The Most Frequently Consumed and the Largest Energy Contributing Foods of U.S. Insulin Takers Using NHANES 2009–2016

Abstract

Abstract Objectives Insulin takers’ diets have rarely been described although insulin dosing is highly dependent on dietary intake. The objective was to determine the most frequently consumed food or beverage items, food subcategories, and food categories, and items that contributing most to total energy intake among U.S. adult insulin takers compared with those with type 2 diabetes without taking insulin (T2D w/o insulin) and those without diabetes. Methods Fasting plasma glucose and hemoglobin A1c concentration from the laboratory tests and diabetic and insulin taking status from questionnaires in the National Health and Nutrition Examination Survey 2009–2016 classified 907 insulin takers, 2 758 T2D w/o insulin, and 34 360 participants without diabetes. U.S. Department of Agriculture Food codes of each item reported in the first reliable 24-hour dietary recall, were categorized by food subcategory and category based on What We Eat in America categories. Raw and weighted frequency and energy contributions of each food item, food subcategory, and food category were calculated and ranked. Results Diet soft drinks ranked 4th and 7th most consumed food subcategory in insulin takers and T2D w/o insulin, respectively. Soft drinks ranked 8th and 6th most consumed food subcategory in T2D w/o insulin and those without diabetes, and contributed 5th and 2nd most to energy, respectively (2.75% and 3.85% of total energy intake, respectively). Eggs and cold cuts were uniquely reported in insulin takers’ top 10 most consumed food subcategory list. Protein foods represented 4 rankings in insulin takers’ top 10 highest energy contributing food subcategory list including chicken, egg, meat dishes, and cold cuts (10.42% of total energy intake), 3 rankings in T2D w/o insulin list including chicken, egg, and meat dishes (7.22% of total energy intake), and only chicken for those without diabetes (2.70% of total energy intake). Conclusions Differences in dietary intake may exist among U.S. adults by diabetic status. Insulin takers are likely to consume more protein foods and less soft drinks compared to those with T2D w/o insulin and those without diabetes. Lists of the most frequently consumed foods and foods contributing most to energy may be helpful for nutrition education, prescribing diets, and technology-based dietary assessment for insulin takers. Funding Sources Eli Lilly and Company.