Associations of Dietary Flavonoids with Risk of Type 2 Diabetes, and Markers of Insulin Resistance and Systemic Inflammation in Women: A Prospective Study and Cross-Sectional Analysis

Yiqing Song, Jo Ann E. Manson, Julie E. Buring, Howard D. Sesso, Simin Liu, Jo Ann E. Manson, Yiqing Song, Jo Ann E. Manson, Julie E. Buring, Simin Liu, Yiqing Song, Julie E. Buring

Research output: Contribution to journalArticle

253 Citations (Scopus)

Abstract

Objective: Flavonoids, as antioxidants, may prevent the progressive impairment of pancreatic β-cell function due to oxidative stress and may thus reduce the occurrence of type 2 diabetes. The aim of the present study was to examine the association of dietary flavonol and flavone intake with type 2 diabetes, and biomarkers of insulin resistance and systemic inflammation. Methods: In 38,018 women aged ≥45 y and free of cardiovascular disease, cancer and diabetes with an average 8.8y of follow-up, we calculated relative risks (RRs) of incident type 2 diabetes (1,614 events) according to dietary intake of total or individual flavonols and flavones and flavonoid-rich foods. We also measured and examined plasma concentrations of insulin, HbA1C, CRP, and IL-6 in relation to total flavonol and flavone intake among 344 nondiabetic women. Results: During 332,905 person-years of follow-up, none of total flavonols and flavones, quercetin, kaempferol, myricetin, apigenin, and luteolin was significantly associated with risk of type 2 diabetes. Among flavonoid-rich foods, apple and tea consumption was associated with diabetes risk. Women consuming ≥1 apple/d showed a significant 28% reduced risk of type 2 diabetes compared with those who consumed no apples (the multivariate-adjusted RR = 0.72, 95% CI: 0.56, 0.92; p = 0.006 for trend). Tea consumption was also inversely associated with diabetes risk but with a borderline significant trend (≥4 cups/d vs. none: RR 0.73, 95% CI: 0.52–1.01; p for trend = 0.06). In 344 nondiabetic women, total intake of flavonols and flavones was not significantly related to plasma concentrations of fasting insulin, HbA1C, CRP, or IL-6. Conclusions: These results do not support the hypothesis that high intake of flavonols and flavones reduces the development of type 2 diabetes, although we cannot rule out a modest inverse association with intake of apples and tea.

Original languageEnglish (US)
Pages (from-to)376-384
Number of pages9
JournalJournal of the American College of Nutrition
Volume24
Issue number5
DOIs
StatePublished - Oct 1 2005
Externally publishedYes

Fingerprint

Flavonoids
Type 2 Diabetes Mellitus
Insulin Resistance
Cross-Sectional Studies
Flavones
Flavonols
Prospective Studies
flavone
Inflammation
Malus
Tea
Interleukin-6
Insulin
Apigenin
Luteolin
Food
Quercetin
Type 1 Diabetes Mellitus
Fasting
Oxidative Stress

Keywords

  • Flavonoids
  • Flavonols and flavones
  • Insulin resistance
  • Systemic inflammation
  • Type 2 diabetes

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Associations of Dietary Flavonoids with Risk of Type 2 Diabetes, and Markers of Insulin Resistance and Systemic Inflammation in Women : A Prospective Study and Cross-Sectional Analysis. / Song, Yiqing; Manson, Jo Ann E.; Buring, Julie E.; Sesso, Howard D.; Liu, Simin; Manson, Jo Ann E.; Song, Yiqing; Manson, Jo Ann E.; Buring, Julie E.; Liu, Simin; Song, Yiqing; Buring, Julie E.

In: Journal of the American College of Nutrition, Vol. 24, No. 5, 01.10.2005, p. 376-384.

Research output: Contribution to journalArticle

Song, Yiqing ; Manson, Jo Ann E. ; Buring, Julie E. ; Sesso, Howard D. ; Liu, Simin ; Manson, Jo Ann E. ; Song, Yiqing ; Manson, Jo Ann E. ; Buring, Julie E. ; Liu, Simin ; Song, Yiqing ; Buring, Julie E. / Associations of Dietary Flavonoids with Risk of Type 2 Diabetes, and Markers of Insulin Resistance and Systemic Inflammation in Women : A Prospective Study and Cross-Sectional Analysis. In: Journal of the American College of Nutrition. 2005 ; Vol. 24, No. 5. pp. 376-384.
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abstract = "Objective: Flavonoids, as antioxidants, may prevent the progressive impairment of pancreatic β-cell function due to oxidative stress and may thus reduce the occurrence of type 2 diabetes. The aim of the present study was to examine the association of dietary flavonol and flavone intake with type 2 diabetes, and biomarkers of insulin resistance and systemic inflammation. Methods: In 38,018 women aged ≥45 y and free of cardiovascular disease, cancer and diabetes with an average 8.8y of follow-up, we calculated relative risks (RRs) of incident type 2 diabetes (1,614 events) according to dietary intake of total or individual flavonols and flavones and flavonoid-rich foods. We also measured and examined plasma concentrations of insulin, HbA1C, CRP, and IL-6 in relation to total flavonol and flavone intake among 344 nondiabetic women. Results: During 332,905 person-years of follow-up, none of total flavonols and flavones, quercetin, kaempferol, myricetin, apigenin, and luteolin was significantly associated with risk of type 2 diabetes. Among flavonoid-rich foods, apple and tea consumption was associated with diabetes risk. Women consuming ≥1 apple/d showed a significant 28{\%} reduced risk of type 2 diabetes compared with those who consumed no apples (the multivariate-adjusted RR = 0.72, 95{\%} CI: 0.56, 0.92; p = 0.006 for trend). Tea consumption was also inversely associated with diabetes risk but with a borderline significant trend (≥4 cups/d vs. none: RR 0.73, 95{\%} CI: 0.52–1.01; p for trend = 0.06). In 344 nondiabetic women, total intake of flavonols and flavones was not significantly related to plasma concentrations of fasting insulin, HbA1C, CRP, or IL-6. Conclusions: These results do not support the hypothesis that high intake of flavonols and flavones reduces the development of type 2 diabetes, although we cannot rule out a modest inverse association with intake of apples and tea.",
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AU - Manson, Jo Ann E.

AU - Buring, Julie E.

AU - Sesso, Howard D.

AU - Liu, Simin

AU - Manson, Jo Ann E.

AU - Song, Yiqing

AU - Manson, Jo Ann E.

AU - Buring, Julie E.

AU - Liu, Simin

AU - Song, Yiqing

AU - Buring, Julie E.

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N2 - Objective: Flavonoids, as antioxidants, may prevent the progressive impairment of pancreatic β-cell function due to oxidative stress and may thus reduce the occurrence of type 2 diabetes. The aim of the present study was to examine the association of dietary flavonol and flavone intake with type 2 diabetes, and biomarkers of insulin resistance and systemic inflammation. Methods: In 38,018 women aged ≥45 y and free of cardiovascular disease, cancer and diabetes with an average 8.8y of follow-up, we calculated relative risks (RRs) of incident type 2 diabetes (1,614 events) according to dietary intake of total or individual flavonols and flavones and flavonoid-rich foods. We also measured and examined plasma concentrations of insulin, HbA1C, CRP, and IL-6 in relation to total flavonol and flavone intake among 344 nondiabetic women. Results: During 332,905 person-years of follow-up, none of total flavonols and flavones, quercetin, kaempferol, myricetin, apigenin, and luteolin was significantly associated with risk of type 2 diabetes. Among flavonoid-rich foods, apple and tea consumption was associated with diabetes risk. Women consuming ≥1 apple/d showed a significant 28% reduced risk of type 2 diabetes compared with those who consumed no apples (the multivariate-adjusted RR = 0.72, 95% CI: 0.56, 0.92; p = 0.006 for trend). Tea consumption was also inversely associated with diabetes risk but with a borderline significant trend (≥4 cups/d vs. none: RR 0.73, 95% CI: 0.52–1.01; p for trend = 0.06). In 344 nondiabetic women, total intake of flavonols and flavones was not significantly related to plasma concentrations of fasting insulin, HbA1C, CRP, or IL-6. Conclusions: These results do not support the hypothesis that high intake of flavonols and flavones reduces the development of type 2 diabetes, although we cannot rule out a modest inverse association with intake of apples and tea.

AB - Objective: Flavonoids, as antioxidants, may prevent the progressive impairment of pancreatic β-cell function due to oxidative stress and may thus reduce the occurrence of type 2 diabetes. The aim of the present study was to examine the association of dietary flavonol and flavone intake with type 2 diabetes, and biomarkers of insulin resistance and systemic inflammation. Methods: In 38,018 women aged ≥45 y and free of cardiovascular disease, cancer and diabetes with an average 8.8y of follow-up, we calculated relative risks (RRs) of incident type 2 diabetes (1,614 events) according to dietary intake of total or individual flavonols and flavones and flavonoid-rich foods. We also measured and examined plasma concentrations of insulin, HbA1C, CRP, and IL-6 in relation to total flavonol and flavone intake among 344 nondiabetic women. Results: During 332,905 person-years of follow-up, none of total flavonols and flavones, quercetin, kaempferol, myricetin, apigenin, and luteolin was significantly associated with risk of type 2 diabetes. Among flavonoid-rich foods, apple and tea consumption was associated with diabetes risk. Women consuming ≥1 apple/d showed a significant 28% reduced risk of type 2 diabetes compared with those who consumed no apples (the multivariate-adjusted RR = 0.72, 95% CI: 0.56, 0.92; p = 0.006 for trend). Tea consumption was also inversely associated with diabetes risk but with a borderline significant trend (≥4 cups/d vs. none: RR 0.73, 95% CI: 0.52–1.01; p for trend = 0.06). In 344 nondiabetic women, total intake of flavonols and flavones was not significantly related to plasma concentrations of fasting insulin, HbA1C, CRP, or IL-6. Conclusions: These results do not support the hypothesis that high intake of flavonols and flavones reduces the development of type 2 diabetes, although we cannot rule out a modest inverse association with intake of apples and tea.

KW - Flavonoids

KW - Flavonols and flavones

KW - Insulin resistance

KW - Systemic inflammation

KW - Type 2 diabetes

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