Perfluoroalkyl and polyfluoroalkyl substances (PFAS), common chemicals that can be found in food packaging and household products, are associated with diabetes and microvascular disease, according to a study published in Diabetes Journal. However, the study indicated that this risk can be reduced with certain lifestyle changes.
Researchers analyzed data from a prospective cohort of 957 participants from the Diabetes Prevention Program trial and Diabetes Prevention Program Outcomes Study. Participants were randomized to an intensive lifestyle intervention designed to help them lose 7% of their body weight that included diet, physical activity, and behavior modification or a placebo medication. The lifestyle modification group had case managers coach them on how to reduce fat intake and cut calories to achieve steady weight loss of one to two pounds per week. These participants were also tasked with completing moderate to vigorous exercise for a minimum of 150 minutes a week.
Researchers quantified plasma concentrations for six PFAS at baseline and two years after randomization, and participants were monitored for approximately 15 years.
During a median follow-up of 8.9 years, 507 people developed diabetes. Those in the intervention cohort were 28% less likely to develop diabetes than the placebo group.
A doubling in baseline branched perfluorooctanoic acid concentration was associated with a 14% increase in diabetes risk for the placebo cohort (hazard ratio [HR], 1.14; 95% confidence interval [CI], 1.04-1.25), but this was not the case for the lifestyle intervention group (HR, 1.01; 95% CI, 0.92-1.11; P=0.11). Two years after randomization, mean change in plasma baseline branched perfluorooctanoic acid concentration was 0.96 ng/mL in the placebo group (95% CI, 0.71-1.22) and 0.31 ng/mL in the lifestyle intervention group (95% CI, 0.14-0.48).
Each doubling in N-ethyl-perfluorooctane sulfonamido acetic acid was associated with 17% greater odds of prevalent microvascular disease (odds ratio [OR], 1.17; 95% CI, 1.05-1.31), and a similar association was observed for perfluorodimethylhexane sulfonic acid (OR, 1.18; 95% CI, 1.04-1.35), regardless of treatment.
“Our results suggest that exercise and diet may attenuate the diabetogenic association of PFAS,” the researchers concluded. The researchers noted that since 90% of the study participants were overweight or obese, the results may not be generalizable to other populations.