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      Optimised Glucose “Time in Range” Using Continuous Glucose Monitors in 4,805 Non-Diabetic Individuals Is Associated With Favourable Diet and Health: The ZOE PREDICT Studies

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          Abstract

          Objectives

          Continuous glucose monitoring (CGM) enables the dynamic measurement of glycemic control. In diabetic cohorts, time in range (TIR), measured by CGM, is discriminatory of future disease development. However, the value of CGM metrics in non-diabetic populations and their relationship with health outcomes is unclear. This research developed ‘optimised’ TIR targets specific to healthy populations and explored their relationship with diet and health.

          Methods

          The ZOE PREDICT studies, one (n = 1002, UK), two (n = 987, US) and three (n = 4,500, US) collected demographic information, habitual and free-living diet data, cardiometabolic blood biomarkers and postprandial responses to standardized meals in clinic and free-living settings. TIR was calculated from CGMs (2–4 days free-living) using 1) the American Diabetes Association (ADA); 70–140 mg/dL (TIR ADA) and 2) a novel optimised; 70–100 mg/dL (TIR optimised) target. Habitual diet quality (plant-based diet indices; PDI, healthy-PDI and unhealthy-PDI), and free-living nutrient intakes (% energy) were calculated. Associations (spearman's, adjusted for age, sex and BMI) between TIR and diet were examined, and differences in diet and health outcomes between quintile 1 (Q1) and 5 (Q5) of TIR targets were assessed.

          Results

          Mean fasting glucose was 91 ± 10 mg/dL, HbA1c 5.3 ± 0.4%, TIR optimised 70 ± 17% and TIR ADA 91 ± 13% (n = 4805 after exclusions, 78% females, mean age 46 ± 12y). Individuals with better glycemic control (TIR optimised Q5 vs Q1) were younger (mean ± SD) (45 ± 11  vs 49 ± 12y), had lower HbA1c (5.2 ± 0.4  vs 5.5 ± 0.5) and fasting glucose (91 ± 14  vs 97 ± 23 mg/dL) and higher HDL-cholesterol (1.7 ± 0.4  vs 1.6 ± 0.5mmol/L) (P< 0.001 for all). TIR optimised (PREDICT 1 n = 868) was associated with a favourable diet (lower unhealthy-PDI and carbohydrate intakes and higher protein intakes) and cardiometabolic risk profile (lower HbA1c and ASCVD) (P < 0.05 for all). However, TIR ADA was not associated with diet or health outcomes.

          Conclusions

          We demonstrate that an optimised TIR target (70–100 mg/dL) is discriminatory of ASCVD risk despite normal fasting HbA1c. These findings demonstrate the utility of CGM's in non-diabetic populations and highlight the potential application of dietary strategies to improve TIR and subsequent metabolic complications.

          Funding Sources

          ZOE Ltd.

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          Author and article information

          Contributors
          Journal
          Curr Dev Nutr
          Curr Dev Nutr
          cdn
          Current Developments in Nutrition
          Oxford University Press
          2475-2991
          June 2022
          14 June 2022
          14 June 2022
          : 6
          : Suppl 1
          : 1108
          Affiliations
          Kings College London
          Kings College London
          University of Nottingham
          Lund University
          Zoe Ltd
          Kings College London
          Article
          nzac078.002
          10.1093/cdn/nzac078.002
          9194241
          77f67e0c-4efa-46e8-a6cf-0cdeb05f4a64
          © The Author 2022. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.

          This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@ 123456oup.com

          History
          Page count
          Pages: 1
          Categories
          Precision Nutrition/Nutrient-Gene Interactions
          AcademicSubjects/MED00060

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