- A study finds that dietary issues are responsible for most of the world’s new cases of type 2 diabetes.
- Its authors found that a lack of whole grains and consuming too much refined grain and wheat and processed meats were the primary drivers of diet-related type 2 diabetes.
- The areas of the world in which diet was most responsible for the disease were central and eastern Europe and central Asia.
In 2018, 70.3% of the world’s 14.1 million new diagnoses of type 2 diabetes (T2D) were attributable to 11 dietary factors, according to a new study.
Three dietary factors, in particular, stood out as being the greatest drivers of new cases of type 2 diabetes globally: insufficient amounts of whole grains and over-consumption of refined grains and wheat and processed meats.
Of all the new cases caused by nutrition issues, a deficit in whole grains accounted for 26.1%, too many refined grains and wheat 24.6%, and processed meat intake 20.3%.
Overall, poor carbohydrate quality stands out as the leading factor in the development of type 2 diabetes.
The study’s findings differ from previous analyses in being the first to explicitly consider the consumption of refined grains and wheat among the dietary factors it considered.
Global data from 2017 found that roughly 462 million people worldwide had type 2 diabetes. It is estimated that by 2030, that number will rise to over 540 million people with the disease.
Type 2 diabetes is a disease in which the body becomes unable to regulate blood sugar levels due to an inability to use the insulin it produces. Without management, type 2 diabetes can lead to cardiovascular issues, nerve damage, kidney failure, and other undesirable outcomes.
In general, the study determined that diet was a more significant factor in type 2 diabetes in men.
Researchers at the Friedman School of Nutrition Science and Policy at Tufts University in Medford, MA, conducted the study. The findings appear in Nature Medicine.
Healthier foods for T2D vs. refined carbs
“The scientific evidence linking refined grains consumption to type 2 diabetes is clear,” said the study’s first author, Tufts’ Dr. Meghan O’Hearn, Ph.D.
“Refined grains, starches, and sugars induce rapid blood glucose spikes, conversion of sugar to fat in the liver accumulating around abdominal organs, and also can displace other healthier foods (like whole grains) in people’s diets, all leading to increased risk for type 2 diabetes,” explained Dr. O’Hearn.
University of Toronto’s Dr. Vasanti Malik, Sc.D., said, “Whole grains … tend to have a lower glycemic index — blood glucose raising potential — than refined grain because they are digested and absorbed more slowly due to fiber, which is beneficial for diabetes.”
Dr. Malik was not involved in the study.
T2D and diet: Regions of greatest impact
The study reported the two areas with the highest incidence of type 2 diabetes (T2D) from dietary causes were central and eastern Europe and central Asia, which accounted for 85.6% of those regions’ new T2D diagnoses. In Latin America and the Caribbean, slightly less, 81.8%, of new cases were attributable to diet.
South Asia had the lowest percentage of diet-attributable T2D, 55.4%.
Overall, T2D from dietary causes was most common in urban environments compared to rural ones. It was also more frequently a factor among highly educated people.
“For example, increases in type 2 diabetes due to excess unprocessed red meat consumption in East Asia from 1990 to 2018 mirror the tremendous population growth, increased urbanization, and demographic shifts in this region,” Dr. O’Hearn pointed out.
An exception to this, however, were high-income nations as well as nations in central and eastern Europe and central Asia, where T2D linked to diet was more frequent for rural individuals and people with less education.
Despite having the highest incidence of T2D from dietary causes, central and eastern Europe and central Asia actually had declining rates of T2D attributed to excess red meat consumption. Dr. O’Hearn added that declining rates of red meat-related T2D these areas may actually reflect a “growing awareness among consumers and businesses alike of the negative human health impacts and planetary health strains of red meat consumption.”
“Our findings in many respects mirror local socioeconomic contexts,” said Dr. O’Hearn.
“The food environment is a key factor as this can influence access and availability of food (i.e., easy access to low-cost, fast foods or low-quality processed foods in lower income areas),” Dr. Malik explained.
Importance of diet by age group
Among age groups, younger people had the highest percentage of T2D cases attributable to diet, though they had fewer T2D diagnoses overall.
The group with the largest raw number of such cases were middle-aged adults from 45 to 60 years of age, even with a percentage of T2D cases that was smaller.
“Our findings suggest that there are differences in dietary habits at different ages, and that older adults have other competing risk factors for type 2 diabetes besides dietary risk.
In contrast, the vast majority of type 2 diabetes cases are due to poor diet among young adults.”
– Dr. O’Hearn
Doing better in the future
“There is a need for widespread nutrition education and other policies that can help consumers make more healthful choices,” said Dr. Malik.
Some examples she listed include “front-of-package labeling, restricting unhealthy food/beverage marketing to children, sugary beverage taxation, and [creating] healthful food environments — i.e., school meal programs — [and] nutrition standards in institutions, etc.”
Addressing the access and financial obstacles to healthier nutrition, Dr. O’Hearn is now Impact Director for Food Systems of the Future, an organization which, in her words, “was founded to catalyze, enable, and scale market-driven agtech, foodtech, and innovative businesses across the value chain to improve nutrition outcomes in underserved and low-income communities.”
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