High cortisol levels associated with low quality food choice in Type II Diabetics

In type II diabetes (T2DM), the hypothalamic‐pituitary axis (HPA) and cortisol regulation may be impaired. Glucocorticoids increase consumption of “comfort foods” high in sugar and fat. We explored the relationship between cortisol levels and food quality choice in T2DM. A total of107 middle aged individuals, 49 controls, 31 insulin resistant, and 27 with T2DM, matched on age, gender and education were evaluated. Standard clinical blood tests and cortisol values were measured from fasting blood samples. Participants recorded all consumed food and drink items in a consecutive three‐day food diary. Fruits, vegetables, fish, whole grains, and nuts were classified as high quality foods. Meat, junk food, soda, fried foods, fast food, and simple carbohydrates were classified as low quality foods. Controlling for education and waist‐to‐height‐ratio (WTHR), log‐transformed cortisol (LogC) significantly predicted the percent of low quality foods chosen (R 2 =.132, β=.261, P<.01) and percent of high quality foods chosen (R 2 =.132, β=−.261, P<.01). LogC positively correlated to Hemoglobin A1C values (HbA1C), a measure of long term glucose control (Pearson's r=.531, P<.001). Cortisol levels increase with poorer glucose control. Higher cortisol values were associated with low quality food choice while lower cortisol values were associated with high quality food choice. Grant Funding Source : NIH grant DK064087 and NCRR grant 1UL1RR029893