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Estimating the Direct Effect between Dietary Macronutrients and Cardiometabolic Disease, Accounting for Mediation by Adiposity and Physical Activity

Assessing the causal effects of individual dietary macronutrients and cardiometabolic disease is challenging because distinguish direct effects from those mediated or confounded by other factors is difficult. To estimate these effects, intake of protein, carbohydrate, sugar, fat, and its subtypes we...

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Autores principales: Pomares-Millan, Hugo, Atabaki-Pasdar, Naeimeh, Coral, Daniel, Johansson, Ingegerd, Giordano, Giuseppe N., Franks, Paul W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949537/
https://www.ncbi.nlm.nih.gov/pubmed/35334875
http://dx.doi.org/10.3390/nu14061218
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author Pomares-Millan, Hugo
Atabaki-Pasdar, Naeimeh
Coral, Daniel
Johansson, Ingegerd
Giordano, Giuseppe N.
Franks, Paul W.
author_facet Pomares-Millan, Hugo
Atabaki-Pasdar, Naeimeh
Coral, Daniel
Johansson, Ingegerd
Giordano, Giuseppe N.
Franks, Paul W.
author_sort Pomares-Millan, Hugo
collection PubMed
description Assessing the causal effects of individual dietary macronutrients and cardiometabolic disease is challenging because distinguish direct effects from those mediated or confounded by other factors is difficult. To estimate these effects, intake of protein, carbohydrate, sugar, fat, and its subtypes were obtained using food frequency data derived from a Swedish population-based cohort (n~60,000). Data on clinical outcomes (i.e., type 2 diabetes (T2D) and cardiovascular disease (CVD) incidence) were obtained by linking health registry data. We assessed the magnitude of direct and mediated effects of diet, adiposity and physical activity on T2D and CVD using structural equation modelling (SEM). To strengthen causal inference, we used Mendelian randomization (MR) to model macronutrient intake exposures against clinical outcomes. We identified likely causal effects of genetically predicted carbohydrate intake (including sugar intake) and T2D, independent of adiposity and physical activity. Pairwise, serial- and parallel-mediational configurations yielded similar results. In the integrative genomic analyses, the candidate causal variant localized to the established T2D gene TCF7L2. These findings may be informative when considering which dietary modifications included in nutritional guidelines are most likely to elicit health-promoting effects.
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spelling pubmed-89495372022-03-26 Estimating the Direct Effect between Dietary Macronutrients and Cardiometabolic Disease, Accounting for Mediation by Adiposity and Physical Activity Pomares-Millan, Hugo Atabaki-Pasdar, Naeimeh Coral, Daniel Johansson, Ingegerd Giordano, Giuseppe N. Franks, Paul W. Nutrients Article Assessing the causal effects of individual dietary macronutrients and cardiometabolic disease is challenging because distinguish direct effects from those mediated or confounded by other factors is difficult. To estimate these effects, intake of protein, carbohydrate, sugar, fat, and its subtypes were obtained using food frequency data derived from a Swedish population-based cohort (n~60,000). Data on clinical outcomes (i.e., type 2 diabetes (T2D) and cardiovascular disease (CVD) incidence) were obtained by linking health registry data. We assessed the magnitude of direct and mediated effects of diet, adiposity and physical activity on T2D and CVD using structural equation modelling (SEM). To strengthen causal inference, we used Mendelian randomization (MR) to model macronutrient intake exposures against clinical outcomes. We identified likely causal effects of genetically predicted carbohydrate intake (including sugar intake) and T2D, independent of adiposity and physical activity. Pairwise, serial- and parallel-mediational configurations yielded similar results. In the integrative genomic analyses, the candidate causal variant localized to the established T2D gene TCF7L2. These findings may be informative when considering which dietary modifications included in nutritional guidelines are most likely to elicit health-promoting effects. MDPI 2022-03-13 /pmc/articles/PMC8949537/ /pubmed/35334875 http://dx.doi.org/10.3390/nu14061218 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pomares-Millan, Hugo
Atabaki-Pasdar, Naeimeh
Coral, Daniel
Johansson, Ingegerd
Giordano, Giuseppe N.
Franks, Paul W.
Estimating the Direct Effect between Dietary Macronutrients and Cardiometabolic Disease, Accounting for Mediation by Adiposity and Physical Activity
title Estimating the Direct Effect between Dietary Macronutrients and Cardiometabolic Disease, Accounting for Mediation by Adiposity and Physical Activity
title_full Estimating the Direct Effect between Dietary Macronutrients and Cardiometabolic Disease, Accounting for Mediation by Adiposity and Physical Activity
title_fullStr Estimating the Direct Effect between Dietary Macronutrients and Cardiometabolic Disease, Accounting for Mediation by Adiposity and Physical Activity
title_full_unstemmed Estimating the Direct Effect between Dietary Macronutrients and Cardiometabolic Disease, Accounting for Mediation by Adiposity and Physical Activity
title_short Estimating the Direct Effect between Dietary Macronutrients and Cardiometabolic Disease, Accounting for Mediation by Adiposity and Physical Activity
title_sort estimating the direct effect between dietary macronutrients and cardiometabolic disease, accounting for mediation by adiposity and physical activity
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949537/
https://www.ncbi.nlm.nih.gov/pubmed/35334875
http://dx.doi.org/10.3390/nu14061218
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