Study Details Role of Food Intake Timing on Longevity in Diabetes

Using data from an analysis of dietary information obtained from the National Health and Nutrition Examination Survey (NHANES), a team of investigators details what they purport is an ideal diet for extending longevity in patients with diabetes.

Results of the study, which leveraged data from more than 4500 patients with diabetes, detail the impact of aligning food intake with a patient’s biological clock and how specific food items could play a role in longevity, including vegetables and dairy products.

“We observed that eating potatoes in the morning, whole grains in the afternoon, greens and milk in the evening and less processed meat in the evening was associated with better long-term survival in people with diabetes,” said Qingrao Song, MD, of Harbin Medical University in Harbin, China. "Nutritional guidelines and intervention strategies for diabetes should integrate the optimal consumption times for foods in the future.”

With an interest in exploring the impact of nutrition on long-term survival in patients with type 2 diabetes, investigators designed their study as an analysis of data within the NHANES study related to patients with type 2 diabetes from 2003-2014. During this time period, NHANES collected data related to 4642 patients with diabetes meeting inclusion criteria.

As part of NHANES food intake was assessed through 2 nonconsecutive 24-hour dietary recall interviews. The primary outcome of the current analysis was incidence of cardiovascular disease and all-cause mortality. The primary exposure for the analyses was intake of the major food groups and how it aligns with different intake periods, which were defined as forenoon, afternoon, and evening. Covariates included in the investigators’ analyses included sex, age, BMI, education, race/ethnicity, and family history of cardiovascular disease.

Upon analysis, results indicate those in the highest quantile of potato (HR, 0.46 [95% CI, 0.24-0.89]) and starchy vegetables (HR, 0.32 [95% CI, 0.15-0.72]) in the forenoon had a lower mortality risk than those in the lowest quantile of consumption. When assessing food intake during the afternoon, those with increased intake of whole grain had a lower mortality from cardiovascular disease than their counterparts in the lowest quantile of consumption (HR, 0.67 [95% CI, 0.48-0.95]).

When assessing food intake during the evening, results suggested those in the highest quantile of milk intake were at lower risk of mortality from cardiovascular disease (HR, 0.56 [95% CI, 0.36-0.88]) and all-cause mortality (HR, 0.71 [95% CI, 0.54-0.92]). Similarly, those in the highest quantile of dark vegetable intake were at a lower risk of mortality from cardiovascular disease compared to those in the lowest quantile (HR, 0.55 [95% CI, 0.35-0.87]). Conversely, those in the highest quantile of intake for processed meat had an increased risk of cardiovascular mortality compared to their counterparts in the lowest quantile (HR, 1.74 [95% CI, 1.07-2.82]).

Further analysis suggested isocalorically switched 0.1 serving potato or starchy vegetables consumed in the afternoon or evening to forenoon, 0.1 serving dark vegetable consumed in the afternoon to the evening, and 0.1 serving whole grain consumed in the forenoon to the afternoon was associated with a reduction in risk of cardiovascular mortality.

“People with diabetes are under a disrupted biological rhythm of glucose metabolism, and accumulating evidence in recent years has indicated that food intake time is as important as quantity and quality for maintaining health. Therefore, nutritional therapy that considers consumption time will be a major component of diabetes treatment,” wrote investigators.

This study, “The Association of Consumption Time for Food With Cardiovascular Disease and All-Cause Mortality Among Diabetic Patients,” was published in The Journal of Clinical Endocrinology and Metabolism.