Fat Consumption and HbA1c Levels
The EPIC-Norfolk Study
- Anne-Helen Harding, MPHIL,
- Lincoln A. Sargeant, DM, PHD,
- Ailsa Welch, BSC,
- Suzy Oakes,
- Robert N. Luben, BSC,
- Sheila Bingham, PHD,
- Nicholas E. Day, MB, PHD,
- Kay-Tee Khaw, FRCP and
- Nicholas J. Wareham, MB, PHD
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
OBJECTIVE—To describe the relationship between total dietary fat and the pattern of fat intake and HbA1c.
RESEARCH DESIGN AND METHODS—In this cross-sectional study, 2,759 men and 3,464 women (40–78 years of age) without a previous diagnosis of type 2 diabetes were recruited from a population-based sampling frame. Diet was assessed using a self-reported semiquantitative food frequency questionnaire.
RESULTS—The HbA1c level was negatively associated with the polyunsaturated fat–to–saturated fat ratio (P:S ratio) of the diet (β = −0.0338 HbA1c% per SD change in P:S ratio; P < 0.001) and positively associated with the total level of fat intake (β = 0.0620 HbA1c% per SD change in total fat intake; P < 0.001), adjusted for age and total energy intake. The associations remained significant when adjusted for each other and for total energy, protein, age, sex, family history of diabetes, BMI, waist-to-hip ratio, physical activity, and smoking (for P:S ratio, β = −0.0200 HbA1c% per SD change in P:S ratio, P = 0.013; for total fat, β = 0.420% HbA1c% per SD change in total fat intake, P < 0.001). The benefits from a high P:S ratio were attributed to a lower saturated fat intake.
CONCLUSIONS—These findings demonstrate independent associations between HbA1c concentration across the normal range of HbA1c and both total fat intake and the pattern of dietary fat intake. They provide further support to efforts promoting modifications in the intake of dietary fat.
- E%, percent total energy intake
- EPIC-Norfolk, Norfolk arm of the European Prospective Investigation into Cancer
- FFQ, food frequency questionnaire
- P:S ratio, polyunsaturated fat–to–saturated fat ratio
- WHR, waist-to-hip ratio
Address correspondence and reprint requests to Dr. N.J. Wareham, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge CB2 2SR, United Kingdom. E-mail:.
Received for publication 31 January 2001 and accepted in revised form 13 July 2001.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.