Can anthropometric measurements and diet analysis serve as useful tools to determine risk factors for insulin-resistant diabetes type 2 among white and black Americans?

OBJECTIVE

Central obesity is implicated in the development of insulin resistance by increasing insulin demand and eventually leading to hyperinsulinemia. Anthropometric measurements have been helpful in determining the risk factors in developing diabetes mellitus type 2. In this study we investigated whether anthropometric measurements differ among diabetics of different races. We also evaluated whether nutrient intake of these individuals was related to anthropometric measurement changes.

METHODS

Subjects were recruited from four groups: white control (n = 10), black control (n = 10), white diabetic (n = 5), and black diabetic (n = 10). The diabetic subjects had type 2 diabetes with insulin resistance on insulin monotherapy (age and sex matched). The following determinations were made: diet analysis, body mass index (kg/m(2)), the ratio of waist (umbilical level) to hip (maximum at buttocks) circumference, the ratio of waist to thigh (mid-thigh), and body fat percentage.

RESULTS

The micronutrient consumption was fairly similar in all groups with the exception of vitamin A (greatest consumption in the white control group, P < 0.05; and the lowest consumption in the black control group, P < 0.05). The data also suggested that central obesity (greatest waist-to-hip ratio) was present in the individuals with type 2 diabetes. The higher total fat, including saturated, monounsaturated, polyunsaturated, and cholesterol, intake in the diabetic groups were observed.

CONCLUSION

The type of fat consumed may be as important as the total fat consumption in the development of insulin resistance. The diet analysis can provide valuable information about the dietary habits of an individual and the possible causes of metabolic problems leading to a disease state. However, genetic factors must be considered when looking at diabetes incidence in different ethnic groups. For example, even though the black diabetic group consumed less fat in comparison with the other groups, their body fat percentages were higher. Therefore, we cannot conclude that high fat intake is primarily responsible for increased body fat percentage. Although anthropometric measurements are a useful tool in risk assessment, researchers should consider anatomic differences among different racial groups as covariables. Diet analysis when used in conjunction with anthropometric measurements can serve as a useful tool to detect whether metabolic alterations are related to dietary habits.