Background: The diets of Asian Indians (AIs) may place them at greater risk of diabetes Caucasian populations. The objective of this study was to develop a dietary index of diabetes risk in adult AIs.
Methods: Data were included from a representative sample of adults from Delhi, India in 2014 - 2015 (n = 2,660). Insulinogenic Index (IGI), Disposition Index (DI), Matsuda’s index (MI), HOMA-IR and HOMA-B were calculated from fasting, 30-min and 2-hour insulin and plasma glucose from an OGTT. Intakes of 25 food groups were estimated using a 28-item food frequency questionnaire, the Indian Food Composition Table and Nutritionist Pro. Reduced rank regression (RRR) was used to estimate the relationship between dietary variables and standardized natural logs of IGI, DI, MI, HOMA-IR and HOMA-B (response variables). The first RRR pattern was extracted, RRR pattern score was computed, and respondents were split into quartiles according to RRR pattern score. Logistic regression was used to estimate the relationship between quartile of RRR pattern score and diabetes, adjusting for age and gender.
Results: There were 2,572 (96.7%) respondents with complete data for diet and response variables. The first RRR pattern explained 3.1% of the variation in response variables, 7.1% of the variance in diet variables, and was moderately correlated with MI (-0.24), HOMA-IR (0.19) and HOMA-B (0.17) (all p <0.05). Intakes of pickles (0.52), milk-based products (0.32), milk (0.27), uncooked vegetables (0.27) low-sugar fruits (0.24), rice (-0.52), fish (-0.35), and organ meats (-0.33) were significantly correlated with the first RRR pattern. Those in Q4 of the first RRR pattern were 1.63 (95% CI: 1.31, 2.02) as likely as those in Q1 to have diabetes. The relationship was attenuated with adjustment for age and gender (OR: 1.29; 95% CI: 1.03, 1.61).
Conclusion: A diet pattern high in intakes of pickles, milk and milk-based products, and low in intakes of rice, fish and organ meats may increase diabetes risk in adult AIs.
C.N. Ford: None. L.R. Staimez: None. N.I. Shaikh: None. N. Tandon: None. D. Prabhakaran: None. K. Narayan: None. V. Garg: None.
National Heart, Lung, and Blood Institute; Department of Health and Human Services (HHSN268200900026C); United Health Group, Minneapolis, MN