Dietary mineral patterns are associated with the pre-diabetes regression and progression: the Tehran lipid and glucose study (TLGS).

Aim: We investigated the potential association between dietary mineral patterns and longitudinal change of glycemic status among individuals with prediabetes (Pre-DM).

Methods: This study included 1456 individuals with Pre-DM (mean age of 47.2 ± 12.8, and 52.5% men) who participated in the third (2006-2008) and fourth (2009-2011) examinations of the Tehran Lipid and Glucose Study (TLGS) that followed up until 2015-2017. The participants' habitual dietary intakes of minerals were assessed using a semi-quantitative food frequency questionnaire (FFQ) at baseline. Principle factor analysis (PCA) identified three major mineral patterns (with a total variance of 92.3%), including multi-mineral (MM) (characterized by higher loads of phosphorous, zinc, calcium, magnesium, and copper), chromium-selenium (Cr-Se), and iron-manganese (Fe-Mn) patterns. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of developing type 2 diabetes (T2D) and regression to normal glucose regulation (NGR) across tertile categories of mineral patterns score.

Results: After a median follow-up of 5.8 years, the incidence rates of T2D and NGR was 23.8% and 46.8%, respectively. After adjustment of T2D risk score (i.e., composed of age, sex, family history of diabetes, history of gestational diabetes, body mass index, and physical activity level) and dietary confounders, Cr-Se and Fe-Mn patterns were associated with an increased chance of returning to NGR by 26% (HR = 1.26, 95% CI = 1.02-1.55) and 42% (HR = 1.42, 95% CI = 1.14-1.76), respectively. Fe-Mn pattern was also associated with a reduced risk of developing T2D (HR = 0.67, 95% CI = 0.49-0.92).

Conclusion: Our findings emphasize the potential benefits of dietary Fe-Mn and Cr-Se intakes in pre-diabetic individuals.