Global study reveals role of diet in 70% of new type 2 diabetes patients

A recent study published in the journal natural medicineresearchers used a new risk assessment model to estimate the absolute and proportional burden of new type 2 diabetes (T2D) cases in adults in 184 countries.

study: Type 2 diabetes caused by suboptimal diets in 184 countriesImage Credit: Lightspring/Shutterstock

Background

T2D is a leading cause of death worldwide and has a significant socio-economic impact. Population from 1980 to 2021 living with diabetes (90% of T2D cases) have surged from 108 million to 537 million worldwide, with a corresponding increase in adult obesity.

The incidence of T2D has only increased globally in the last 40 years and continues to rise. Left unchecked, T2D will further degrade human health and economic productivity and put enormous pressure on healthcare systems around the world.

Studies have demonstrated direct and weight gain-mediated effects of several dietary factors on the pathogenesis of T2D. However, the absolute and proportional contributions of suboptimal diets or specific dietary factors to her T2D incidence worldwide remain unclear.

About research

In this study, researchers estimated the effects of 11 dietary factors. That is, inadequate intake of whole grains, fruits, nuts, yogurt, seeds and vegetables (non-starchy), excessive intake of refined wheat and rice, and unprocessed red meat. , his T2D incidence globally on processed meats, sweetened beverages (SSBs), fruit juices and potatoes.

They generated these estimates using dietary data from the Global Diet Database (GDD) of adults in 184 countries. The team analyzed the absolute change in his 1990-2018 proportionate burden of T2D attributable to suboptimal diets stratified by world region and each risk factor from 1990-2018. presented.

GDD classified all 184 countries into world regions. This is because the researchers found that his 30 most populous helped specifically discuss the T2D trend of Effects mediated by weight gain.

They stratified the findings by age, gender, urbanity, and education of the participants. In addition, they stratified the findings for each country by the sociodemographic index (SDI), a measure of national development. The SDI is expressed on a scale of 0 to 1 based on average rankings for educational attainment, per capita income and fertility rate.

Assuming that the 50% benefit of whole grain intake is due to substitution with refined wheat and rice intakes, the researchers used a proportional I used multiplication. They modeled the effects of milled rice and wheat intake separately, but combined this using proportional multiplication.

The team compared trends in T2D incidence from 1990 to 2018, and based all data on median and corresponding 95% UI quantifications using 1,000 multi-way stochastic Monte Carlo simulations. reported as

result

The research model estimates that suboptimal intake of 11 dietary factors led to 14.1 million new T2D cases worldwide in 2018. Excessive intake of harmful dietary factors has a higher proportion of this burden than inadequate intake of protective dietary factors (60.8% vs. 39.2%). Inadequate whole grain intake leads to most T2D cases worldwide (26.1%), followed by refined wheat and rice (24.6%), processed meat (20.3%), and unprocessed red meat (20.1%). ) followed by overdose.

The researchers noted marked heterogeneity in T2D incidence due to overall suboptimal diet and individual dietary factors at the national level and worldwide. Furthermore, they observed an inverse correlation between his incidence of T2D attributed to diet and age. However, the absolute T2D burden assessed per million population was highest in middle age, i.e. he was 45–60 years old, suggesting the interaction between differences in dietary habits and absolute T2D risk at different ages. is showing.

Moreover, some of the dietary factors showed considerable regional heterogeneity. Regionally, the greatest increases and decreases in diet-related T2D incidence were in sub-Saharan Africa (+9.3 absolute percentage) and high-income countries (-1.5%), respectively.

For example, consumption of refined wheat and rice increased the incidence of T2D in the Middle East, North Africa (+4.1%) and sub-Saharan Africa (+3.3%), whereas in South and Central Asia Reduced cases of T2D caused by excess refined rice. -Increased in Eastern European and Central Asian regions, but increased due to overconsumption of refined wheat in the same regions.

The incidence of diet-related type 2 diabetes was higher in men and women, in highly educated and less educated individuals, and in urban and rural areas. However, in high-income countries, Central Asia, Central and Eastern Europe, his diet-induced incidence of T2D was higher in uneducated people. In populous countries such as Poland and Russia, excessive consumption of unprocessed red and processed meats and potatoes primarily contributes to her relatively high T2D load. Since the 1990s, the correlation between his T2D incidence attributed to national diet and socioeconomic development has become less strong. Latin America and the Caribbean had the second highest dietary-induced T2D burden, particularly in Colombia and Mexico, where excessive SSB, processed meat intake, and insufficient whole grain intake contributed to his T2D incidence. caused an increase in

In areas with a high T2D burden attributed to the diet of tertiary-educated people, such as high-income countries, educational and social safety intervention programs target nutritious diets to reduce T2D-related health inequities. should be Conversely, in regions where her diet-induced T2D burden is highest among highly educated adults, such as South Asia, other approaches such as proper package labeling may be more effective. By investing in manufacturing, marketing and selling products that align with societal goals, financial markets have the potential to make significant contributions to human health and equity in the world.

Data show that body mass index (BMI) is increasing rapidly in rural areas of low- and middle-income countries due to the increased supply of processed foods in these areas. Therefore, interventions and public health policies tailored to local contexts will be required to manage these nutrition- and health-related inequities. Notably, his incidence of T2D attributed to direct etiological effects of dietary factors was generally higher than their individual BMI-mediated effects. In light of these findings, multisectoral strategies to improve dietary quality throughout life remain important, especially during childhood and adolescence, when people often form lifelong dietary habits.

In 2018, there was a modest correlation between diet-induced T2D burden and SDI (r = 0.29) that varied across world regions. The authors found positive correlations in sub-Saharan Africa, South Asia, and high-income countries, and negative correlations in Latin America, Central Asia, Central and Eastern Europe, the Caribbean, Southeast and East Asia. I pointed out that they are related. However, this correlation he found to be stronger in 1990 (r = 0.53) than in 2018, making these trends comparable across all regions of the world. These findings point to poorer diet quality in countries with lower SDIs. However, there was no sociodemographic development.

Conclusion

The study highlighted carbohydrate quality as an area that urgently needs attention. In particular, excessively refined rice and wheat intake and inadequate consumption of whole grains are the top two dietary factors for type 2 diabetes globally, with trends varying over time and by region of the world. In the proportion of his T2D burden related to diet, excessive intake of unprocessed red meat was the most contributor to the global increase in his T2D incidence among all 11 dietary factors evaluated. . In conclusion, these findings should inform clinical and public health planning to improve diet quality globally to reduce the global burden of type 2 diabetes.