High LDL cholesterol levels associated with a reduced risk of diabetes

This study was published in Diabetologia 2015 Sep 26

Study title and authors:
Low-density-lipoprotein cholesterol concentrations and risk of incident diabetes: epidemiological and genetic insights from the Framingham Heart Study.

Andersson C, Lyass A, Larson MG, Robins SJ, Vasan RS
Framingham Heart Study, 73 Mt Wayte Avenue, Suite 2, Framingham, MA, 01702-5827, USA. ca@heart.dk.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/26409460

One of the aims of this study was to assess the association of low density lipoprotein (LDL) cholesterol levels with diabetes risk. The study included 6,011 individuals, (average age 50 years), who were not treated with cholesterol lowering or antihypertensive medications and who were free from cardiovascular disease at the start of the study. Diabetes was assessed at the next examination (average 4.5 years later).

The study found that each standard deviation increase in LDL levels was associated with a 19% reduced risk of diabetes. 

Andersson concluded: "These observations may contribute to our understanding of why lipid-lowering treatment may cause diabetes in some individuals."

High red meat consumption associated with a 9% reduction in death from diabetes

This study was published in BMC Public Health 2015 Jul 10;15(1):633

 

Study title and authors:

Spatiotemporal variation in diabetes mortality in China: multilevel evidence from 2006 and 2012.

Zhou M, Astell-Burt T, Yin P, Feng X, Page A, Liu Y, Liu J, Li Y, Liu S, Wang L, Wang L, Wang L.

National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China. maigengzhou@126.com.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/26159911

This study investigated diabetes death rates. The six year study included data from 73 million people.

Regarding red meat consumption, the study found, those who consumed the most red meat had a 9% lower death rate from diabetes than those who consumed the least red meat.

Regarding cholesterol levels, the study found, those who had the highest cholesterol levels had a 3% lower death rate from diabetes compared to those who had the lowest cholesterol levels.

The metabolic syndrome may be caused by a high fructose, and relatively low fat, low cholesterol diet

This paper was published in the Archives of Medical Science 2011 Feb;7(1):8-20

Study title and authors:
Is the metabolic syndrome caused by a high fructose, and relatively low fat, low cholesterol diet?

Seneff S, Wainwright G, Mascitelli L.
Department of Electrical Engineering and Computer Science, MIT, Cambridge, MA, USA.

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22291727

The metabolic syndrome is a term that has been used to describe a number of risk factors such as elevated triglyceride levels, small sized dense low density lipoprotein (LDL) cholesterol particles, low levels of high-density lipoprotein (HDL) cholesterol, obesity, insulin resistance, glucose intolerance and elevated blood pressure, and it is associated with an increased risk of type II diabetes and coronary heart disease.

The authors have developed a new hypothesis regarding metabolic syndrome; namely it is a consequence of a high intake in carbohydrates and food with a high glycemic index, particularly fructose, and relatively low intake of cholesterol and saturated fat.

The authors show how the risk factors for metabolic syndrome may be exacerbated by the above way of eating:
(a) Elevated triglyceride levels: Studies show that higher levels of dietary fructose lead to increased triglyceride levels and that zero-cholesterol diets have been shown to increase triglyceride levels.
(b) Small sized low density lipoprotein (LDL) cholesterol particles: The liver normally clears the dangerous small sized dense low density lipoprotein (LDL) cholesterol. However in conditions of excess dietary fructose (fructose is converted to fat by the liver) the liver is overwhelmed and cannot keep up in clearing all the dangerous small sized dense low density lipoprotein (LDL) cholesterol.
(c) Low levels of high-density lipoprotein (HDL) cholesterol: The scientific literature shows that low levels of high-density lipoprotein (HDL) cholesterol is the best predictor of heart disease and is associated with an increased risk of type II diabetes. This may be because that low concentrations of bile salts correspond to a reduction of HDL levels and that low-fat, high fructose diets lead to reduced bile salts because of the reduced need for the bile salts to digest fats.
(d) Obesity: Studies reveal that the obese are often deficient in vitamin D. The best sources of vitamin D are foods rich in saturated fat such as lard, butter and egg yolk.
(e) Insulin resistance: Scientific papers reveal that the overconsumption of fructose leads to liver insulin resistance.
(f) Glucose intolerance: In high carbohydrate, low fat diets, glucose and fructose enter the bloodstream very rapidly due to the abundance of carbohydrates and the lack of buffering in the gut by dietary fats. This causes a sharp rise in blood glucose levels and the excessive glucose and fructose may damage proteins.
(g) Blood pressure: Depleted amounts of cholesterol in the outer shells of fat cells weaken the structure of the cell walls and leads to sodium leakage, which results in excess sodium in the bloostream. This causes the blood vessels to constrict with the resulting increase in blood pressure.

The findings of this paper suggest the metabolic syndrome may be caused by a high fructose, and relatively low fat, low cholesterol diet.

Seneff concludes: "We would urge medical practitioners to encourage individuals exhibiting metabolic syndrome to strongly limit the consumption of dietary fructose and other high-glycemic-index carbohydrates, and to stop discouraging them from consuming foods rich in cholesterol."

Links to other studies:
High dietary intake of fructose leads to diabetes
LDL cholesterol size: does it matter?
Beneficial effects of a high fat, low carbohydrate diet on fat reduction in type 2 diabetic patients with obesity

Small LDL cholesterol size (caused by a high carbohydrate diet) is the highest risk factor for heart disease in type II diabetics

This study was published in Metabolism 2005 Feb;54(2):227-34

Study title and authors:

Low-density lipoprotein size and subclasses are markers of clinically apparent and non-apparent atherosclerosis in type 2 diabetes.

Berneis K, Jeanneret C, Muser J, Felix B, Miserez AR.

Department of Internal Medicine and Central Laboratories, Basel University Hospital Bruderholz, Switzerland 4101. kaspar@berneis.ch

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/15690318

This study investigated the significance of various risk factors in the development of heart disease in type II diabetics. The investigators measured ten different risk factors in 38 overweight type II diabetics, such as  body mass index, blood pressure, smoking, high density lipoprotein (HDL) cholesterol, and low density lipoprotein (LDL) cholesterol particle size.

Berneis found that small low density lipoprotein (LDL) cholesterol particle size was most strongly associated with the highest risk of heart disease in type II diabetics.

Small particle sizes of low density lipoprotein (LDL) cholesterol are caused by diets high in carbohydrate and low in fat see here and here.

High carbohydrate diets increase the risk of diabetes

This study was published in Metabolism 1996 Oct;45(10):1267-72

Study title and authors:

Lipoproteins, apolipoproteins, and low-density lipoprotein size among diabetics in the Framingham offspring study.

Siegel RD, Cupples A, Schaefer EJ, Wilson PW.

Division of Endocrinology, Diabetes, Metabolism, and Molecular Medicine, New England Medical Center, Boston, MA 02111, USA.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/8843183

This study compared values for triglycerides, very low density lipoprotein (VLDL) cholesterol, low density lipoprotein (LDL) cholesterol particle size, apolipoprotein B (apoB), apolipoprotein A-1 (apo A-1) and high density lipoprotein (HDL) cholesterol were analyzed in 174 diabetic and 3,757 nondiabetic subjects and data from a total of 2,025 men and 2,042 women were subjected to statistical analysis.

The study found:

• Diabetics have higher triglyceride levels than non diabetics.
• Diabetics have higher VLDL cholesterol levels than non diabetics.
• Diabetics have more small dense LDL cholesterol particles than non diabetics.
• Diabetes is not associated with elevated LDL cholesterol levels.
• Diabetics have more apolipoprotein B than non diabetics.
• Diabetics have less apolipoprotein A-1 than non diabetics.
• Diabetics have less HDL cholesterol than non diabetics.

All the above markers for diabetes are caused by a diet high in carbohydrate and low in fat see here.

High dietary cholesterol helps to prevent diabetes

Published in the American Journal of Clinical Nutrition, doi:10.3945/ajcn.2009.28441 Vol. 91, No. 6, 1627-1633, June 2010

Predicted 25-hydroxyvitamin D score and incident type 2 diabetes in the Framingham Offspring Study 1,2,3,4
Enju Liu, James B Meigs, Anastassios G Pittas, Christina D Economos, Nicola M McKeown, Sarah L Booth and Paul F Jacques
1 From the Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University Boston MA (EL NMM SLBPFJ); the General Medicine DivisionDepartment of Medicine Massachusetts General HospitalHarvard Medical School Boston MA (JBM); the Division of Endocrinology DiabetesMetabolism Tufts Medical Center Boston MA (AGP);the Friedman School of Nutrition SciencePolicy Tufts University Boston MA (CDE NMM SLBPFJ).
2 None of the sponsors had any role in the design of the study; the design was exclusively the work of the authors.
3 Supported in part by the US Department of Agriculture, under agreement no. 58-1950-7-707, National Institute of Aging (AG14759), and the Framingham Heart Study of the National Heart, Lung, and Blood Institute of the National Institutes of Health (contract no. N01-HC-25195); and by an American Diabetes Association Career Development Award (JBM), NIDDK K24 DK080140 (JBM), R01DK076092 and R21DK078867 (AGP), and the Beverage Institute for Health and Wellness (CDE).
4 Address correspondence to PF Jacques, Epidemiology Program, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA 02111. E-mail: paul.jacques@tufts.edu.

This study can be accessed at: http://www.ajcn.org/cgi/content/abstract/91/6/1627
 
The objective of the study was to examine the relationship between vitamin D status and incidence of type 2 diabetes. In the study the vitamin D levels of 3,066 men and women were analysed for 7 years.

The study found that those with the highest vitamin D levels had a 40% decreased risk of diabetes compared to those with the lowest vitamin D.
 
Vitamin D can be obtained from sunshine and foods. Interestingly, foods that provide this vitamin - all of which are animal foods, such as butter,eggs, liver, organ meats and seafood - tend to be high in cholesterol. In fact one of cholesterol's many functions in the body is to act as a precursor to vitamin D.

So, no cholesterol and no animal foods = low vitamin D. Therefore low vitamin D = higher rates of diabetes.

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