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Open AccessArticle

Potentially Heterogeneous Cross-Sectional Associations of Seafood Consumption with Diabetes and Glycemia in Urban South Asia

1
Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
2
Public Health Foundation of India, Gurgaon Haryana 122002, India
3
All India Institutes of Medical Sciences, Delhi 110029, India
4
Madras Diabetes Research Foundation, Chennai 600086, India
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Department of Community Health Sciences, Aga Khan University, Karachi 74800, Pakistan
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Hubert Department of Global Health, Emory University Rollins School of Public Health, Emory Global Diabetes Research Center, Atlanta, GA 30322, USA
7
Department of Global Health and Population, Harvard University T.H. Chan School of Public Health, Boston, MA 02115, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(2), 459; https://doi.org/10.3390/ijerph17020459
Received: 22 November 2019 / Revised: 1 January 2020 / Accepted: 7 January 2020 / Published: 10 January 2020
(This article belongs to the Special Issue Advances in the Field of Human Health and Environment)
Aims: In this study, we aimed to estimate cross-sectional associations of fish or shellfish consumption with diabetes and glycemia in three South Asian mega-cities. Methods: We analyzed baseline data from 2010–2011 of a cohort (n = 16,287) representing the population ≥20 years old that was neither pregnant nor on bedrest from Karachi (unweighted n = 4017), Delhi (unweighted n = 5364), and Chennai (unweighted n = 6906). Diabetes was defined as self-reported physician-diagnosed diabetes, fasting plasma glucose ≥126 mg/dL (7.0 mmol/L), or glycated hemoglobin A1c (HbA1c) ≥6.5% (48 mmol/mol). We estimated adjusted and unadjusted odds ratios for diabetes using survey estimation logistic regression for each city, and differences in glucose and HbA1c using survey estimation linear regression for each city. Adjusted models controlled for age, gender, body mass index, waist–height ratio, sedentary lifestyle, educational attainment, tobacco use, an unhealthy diet index score, income, self-reported physician diagnosis of high blood pressure, and self-reported physician diagnosis of high cholesterol. Results: The prevalence of diabetes was 26.7% (95% confidence interval: 24.8, 28.6) in Chennai, 36.7% (32.9, 40.5) in Delhi, and 24.3% (22.0, 26.6) in Karachi. Fish and shellfish were consumed more frequently in Chennai than in the other two cities. In Chennai, the adjusted odds ratio for diabetes, comparing more than weekly vs. less than weekly fish consumption, was 0.81 (0.61, 1.08); in Delhi, it was 1.18 (0.87, 1.58), and, in Karachi, it was 1.30 (0.94, 1.80). In Chennai, the adjusted odds ratio of prevalent diabetes among persons consuming shellfish more than weekly versus less than weekly was 1.08 (95% CI: 0.90, 1.30); in Delhi, it was 1.35 (0.90, 2.01), and, in Karachi, it was 1.68 (0.98, 2.86). Conclusions: Both the direction and the magnitude of association between seafood consumption and glycemia may vary by city. Further investigation into specific locally consumed seafoods and their prospective associations with incident diabetes and related pathophysiology are warranted. View Full-Text
Keywords: diabetes mellitus; glycated hemoglobin A; blood glucose; seafood; shellfish; diet; diet surveys; India; Pakistan diabetes mellitus; glycated hemoglobin A; blood glucose; seafood; shellfish; diet; diet surveys; India; Pakistan
MDPI and ACS Style

Gribble, M.O.; Head, J.R.; Prabhakaran, D.; Kapoor, D.; Garg, V.; Mohan, D.; Anjana, R.M.; Mohan, V.; Vasudevan, S.; Kadir, M.M.; Tandon, N.; Narayan, K.M.V.; Patel, S.A.; Jaacks, L.M. Potentially Heterogeneous Cross-Sectional Associations of Seafood Consumption with Diabetes and Glycemia in Urban South Asia. Int. J. Environ. Res. Public Health 2020, 17, 459.

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