WeeklySA_AdminCHOICES: Insufficient intake of whole grains, excesses of refined rice and wheat, and the overconsumption of processed meat…
By WSAM Correspondent
A research model of dietary intake in 184 countries estimates that poor diet contributed to over 14.1 million cases of type 2 diabetes in 2018, representing over 70% of new diagnoses globally.
The analysis, which looked at data from 1990 and 2018, provides valuable insight into which dietary factors are driving type 2 diabetes burden by world region. The study was published April 17 in the journal Nature Medicine. The study was developed by researchers at the Friedman School of Nutrition Science and Policy at Tufts University.
Of the 11 dietary factors considered, three had an outsized contribution to the rising global incidence of type 2 diabetes: Insufficient intake of whole grains, excesses of refined rice and wheat, and the overconsumption of processed meat. Factors such as drinking too much fruit juice and not eating enough non-starchy vegetables, nuts, or seeds, had less of an impact on new cases of the disease.
“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 senior researcher Dariush Mozaffarian, Jean Mayer Professor of Nutrition and dean for policy at the Friedman School. “These new findings reveal critical areas for national and global focus to improve nutrition and reduce devastating burdens of diabetes.”
Type 2 diabetes is characterized by the resistance of the body’s cells to insulin. Of the 184 countries included in the Nature Medicine study, all saw an increase in type 2 diabetes cases between 1990 and 2018, representing a growing burden on individuals, families, and healthcare systems.
The research team based their model on information from the Global Dietary Database, along with 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.
The analysis revealed that poor diet is causing a larger proportion of total type 2 diabetes incidence in men versus women, in younger versus older adults, and in urban versus rural residents at the global level.
Regionally, Central and Eastern Europe and Central Asia —particularly in Poland and Russia, where diets tend to be rich in red meat, processed meat, and potatoes —had the greatest number of type 2 diabetes cases linked to diet. Incidence was also high in Latin America and the Caribbean, especially in Colombia and Mexico, which was credited to high consumption of sugary drinks, processed meat, and low intake of whole grains.
Regions where diet had less of an impact on type 2 diabetes cases included South Asia and Sub-Sharan Africa —though the largest increases in type 2 diabetes due to poor diet between 1990 and 2018 were observed in Sub-Saharan Africa. Of the 30 most populated countries studied, India, Nigeria, and Ethiopia had the fewest cases of type 2 diabetes related to unhealthy eating.
“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 heath inequities worldwide,” says co-researcher Meghan O’Hearn. She conducted this research while a PhD candidate at the Friedman School and currently works as Impact Director for Food Systems for the Future, a non-profit institute and for-profit fund that enables innovative food and agriculture enterprises to measurably improve nutrition outcomes for underserved and low-income communities. “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.”
Other recent studies have estimated that 40% of type 2 diabetes cases globally are attributed to suboptimal diet, lower than the 70% reported in the Nature Medicine paper. The research team attributes this to the new information in their analysis, such as the first ever inclusion of refined grains, which was one of the top contributors to diabetes burdens; and updated data on dietary habits based on national individual-level dietary surveys, rather than agricultural estimates. The investigators also note that they presented the uncertainty of these new estimates, which can continue to be refined as new data emerges.
TO FIGHTING
OFF COVID
PNEUMONIA
VITAMIN D KEY TO FIGHTING OFF COVID PNEUMONIA
NUTRIENTS: Scientists find evidence that the vitamin increases the lung lining’s ability to block infection…
By WSAM Correspondent
Patients with low Vitamin D levels have a greater chance of COVID-19 infection—and severe disease and death, according to doctors who have been studying the impact of the virus on the body’s airways.
Now, research led by scientists from Lankenau Institute for Medical Research (LIMR), points to an explanation for the link and provides evidence that higher Vitamin D intake can help fight off the disease.
The study, published this week in Physiological Reports, indicates the vitamin strengthens the lung lining, preventing COVID-19 as well as other viruses from penetrating the body’s airways to cause infection, and possibly also reducing fluid leakage into the airways, which causes pneumonia.
“Your body is mostly sacs and tubes,” said senior researcher James Mullin, a LIMR professor and director of research for Lankenau Medical Centre’s astroenterology division.
“If their linings are in good shape, you’re in good shape. If they’re leaking and fail to provide a proper barrier, it’s a problem. When you have a respiratory infection, that means the barrier in your lungs is leaking. Our research gives evidence that Vitamin D strengthens the barrier function of the lung lining, likely helping to prevent or stop an infection.”
The study examined cell cultures from human lung linings and examined them using two independent metrics. It found Vitamin D increased barrier function by 40% and 25%, respectively. The study builds on a body of research by Mullin’s team indicating Vitamin A, zinc and other micronutrients play a similar role to Vitamin D. This same research group recently published a review article on the general topic of fluid leak in various diseases and combating it clinically with elevated levels of micronutrients.
Published literature has indicated that patients with Vitamin D deficiency were five times more likely to become infected by COVID-19. Data supporting supplemental doses for those with Vitamin D levels in the normal range are less clear, the authors said.
“The benefits, however, are so clear and the risks so minimal that we believe physicians should be recommending supplemental Vitamin D right away,” Mullin said. “Cytokine storms, where the body’s immune response kicks into overdrive and can result in severe disease and death in COVID, compromise the body’s airway barrier function. We already know from past studies that Vitamin D blunts cytokine storms in cases of flu. In cases of COVID-19, vitamin D therapy may allow time for a patient’s own immune defenses to kick in before it’s too late.”
