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Worldwide dietary and lifestyle factors associated with diabetes prevalence and total cholesterol levels: an ecological analysis

Published online by Cambridge University Press:  15 April 2015

C. Oggioni ,
H. Cena ,
J. C. K. Wells ,
K. Soroka ,
J. Lara ,
C. Celis Morales  and
M. Siervo
C. Oggioni
Affiliation:
Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, IT
H. Cena
Affiliation:
Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, IT
J. C. K. Wells
Affiliation:
Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
K. Soroka
Affiliation:
Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK
J. Lara
Affiliation:
Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK
C. Celis Morales
Affiliation:
Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK
M. Siervo
Affiliation:
Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK
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Abstract

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Information
Proceedings of the Nutrition Society , Volume 74 , Issue OCE1: Summer Meeting, 14–17 July 2014, Carbohydrates in health: friends or foes , 2015 , E125
Copyright
Copyright © The Authors 2015 

The worldwide epidemiology of diabetes and hypercholesterolemia is changing rapidly(Reference Murray and Lopez1, Reference Hu2) as a result of the diffusion of Westernised nutritional and lifestyle patterns(Reference Kohl, Craig, Lambert, Inoue, Alkandari and Leetongin3, Reference Popkin4). We conducted an ecological analysis to identify dietary, lifestyle and socio-economic factors associated with global distribution of diabetes prevalence and total cholesterol levels.

Country-specific estimates of diabetes prevalence and total cholesterol levels were obtained from freely available electronic databases maintained and updated by as the World Health Organisation (WHO), Food and Agriculture Organisation (FAO) and the World Bank. Data on diabetes prevalence and cholesterol concentrations were then matched to year- and country-specific food and energy availability for consumption and to year-specific information on physical inactivity, urbanisation, gross domestic product (GDP), life expectancy, and smoking. Cluster analysis was used to derive typical dietary patterns of global food consumption and their association with diabetes prevalence and total cholesterol levels was evaluated. Socio-demographic and dietary predictors of diabetes prevalence and total cholesterol levels were identified using multiple regression models.

Physical inactivity and eggs consumption emerged as predictors of diabetes and total cholesterol levels in fully-adjusted multiple regression models, respectively. Three dietary patterns (agricultural, transitional and westernised) were identified by the cluster analysis. A significant increase in diabetes prevalence and total cholesterol levels was observed as countries move from an agricultural to a westernised dietary pattern (Fig. 1).

Fig. 1. Differences in total cholesterol levels and prevalence of diabetes between dietary patterns.

Prevention of physical inactivity is a global priority as closely linked to worldwide diabetes burden. The role of global consumption of eggs as a predictor of total cholesterol levels is a novel finding which requires further validation in epidemiological studies conducted in developed and developing countries.

References

1.Murray, CJ, Lopez, AD (1997) Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 349(9063), 1436–42.Google Scholar
2.Hu, FB (2011) Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes care 34(6), 1249–57.Google Scholar
3.Kohl, HW 3rd, Craig, CL, Lambert, EV, Inoue, S, Alkandari, JR, Leetongin, G, et al. (2012) The pandemic of physical inactivity: global action for public health. Lancet 380(9838), 294–305.Google Scholar
4.Popkin, BM (1999) Urbanization, lifestyle changes and the nutrition transition. World Dev 27(11), 1905–16.Google Scholar
Figure 0

Fig. 1. Differences in total cholesterol levels and prevalence of diabetes between dietary patterns.