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Lignan Intake & Diabetes Risk

iStock-1892204408JAMA Network Open recently published an analysis of several large cohorts of men and women, indicating a lower risk for developing type 2 diabetes with higher dietary intake of lignans, polyphenols abundant in certain plant-based foods. This analysis included data from 3 large prospective U.S. cohorts and over 30 years of follow-up, including the Nurses’ Health Study I and II (NHS I and II), the Health Professionals Follow-up Study (HPFS) as well as a subset of the HPFS, the Men’s Lifestyle Validation Study (MLVS). Collectively this study included over 200,000 participants and over 5 million person-years of follow-up.

The study concluded that dietary intake of both total and individual lignans (with the exception of lariciresinol) was associated with a lower risk of developing type 2 diabetes. Comparing the highest to lowest quintiles of intake, total lignan consumption was associated with a 13% lower risk for diabetes, while secoisolariciresinol was associated with the greatest risk reduction for diabetes, a 28% lower risk. Secoisolariciresinol also interacted with BMI and menopausal status, with the highest intake having the largest benefit among people with obesity as well as premenopausal women. A subgroup analysis also found lignan intake to be associated with lower HbA1c and C-reactive protein levels.

It’s worth noting that lignans are metabolized by gut microbiota to enterolignans, previously found to be associated with a lower risk for diabetes, coronary artery disease, and reduced weight gain. It’s not clear why secoisolariciresinol was associated with the largest benefit in this study; it may be because of greater bioavailability or unique metabolism, but it may also be attributed to a diet higher in flaxseeds, whole grain cereals, and tea, each associated with benefit. It should also be noted that even in the highest quintile, lignan intake was low compared to levels reported in other countries, and an apparent dose-dependent effect suggests the possibility of more robust protection with even higher intakes.

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