Abstract
BackgroundDiet quality has been linked to obesity, but this relationship remains unclear in individuals with type 2 diabetes (T2D). The aim of this study is to examine the association between diet quality and obesity in Chinese adults with T2D.MethodsBetween April and November 2016, a total of 211 Chinese T2D adults who underwent assessment of diabetes-related treatment goals and metabolic control were recruited into two groups based on their body mass index (BMI): obese group (BMI ≥30 kg/m2) and non-obese group (BMI = 18.5–24.9 kg/m2). Diet quality indices including Alternate Healthy Eating Index-2010 (AHEI-2010), Diet Quality Index-International (DQI-I), and Dietary Approach to Stop Hypertension (DASH) score, were derived from a validated food frequency questionnaire.ResultsObese T2D patients had significantly lower AHEI-2010 (P < 0.001), DQI-I (P < 0.001), and DASH total scores (P = 0.044) than their non-obese counterparts, independent of age and sex. They also had higher total energy (P < 0.001), protein percentage of energy (P = 0.023), and meat, poultry and organ meat (P < 0.001), but lower vegetable (P = 0.014) intakes. Our multivariate logistic regression analyses demonstrated that the AHEI-2010, but not DQI-I and DASH, total score had an inverse association with obesity, independent of sociodemographics, anti-diabetic medication use, physical activity level and total energy intake (odds ratio [OR] per standard deviation (1-SD) increase: 0.95, 95% confidence interval [CI]: 0.91–0.99, P = 0.020). This association remained significant after further adjustment for glycemic control. Inverse associations were also found between obesity and multivariate-adjusted component scores, including AHEI-2010 red/processed meat (OR per 1-SD: 0.71, 95% CI: 0.51–0.99, P = 0.044), DQI-I variety (OR per 1-SD: 0.63, 95% CI: 0.46–0.86, P = 0.004), and DASH red/processed meat (OR per 1-SD: 0.57, 95% CI: 0.38–0.84, P = 0.005).ConclusionsBetter diet quality, as characterized by higher AHEI-2010 scores, was associated with lower odds of obesity in Chinese adults with T2D. Dietary patterns reflecting high consumption of plant-based foods and low consumption of animal-based, high-fat, and processed foods may be imperative to optimize nutritional guidance for obesity management in this population.
Highlights
Diet quality has been linked to obesity, but this relationship remains unclear in individuals with type 2 diabetes (T2D)
The aim of this study was to investigate the association between diet quality, as assessed by AHEI-2010, Dietary Approach to Stop Hypertension (DASH) score and Diet Quality Index-International (DQI-I), and obesity in Chinese T2D patients
This study enrolled a total of 211 Hong Kong Chinese adults with T2D (115 men and 96 women), of whom (49.8%) and (50.2%) were in the non-obese and obese groups, respectively
Summary
Diet quality has been linked to obesity, but this relationship remains unclear in individuals with type 2 diabetes (T2D). Type 2 diabetes (T2D) is an alarming epidemic globally and of particular concern in Asia [1]. This epidemic is rapidly increasing in prevalence and presents unique clinical features among Asians, such as onset at a younger age and a lower body mass index (BMI), and more severe diabetic complications in younger patients and those exposed to famine prenatally or during early childhood [2, 3]. China has the largest number of individuals affected by diabetes in any country, posing many challenges and a tremendous burden on its healthcare system due to diabetes-related complications and mortality [8]. The Hong Kong Diabetes Registry, an ongoing prospective cohort established in 1995, showed that obese T2D patients had worse metabolic control than T2D patients of normal weight but were challenging to treat and had an extremely high risk of future diabetes-related cardiovascular-renal complications [10, 11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
