary Patterns of Insulinemia, Inflammation and Glycemia, and Pancreatic Cancer Risk: Findings from the Women's Health Initiative

Author

Jin, Qi, Hart, Phil A, Shi, Ni, Joseph, Joshua J, Donneyong, Macarius, Conwell, Darwin L, Clinton, Steven K, Cruz-Monserrate, Zobeida, Brasky, Theodore M, Tinker, Lesley F, Liu, Simin, Shadyab, Aladdin H, Thomson, Cynthia A, Qi, Lihong, Rohan, Thomas, and Tabung, Fred K

Subjects
Health Services and Systems, Biomedical and Clinical Sciences, Nutrition and Dietetics, Health Sciences, Nutrition, Aging, Digestive Diseases, Prevention, Diabetes, Obesity, Rare Diseases, Pancreatic Cancer, Cancer, Metabolic and endocrine, Aged, Blood Glucose, Diabetes Mellitus, Type 2, Diet Surveys, Feeding Behavior, Female, Follow-Up Studies, Glycemic Index, Glycemic Load, Humans, Hyperinsulinism, Inflammation, Insulin, Middle Aged, Pancreatic Neoplasms, Risk Assessment, Risk Factors, United States, Women's Health, Medical and Health Sciences, Epidemiology, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundPancreatic cancer risk is increasing in countries with high consumption of Western dietary patterns and rising obesity rates. We examined the hypothesis that specific dietary patterns reflecting hyperinsulinemia (empirical dietary index for hyperinsulinemia; EDIH), systemic inflammation (empirical dietary inflammatory pattern; EDIP), and postprandial glycemia [glycemic index (GI); glycemic load (GL)] are associated with pancreatic cancer risk, including the potential modifying role of type 2 diabetes (T2D) and body mass index (BMI).MethodsWe calculated dietary scores from baseline (1993-1998) food frequency questionnaires among 129,241 women, 50-79 years-old in the Women's Health Initiative. We used multivariable-adjusted Cox regression to estimate HRs and 95% confidence intervals (95% CI) for pancreatic cancer risk.ResultsDuring a median 19.9 years of follow-up, 850 pancreatic cancer cases were diagnosed. We observed no association between dietary scores and pancreatic cancer risk overall. However, risk was elevated among participants with longstanding T2D (present >3 years before pancreatic cancer diagnosis) for EDIH. For each 1 SD increment in dietary score, the HRs (95% CIs) were: EDIH, 1.33 (1.06-1.66); EDIP, 1.26 (0.98-1.63); GI, 1.26 (0.96-1.67); and GL, 1.23 (0.96-1.57); although interactions were not significant (all P interaction >0.05). Separately, we observed inverse associations between GI [0.86 (0.76-0.96), P interaction = 0.0068] and GL [0.83 (0.73-0.93), P interaction = 0.0075], with pancreatic cancer risk among normal-weight women.ConclusionsWe observed no overall association between the dietary patterns evaluated and pancreatic cancer risk, although women with T2D appeared to have greater cancer risk.ImpactThe elevated risk for hyperinsulinemic diets among women with longstanding T2D and the inverse association among normal-weight women warrant further examination.

Published
2021

10. Insulinemic and Inflammatory Dietary Patterns Show Enhanced Predictive Potential for Type 2 Diabetes Risk in Postmenopausal Women

Author

Jin, Qi, Shi, Ni, Aroke, Desmond, Lee, Dong Hoon, Joseph, Joshua J, Donneyong, Macarius, Conwell, Darwin L, Hart, Phil A, Zhang, Xuehong, Clinton, Steven K, Cruz-Monserrate, Zobeida, Brasky, Theodore M, Jackson, Rebecca, Tinker, Lesley F, Liu, Simin, Phillips, Lawrence S, Shadyab, Aladdin H, Nassir, Rami, Bao, Wei, and Tabung, Fred K

Subjects
Biomedical and Clinical Sciences, Nutrition and Dietetics, Nutrition, Prevention, Aging, Diabetes, Metabolic and endocrine, Diabetes Mellitus, Type 2, Diet, Dietary Carbohydrates, Female, Glycemic Index, Humans, Postmenopause, Medical and Health Sciences, Endocrinology & Metabolism, Biomedical and clinical sciences, Health sciences
Abstract

ObjectiveThe empirical dietary index for hyperinsulinemia (EDIH) and empirical dietary inflammatory pattern (EDIP) scores assess the insulinemic and inflammatory potentials of habitual dietary patterns, irrespective of the macronutrient content, and are based on plasma insulin response or inflammatory biomarkers, respectively. The glycemic index (GI) and glycemic load (GL) assess postprandial glycemic potential based on dietary carbohydrate content. We tested the hypothesis that dietary patterns promoting hyperinsulinemia, chronic inflammation, or hyperglycemia may influence type 2 diabetes risk.Research design and methodsWe calculated dietary scores from baseline (1993-1998) food frequency questionnaires among 73,495 postmenopausal women in the Women's Health Initiative, followed through March 2019. We used multivariable-adjusted Cox regression to estimate hazard ratios (HRs) and 95% CIs for type 2 diabetes risk. We also estimated multivariable-adjusted absolute risk of type 2 diabetes.ResultsDuring a median 13.3 years of follow-up, 11,009 incident cases of type 2 diabetes were diagnosed. Participants consuming the most hyperinsulinemic or proinflammatory dietary patterns experienced greater risk of type 2 diabetes; HRs (95% CI) comparing highest to lowest dietary index quintiles were EDIH 1.49 (1.32-1.68; P trend < 0.0001) and EDIP 1.45 (1.29-1.63; P trend < 0.0001). The absolute excess incidence for the same comparison was 220 (EDIH) and 271 (EDIP) cases per 100,000 person-years. GI and GL were not associated with type 2 diabetes risk: GI 0.99 (0.88-1.12; P trend = 0.46) and GL 1.01 (0.89-1.16; P trend = 0.30).ConclusionsOur findings in this diverse cohort of postmenopausal women suggest that lowering the insulinemic and inflammatory potentials of the diet may be more effective in preventing type 2 diabetes than focusing on glycemic foods.

Published
2021

11. Rationale and design of the linking education, produce provision, and community referrals to improve diabetes care (LINK) study

Author

Walker, Daniel M., Garner, Jennifer A., Hefner, Jennifer L., Headings, Amy, Jonas, Daniel E., Clark, Aaron, Bose-Brill, Seuli, Nawaz, Saira, Seiber, Eric, McAlearney, Ann Scheck, Brock, Guy, Zhao, Songzhu, Reopell, Luiza, Coovert, Nicolette, Shrodes, Jennifer C., Spees, Colleen K., Sieck, Cynthia J., Di Tosto, Gennaro, DePuccio, Matthew J., Williams, Amaris, Hoseus, Jenelle, Baker, Carrie, Brown, Michelle Moskowitz, and Joseph, Joshua J.

Published
2023
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20. A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association

Author

Ndumele, Chiadi E., Neeland, Ian J., Tuttle, Katherine R., Chow, Sheryl L., Mathew, Roy O., Khan, Sadiya S., Coresh, Josef, Baker-Smith, Carissa M., Carnethon, Mercedes R., Després, Jean-Pierre, Ho, Jennifer E., Joseph, Joshua J., Kernan, Walter N., Khera, Amit, Kosiborod, Mikhail N., Lekavich, Carolyn L., Lewis, Eldrin F., Lo, Kevin B., Ozkan, Bige, Palaniappan, Latha P., Patel, Sonali S., Pencina, Michael J., Powell-Wiley, Tiffany M., Sperling, Laurence S., Virani, Salim S., Wright, Jackson T., Rajgopal Singh, Radhika, Elkind, Mitchell S.V., and Rangaswami, Janani

Published
2023
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21. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association

Author

Ndumele, Chiadi E., Rangaswami, Janani, Chow, Sheryl L., Neeland, Ian J., Tuttle, Katherine R., Khan, Sadiya S., Coresh, Josef, Mathew, Roy O., Baker-Smith, Carissa M., Carnethon, Mercedes R., Despres, Jean-Pierre, Ho, Jennifer E., Joseph, Joshua J., Kernan, Walter N., Khera, Amit, Kosiborod, Mikhail N., Lekavich, Carolyn L., Lewis, Eldrin F., Lo, Kevin B., Ozkan, Bige, Palaniappan, Latha P., Patel, Sonali S., Pencina, Michael J., Powell-Wiley, Tiffany M., Sperling, Laurence S., Virani, Salim S., Wright, Jackson T., Rajgopal Singh, Radhika, and Elkind, Mitchell S.V.

Published
2023
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29. Interferon gamma mediates the reduction of adipose tissue regulatory T cells in human obesity

Author

Bradley, David, Smith, Alan J., Blaszczak, Alecia, Shantaram, Dharti, Bergin, Stephen M., Jalilvand, Anahita, Wright, Valerie, Wyne, Kathleen L., Dewal, Revati S., Baer, Lisa A., Wright, Katherine R., Stanford, Kristin I., Needleman, Bradley, Brethauer, Stacy, Noria, Sabrena, Renton, David, Joseph, Joshua J., Lovett-Racke, Amy, Liu, Joey, and Hsueh, Willa A.

Published
2022
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31. Renin‐Angiotensin‐Aldosterone System, Glucose Metabolism and Incident Type 2 Diabetes Mellitus: MESA

Author

Joseph, Joshua J, Tcheugui, Justin B Echouffo, Effoe, Valery S, Hsueh, Willa A, Allison, Matthew A, and Golden, Sherita H

Subjects
Prevention, Clinical Research, Nutrition, Aging, Diabetes, Cardiovascular, Metabolic and endocrine, African Americans, Aged, Aldosterone, Asian Americans, Blood Glucose, Cohort Studies, Diabetes Mellitus, Type 2, Female, Hispanic or Latino, Humans, Incidence, Insulin Resistance, Insulin-Secreting Cells, Linear Models, Male, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Prospective Studies, Renin, Renin-Angiotensin System, Whites, aldosterone, race and ethnicity, renin angiotensin system, type 2 diabetes mellitus, White People, Black or African American, Asian, Cardiorespiratory Medicine and Haematology
Abstract

Background Mechanistic studies suggest that aldosterone impairs glucose metabolism. We investigated the cross-sectional associations of aldosterone and plasma renin activity with fasting plasma glucose, insulin resistance ( IR ), β-cell function, and longitudinal association with incident diabetes mellitus among adults in MESA (the multiethnic study of atherosclerosis) prospective cohort study. Methods and Results Homeostatic model assessment of IR ( HOMA 2- IR ) and HOMA 2-β were used to estimate IR and β-cell function, respectively. Incident diabetes mellitus was defined as fasting plasma glucose ≥126 mg/dL or anti-diabetic medication use at follow-up. Linear regression was used to examine cross-sectional associations of aldosterone with fasting plasma glucose, HOMA 2- IR and HOMA 2-β; Cox regression was used to estimate hazard ratios ( HR ) for incident diabetes mellitus with multivariable adjustment. There were 116 cases of incident diabetes mellitus over 10.5 years among 1570 adults (44% non-Hispanic white, 13% Chinese American, 19% Black, 24% Hispanic American, mean age 64±10 years, 51% female). A 100% increase in log-aldosterone was associated with a 2.6 mg/dL higher fasting plasma glucose, 15% higher HOMA 2- IR and 6% higher HOMA 2-β ( P

Published
2018

36. Antecedent longitudinal changes in body mass index are associated with diurnal cortisol curve features: The multi-ethnic study of atherosclerosis

Author

Joseph, Joshua J, Wang, Xu, Roux, Ana V Diez, Sanchez, Brisa N, Seeman, Teresa E, Needham, Belinda L, and Golden, Sherita Hill

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Aging, Rehabilitation, Cardiovascular, Nutrition, Obesity, Clinical Research, Aged, Aged, 80 and over, Area Under Curve, Atherosclerosis, Body Mass Index, Circadian Rhythm, Cohort Studies, Cross-Sectional Studies, Ethnicity, Female, Humans, Hydrocortisone, Longitudinal Studies, Male, Middle Aged, United States, Waist Circumference, Cortisol, Waist circumference, Body mass index, Hypothalamic-Pituitary-Adrenal axis, Hypothalamic–Pituitary–Adrenal axis, Endocrinology & Metabolism, Clinical sciences
Abstract

ContextPrior studies have shown a cross-sectional association between body mass index (BMI) and salivary diurnal cortisol profile features (cortisol features); however, to our knowledge prior population-based studies have not examined the longitudinal association of body-mass index (BMI) with cortisol features.ObjectiveTo examine the association of (1) prior annual BMI percent change over 7years with cortisol features, (2) baseline cortisol features with subsequent change in BMI over 6years and (3) the association of change in cortisol features with change in BMI over 6years.DesignLongitudinal study.SettingMulti-Ethnic Study of Atherosclerosis (MESA) Stress I & II Studies (2004-2006 & 2010-2012).Participants1685 ethnically diverse men and women attended either MESA Stress exam (mean age 65±10years at MESA Stress I; mean age 69±9years at MESA Stress II).Outcome measuresLog-transformed cortisol features including wake-up cortisol, cortisol awakening response, early decline slope (30min to 2h post-awakening), late decline slope (2h post-awakening to bedtime), bedtime, and total area under the curve (AUC) cortisol.ResultsOver 7years, following multivariable adjustment, (1) a 1% higher prior annual BMI % increase was associated with a 2.9% (95% CI: -5.0%, -0.8%) and 3.0% (95% CI: -4.7%, -1.4%) lower current wake-up and total AUC cortisol, respectively; (2) there was no significant association between baseline cortisol features and subsequent change in BMI and (3) among participants with BMI≥30kg/m2, flattening of the late decline slope was associated with increases in BMI (every 1-unit increase late decline slope were associated with a 12.9% increase (95%CI: -1%, 26.8%) in BMI, respectively).ConclusionsWe found a significant association between prior annual BMI % change and cortisol features, but no significant association between baseline cortisol features and subsequent change in BMI. In participants with obesity increases in BMI were associated with less pronounced declined. Collectively, our results suggest that greater adiposity may lead to a blunted diurnal cortisol profile.

Published
2017

42. Association of Socioeconomic Status With Life's Essential 8 in the National Health and Nutrition Examination Survey: Effect Modification by Sex

Author

Williams, Amaris, primary, Nolan, Timiya S., additional, Luthy, Jacsen, additional, Brewer, LaPrincess C., additional, Ortiz, Robin, additional, Venkatesh, Kartik K., additional, Sanchez, Eduardo, additional, Brock, Guy N., additional, Nawaz, Saira, additional, Garner, Jennifer A., additional, Walker, Daniel M., additional, Gray, Darrell M., additional, and Joseph, Joshua J., additional

Published
2024
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43. Sustainability of social needs resolution interventions: A call to consider cost

Author

Seiber, Eric E., primary, Garrity, Katharine, additional, Moon, Kyle J., additional, Jankowski, Emma, additional, Nawaz, Saira, additional, Garner, Jennifer A., additional, Headings, Amy, additional, Jonas, Daniel E., additional, Clark, Aaron, additional, Bose-Brill, Seuli, additional, Shrodes, Jennifer C., additional, Hoseus, Jenelle, additional, Baker, Carrie, additional, McAlearney, Ann Scheck, additional, Hefner, Jennifer L., additional, Joseph, Joshua J., additional, Vallangeon, Dana, additional, and Walker, Daniel M., additional

Published
2024
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