Document Detail

High cortisol levels are associated with low quality food choice in type 2 diabetes.
MedLine Citation:
PMID:  21983796     Owner:  NLM     Status:  MEDLINE    
Hypothalamic-pituitary-adrenal (HPA) axis control may be impaired in type 2 diabetes (T2DM). Glucocorticoids increase consumption of low quality foods high in calories, sugar, and fat. We explored the relationship between cortisol levels, poor blood glucose control, and food quality choice in T2DM. Twenty-seven healthy controls were age-, gender- and education-matched to 27 T2DM participants. Standard clinical blood tests and cortisol values were measured from fasting blood samples. Participants recorded all consumed food and drink items in a consecutive 3-day food diary. Diaries were analyzed for "high quality" and "low quality" foods using a standardized method with high reliability (0.97 and 0.86, respectively). Controlling for education, body mass index (BMI) and hemoglobin A1C (HbA1C), log-transformed cortisol (LogC) predicted the percent of low quality foods (R (2) = 0.092, β = 0.360, P < 0.05), but not the percent of high quality foods chosen. Controlling for education, BMI, and LogC, HbA1C significantly predicted both the percent of low quality foods (ΔR (2) = 0.079, β = 0.348, P = 0.024) and high quality foods chosen (ΔR (2) = 0.085, β = -0.362, P = 0.022). The relationship between HbA1C and low quality food choice may be mediated by cortisol, controlling for BMI and education (P < 0.01). HbA1C displayed both an indirect (cortisol-mediated) effect (P < 0.05) and direct effect on low quality food choice (P < 0.05). The relationship between HbA1C and low quality food choice may be partially mediated by cortisol. Poor blood glucose control may cause HPA axis disruption, increased consumption of low quality foods.
Michelle Duong; Jessica I Cohen; Antonio Convit
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-10-09
Journal Detail:
Title:  Endocrine     Volume:  41     ISSN:  1559-0100     ISO Abbreviation:  Endocrine     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-09     Completed Date:  2012-07-02     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  9434444     Medline TA:  Endocrine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  76-81     Citation Subset:  IM    
Brain, Obesity and Diabetes Laboratory (BODyLab), New York University School of Medicine, 145 East 32nd Street, 8th Floor, New York, NY 10016, USA.
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MeSH Terms
Biological Markers / blood
Body Mass Index
Case-Control Studies
Choice Behavior / physiology*
Diabetes Mellitus, Type 2 / blood,  physiopathology*
Diet Records
Eating / physiology*
Food / standards*
Hemoglobin A, Glycosylated / metabolism
Hydrocortisone / blood*
Hypothalamo-Hypophyseal System / physiopathology
Linear Models
Middle Aged
Pituitary-Adrenal System / physiopathology
Grant Support
Reg. No./Substance:
0/Biological Markers; 0/Hemoglobin A, Glycosylated; 50-23-7/Hydrocortisone

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