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Mohan V, Sudha V, Shobana S, Gayathri R, Krishnaswamy K. Are Unhealthy Diets Contributing to the Rapid Rise of Type 2 Diabetes in India? J Nutr 2023; 153:940-948. [PMID: 36858259 DOI: 10.1016/j.tjnut.2023.02.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
The prevalence of diabetes is increasing at an alarming rate globally, particularly in India. In the urban areas, the prevalence of diabetes among adults aged ≥20 y, which was around 2% in the early 1970's, has increased by >20% in 50 y. The rapid nutrition transition due to high economic growth rates increased urbanization and globalization has resulted in higher intakes of processed refined grain staples, mainly white rice in Southern and Eastern India and refined wheat in Northern and Western India. This coupled with inadequate quantity and quality of protein; unhealthy fats; lower intake of vegetables, fruits, and fiber; and a sedentary lifestyle are the main drivers of the diabetes epidemic in India. This review attempts to discuss both the quality and quantity of Indian diets with specific reference to macronutrients. This review also outlines some of the strategies that can be employed to slow down the diabetes epidemic in this region. We believe that the lessons learned from India would be applicable to other developing nations as well, particularly to the South East Asian region. J Nutr 2023;xx:xxx.
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Affiliation(s)
- Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialties Centre, IDF Centre of Diabetes Education, Chennai, Tamil Nadu, India.
| | - Vasudevan Sudha
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Shanmugam Shobana
- Department of Diabetes Food Technology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Rajagopal Gayathri
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Kamala Krishnaswamy
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
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Wuni R, Adela Nathania E, Ayyappa AK, Lakshmipriya N, Ramya K, Gayathri R, Geetha G, Anjana RM, Kuhnle GGC, Radha V, Mohan V, Sudha V, Vimaleswaran KS. Impact of Lipid Genetic Risk Score and Saturated Fatty Acid Intake on Central Obesity in an Asian Indian Population. Nutrients 2022; 14:2713. [PMID: 35807893 PMCID: PMC9269337 DOI: 10.3390/nu14132713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/22/2022] Open
Abstract
Abnormalities in lipid metabolism have been linked to the development of obesity. We used a nutrigenetic approach to establish a link between lipids and obesity in Asian Indians, who are known to have a high prevalence of central obesity and dyslipidaemia. A sample of 497 Asian Indian individuals (260 with type 2 diabetes and 237 with normal glucose tolerance) (mean age: 44 ± 10 years) were randomly chosen from the Chennai Urban Rural Epidemiological Study (CURES). Dietary intake was assessed using a previously validated questionnaire. A genetic risk score (GRS) was constructed based on cholesteryl ester transfer protein (CETP) and lipoprotein lipase (LPL) genetic variants. There was a significant interaction between GRS and saturated fatty acid (SFA) intake on waist circumference (WC) (Pinteraction = 0.006). Individuals with a low SFA intake (≤23.2 g/day), despite carrying ≥2 risk alleles, had a smaller WC compared to individuals carrying <2 risk alleles (Beta = −0.01 cm; p = 0.03). For those individuals carrying ≥2 risk alleles, a high SFA intake (>23.2 g/day) was significantly associated with a larger WC than a low SFA intake (≤23.2 g/day) (Beta = 0.02 cm, p = 0.02). There were no significant interactions between GRS and other dietary factors on any of the measured outcomes. We conclude that a diet low in SFA might help reduce the genetic risk of central obesity confirmed by CETP and LPL genetic variants. Conversely, a high SFA diet increases the genetic risk of central obesity in Asian Indians.
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Affiliation(s)
- Ramatu Wuni
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (R.W.); (G.G.C.K.)
| | - Evelyn Adela Nathania
- Indonesia International Institute for Life Sciences, JI. Pulomas Barat Kav. 88, Jakarta Timur 13210, Indonesia;
| | - Ashok K. Ayyappa
- Department of Molecular Genetics, Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 603103, India; (A.K.A.); (K.R.); (R.M.A.); (V.R.); (V.M.)
| | - Nagarajan Lakshmipriya
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
| | - Kandaswamy Ramya
- Department of Molecular Genetics, Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 603103, India; (A.K.A.); (K.R.); (R.M.A.); (V.R.); (V.M.)
| | - Rajagopal Gayathri
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
| | - Gunasekaran Geetha
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
| | - Ranjit Mohan Anjana
- Department of Molecular Genetics, Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 603103, India; (A.K.A.); (K.R.); (R.M.A.); (V.R.); (V.M.)
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
- Dr. Mohan’s Diabetes Specialties Centre, IDF Centre of Excellence in Diabetes Care, Gopalapuram, Chennai 600086, India
| | - Gunter G. C. Kuhnle
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (R.W.); (G.G.C.K.)
| | - Venkatesan Radha
- Department of Molecular Genetics, Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 603103, India; (A.K.A.); (K.R.); (R.M.A.); (V.R.); (V.M.)
| | - Viswanathan Mohan
- Department of Molecular Genetics, Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 603103, India; (A.K.A.); (K.R.); (R.M.A.); (V.R.); (V.M.)
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
- Dr. Mohan’s Diabetes Specialties Centre, IDF Centre of Excellence in Diabetes Care, Gopalapuram, Chennai 600086, India
| | - Vasudevan Sudha
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
| | - Karani Santhanakrishnan Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (R.W.); (G.G.C.K.)
- The Institute for Food, Nutrition, and Health (IFNH), University of Reading, Reading RG6 6AP, UK
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