Food variety, dietary diversity, and type 2 diabetes in a multi-center cross-sectional study among Ghanaian migrants in Europe and their compatriots in Ghana: the RODAM study
Danquah, Ina; Galbete, Cecilia; Meeks, Karlijn; Nicolaou, Mary; Klipstein-Grobusch, Kerstin; Addo, Juliet; Aikins, Ama de-Graft; Amoah, Stephen K; Agyei-Baffour, Peter; Boateng, Daniel; Bedu-Addo, George; Spranger, Joachim; Smeeth, Liam; Owusu-Dabo, Ellis; Agyemang, Charles; Mockenhaupt, Frank P; Beune, Erik; Schulze, Matthias B
(2018) European Journal of Nutrition, volume 57, issue 8, pp. 2723 - 2733
(Article)
Abstract
PURPOSE: The 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. METHODS: In the multi-center cross-sectional
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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. RESULTS: The 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. CONCLUSIONS: In 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.
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Keywords: Adult, Aged, Cross-Sectional Studies, Diabetes Mellitus, Type 2/ethnology, Diet, Emigrants and Immigrants, Europe/epidemiology, Female, Ghana/ethnology, Humans, Life Style, Male, Middle Aged, Nutrition Assessment, Socioeconomic Factors, Type 2 diabetes, Dietary patterns, Africa, Food variety, Dietary diversity, Nutrition and Dietetics, Medicine (miscellaneous), Multicenter Study, Journal Article
ISSN: 1436-6215
Publisher: D. Steinkopff-Verlag
Note: Funding Information: Acknowledgements The authors are very grateful to the advisory board members for their valuable support in shaping the methods, to the research assistants, interviewers, and other staff of the five research locations who have taken part in gathering the data and, most of all, to the Ghanaian volunteers participating in this project. We gratefully acknowledge Karien Stronks from the Academic Medical Centre for the attentive coordination of the RODAM study and Jan van Straalen from the Academic Medical Centre for his valuable support with analysis and standardization of the lab procedures. We thank the AMC Biobank for support in Biobank management and storage of collected samples. This work was supported by the European Commission under the Framework Programme (Grant number: 278901). CG was supported by NutriAct–Competence Cluster Nutrition Research Berlin-Potsdam funded by the German Federal Ministry of Education and Research (FKZ: 01EA1408A-G). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: The authors are very grateful to the advisory board members for their valuable support in shaping the methods, to the research assistants, interviewers, and other staff of the five research locations who have taken part in gathering the data and, most of all, to the Ghanaian volunteers participating in this project. We gratefully acknowledge Karien Stronks from the Academic Medical Centre for the attentive coordination of the RODAM study and Jan van Straalen from the Academic Medical Centre for his valuable support with analysis and standardization of the lab procedures. We thank the AMC Biobank for support in Biobank management and storage of collected samples. This work was supported by the European Commission under the Framework Programme (Grant number: 278901). CG was supported by NutriAct?Competence Cluster Nutrition Research Berlin-Potsdam funded by the German Federal Ministry of Education and Research (FKZ: 01EA1408A-G). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors declare that they have no conflicts of interest. Publisher Copyright: © 2017, The Author(s).
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