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Dietary carbohydrates, glycaemic load, food groups and newly detected type 2 diabetes among urban Asian Indian population in Chennai, India (Chennai Urban Rural Epidemiology Study 59)

  • Viswanathan Mohan (a1), Ganesan Radhika (a1), Rangaswamy Mohan Sathya (a1), Selvi Ramjothi Tamil (a1), Anbazhagan Ganesan (a1) and Vasudevan Sudha (a1)...
Abstract

The aim of the study was to examine the association of dietary carbohydrates and glycaemic load with the risk of type 2 diabetes among an urban adult Asian Indian population. Adult subjects aged >20 years (n 1843) were randomly selected from the Chennai Urban Rural Epidemiology Study, in Chennai city in southern India. Dietary carbohydrates, glycaemic load and food groups were assessed using FFQ. Oral glucose tolerance tests were performed using 75 g glucose in all subjects. Diagnosis of diabetes was based on WHO Consulting Group criteria. OR for newly detected diabetes were calculated for carbohydrates, glycaemic load and specific food groups comparing subjects in the highest with those in the lowest quartiles, after adjustment for potential confounders such as age, sex, BMI, family history of diabetes, physical activity, current smoking, alcohol consumption and relevant dietary factors. We identified 156 (8·5 %) newly diagnosed cases of type 2 diabetes. Refined grain intake was positively associated with the risk of type 2 diabetes (OR 5·31 (95 % CI 2·98, 9·45); P < 0·001). In the multivariate model, after adjustment for potential confounders, total carbohydrate (OR 4·98 (95 % CI 2·69, 9·19), P < 0·001), glycaemic load (OR 4·25 (95 % CI 2·33, 7·77); P < 0·001) and glycaemic index (OR 2·51 (95 % CI 1·42, 4·43); P = 0·006) were associated with type 2 diabetes. Dietary fibre intake was inversely associated with diabetes (OR 0·31 (95 % CI 0·15, 0·62); P < 0·001). In urban south Indians, total dietary carbohydrate and glycaemic load are associated with increased, and dietary fibre with decreased, risk of type 2 diabetes.

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*Corresponding author: Dr V. Mohan, fax +9144 2835 0935, email drmohans@vsnl.net
References
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1Sicree, R, Shaw, J & Zimmet, P (2006) Diabetes and impaired glucose tolerance. In Diabetes Atlas, 3rd ed., pp. 15103 [Gan, D, editor]. Kortrijik, Belgium: International Diabetes Federation.
2Mohan, V (2004) Why are Indians more prone to diabetes? J Assoc Physicians India 52, 468474.
3Mohan, V, Gokulakrishnan, K, Deepa, R, et al. (2005) Association of physical inactivity with components of metabolic syndrome and coronary artery disease – The Chennai Urban Population Study (CUPS no. 15). Diabet Med 22, 12061211.
4Food and Agriculture Organization (2006) The double burden of malnutrition in India. In The Double Burden of Malnutrition. Case Studies from Six Developing Countries. FAO Food and Nutrition paper no. 84, pp. 99160. Rome: FAO.
5Chattopadhyay, PK (2005) Postharvest technology for rice in India: a changing scenario. In Rice is Life: Scientific Perspectives for the 21st Century, Proceedings of the World Rice Research Conference, Tsukuba, Japan, 5–7 November 2004, pp. 294296 [Toriyama, K, Heong, KL and Hardy, B, editors]. Los Baños, Laguna, Philippines: International Rice Research Institute.
6Wolever, TMS & Mehling, C (2003) Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance. Am J Clin Nutr 77, 612621.
7Villegas, R, Liu, S, Gao, YT, et al. (2007) Prospective study of dietary carbohydrates, glycemic index, glycemic load, and incidence of type 2 diabetes mellitus in middle-aged Chinese women. Arch Intern Med 167, 23102316.
8Feskens, EJ, Bowles, CH & Kromhout, D (1991) Carbohydrate intake and body mass index in relation to the risk of glucose intolerance in an elderly population. Am J Clin Nutr 54, 136140.
9Salmeron, J, Manson, JE, Stampfer, MJ, et al. (1997) Dietary fibre, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 277, 472477.
10Colditz, GA, Mansao, JE, Stampfer, MJ, et al. (1992) Diet and risk of clinical diabetes in women. Am J Clin Nutr 55, 10181023.
11Hu, FB, Manson, JE, Stampfer, MJ, et al. (2001) Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Eng J Med 345, 790797.
12Salmeron, J, Ascherio, A, Rimm, EB, et al. (1997) Dietary fiber, glycemic load and risk of NIDDM in men. Diabetes Care 20, 545550.
13Schulze, MB, Liu, S, Rimm, EB, et al. (2004) Glycaemic index, glycemic load and dietary fibre intake and incidence of type 2 diabetes in younger and middle aged women. Am J Clin Nutr 80, 348356.
14Meyer, KA, Kushi, LH, Jacobs, DR Jr, et al. (2000) Carbohydrates, dietary fibre, and incident type 2 diabetes in older women. Am J Clin Nutr 71, 921930.
15Stevens, J, Ahn, K, Juhaeri, HD, et al. (2002) Dietary fibre intake and glycemic index and incidence of diabetes in African-American and white adults: the ARIC study. Diabetes Care 25, 17151721.
16Lundgren, H, Bengtsson, C, Blohme, G, et al. (1989) Dietary habits and incidence of non-insulin dependent diabetes mellitus in a population study of women in Gothenburg, Sweden. Am J Clin Nutr 49, 329335.
17Murakami, K, Sasaki, S, Takahashi, Y, et al. (2006) Dietary glycemic index and load in relation to metabolic risk factors in Japanese female farmers with traditional dietary habits. Am J Clin Nutr 83, 11611169.
18Mohan, V, Shanthirani, CS & Deepa, R (2003) Glucose intolerance (diabetes and IGT) in a selected South Indian population with special reference to family history, obesity and lifestyle factors: the Chennai Urban Population Study. J Assoc Physicians India 51, 771777.
19McKeigue, PM (1992) Coronary heart disease in Indians, Pakistanis and Bangladeshis: etiology and possibilities for prevention. Br Heart J 67, 341342.
20Reddy, KS & Yusuf, S (1998) Emerging epidemic of cardiovascular disease in developing countries. Circulation 97, 596601.
21Deepa, M, Pradeepa, R, Rema, M, et al. (2003) The Chennai Urban Rural Epidemiology Study (CURES) – study design and methodology (urban component) (CURES-I). J Assoc Physicians India 51, 863870.
22Michles, KB, Welch, AA, Luben, R, et al. (2005) Measurement of fruit and vegetable consumption with diet questionnaires and implications for analyses and interpretations. Am J Epidemiol 161, 987994.
23Alberti, KG & Zimmet, PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus, provisional report of a WHO consultation. Diabet Med 15, 539553.
24Sudha, V, Radhika, G, Sathya, RM, et al. (2006) Reproducibility and validity of an interviewer-administered semi-quantitative food frequency questionnaire to assess dietary intake of urban adults in Southern India. Int J Food Sci Nutr 57, 481493.
25Radhika, G, Ganesan, A, Sathya, RM, et al. (2009) Dietary carbohydrates, glycemic load and serum high-density lipoprotein cholesterol concentrations among South Indian adults. Eur J Clin Nutr 63, 413420.
26Willet, WC, Howe, GR & Kushi, LH (1997) Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr 65, 1220S1228S.
27Foster-Powell, K, Holt, SH & Brand-Miller, JC (2002) International table of glycemic index and glycemic load values. Am J Clin Nutr 76, 556.
28Food and Agriculture Organization & World Health Organization (1998) Carbohydrates in Human Nutrition. Joint FAO/WHO Expert Consultation, Rome, 14–18 April 1997. Food and Nutrition paper no. 66. Rome: FAO.
29Juliano, BO (1993) Rice in Human Nutrition. Rome: International Rice Research Institute and FAO.
30Radhika, G, Van Dam, RM, Sudha, V, et al. (2009) Refined grain consumption and metabolic syndrome among urban Asian Indians (Chennai Urban Rural Epidemiology Study 57). Metabolism 58, 675681.
31Burkitt, DP (1973) Some diseases characteristic of modern Western civilization. Br Med J 1, 274278.
32Liu, S, Manson, JE & Stampfer, MJ (2001) Dietary glycemic load assessed by food-frequency questionnaire in relation to plasma high-density-lipoprotein cholesterol and fasting plasma triacylglycerol in postmenopausal women. Am J Clin Nutr 73, 560566.
33World Health Organization (2003) Diet, Nutrition and the Prevention of Chronic Diseases. Joint WHO/FAO Expert Consultation. WHO Technical Report Series no. 916. Geneva: WHO.
34Van Dam, RM, Rimm, EB, Willett, WC, et al. (2002) Dietary patterns and risk of type 2 diabetes mellitus in US men. Ann Intern Med 136, 201209.
35Hodge, AM, English, DR, O'Dea, K, et al. (2004) Glycemic index and dietary fiber and the risk of type 2 diabetes. Diabetes Care 27, 27012706.
36Williams, DE, Wareham, NJ, Cox, BD, et al. (1999) Frequent salad vegetable consumption is associated with a reduction in the risk of diabetes mellitus. J Clin Epidemiol 52, 329335.
37Liu, S, Serdula, M, Janket, SJ, et al. (2004) A prospective study of fruit and vegetable intake and the risk of type 2 diabetes in women. Diabetes Care 27, 29932996.
38Van Dam, RM, Visscher, AW, Feskens, EJ, et al. (2000) Dietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study. Eur J Clin Nutr 54, 726731.
39Barclay, AW, Petocz, P, Joanna, MP, et al. (2008) Glycemic index, glycemic load and chronic disease risk – a meta-analysis of observational studies. Am J Clin Nutr 87, 627637.
40Radhika, G, Sudha, V, Sathya, RM, et al. (2008) Association of fruit and vegetable intake with cardiovascular risk factors in urban south Indians. Br J Nutr 99, 398405.
41Anastassios, GP, Joseph, L, Hu, FB, et al. (2007) The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 92, 20172029.
42iGovernment (2008) India to fast track war against diabetes, heart diseases. http://www.igovernment.in/site/pilot-project-to-fight-diabetes-cardio-vascular-diseases-launched/ (accessed September 2008).
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
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