Americans with Diabetes are Adhering to a Low Glycemic Diet but are Eating a High Fat Southern Diet which is Associated with Cardiovascular Disease

Abstract

Traditional diabetes nutrition education has emphasized consuming a high fiber, low glycemic diet. Healthy diet adherence has previously been analyzed by examining individual foods and nutrients; however, focusing on overall dietary patterns may be more practical for disease monitoring. Through factor analysis on 56 food groups (obtained from the Block98 Food Frequency Questionnaire), using a nationally representative sample of 21,636 black and white participants in the REGARDS study (age >; 45), five dietary patterns emerged. Logistic regression was used to calculate odds ratios (OR) for adherence to each dietary pattern. People with diabetes were more likely (OR=1.18, p<0.001) to adhere to a plant based dietary pattern, less likely to adhere to a high sweets pattern (OR=0.77, p<0.001) and more likely to adhere to a Southern style pattern (OR=1.27, p<0.001) after adjustment for age, race, sex, education and income. Our results suggest that even if people with diabetes are adhering to low glycemic recommendations, they are still consuming fried foods and added fats typical of a Southern dietary pattern. Given our previous work showing a twofold increased risk of cardiovascular disease (CVD) with a Southern diet – and since diabetes is a risk equivalent for CVD ‐‐ future education may need to stress a reduction in Southern dietary patterns to improve cardiovascular health.Grant Funding Source: NIH‐NINDS and a grant from General Mills