Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA.
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Nutr Diabetes. 2022 Oct 13;12(1):44. doi: 10.1038/s41387-022-00221-3.
We examined links among dietary patterns (DPs), insulin resistance (IR), and diabetes risk by heritage in the Hispanic Community Health Study/Study of Latinos.
Hispanics/Latinos of Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American heritage aged 18-74 years and diabetes-free completed two 24 h dietary recalls at baseline (2008-2011) and provided 6-year follow-up data (2014-2017; n = 7774). We classified 6-year IR status [improved, unchanged (referent), worsened] using a 1-SD change in fasting insulin between visits and defined incident diabetes based on American Diabetes Association criteria. We derived heritage-specific DPs via principal factor analysis and estimated their associations with 6-year IR status (multinomial) and incident diabetes (binary) using complex survey-based logistic regression.
Five overarching DPs based on high-loading foods were shared by two or more heritage groups: "Burger, Fries, & Soft Drinks"; "White Rice, Beans, & Red Meats"; "Fish & Whole Grains"; "Cheese & Sweets"; and "Stew & Corn". Comparing highest-to-lowest DP quintiles, the Dominican "Burger, Fries, & Soft Drinks" and Cuban "White Rice, Beans, & Red Meats" DPs were associated with worsened 6-year IR status (log-odds: 2.35, 95% CI: 1.02, 3.68, P = 0.037 and log-odds: 1.27, 95% CI: 0.49, 2.06, P = 0.009, respectively). The Puerto Rican "Burger, Fries, & Soft Drinks" and the Central American "White Rice, Beans, & Red Meats" DPs were associated with greater diabetes incidence (OR: 3.00, 95% CI:1.50, 5.99 and OR: 2.41, 95% CI: 1.05, 5.50, respectively).
A diet characterized by higher intakes of burgers, fries, and soft drinks and another characterized by higher intakes of white rice, beans, and red meats may be adversely associated with IR and diabetes risk in some Hispanic/Latino heritage groups. Future work is needed to offer more heritage-specific dietary guidance for diabetes prevention in this population.
我们通过西班牙裔美国人社区健康研究/拉丁裔研究，研究了饮食模式（DPs）、胰岛素抵抗（IR）和糖尿病风险之间的联系及其与遗传因素的关系。
18-74 岁、无糖尿病的古巴裔、多米尼加裔、墨西哥裔、波多黎各裔、中美洲裔和南美洲裔西班牙裔/拉丁裔参与者在基线（2008-2011 年）完成了两次 24 小时饮食回忆，并提供了 6 年随访数据（2014-2017 年；n=7774）。我们使用两次就诊之间空腹胰岛素的 1-SD 变化来衡量 6 年期间的 IR 状态[改善、不变（参照）、恶化]，并根据美国糖尿病协会的标准定义新发糖尿病。我们通过主成分分析得出特定遗传背景的 DP，并使用基于复杂调查的逻辑回归来估计它们与 6 年期间的 IR 状态（多项）和新发糖尿病（二项）之间的关联。
基于高负荷食物得出了五个涵盖面广的 DP，这五个 DP 是由两个或两个以上的遗传群体共享的：“汉堡、薯条和软饮料”；“白米、豆类和红色肉类”；“鱼和全谷物”；“奶酪和甜食”；以及“炖菜和玉米”。与 DP 五分位数从高到低相比，多米尼加的“汉堡、薯条和软饮料”和古巴的“白米、豆类和红色肉类”DP 与 6 年期间的 IR 状态恶化有关（优势比：2.35，95%可信区间：1.02，3.68，P=0.037 和优势比：1.27，95%可信区间：0.49，2.06，P=0.009）。波多黎各的“汉堡、薯条和软饮料”和中美洲的“白米、豆类和红色肉类”DP 与更高的糖尿病发病率有关（比值比：3.00，95%可信区间：1.50，5.99 和比值比：2.41，95%可信区间：1.05，5.50）。
某些西班牙裔/拉丁裔群体中，以较高汉堡、薯条和软饮料摄入量为特征的饮食模式和以较高白米、豆类和红色肉类摄入量为特征的饮食模式可能与 IR 和糖尿病风险呈负相关。需要进一步研究为这一人群提供更具遗传背景的饮食指导，以预防糖尿病。
