Associations Between Adherence to the Dietary Approaches To Stop Hypertension (Dash) Diet and Six Glucose Homeostasis Traits in the Microbiome and Insulin Longitudinal Evaluation Study (Miles)

Authors

Gautam Ramesh
Alexis C Wood
Matthew A Allison
Stephen S Rich
Elizabeth T Jensen
Yii-Der I Chen
Jerome I Rotter
Alain G Bertoni
Mark O Goodarzi

Publication Date

6-1-2022

Journal

Nutrition, Metabolism and Cardiovascular Diseases

DOI

10.1016/j.numecd.2022.03.014

PMID

35459606

PMCID

PMC9167769

PubMedCentral® Posted Date

6-1-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Adult, Aged, Blood Glucose, Diabetes Mellitus, Type 2, Diet, Dietary Approaches To Stop Hypertension, Homeostasis, Humans, Hypertension, Insulin, Microbiota, Middle Aged, DASH diet, plant-based, Type 2 diabetes, glucose homeostasis, oral glucose tolerance test

Abstract

Background and aims: The DASH diet conveys protection against type 2 diabetes mellitus (T2D) Via plant-based and non-plant-based recommendations. Research has not identified which glucose homeostasis pathways are improved. We examined associations between adherence to a DASH diet and six glucose homeostasis traits, probing whether associations could be attributed to the plant-based (DASH-P) and/or non-plant based (DASH-NP) components.

Methods and results: We included data from 295 adults without T2D (age 59.3 ± 9.00 years; 63.46% non-Hispanic White and 36.54% African American, self-reported race ancestry) participating in the Microbiome and Insulin Longitudinal Evaluation Study (MILES). An oral glucose tolerance test (OGTT) yielded fasting plasma glucose, insulin, C-peptide, and insulin secretion, sensitivity, and disposition index. Habitual dietary intake was assessed by food frequency questionnaire (FFQ). Associations between DASH components and glucose homeostasis traits were examined, controlling for demographics, body mass index (BMI), physical activity, and energy intake. For significant associations, the models were repeated with scores for DASH-P and DASH-NP as predictors in the same model. DASH and DASH-P scores were inversely associated with fasting plasma glucose (DASH:β = -0.036 ± 0.012,P = 0.005; DASH-P: β = -0.04 ± 0.017,P = 0.002), and positively associated with insulin sensitivity (DASH:β = 0.022 ± 0.012,P = 0.042; DASH-P: = 0.036 ± 0.015,P = 0.014). The DASH score was also associated with disposition index (β = 0.026 ± 0.013,P = 0.038), but this association did not reach significance with DASH-P (β = 0.035 ± 0.018,P = 0.051). No associations were observed with DASH-NP score (all P > 0.05).

Conclusions: DASH diet is associated with improvement in specific glucose homeostasis traits, likely arising from increased plant-based foods. Such research may help tailor future dietary advice to specific metabolic risk, and to food groups most effective at improving these.