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Endocrine

, Volume 41, Issue 1, pp 76–81 | Cite as

High cortisol levels are associated with low quality food choice in type 2 diabetes

  • Michelle Duong
  • Jessica I. Cohen
  • Antonio ConvitEmail author
Original Article

Abstract

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.

Keywords

HPA Cortisol Food diary Hemoglobin A1C Food choice Type II diabetes 

Notes

Acknowledgments

This study was supported by a grant from the National Institutes of Health DK064087 and supported in part by grant1UL1RR029893 from the National Center for Research Resources.

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Michelle Duong
    • 1
  • Jessica I. Cohen
    • 1
  • Antonio Convit
    • 1
    • 2
    Email author
  1. 1.Brain, Obesity and Diabetes Laboratory (BODyLab)New York University School of MedicineNew YorkUSA
  2. 2.Nathan Kline Institute for Psychiatric ResearchOrangeburgUSA

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