Influence of Nutritional Factors on Prevalence of Diabetes

Abstract

Twelve age-matched populations of eleven countries were tested by standardized methods to determine associations between prevalence of hyperglycemia and certain epidemiologic variables, including several nutritional factors. There were great differences among some of these populations in socioeconomic status, diet, adiposity, and race. Environmental and demographic circumstances varied widely and prevalence of diabetes differed as much as ten-fold. There was in general a positive association between prevalence of diabetes and dietary intake of fat and of sugar, and a negative association between prevalence of diabetes and total carbohydrate consumption; but some inconsistencies in these associations suggested that they may have been partly or completely coincidental. Prevalence of diabetes correlated well with serum cholesterol levels, both among and within populations. Thejnost impressive and consistent association in these studies was between prevalence of diabetes and fatness (as estimated by weight in relation to height). Both within and among countries and races, this association was observed to a high degree. Interracial differences in prevalence of diabetes were small when racial groups were matched for adiposity. In a group of 1,645 subjects from the general population of Central America, those with abnormal glucose tolerance had a substantially higher prevalence of electrocardiographic abnormalities than those with normal tolerance.

Type 2 (non-insulin-dependent) diabetes ? An epidemiological overview

“…These earlier studies were mainly hospital-based and more recent population-based epidemiological studies have failed to confirm the association [88,91]. On the other hand, Middleton and Caird found a positive association in an English community [92].…”

“…more frequent testing, obesity, reduced physical activity, consanguinity. West et al determined diabetes prevalence rates by class in Central America [88]. In those with moderate income and relatively privileged social status, diabetes was about four times more common that in the poor.…”

Obesity, Insulin Resistance, and Cardiovascular Disease

“…Given the importance of excess adiposity as increasing risk of CVD, type 2 diabetes, and hypertension (West and Kalbfleisch, 1971;Havlik et al, 1983;Rimm et al, 1995), and the combination of an increase in the prevalence of overweight/obesity and a health care system unprepared to deal with this situation, it is essential that considerable thought be given as to how to best address this dilemma. In this context, it must be emphasized that CVD, type 2 diabetes, and hypertension are characterized by resistance to insulin-mediated glucose disposal (Reaven, 1988(Reaven, ,2001 and that insulin resistance, as well as the compensatory hyperinsulinemia associated with insulin resistance, have been shown to be independent predictors of all three clinical syndromes (Yip et al, 1998;Zavaroni et al, 1999;Facchini et al, 2001).…”

Nutritional habits in the Mediterranean Basin. The macronutrient composition of diet and its relation with the traditional Mediterranean diet. Multi-centre study of the Mediterranean Group for the Study of Diabetes (MGSD)

“…In some of these populations, an increase in the prevalence of diabetes has also been documented. However there is still controversy in the literature about the role of dietary habits in the development of glucose intolerance (West & Kalbfleisch, 1971;Pan et al, 1997), although there is evidence that high carbohydrate and high monounsaturated fat diets improve insulin sensitivity and glucose disposal (Perez-Jimenez et al, 2001).…”