Shirin Kasturia1, Mohammed K Ali2, K M Venkat Narayan2, Nikhil Tandon3, Roopa Shivashankar4, Vandana Garg4, Deksha Kapoor4, Anitha Mohanasundaram5, Deepa Mohan5, Muhammad M Kadir6, Dorairaj Prabhakaran4, Viswanathan Mohan5, Lindsay M Jaacks7. 1. School of Medicine and Rollins School of Public Health, Emory University, Atlanta, GA, USA. 2. Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 3. Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, NCR, India. 4. Centre for Chronic Disease Control, Public Health Foundation of India, Gurgaon, Haryana, India. 5. Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India. 6. Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan. 7. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA. jaacks@hsph.harvard.edu.
Abstract
BACKGROUND AND OBJECTIVES: To determine how frequently diabetic diets are recommended to individuals with diabetes in South Asia, whether they are followed, and if they are associated with healthier dietary choices and clinical benefits. METHODS AND STUDY DESIGN: Data are from the Centre for cArdiometabolic Risk Reduction in South-Asia Cohort Study. Participants with self-reported physician-diagnosed diabetes (n=1849) were divided into four groups based on whether they reported being prescribed and/or were following a diabetic diet. Linear regression was used to estimate associations between these groups and outcomes. RESULTS: 53% of participants with self-reported diabetes reported not being prescribed or following a diabetic diet. Among those prescribed and following a diet, mean whole grain consumption was 1.18 times/day and refined grain consumption was 0.75 times/day compared to 0.88 times/day and 1.74 times/day, respectively, among those neither prescribed nor following a diet (both p<0.0001). Following a diet despite not being prescribed a diet was not associated with glycemic control, blood pressure, or body mass index, but was associated with a -8.54 mg/dL (95% confidence interval: -15.5, -1.58) lower low-density lipoprotein cholesterol compared to not following and not being prescribed a diet after adjustment for confounders. CONCLUSION: Though participants who were prescribed diabetic diets and followed them exhibited healthier dietary choices, the majority of participants with diabetes in urban South Asia was neither prescribed nor followed such diets. Moreover, there was no statistically significant clinical benefit, thus indicating that current dietary modifications may not be large enough or consistent enough to produce meaningful changes in health outcomes in this population.
BACKGROUND AND OBJECTIVES: To determine how frequently diabetic diets are recommended to individuals with diabetes in South Asia, whether they are followed, and if they are associated with healthier dietary choices and clinical benefits. METHODS AND STUDY DESIGN: Data are from the Centre for cArdiometabolic Risk Reduction in South-Asia Cohort Study. Participants with self-reported physician-diagnosed diabetes (n=1849) were divided into four groups based on whether they reported being prescribed and/or were following a diabetic diet. Linear regression was used to estimate associations between these groups and outcomes. RESULTS: 53% of participants with self-reported diabetes reported not being prescribed or following a diabetic diet. Among those prescribed and following a diet, mean whole grain consumption was 1.18 times/day and refined grain consumption was 0.75 times/day compared to 0.88 times/day and 1.74 times/day, respectively, among those neither prescribed nor following a diet (both p<0.0001). Following a diet despite not being prescribed a diet was not associated with glycemic control, blood pressure, or body mass index, but was associated with a -8.54 mg/dL (95% confidence interval: -15.5, -1.58) lower low-density lipoprotein cholesterol compared to not following and not being prescribed a diet after adjustment for confounders. CONCLUSION: Though participants who were prescribed diabetic diets and followed them exhibited healthier dietary choices, the majority of participants with diabetes in urban South Asia was neither prescribed nor followed such diets. Moreover, there was no statistically significant clinical benefit, thus indicating that current dietary modifications may not be large enough or consistent enough to produce meaningful changes in health outcomes in this population.