Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, USA.
Nutrients. 2020 Jul 8;12(7):2027. doi: 10.3390/nu12072027.
Calorie-dense diet is a main driver of the global epidemics of obesity and type 2 diabetes (T2DM). While various dietary strategies and patterns are efficacious in reducing risk and improving glycemic control, dietary intake and diet quality have been inadequately studied among individuals who remain living in their native environments. There is also little published on dietary patterns of diverse ethnic, cultural, or regional populations.
To explore dietary intakes, patterns and overall diet quality in adults with obesity and T2DM from diverse countries. We hypothesized that individuals sharing a common clinical phenotype (age, BMI, years since T2DM diagnosis and inadequate glycemic control) would demonstrate comparable high calorie "western" dietary patterns and low diet quality despite differences in geographic regions and cultures.
Diet data were acquired from 611 adults in Argentina, Germany, Poland, Serbia, Slovakia, Slovenia, Spain, Turkey and the USA via three 24-h diet recalls. Contribution of 168 foods to 14 primary food groups was confirmed by Spearman's rank-order correlations and Principle Component Factor Analysis identified dietary patterns. Diet quality was assessed using the Healthy Eating Index 2015.
Eleven dietary patterns were extracted; the most common were a "Mediterranean-like" pattern shared by six countries and a "Calorie Dense" pattern shared by five countries. Also common were "Lacto-Vegetarian, "Pesco-Vegetarian," and "Vegan" patterns. Only 2.1% of subjects had good diet quality (HEI-2015 score >80).
The diet pattern data suggest that influences of more traditional region-specific diets remain. However, overall diet quality was poor and may contribute to inadequate glycemic control, possibly due to excess intake of high calorie/nutrient poor foods, which may be associated with global transitions occurring in the available food supply.
高热量饮食是肥胖和 2 型糖尿病（T2DM）全球流行的主要驱动因素。虽然各种饮食策略和模式在降低风险和改善血糖控制方面都有效，但在生活在本土环境中的人群中，饮食摄入和饮食质量的研究还不够充分。在不同种族、文化或地区的人群中，关于饮食模式的研究也很少。
探讨来自不同国家的肥胖和 T2DM 成年患者的饮食摄入、模式和整体饮食质量。我们假设，具有共同临床表型（年龄、BMI、T2DM 诊断后年限和血糖控制不充分）的个体，尽管地理位置和文化存在差异，但仍会表现出类似的高热量“西方”饮食模式和低饮食质量。
通过三次 24 小时饮食回忆，从阿根廷、德国、波兰、塞尔维亚、斯洛伐克、斯洛文尼亚、西班牙、土耳其和美国的 611 名成年人那里获取饮食数据。通过 Spearman 秩相关和主成分因子分析，确认了 168 种食物对 14 种主要食物组的贡献，确定了饮食模式。使用 2015 年健康饮食指数评估饮食质量。
提取了 11 种饮食模式；最常见的模式是六国共享的“地中海式”模式和五国共享的“高热量”模式。此外，还常见的模式有“乳素食、鱼素食和纯素食”模式。只有 2.1%的受试者饮食质量良好（HEI-2015 评分>80）。
饮食模式数据表明，更传统的特定地区饮食的影响仍然存在。然而，整体饮食质量较差，可能导致血糖控制不充分，这可能是由于摄入过多高热量/营养差的食物所致，而这些食物可能与全球食品供应中发生的转变有关。
