Poor diet contributed to over 14.1 million cases of Type 2 diabetes in 2018, representing over 70 per cent of new diagnoses globally, according to a study.
Of the 30 most populated countries studied, India, Nigeria, and Ethiopia had the fewest case of type 2 diabetes related to unhealthy eating, the researchers said.
The analysis, published in the journal Nature Medicine, looked at data from 1990 and 2018, providing valuable insight into which dietary factors are driving type 2 diabetes burden by world region.
The researchers found that Of the 11 dietary factors considered, three had an outsized contribution to the rising global incidence of type 2 diabetes: Insufficient intake of whole grains, excesses of refined rice and wheat, and the overconsumption of processed meat.
Factors such as drinking too much fruit juice and not eating enough non-starchy vegetables, nuts, or seeds, had less of an impact on new cases of the disease, they said.
"Our study suggests poor carbohydrate quality is a leading driver of diet-attributable type 2 diabetes globally, and with important variation by nation and over time," said study senior author Dariush Mozaffarian, from Tufts University in the US. "These new findings reveal critical areas for national and global focus to improve nutrition and reduce devastating burdens of diabetes," Mozaffarian said.
Type 2 diabetes is characterised by the resistance of the body's cells to insulin, a hormone created by pancreas that controls the amount of glucose in the bloodstream at any given moment.
Of the 184 countries included in the study, all saw an increase in type 2 diabetes cases between 1990 and 2018, representing a growing burden on individuals, families, and health care systems.
The research team based its model on information from the Global Dietary Database, along with population demographics from multiple sources, global type 2 diabetes incidence estimates, and data on how food choices impact people living with obesity and type 2 diabetes from multiple published papers.
The analysis showed that poor diet is causing a larger proportion of total type 2 diabetes incidence in men versus women, in younger versus older adults, and in urban versus rural residents at the global level.
Regionally, Central and Eastern Europe and Central Asia—particularly in Poland and Russia, where diets tend to be rich in red meat, processed meat, and potatoes—had the greatest number of type 2 diabetes cases linked to diet, the researchers said. Incidence was also high in Latin America and the Caribbean, especially in Colombia and Mexico, which was credited to high consumption of sugary drinks, processed meat, and low intake of whole grains.
Regions where diet had less of an impact on type 2 diabetes cases included South Asia and Sub-Sharan Africa — though the largest increases in type 2 diabetes due to poor diet between 1990 and 2018 were observed in Sub-Saharan Africa.
"Left unchecked and with incidence only projected to rise, type 2 diabetes will continue to impact population health, economic productivity, health care system capacity, and drive heath inequities worldwide," said study first author Meghan O'Hearn, who conducted the research as a Ph.D. candidate at the Friedman School of Nutrition Science and Policy at Tufts University.
"These findings can help inform nutritional priorities for clinicians, policymakers, and private sector actors as they encourage healthier dietary choices that address this global epidemic," O'Hearn added.
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