Abstract

PurposeThe importance of dietary diversification for type 2 diabetes (T2D) risk remains controversial. We investigated associations of between- and within-food group variety with T2D, and the role of dietary diversification for the relationships between previously identified dietary patterns (DPs) and T2D among Ghanaian adults.MethodsIn the multi-center cross-sectional Research on Obesity and Diabetes among African Migrants (RODAM) Study (n = 3810; Ghanaian residence, 56%; mean age, 46.2 years; women, 63%), we constructed the Food Variety Score (FVS; 0–20 points), the Dietary Diversity Score (DDS; 0–7 points), and the Diet Quality Index-International (DQI-I) variety component (0–20 points). The associations of these scores, of a “rice, pasta, meat and fish” DP, of a “mixed” DP, and of a “roots, tubers and plantain” DP with T2D were calculated by logistic regression.ResultsThe FVS was inversely associated with T2D, adjusted for socio-demographic, lifestyle, and anthropometric factors [odds ratio (OR) for T2D per 1 standard deviation (SD) increase: 0.81; 95% confidence interval (CI) 0.71–0.93]. The DDS and the DQI-I variety component were not associated with T2D. There was no association of the “mixed” DP and the “roots, tubers and plantain” DP with T2D. Yet, the “rice, pasta, meat and fish” DP is inversely associated with T2D (OR for T2D per 1 SD increase: 0.82; 95% CI 0.71–0.95); this effect was slightly attenuated by the FVS.ConclusionsIn this Ghanaian population, between-food group variety may exert beneficial effects on glucose metabolism and partially explains the inverse association of the “rice, pasta, meat and fish” DP with T2D.

Highlights

  • Type 2 diabetes (T2D) constitutes a major public health challenge among sub-Saharan African populations, both in the countries of origin and for African minority populations in Europe

  • Partial Spearman correlations were calculated for the constructed scores (FVS, Dietary Diversity Score (DDS), and Diet Quality Index-International (DQI-I)) and the previously identified patterns, adjusted for age, sex (m/f), study site (5 sites), education (4 categories), energy intake, smoking status, physical activity (MET-h/week), Body mass index (BMI), and waist circumference

  • 95% confidence intervals (CIs), and p values for T2D were calculated per 1 score point and per 1 standard deviation (SD) of the constructed variety scores using logistic regression

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Summary

Introduction

Type 2 diabetes (T2D) constitutes a major public health challenge among sub-Saharan African populations, both in the countries of origin and for African minority populations in Europe. Among ethnic minority populations in high-income countries (HICs), data regarding dietary diversification and the risk of T2D remain scarce and so far inconclusive [12,13,14]. Tunisian migrants in France showed better between- and within-food group varieties than French natives, which partly explained the lower prevalence of T2D in this African migrant population [13]. This was not seen among African Americans in the large Coronary Artery Risk Development in Young Adults (CARDIA) study [14]

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