Dietary Inflammatory Index predicts diabetes severity
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A higher score on the Dietary Inflammatory Index — indicating a more proinflammatory diet — had a significant association with diabetes, according to a new study.
The association with diabetes was even stronger when a patient’s HbA1c was greater than 9%, researchers also wrote in the Journal of the American Board of Family Medicine.
The Dietary Inflammatory Index is a tool that measures the impact of different types of food and nutrients on inflammatory biomarkers, according to Dana E. King, MD, MS, and Jun Xiang, MS, MA, of the department of family medicine at West Virginia University. They evaluated the association between the tool and diabetes during a cross-sectional analysis of 4,434 adults (mean age, 49.4 years; mean BMI, 29.3 kg/m2, and mean Diabetes Inflammatory Index, 0.65). Of the participants, 14.1% had diabetes and 26.5% had prediabetes.
King and Xiang found that the mean Diabetes Inflammatory Index score in the adults with diabetes was 0.79. The score in those without diabetes was 0.5. In addition, patients with HbA1c higher than 9% had significantly higher Dietary Inflammatory Index scores compared with those with HbA1c from 6.5% to 9% (1.37 vs. 0.54), and those with HbA1c of 6.5% or lower (1.37 vs. 0.5). Researchers also found that a one-point increase in Diabetes Inflammatory Index score increased the odds of diabetes by 13%. Among the adults with diabetes, each one-point increase in the Dietary Inflammatory Index score increased the odds of having HbA1c higher than 9% by 43%.
“Our study confirmed that the Dietary Inflammatory Index is strongly associated with the severity of diabetes — the more ‘inflammatory’ a patient’s diet, the more severe their diabetes is likely to be,” King told Healio Primary Care. “Hopefully, the findings will prompt primary care doctors to ask even more questions about intake of refined and sugary foods in their patients with diabetes, especially those patients with higher levels of HbA1c.” – by Janel Miller
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Although there may be an association between the Dietary Inflammatory Index and the severity of diabetes, there is not yet evidence that changing the inflammatory items in the diet can change the severity of diabetes. We have long known that diet contributes, in part, to type 2 diabetes and much debate surrounds what eating pattern is ideal. What we don’t know is exactly how, or if, particular foods play more of a role than others. But we do know that overall weight reduction by 7% has been shown to improve type 2 diabetes.
At this point, much more work needs to be done to translate this index into a clinical tool, but it may be the first step in possibly identifying specific foods to target in those with type 2 diabetes or at risk for type 2 diabetes. Primary care physicians should continue to track diabetes severity using accepted methods. They should also continue to support patients with diabetes, or those at risk, in making lifestyle changes such as a 7% weight reduction, increasing physical activity to 150 minutes per week and decreased tobacco use.
Reference: American Diabetes Association Standards of Care. https://care.diabetesjournals.org/content/42/Supplement_1.
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