Abstract
Background/objectivesWe aimed to study the associations of dietary patterns (DPs) with type 2 diabetes (T2D) among Ghanaian adults.Subjects/methodsIn the multi-centre, cross-sectional RODAM (Research on Obesity and Diabetes among African Migrants) study (n = 4543), three overall DPs (“mixed”, “rice, pasta, meat and fish,” and “roots, tubers and plantain”) and two site-specific DPs per study site (rural Ghana, urban Ghana and Europe) were identified by principal component analysis. The DPs–T2D associations were calculated by logistic regression models.ResultsHigher adherence to the “rice, pasta, meat and fish” DP (characterized by legumes, rice/pasta, meat, fish, cakes/sweets, condiments) was associated with decreased odds of T2D, adjusted for socio-demographic factors, total energy intake and adiposity measures (odds ratio (OR)per 1 SD = 0.80; 95% confidence interval (CI) = 0.70–0.92). Similar DPs and T2D associations were discernible in urban Ghana and Europe. In the total study population, neither the “mixed” DP (whole grain cereals, sweet spreads, dairy products, potatoes, vegetables, poultry, coffee/tea, sodas/juices, olive oil) nor the “roots, tubers and plantain” DP (refined cereals, fruits, nuts/seeds, roots/tubers/plantain, fermented maize products, legumes, palm oil, condiments) was associated with T2D. Yet, after the exclusion of individuals with self-reported T2D, the “roots, tubers and plantain” DP was inversely associated with T2D (ORper 1 SD = 0.88; 95% CI = 0.69–1.12).ConclusionIn this Ghanaian population, DPs characterized by the intake of legumes, fish, meat and confectionery were inversely associated with T2D. The effect of a traditional-oriented diet (typical staples, vegetables and legumes) remains unclear.
Highlights
The International Diabetes Federation (IDF) estimated in the 7th Atlas edition (2015) that about 75% of the adults with diabetes mellitus are living in low-income and middle-income countries[1]
In this Ghanaian population, dietary patterns (DPs) characterized by the intake of legumes, fish, meat and confectionery were inversely associated with type 2 diabetes mellitus (T2D)
While women presented with higher Body mass index (BMI) and waist circumference than men, the prevalence of T2D was lower among women (8.4 vs. 11.1%)
Summary
The International Diabetes Federation (IDF) estimated in the 7th Atlas edition (2015) that about 75% of the adults with diabetes mellitus are living in low-income and middle-income countries[1]. Regarding the situation in the IDF-African region, there were more than 14 million people with diabetes mellitus in 2015, and this number will be more than doubled by 2040. Diet constitutes one of the major modifiable factors of T2D6, 7 In this regard, both, urbanization in sub-Saharan Africa and international migration, can lead to changes in the dietary habits, from a more traditional diet to a more westernized one. We deeply described food consumption and explored DPs in Ghanaian migrants in Europe and their compatriots in Ghana within the context of the large RODAM (Research on Obesity and Diabetes among African Migrants) study[12]. Due to the high site-specificity of the previously described DPs as well as the observed differences in T2D prevalence across rural Ghana, urban Ghana and Europe[2], we aimed at constructing DPs in the three different locations and at examining their relationships with T2D
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