Wang Xueyin, Jung Molly, Mossavar-Rahmani Yasmin, Sotres-Alvarez Daniela, Espinoza Giacinto Rebeca A, Pirzada Amber, Reina Samantha A, Casagrande Sarah S, Wang Tao, Avilés-Santa M Larissa, Kaplan Robert C, Qi Qibin
Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824.
J Clin Endocrinol Metab. 2016 Apr;101(4):1856-64. doi: 10.1210/jc.2015-3237. Epub 2016 Mar 7.
Diet modification is a mainstay of diabetes management. US Hispanics/Latinos are disproportionately affected by diabetes, but few studies have examined dietary intake among US Hispanics/Latinos with diabetes, and little is known regarding the influence of diabetes awareness on dietary intake.
We evaluated macronutrient intake and its associations with diabetes awareness and glycemic control among US Hispanics/Latinos with diabetes.
This analysis included 3310 diabetic adults aged 18–74 years from the Hispanic Community Health Study/Study of Latinos (2008–2011).
Diabetes was defined as diagnosed (based on medical history or antihyperglycemic medication use) or undiagnosed diabetes (based on fasting glucose ≥ 126 mg/dL, glycated hemoglobin [HbA1c] ≥ 6.5%, or 2 h glucose ≥ 200 mg/dL in the absence of a physician diagnosis). Dietary intake was assessed using two 24-hour recalls.
Among Hispanic/Latino adults with diabetes, 21.2%, 55.7%, and 71.2% met the American Diabetes Association recommendations for fiber (≥14 g per 1000 kcal), saturated fat (<10% of total energy), and cholesterol intake (<300 mg), respectively. Compared with those with undiagnosed diabetes, people with diagnosed diabetes consumed less carbohydrate (50.3 vs 52.4% of total energy; P = .017), total sugar (19.1 vs 21.5% of total energy; P = .002), added sugar (9.8 vs 12.1% of total energy; P < .001), and more total fat (30.7 vs 29.3% of total energy; P = .048) and monounsaturated fat (11.5 vs 10.7% of total energy; P = .021). Association between diabetes awareness and low total and added sugar intake was observed in individuals of Mexican and Puerto Rican background but not in other groups (P for interaction < .05). Among people with diagnosed diabetes, those with HbA1c of 7% or greater consumed more total fat, saturated fat, and cholesterol than those with HbA1c less than 7% (all P < .05).
Among US Hispanics/Latinos with diabetes, fiber intake is low, and diabetes awareness is associated with reduced carbohydrate and sugar intake and increased monounsaturated fat intake. Sugar intake may require special attention in certain Hispanic/Latino background groups.
饮食调整是糖尿病管理的主要手段。美国西班牙裔/拉丁裔受糖尿病影响的比例过高，但很少有研究调查美国患糖尿病的西班牙裔/拉丁裔的饮食摄入情况，关于糖尿病认知对饮食摄入的影响也知之甚少。
我们评估了美国患糖尿病的西班牙裔/拉丁裔的常量营养素摄入量及其与糖尿病认知和血糖控制的关联。
该分析纳入了西班牙裔社区健康研究/拉丁裔研究（2008 - 2011年）中3310名年龄在18 - 74岁的糖尿病成年人。
糖尿病的定义为已确诊（基于病史或使用抗高血糖药物）或未确诊糖尿病（基于空腹血糖≥126mg/dL、糖化血红蛋白[HbA1c]≥6.5%或2小时血糖≥200mg/dL，且无医生诊断）。饮食摄入通过两次24小时回顾法进行评估。
在患有糖尿病的西班牙裔/拉丁裔成年人中，分别有21.2%、55.7%和71.2%的人符合美国糖尿病协会关于纤维（每1000千卡≥14克）、饱和脂肪（占总能量<10%）和胆固醇摄入（<300毫克）的建议。与未确诊糖尿病的人相比，已确诊糖尿病的人碳水化合物摄入量较少（占总能量的50.3%对52.4%；P = 0.017）、总糖摄入量较少（占总能量的19.1%对21.5%；P = 0.002）、添加糖摄入量较少（占总能量的9.8%对12.1%；P < 0.001），而总脂肪摄入量较多（占总能量的30.7%对29.3%；P = 0.048）和单不饱和脂肪摄入量较多（占总能量的11.5%对10.7%；P = 0.021）。在墨西哥和波多黎各背景的个体中观察到糖尿病认知与低总糖和添加糖摄入量之间的关联，但在其他群体中未观察到（交互作用P < 0.05）。在已确诊糖尿病的人群中，HbA1c≥7%的人比HbA1c<7%的人总脂肪、饱和脂肪和胆固醇摄入量更多（所有P < 0.05）。
在美国患糖尿病的西班牙裔/拉丁裔中，纤维摄入量较低，糖尿病认知与碳水化合物和糖摄入量减少以及单不饱和脂肪摄入量增加有关。在某些西班牙裔/拉丁裔背景群体中，糖摄入量可能需要特别关注。
