Relationship between diet and type 2 diabetes V1.0
Research type
Research Study
Full title
An investigation of the relationship between diet and type 2 diabetes among different ethnicity in Leicester, UK, using a self-completed questionnaire (Formerly: An investigation of the relationship between diet and type 2 diabetes among different ethnicity in Leicester, UK using questionnaire and laboratory based methods.)
IRAS ID
228498
Contact name
Kshama Joshi
Contact email
Sponsor organisation
De Montfort University
Duration of Study in the UK
6 years, 0 months, 0 days
Research summary
Research Summary
One of the leading cause for type 2 diabetes is deficiency or overload of nutrients. There are some studies which provides a link between diet and diabetes or ethnicity based diet and diabetes, however, only limited amount of information is available to understand possible link between ethnicity based dietary intake of nutrients and type 2 diabetes. This research paper intends to study, dietary habits which will facilitate the information about deficiency or overload of certain nutrients in the case of type 2 diabetes. By studying the current dietary intake of a person, one can estimate the level of nutrients in person’s body. These levels will then be compared with the recommended standards to identify the cause and effect between dietary nutrients and type 2 diabetes.
This research will use mixed method approach. A comprehensive questionnaire and collection of scalp hair and toenail samples (from studied cohort).
a) Questionnaire will provide the necessary information of respondent’s diet and other health and lifestyle.
b) Analysis of scalp hair and toenail samples using Inductive Coupled Plasma Mass Spectrometer (ICP-MS) will provide concentrations of studied nutrients.Summary of Results
Background Prevalence of type 2 diabetes (T2DM) is six times more in South Asians than White British population in the UK. Diet is a primary modifiable risk factor of T2DM, as it is associated with the development and control of T2DM. Currently, there is no provision available at NHS primary-care to obtain dietary information from the general population and T2DM patients when, even modest attention could be beneficial as a prevention strategy. Here for the first time an ethnicity specific Web-based food frequency questionnaire (FFQ) was developed to assess dietary information for developing dietary models associated with T2DM.
Methods
Data analysis was carried among 392 adults (T2DM=184 and without T2DM=208) aged 18 - 80 years. Recruitment was done from community centres and GP practices in Leicester, UK. An ethnicity specific European Prospective Investigation into Cancer & Nutrition (EPIC)-Norfolk FFQ was developed. FFQ EPIC Tool for Analysis (FETA) software was used to convert the dietary data into a quantifiable format. All necessary approvals and consents were obtained prior to the study. Chi-square test, odds ratio (OR) was used to find statistical significance using IBM SPSS (version 26). Multivariate binary logistic regression was used to develop predictive models. Model performance was calculated using area under receiver operating characteristic curve (AUROC) and area under the precision-recall curve (AUPRC).
Results
Analysis of 22 nutrients revealed differences in intake between T2DM and those without T2DM. Consumption of carbohydrate, monounsaturated fatty acids (MUFAs), selenium, and zinc were significantly lower in T2DM patients. Participants without T2DM had a higher consumption of carbohydrate, fat-total, potassium, magnesium, copper, iodine, zinc and folate. MUFAs and magnesium intake were identified as dietary risk predictors by binary logistic regression. Compared to the base model (AUROC 0.663 [95% CI 0.610-0.717], AUPRC 0.61), the macro model (AUROC 0.703 [95% CI 0.652-0.755], AUPRC 0.65), micro model (AUROC 0.704 [0.652-0.755)], AUPRC 0.65) and all-nutrient model (AUROC 0.703 [95% CI 0.652-0.755], AUPRC 0.65) performed better.
Conclusion
An ethnicity specific Web-based FFQ was developed that captured dietary patterns in South Asians and assisted in the development of better performing dietary models associated with T2DM. This can be used as a non-invasive and inexpensive tool to predict the development of T2DM in the general population. Furthermore, it can also provide precision nutrition guidance for those with T2DM for better management of their condition. In the future, a large multicentre clinical study is warranted to validate the methodology proposed through this research.
Keywords
Diet, ethnicity, type 2 diabetes, macro, and micronutrients, FFQ, logistic regression model.REC name
West of Scotland REC 5
REC reference
17/WS/0234
Date of REC Opinion
13 Dec 2017
REC opinion
Further Information Favourable Opinion