Abstract
BackgroundIn Lebanon, Type 2 diabetes (T2D) has a major public health impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities. Diet is an important environmental factor in the development and prevention of T2D. Dietary patterns may exert greater effects on health than individual foods, nutrients, or food groups. The objective of this study is to examine the association between dietary patterns and the odds of T2D among Lebanese adults.MethodsFifty-eight recently diagnosed cases of T2D and 116 population-based age, sex, and place of residence matched control participants were interviewed. Data collection included a standard socio-demographic and lifestyle questionnaire. Dietary intake was evaluated by a semi-quantitative 97-item food frequency questionnaire. Anthropometric measurements including weight, height, waist circumference, and percent body fat were also obtained. Dietary patterns were identified by factor analysis. Multivariate logistic regression analysis was used to evaluate the associations of extracted patterns with T2D. Pearson correlations between these patterns and obesity markers, energy, and nutrient intakes were also examined.ResultsFour dietary patterns were identified: Refined Grains & Desserts, Traditional Lebanese, Fast Food and Meat & Alcohol. While scores of the “Refined Grains & Desserts” had the highest correlations with energy (r = 0.74) and carbohydrates (r = 0.22), those of the “Fast Food” had the highest correlation with fat intake (r = 0.34). After adjustment for socio-demographic and lifestyle characteristics, scores of the Refined Grains & Desserts and Fast Food patterns were associated with higher odds of T2D (OR: 3.85, CI: 1.13-11.23 and OR: 2.80, CI: 1.14-5.59; respectively) and scores of the Traditional Lebanese pattern were inversely associated with the odds of T2D (OR: 0.46, CI: 0.22-0.97).ConclusionsThe findings of this study demonstrate direct associations of the Refined Grains & Desserts and Fast Food patterns with T2D and an inverse association between the Traditional Lebanese pattern and the disease among Lebanese adults. These results may guide the development of nutrition interventions for the prevention and management of T2D among Lebanese adults.
Highlights
Type 2 Diabetes (T2D) has reached epidemic proportions in both developed and developing countries and is recognized as a major global health problem [1,2,3,4]
Similar to other counties of the Middle East North Africa Region (MENA) region, is witnessing a polarization in disease patterns with under nutrition and its related diseases coexisting with chronic diseases such as Type 2 diabetes (T2D) and cardiovascular diseases typically associated with developed countries [5]
Even though the prevalence of T2D among adults in Lebanon (15.8%) [6] appears to be lower than that reported from most other countries in the MENA region including Bahrain (25.5%), United Arab Emirates (23.3%) and Saudi Arabia (23.7%) [5], available data in the country suggested that prevalence rates of the disease are following an alarming trend over time, increasing from 11.6% in 1999 to 15.8% in 2004 [6,7]
Summary
Type 2 Diabetes (T2D) has reached epidemic proportions in both developed and developing countries and is recognized as a major global health problem [1,2,3,4]. According to the International Diabetes Federation, the projected prevalence of T2D among adults in Lebanon for year 2020 is 20.4% [8] This is corroborated by a recent report suggesting that, worldwide, the greatest relative increase in the number of people with diabetes is expected to occur in countries of the Middle Eastern crescent [9]. This escalating trend in disease prevalence coupled to significant downstream pathophysiologic effects and enormous financial liabilities poses a major public health problem that necessitates the search for mitigating factors and strategies to address them. The objective of this study is to examine the association between dietary patterns and the odds of T2D among Lebanese adults
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