A groundbreaking study from the Friedman School of Nutrition Science and Policy at Tufts University has found that poor diet is responsible for over 14.1 million new cases of type 2 diabetes diagnosed in 2018. This means that poor dietary choices are linked to over 70% of new diagnoses worldwide, leading to a growing burden on individuals, families, and the global healthcare system.
The study focused on 11 dietary factors that could potentially contribute to the rising incidence of type 2 diabetes. But three factors were found to be particularly impactful: inadequate intake of whole grains, excessive intake of refined rice and wheat, and overconsumption of processed meat. The study also found that drinking too much fruit juice and not consuming enough non-starchy vegetables, nuts, or seeds had less impact on new disease cases.
Senior author Dariush Mozaffarian, Jean Mayer Professor of Nutrition and dean for policy at the Friedman School, stated that poor carbohydrate quality is the leading driver of diet-attributable type 2 diabetes globally. Poor diet was also linked to a larger proportion of type 2 diabetes incidence in men versus women, in younger versus older adults, and in urban versus rural areas globally.
“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,” says Mozaffarian. “These new findings reveal critical areas for national and global focus to improve nutrition and reduce devastating burdens of diabetes.”
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The study, which was published in the journal Nature Medicine, is based on information from the Global Dietary Database, 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.
Type 2 diabetes crisis
Type 2 diabetes is a serious and growing health problem worldwide. According to the International Diabetes Federation (IDF), there were approximately 463 million adults (aged 20-79) living with diabetes in 2019, which corresponds to 9.3% of the global adult population.
Type 2 diabetes is often associated with lifestyle factors such as poor diet, lack of physical activity, and obesity. It is a chronic disease characterised by the body’s resistance to insulin and high levels of glucose in the blood. This condition can lead to a wide range of health problems, including heart disease, stroke, kidney failure, blindness, and nerve damage. All of which significantly impact longevity.
The research conducted at Tuft University highlights significant differences in the incidence of type 2 diabetes based on age, gender, location, and dietary patterns. Central and Eastern Europe and Central Asia, particularly Russia and Poland, had the highest number of type 2 diabetes cases linked to poor diet. The same was found in Latin America and the Caribbean, particularly in Mexico and Colombia, due to the popularity of sugary drinks, processed meats and the low intake of whole grains.
On the other hand, regions such as South Asia and Sub-Saharan Africa had fewer cases of type 2 diabetes linked to poor diet, although the largest increases in the number of cases due to unhealthy eating between 1990 and 2018 were observed in Sub-Saharan Africa. India, Nigeria, and Ethiopia had the fewest cases of type 2 diabetes related to unhealthy eating among the 30 most populated countries studied.
The researchers hope their findings spark a significant change in global dietary philosophy, lowering the impact of poor diet on type 2 diabetes incidence globally.
Type 2 diabetes: Where to from here?
The findings of this study have significant implications for the development of public health interventions aimed at reducing the global burden of type 2 diabetes, experts say. The researchers suggest that focusing on improving carbohydrate quality by increasing the consumption of whole grains, reducing the intake of refined grains, and limiting the consumption of processed meat could significantly reduce the incidence of type 2 diabetes worldwide.
In addition, policymakers, healthcare providers, and the food industry can use this information to develop targeted interventions that encourage healthy dietary choices and reduce the burden of type 2 diabetes on individuals, families, and healthcare systems worldwide.
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“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 health inequities worldwide,” says study author Meghan O’Hearn. “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.”
Disclaimer: This research was partially funded by the Bill and Melinda Gates Foundation.