Type 2 Diabetes: How This Single Factor Is Fueling the Crisis – Common in 70% New Cases
Tufts University researchers have established a connection between poor diet and 14 million cases of type 2 diabetes worldwide. According to their analysis, 7 out of 10 cases of type 2 diabetes in 2018 were linked to dietary choices.
Using a research model of dietary intake in 184 countries, the researchers found that poor diet contributed to over 14.1 million cases of type 2 diabetes in 2018, which represents over 70% of new diagnoses globally.
The study, which examined data from 1990 and 2018, offers valuable insights into the dietary factors driving the burden of type 2 diabetes by region. The study was published in the journal Nature Medicine today.
The analysis considered 11 dietary factors and found that three of them had a significant impact on the increase in global type 2 diabetes incidence. These factors were insufficient intake of whole grains, excesses of refined rice and wheat, and the overconsumption of processed meat.
On the other hand, factors such as drinking too much fruit juice and not consuming enough non-starchy vegetables, nuts, or seeds had a lower impact on the emergence of new cases of the disease.
The findings suggest “poor carbohydrate quality is a leading driver of diet-attributable type 2 diabetes globally, and with important variation by nation and over time,” remarks senior author Dariush Mozaffarian.
“These new findings reveal critical areas for national and global focus to improve nutrition and reduce devastating burdens of diabetes.”
The hallmark of type 2 diabetes is the body’s cells’ inability to respond to insulin. The study conducted by Nature Medicine analyzed 184 countries and found that all of them experienced an upsurge in type 2 diabetes cases from 1990 to 2018, posing an escalating burden on individuals, families, and healthcare systems worldwide.
To construct their model, the research team used data from the Global Dietary Database, population demographics from various sources, global type 2 diabetes incidence estimates, and information from numerous published papers on how food choices affect individuals living with obesity and type 2 diabetes.
The analysis showed that at the global level, a greater proportion of total type 2 diabetes incidence is attributed to a poor diet in men versus women, younger versus older adults, and urban versus rural residents.
The study found that in Central and Eastern Europe and Central Asia, particularly in Poland and Russia, where diets are high in red meat, processed meat, and potatoes, there was a greater number of type 2 diabetes cases linked to diet.
Latin America and the Caribbean, particularly Colombia and Mexico, had high incidence rates, which were attributed to the high consumption of sugary drinks, processed meat, and low intake of whole grains.
On the other hand, diet had less of an impact on type 2 diabetes cases in South Asia and Sub-Saharan Africa. Nevertheless, the study noted that the largest increases in type 2 diabetes cases due to poor diet between 1990 and 2018 were observed in Sub-Saharan Africa. Among the 30 most populous countries studied, India, Nigeria, and Ethiopia had the fewest cases of type 2 diabetes associated with unhealthy eating habits.
Meghan O’Hearn, the first author of the study, warns that if left unchecked, the incidence of type 2 diabetes is projected to continue to rise, adversely affecting population health, economic productivity, and healthcare system capacity while also exacerbating health inequalities worldwide.
O’Hearn conducted this research while pursuing her PhD at the Friedman School and now works as an Impact Director for Food Systems for the Future, a non-profit institute and for-profit fund that empowers innovative food and agriculture enterprises to achieve measurable improvements in nutrition outcomes for underserved and low-income communities.
She believes that the study’s findings can inform nutritional priorities for clinicians, policymakers, and private sector stakeholders who promote healthier dietary choices to tackle this global epidemic.
Recent studies have indicated that suboptimal diet is responsible for 40% of type 2 diabetes cases globally, which is lower than the 70% reported in the Nature Medicine paper.
The research team attributes this discrepancy to new information gleaned from their analysis, such as the inclusion of refined grains, which emerged as one of the leading contributors to diabetes burdens.
Additionally, they used updated data on dietary habits based on national individual-level dietary surveys, rather than agricultural estimates.
The investigators also acknowledge the uncertainty of their new estimates, which can be refined further as additional data becomes available.
Source: 10.1038/s41591-023-02278-8
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