Dietary intake of adults with and without diabetes: results from NHANES 2013–2016

Abstract

IntroductionDiet is a critical aspect of the management of adults with diabetes. This paper aims to compare dietary intakes of key macronutrients and micronutrients of US adults with and without diabetes and across the spectrum of diabetes.Research design and methodsWe compared absolute and energy-adjusted dietary intake of major macronutrients and micronutrients among those with and without diabetes and across the spectrum of glycemic control using a 24-hour dietary recall from a cross-sectional, nationally representative sample of 9939 US adults, 20+ years old (National Health and Nutrition Examination Survey 2013–2016). Diabetes was defined as an glycohemoglobin A1c (HbA1c)≥6.5%, fasting glucose ≥126 mg/dL, serum glucose at 2 hours following a 75 g glucose load (oral glucose tolerance test) ≥200 mg/dL, any diagnosis of diabetes or use of diabetes medication (self-reported).ResultsPercent of calories from macronutrients was similar for those with and without diabetes (p>0.05, energy adjusted and adjusted for age, race, and sex). In both groups, sugar accounted for about 20% of calories. Those with diabetes consumed about 7% more calcium (p=0.033), about 5% more sodium (p=0.026), and had lower diet quality (Healthy Eating Index-2015, p=0.021) than those without diabetes. Among those with diabetes, those with an HbA1c>9.0% consumed about 4% less magnesium (p-analysis of variance=0.007) than those with an HbA1c<6.5%. Results were similar within strata of age, race, and sex. Macronutrient intake did not vary consistently by HbA1c level.ConclusionsIn this nationally representative sample, there were no substantial or consistent differences in the dietary intake of macronutrients or micronutrients between US adults with and without diabetes. Improving the diets of those with diabetes will likely require enhanced targeted efforts to improve the dietary intake of persons with diabetes, as well as broad efforts to improve the dietary intake of the general population.

Associations of Adherence to the DASH Diet and the Mediterranean Diet With All-Cause Mortality in Subjects With Various Glucose Regulation States

“…A higher risk of all-cause mortality associated with low sodium excretion (approximately <4.0 g/day) has been reported ( 36 , 37 ). The mean sodium intake in the NHANES participants was around 3,500 mg/2,000 kcal ( 38 ). As sodium is an essential nutrient required for normal physiology, whether a low sodium intake (<2,400 mg/2,100 kcal diet) is appropriate for CV health warrants further investigation ( 39 ).…”

Differences in Dietary Intake Exist Among U.S. Adults by Diabetic Status Using NHANES 2009-2016

“…Previously, few studies have investigated the diet of insulin takers (8–10) nor included consideration of intake contributions by both energy and frequency. To our knowledge, this is the first study to investigate and compare the diets of insulin takers, those who have T2D but do not use insulin, and participants without diabetes.…”

“…Diabetes is a chronic disease that is highly related to diet (55). The lists of foods generated in this study may be used to fill the gap in knowledge of the diets of U.S. adult insulin takers or diabetic patients (8,9), specifically, menus and dietary interventions developed to improve diabetes management may be informed by the lists. Although frequently consumed foods and those contributing most to energy may not satisfy the preferences of every person, they are generally accepted as indicated by their selection in the population.…”

“…Furthermore, it is likely that diabetes status may differentiate food and beverage choice and intake among those using insulin, T2D not using insulin, and those without diabetes as one strategy for glucose control is through the avoidance of certain foods and monitored intake of carbohydrates, for example sugar-sweetened soft drinks (7). However, very little information on the food intake of those taking insulin or those with T2D not taking insulin is available (8–10).…”

Low lean mass is associated with lower urinary tract symptoms in US men from the 2005–2006 national health and nutrition examination survey dataset

“…Hypertension was defined based on self-reported hypertension diagnosis, or a blood pressure measurement ≥140/90 mmHg [ 40 ]. Diabetes was defined as self-reported diabetes diagnosis, use of oral hypoglycemic agents or insulin, a fasting glucose level ≥ 126 mg/dL, or a plasma glucose level ≥ 200 mg/dL at 2 h after oral glucose tolerance test [ 41 ]. Congestive heart failure, chronic obstructive pulmonary disease, coronary artery disease and cancer were all based on a self-reported answer regarding previous diagnosis.…”