Dietary phytochemical index and its relationship with diabetic sensorimotor polyneuropathy: a case-control study.

Phytochemicals are compounds found in fruits, vegetables, whole grains, nuts and legumes that are non-nutritive but have bioactive properties. A high intake of these compounds is essential for optimal health and disease prevention. No study has investigated the association between Dietary Phytochemical Index (DPI) and polyneuropathy in patients with diabetes. This study aimed to examine the association between DPI and Diabetic Sensory-motor Polyneuropathy (DSPN) in a case-control study. In this case-control study, a total of 185 diabetic patients with DSPN (case group) and 185 sex- and age-matched diabetic patients without neuropathy (control group) were enrolled in this study. Participants were 30-60 years old. A validated food frequency questionnaire was used to measure the dietary intake of all participants. Daily energy derived from phytochemical-rich foods was used to calculate the DPI score. Toronto clinical neuropathy score was applied to define DSPN. Anthropometric data and fasting blood glucose levels were measured using standard methods. The Binary logistic regression was used to estimate Crude and multivariable-adjusted OR (95% CI) for DSPN across tertiles of DPI for the whole population. In the crude model, there was a significant trend across the tertile of DPI (OR highest vs. lowest tertile of DPI = 0.33; 95%CI 0.18, 0.52; P-trend < 0.001). After controlling for age, sex, and energy, a significant reverse association was observed between DPI and DSPN (OR highest vs. lowest tertile of DPI = 0.27; 95%CI 0.15, 0·48; P-trend < 0.001). Moreover, after adjusting for a wide range of confounding variables such as energy intake, physical activity, education, smoking status, and HbA1c, participants in the third tertile of DPI had 75% reduced odds for DSPN (95%CI 0.14, 0.45; P-trend < 0.001). Finally in the full adjusted model, after further adjustment for BMI, observed significant association was remained (OR highest vs. lowest tertile of DPI: 0.24; 95% CI 0.13, 0.14; P-trend < 0.001). Higher intakes of phytochemical-rich foods are associated with lower odds of DSPN.

Association of dietary acid-base load and diabetic sensorimotor polyneuropathy in patients with type 2 diabetes mellitus: A case-control study.

OBJECTIVES: The higher acid-forming potential of a diet, could be associated with diabetes. No study has been done to investigate the association between Dietary Acid Load (DAL) and polyneuropathy in patients with diabetes. This study aimed to examine the linkage between the DAL and Diabetic Sensory-motor Polyneuropathy (DSPN) in a case-control study. METHOD: This case-control study was performed at Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, in Kermanshah, Iran between April 2020 and August 2020. A total of 185 subjects with DSPN and 185 sex- and age-matched people in the control group (30-60 years old) participated in this study. Dietary intakes of all people were assessed using a validated food frequency questionnaire. DAL was evaluated through the Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP). Toronto clinical neuropathy score was applied to define DSPN. Anthropometrics data, and fasting blood glucose levels were measured. RESULTS: The Binary logistic regression was used to estimate the Odds Ratios (ORs) and 95% Confidence Intervals (95% CIs) of NEAP and PRAL in relation to DSPN. After adjustment for age, sex, energy people with higher DAL had increased odds for DSPN (ORPRAL = 3.0; 95%CI: 1.8-5.1; p-trend <0.001 and ORNEAP = 3.8; 95%CI: 2.2-6.5; p-trend <0.001). Additional adjustment for physical activity, education, smokers, and economic status strengthened the association (ORPRAL = 3.3; 95%CI:1.9-5.8; p-trend <0.001 and ORNEAP = 3.7; 95%CI: 2.2-6.5; p-trend<0.001). Finally, after additional adjustment for BMI in the full adjustment model, compared to people in the first tertile of DAL, participants in the third tertile had approximately 3.5 times significant greater odds for DSPN (ORPRAL = 3.3; 95%CI: 1.9-5.7; p-trend <0.001 and ORNEAP = 3.6; 95%CI: 2.2-6.2; p-trend<0.001). CONCLUSION: Patients with a higher acidic diet had greater odds for DSPN compared to people with lower DAL.