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Shifts in dietary patterns and risk of type-2 diabetes in a Caribbean adult population: ways to address diabetes burden

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Abstract

Purpose

As the French West Indies are facing an ongoing nutrition transition with increasing type-2 diabetes mellitus (T2DM) prevalence, our study aimed to evaluate the effect of potential shifts in dietary patterns on T2DM risk in French West Indian adults according to several scenarios.

Methods

We used a cross-sectional multistage sampling survey on dietary intake conducted in 2013 on a representative sample of Guadeloupeans and Martinicans adults (n = 1063). From previously identified current dietary patterns, we used PRIME-Diabetes, a comparative risk assessment model, to estimate the effect of potential shifts from the “transitioning” pattern to the “convenient,” the “prudent,” and the “traditional” ones on T2DM risks.

Results

Potential shift in dietary intakes from the “transitioning” pattern to the “traditional” one reduced the T2DM risk in women (− 16% [− 22; − 10]) and in men − 14% [− 21; − 7]), as the shift in dietary intakes toward the “prudent” pattern (− 23% [− 29; − 17] and − 19% − 23; − 14], respectively). These risk reductions were mostly driven by increased whole grains, fruits, green leafy vegetable intakes, and decreases in potatoes, red meats, processed meats, and sugar-sweetened beverages. The shift in dietary intakes toward the “convenient” pattern did not affect the T2DM risks.

Conclusion

To curb the increase in T2DM prevalence and reduce this burden, one public health action could be to target transitioning adults and help them to shift towards a diet associated with a reduced risk of T2DM as a prudent or a traditional diet.

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Data availability

Data described in the manuscript, codebook, and analytic code cannot be made available because they were provided by the French public health agency (Santé Publique France) and are not accessible to the public. Requests can be made to the French public health agency.

Abbreviations

BMI:

Body mass index

DASH:

Dietary approaches to stop hypertension

DQI-I:

Diet quality index-international

mPNNS-GS:

Modified programme national nutrition santé-guideline score

PNNS-GS2:

Programme national nutrition santé-guideline score 2

PRIME:

Preventable risk-integrated ModEl

T2DM:

Type-2 diabetes mellitus

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Acknowledgements

The authors thank the Martinique health observatory (OSM), the Guadeloupe health observatory (Orsag), the regional health agency of Martinique (ARS-Martinique), the regional health agency of Guadeloupe (ARS-Guadeloupe), the French Agency for Food, Environmental and Occupational Health and Safety (Anses) and the French Public Health Agency (Santé Publique France), as the main investigators, promoters, and supporters of the Escal and Kannari surveys. The authors thank the interviewers and all the participants. The authors also thank the Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency and Paris-13 University, as the main investigator of the nutritional part of the surveys and for access to the Escal and Kannari databases and support documentation.

Funding

This study was part of the NuTWInd project (Nutrition Transition in French West Indies), supported by the French National Research Agency (Agence nationale de la recherche, ANR) in the context of the 2016 “appel à projets générique” (ANR-16-CE21-0009).

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Authors and Affiliations

  1. UMR 1110 MOISA, MOISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Montpellier SupAgro, 2 Place Pierre-Viala, 34000, Montpellier, France

    Zoé Colombet & Caroline Méjean

  2. INRAE 1303, ALISS, Ivry-Sur-Seine, France

    Pascal Leroy & Louis-Georges Soler

Authors
  1. Zoé Colombet
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  2. Pascal Leroy
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  3. Louis-Georges Soler
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  4. Caroline Méjean
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Contributions

The authors’ responsibilities were as follows: CM and LGS designed the study, ZC drafted the manuscript, ZC performed the statistical analysis, PL performed the PRIME-Diabetes model, ZC, PL, CM and LGS contributed to the data interpretation and revised each draft for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Zoé Colombet.

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Colombet, Z., Leroy, P., Soler, LG. et al. Shifts in dietary patterns and risk of type-2 diabetes in a Caribbean adult population: ways to address diabetes burden. Eur J Nutr 62, 2233–2243 (2023). https://doi.org/10.1007/s00394-023-03144-6

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