Diabetes Type 2 and Diet in 184 Countries: Guess the Best Food Group?

Data from around the world from 2017 estimated that roughly 462 million people worldwide had type 2 diabetes (DM2) and that by 2030, that number will rise to over 540 million people with the disease.

DM2 is a disease in which the body becomes unable to regulate blood sugar levels due to an inability to use the insulin it produces (insulin resistance) which results in part from diet choices. DM2 can lead to cardiovascular issues, nerve damage, kidney failure, and other undesirable outcomes including shortened lifespan.

Researchers at Tufts University and the Global Dietary Database analyzed food groups and risks for DM2 all over the world and reported interesting findings that have practical applications for your diet choices. 

STUDY METHODS

The researchers used a "risk assessment model" to estimate the incidence of DM2 among adults attributable to 11 dietary factors in 184 countries in 1990 and 2018.

In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million incident cases of DM2, representing 70% of new cases of DM2 globally.

What 4 dietary factors were contributed the largest burdens of DM2 cases?

Suprisingly, they were insufficient whole-grain intake, excess refined rice and wheat intake, and excess processed meat intake like bacon, sausage, turkey, hot dogs, and ham.

Across regions, highest dietary burden of DM2 were in central and eastern Europe, central Asia, Latin America, and the Caribbean. The lowest proportional burdens were in South Asia.

Proportions of diet-attributable DM2 were generally larger in men than in women and more in the young than in the elderly.

Compared with 1990, global diet-attributable DM2 increased by 8.6 million more cases in 2018.

CONCLUSIONS AND COMMENTS

The study's first author commented that “The scientific evidence linking refined grains consumption to type 2 diabetes is clear. Refined grains, starches, and sugars induce rapid blood glucose spikes, conversion of sugar to fat in the liver accumulating around abdominal organs, and also can displace other healthier foods (like whole grains) in people’s diets, all leading to increased risk for type 2 diabetes". 

Whole grains tend to have a lower glycemic index — blood glucose raising potential — than refined grains because they are digested and absorbed more slowly due to fiber, which is beneficial for DM2.

The message is clear and consistent with prior data, eat whole foods of plants, avoid refined foods, and avoid meats, particularly processed meats like bologna and salami to avoid new cases DM2.