Poor carbohydrate quality drives diet-related type 2 diabetes worldwide

Poor carbohydrate quality drives diet-related type 2 diabetes worldwide

A research model of dietary intake in 184 countries, developed by researchers at Tufts University’s Friedman School of Nutrition Science and Policy, estimates that poor diets have contributed to more than 14.1 million cases of type 2 diabetes in 2018, accounting for over 70% of new diagnoses. globally. The analysis, which looked at data from 1990 and 2018, provides valuable insight into the dietary factors that determine the burden of type 2 diabetes by region of the world. The study was published April 17 in the journal Nature Medicine.

Of the 11 dietary factors considered, three had an outsized contribution to the rise in the global incidence of type 2 diabetes: insufficient intake of whole grains, excess refined rice and wheat, and overconsumption of processed meat. Factors such as drinking too much fruit juice and not eating enough non-starchy vegetables, nuts or seeds had less of an impact on new cases of the disease.

Our study suggests that poor carbohydrate quality is a major driver of diet-related type 2 diabetes worldwide, and with significant variation across countries and over time. These new findings point to critical areas for the national and global focus to improve nutrition and reduce devastating burdens of diabetes.

Dariush Mozaffarian, lead author, Jean Mayer Professor of Nutrition and Dean of Policy at the Friedman School

Type 2 diabetes is characterized by the resistance of cells in the body to insulin. Of the 184 countries included in the natural medicine study, all saw an increase in type 2 diabetes cases between 1990 and 2018, which poses a growing burden on individuals, families and healthcare systems.

The research team based their model on information from the World Food Database, as well as population demographics from several sources, global estimates of the incidence of type 2 diabetes, and data on the impact of food choices on people with obesity and type 2 diabetes from several published articles.

The analysis revealed that poor diet is responsible for a greater proportion of the total incidence of type 2 diabetes in men compared to women, in young adults compared to older adults and among urban versus rural residents globally.

Regionally, Central and Eastern Europe and Central Asia – particularly in Poland and Russia, where diets tend to be high in red meat, processed meat and potatoes – recorded the highest number diet-related type 2 diabetes. The incidence was also high in Latin America and the Caribbean, particularly in Colombia and Mexico, which was attributed to high consumption of sugary drinks, processed meat and low consumption of whole grains.

Regions where diet had less of an impact on type 2 diabetes cases included South Asia and sub-Saharan Africa – although the largest increases in type 2 diabetes due to poor diet between 1990 and 2018 have been observed in sub-Saharan Africa. Of the 30 most populous countries studied, India, Nigeria and Ethiopia had the fewest cases of type 2 diabetes linked to poor diet.

Left unchecked and with an incidence that is only expected to increase, type 2 diabetes will continue to impact population health, economic productivity, health system capacity and lead to health inequities. health around the world.”

Meghan O’Hearn, first author

She conducted this research while a doctoral candidate at the Friedman School and currently works as the Director of Impact for Food Systems for the Future, a nonprofit institute and for-profit fund that empowers agribusinesses -Innovative diets measurably improve the nutritional outcomes of underserved populations and low-income communities. “These results can help inform the nutrition priorities of clinicians, policy makers and private sector actors as they encourage healthier dietary choices that respond to this global epidemic.”

Other recent studies have estimated that 40% of type 2 diabetes cases worldwide are attributed to a suboptimal diet, which is lower than the 70% reported in the natural medicine paper. The research team attributes this to new information in their analysis, such as the first-ever inclusion of refined grains, which was a major contributor to diabetes burden; and up-to-date data on dietary habits based on national dietary surveys at the individual level, rather than agricultural estimates. The investigators also note that they presented the uncertainty of these new estimates, which may continue to be refined as new data emerges.

The research reported in this article was supported by the Bill and Melinda Gates Foundation. Full information on authors, funders, methodology, and conflicts of interest is available in the published article. The content is the sole responsibility of the authors and does not necessarily represent the official views of the funders.


Journal reference:

O’Hearn, M. et al. (2023). Incident type 2 diabetes attributable to suboptimal diet in 184 countries. natural medicine. doi.org/10.1038/s41591-023-02278-8.

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