The Portfolio Diet and HbA1c in Adults Living with Type 2 Diabetes Mellitus: A Patient-Level Pooled Analysis of Two Randomized Dietary Trials
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. The Portfolio Diet
2.4. Assessment of the Portfolio Diet
2.5. Outcome
2.6. Statistical Analyses
3. Results
3.1. Participant Characteristics
3.2. Portfolio Diet Adherence
3.3. Portfolio Diet and HbA1c
3.4. Portfolio Diet and Other Cardiometabolic Risk Factors
3.5. Sensitivity and Subgroup Analyses
4. Discussion
4.1. Principle Findings
4.2. Implications
4.3. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Pooled | DMGI | DM-MRI | p Value * |
---|---|---|---|---|
No. | 267 | 124 | 143 | |
Age, years | 61.9 (0.5) | 61.8 (0.9) | 62.1 (0.7) | 0.76 |
Sex, females, n (%) | 98 (36.7) | 45 (36.3) | 53 (37.1) | 0.90 |
T2DM | 267 (100) | 124 (100) | 143 (100) | 1.00 |
Body weight, kg | 85.5 (1.07) | 86.4 (1.72) | 84.8 (1.33) | 0.46 |
BMI, kg/m2 | 30.2 (0.3) | 30.5 (0.5) | 30.0 (0.4) | 0.50 |
HbA1c, % | 7.08 (0.03) | 7.06 (0.05) | 7.10 (0.05) | 0.59 |
TC, mmol/L | 4.1 (0.06) | 4.2 (0.08) | 3.9 (0.09) | 0.03 |
HDL-C, mmol/L | 1.1 (0.02) | 1.1 (0.02) | 1.1 (0.02) | 0.25 |
TG, mmol/L | 1.5 (0.05) | 1.4 (0.07) | 1.5 (0.08) | 0.43 |
LDL-C, mmol/L | 2.3 (0.05) | 2.5 (0.07) | 2.2 (0.07) | 0.001 |
Non-HDL-C, mmol/L | 2.9 (0.06) | 3.1 (0.07) | 2.8 (0.08) | 0.007 |
Smoking, n (%) | 15 (5.6) | 8 (6.5) | 7 (4.9) | 0.58 |
CVD event, n (%) | 19 (7.1) | 9 (7.3) | 10 (7.0) | 0.93 |
Ethnicity, n (%) | 0.15 | |||
White | 180 (67.4) | 87 (70.2) | 93 (65.0) | |
South Asian | 43 (16.1) | 18 (14.5) | 25 (17.5) | |
East Asian | 17 (6.4) | 8 (6.5) | 9 (6.3) | |
African | 13 (4.9) | 7 (5.6) | 6 (4.2) | |
Hispanic | 5 (1.9) | 3 (2.4) | 2 (1.4) | |
Native | 1 (0.4) | 1 (0.8) | 0 | |
Other | 8 (3.0) | 0 | 8 (5.9) | |
Dietary GI | 56.7 | 57.8 | 55.8 | 0.001 |
Medication use, n (%) | ||||
Glycemic-control | 264 (99) | 122 (98) | 142 (99) | 0.48 |
Thiazolinedione | 50 (19) | 42 (34) | 8 (6) | 0.001 |
Biguanide | 232 (87) | 99 (80) | 133 (93) | 0.001 |
Sulfonylureas | 109 (41) | 61 (49) | 48 (34) | 0.01 |
Meglitinides | 6 (2) | 3 (2) | 3 (2) | 0.86 |
α-glucosidase inhibitors | 6 (2) | 5 (4) | 1 (1) | 0.07 |
DPP-4 inhibitors | 29 (11) | 0 | 29 (20) | 0.001 |
Lipid-lowering | 186 (70) | 85 (69) | 101 (71) | 0.71 |
Statin | 182 (68) | 81 (65) | 101 (71) | 0.35 |
Non-statin | 15 (6) | 6 (5) | 9 (6) | 0.61 |
Blood pressure | 186 (70) | 85 (69) | 101 (71) | 0.71 |
Diuretic | 51 (19) | 27 (22) | 24 (17) | 0.30 |
ACEi/ARBs | 168 (63) | 79 (64) | 89 (62) | 0.80 |
Beta blockers | 24 (9) | 8 (6) | 16 (11) | 0.18 |
Calcium channel blockers | 46 (17) | 16 (13) | 30 (21) | 0.08 |
Alpha blockers | 3 (1) | 2 (2) | 1 (1) | 0.48 |
c-PDS | 4.1 (0.3) | 4.2 (0.3) | 4.0 (0.2) | 0.76 |
Portfolio Diet | Baseline * | End (6 Months) * | Change at 6 Months * |
---|---|---|---|
c-PDS | 4.10 (0.17) | 4.44 (0.18) | 0.13 (0.19) |
Nuts and seeds | 1.34 (0.08) | 1.08 (0.08) | −0.27 (0.09) |
Plant protein | 0.51 (0.04) | 0.76 (0.06) | 0.25 (0.06) |
Viscous fibre | 0.82 (0.06) | 0.97 (0.07) | 0.15 (0.08) |
Plant sterols | 0.05 (0.02) | 0.05 (0.02) | 0.00 (0.02) |
MUFA oils | 1.37 (0.08) | 1.37 (0.08) | −0.01 (0.09) |
Dietary pulses, g/d | 31.0 (4.20) | 49.0 (4.70) | 18.1 (5.90) |
Portfolio Diet | β Coefficient * | 95% CI | p-Value |
---|---|---|---|
c-PDS ** | −0.04 | (−0.07, −0.02) | 0.001 |
Nuts and seeds | −0.07 | (−0.12, −0.02) | 0.009 |
Plant protein | −0.11 | (−0.18, −0.03) | 0.009 |
Viscous fibre | −0.05 | (−0.11, 0.01) | 0.09 |
Plant sterols | −0.30 | (−0.64, 0.04) | 0.08 |
MUFA oils | −0.02 | (−0.08, 0.03) | 0.44 |
Dietary pulses, (per 1 cup, 266 g/d) | −0.24 | (−0.45, −0.03) | 0.028 |
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Kavanagh, M.E.; Back, S.; Chen, V.; Glenn, A.J.; Viscardi, G.; Houshialsadat, Z.; Sievenpiper, J.L.; Kendall, C.W.C.; Jenkins, D.J.A.; Chiavaroli, L. The Portfolio Diet and HbA1c in Adults Living with Type 2 Diabetes Mellitus: A Patient-Level Pooled Analysis of Two Randomized Dietary Trials. Nutrients 2024, 16, 2817. https://doi.org/10.3390/nu16172817
Kavanagh ME, Back S, Chen V, Glenn AJ, Viscardi G, Houshialsadat Z, Sievenpiper JL, Kendall CWC, Jenkins DJA, Chiavaroli L. The Portfolio Diet and HbA1c in Adults Living with Type 2 Diabetes Mellitus: A Patient-Level Pooled Analysis of Two Randomized Dietary Trials. Nutrients. 2024; 16(17):2817. https://doi.org/10.3390/nu16172817
Chicago/Turabian StyleKavanagh, Meaghan E., Songhee Back, Victoria Chen, Andrea J. Glenn, Gabrielle Viscardi, Zeinab Houshialsadat, John L. Sievenpiper, Cyril W. C. Kendall, David J. A. Jenkins, and Laura Chiavaroli. 2024. "The Portfolio Diet and HbA1c in Adults Living with Type 2 Diabetes Mellitus: A Patient-Level Pooled Analysis of Two Randomized Dietary Trials" Nutrients 16, no. 17: 2817. https://doi.org/10.3390/nu16172817