Dietary Diversity as a Risk Factor for Obesity in Algerian Patients with Type 2 Diabetes Mellitus
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Data Collection
2.2. Dietary Assessment
2.3. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | All Patients (n = 390) |
---|---|
Sex | |
Male | 111 (28.5) |
Female | 279 (71.5) |
Age (years) | 57.1 ± 10.4 |
<60 years | 231 (59.2) |
≥60 years | 159 (40.8) |
Smoking (yes) | 11 (2.8) |
Family history of diabetes (yes) | 280 (71.8) |
Diabetes duration (years) | 8.8 ± 7.3 |
<10 years | 238 (61.0) |
≥10 years | 152 (39.0) |
Antidiabetic treatment strategies | |
Dietary treatment alone | 11 (2.8) |
Oral anti-diabetic drugs alone, any | 237 (60.8) |
Insulin alone | 47 (12.1) |
Oral anti-diabetic drugs plus insulin | 95 (24.4) |
HbA1c (%) | 7.5 ± 1.7 |
<7% | 168 (43.1) |
≥7% | 222 (59.9) |
Total number of diabetes complications/comorbidities | |
0 | 152 (39.0) |
1–2 | 212 (54.4) |
≥3 | 26 (6.7) |
Diabetes complications and comorbidities among participants | |
Cardiovascular disease | 57 (14.6) |
Retinopathy | 52 (13.3) |
Neuropathy | 11 (2.8) |
Nephropathy | 25 (6.4) |
Hypertension | 184 (47.2) |
BMI (kg/m2) | 29.4 ± 5.0 |
Normal body weight | 79 (20.3) |
Overweight | 150 (38.5) |
Obese | 161 (41.3) |
Waist circumference (cm) | 103.8 ± 12.5 |
Normal | 25 (6.4) |
At risk | 365 (93.5) |
Hip circumference (cm) | 109.3 ± 12.7 |
Waist-to-hip ratio | 0.9 ± 0.09 |
Normal | 44 (11.3) |
At risk | 346 (88.7) |
Body fat (%) | 40.0 ± 8.8 |
Fat mass index (kg/m2) | 12.1 ± 4.5 |
Physical activity level | |
Low | 238 (61.0) |
Moderate | 136 (34.9) |
High | 16 (4.1) |
Independents Variables | Non-Obese (n = 229) | Obese (n = 161) | OR (95% CI) | p |
---|---|---|---|---|
Sex | ||||
Male | 87 (38.0) | 24 (14.9) | 1 | |
Female | 142 (62.0) | 137 (85.1) | 3.497 (2.102–5.820) | <0.0001 |
Age (years) | 57.9 ± 9.8 | 56.0 ± 11.0 | 0.982 (0.963–1.001) | 0.070 |
<60 years | 128 (55.9) | 103 (64.0) | 1 | |
≥60 years | 101 (44.1) | 58 (36.0) | 0.714 (0.472–1.080) | 0.110 |
Smoking | ||||
No | - | - | 1 | |
Yes | 9 (3.9) | 2 (1.2) | 0.307 (0.066–1.442) | 0.135 |
Family history of diabetes | ||||
No | - | - | 1 | |
Yes | 166 (72.5) | 114 (70.8) | 0.921 (0.589–1.439) | 0.716 |
Diabetes duration (years) | 8.8 ± 6.6 | 8.9 ± 8.1 | 1.001 (0.974–1.029) | 0.949 |
<10 years | 138 (60.3) | 100 (62.1) | 1 | |
≥10 years | 91 (39.7) | 61 (37.9) | 0.925 (0.611–1.400) | 0.712 |
Antidiabetic treatment strategies | ||||
Dietary treatment alone | 5 (2.2) | 6 (3.7) | 1 | |
Oral anti-diabetic drugs alone, any | 144 (62.9) | 93 (57.8) | 0.538 (0.160–1.814) | 0.318 |
Insulin alone | 30 (13.1) | 17 (10.6) | 0.472 (0.125–1.781) | 0.268 |
Oral anti-diabetic drugs plus insulin | 50 (21.8) | 45 (28.0) | 0.750 (0.214–2.626) | 0.653 |
HbA1c (%) | 7.5 ± 1.8 | 7.5 ± 1.6 | 0.991 (0.885–1.110) | 0.876 |
<7% | 103 (45.0) | 65 (10.4) | 1 | |
≥7% | 126 (55.0) | 96 (59.6) | 1.207 (0.802–1.817) | 0.366 |
Total number of diabetes complications/comorbidities | ||||
0 | 94 (41.0) | 58 (36.0) | 1 | |
1–2 | 121 (52.8) | 91 (56.5) | 1.219 (0.796–1.865) | 0.362 |
≥3 | 14 (6.1) | 12 (7.5) | 1.389 (0.601–3.210) | 0.442 |
Diabetes complications and comorbidities among participants | ||||
Cardiovascular disease | ||||
No | - | - | 1 | |
Yes | 33 (14.4) | 24 (14.9) | 1.040 (0.589–1.839) | 0.891 |
Retinopathy | ||||
No | - | - | 1 | |
Yes | 34 (14.8) | 18 (11.2) | 0.722 (0.392–1.330) | 0.296 |
Neuropathy | ||||
No | - | - | 1 | |
Yes | 5 (2.2) | 6 (3.7) | 1.734 (0.520–5.783) | 0.370 |
Nephropathy | ||||
No | - | - | 1 | |
Yes | 15 (6.6) | 10 (6.2) | 0.945 (0.413–2.160) | 0.893 |
Hypertension | ||||
No | - | - | 1 | |
Yes | 97 (42.4) | 87 (54.0) | 1.600 (1.066–2.401) | 0.023 |
BMI (kg/m2) | 26.0 ± 2.5 | 34.3 ± 3.7 | - | |
Normal body weight | 79 (34.5) | 0 (0.0) | - | |
Overweight | 150 (65.5) | 0 (0.0) | - | |
Obese | 0 (0.0) | 161 (100) | - | |
Waist circumference (cm) | 97.8 ± 10.4 | 112.3 ± 10.1 | 1.155 (1.121–1.191) | <0.0001 |
Normal | 82 (35.8) | 3 (1.9) | 1 | |
At risk | 147 (64.2) | 158 (98.1) | 29.379 (9.084–95.017) | <0.0001 |
Hip circumference (cm) | 103.6 ± 11.1 | 117.3 ± 10.2 | 1.160 (1.123–1.198) | <0.0001 |
Waist-to-hip ratio | 0.9 ± 0.09 | 0.9 ± 0.08 | 3.732 (0.418–33.329) | 0.238 |
Normal | 29 (12.7) | 15 (9.3) | 1 | |
At risk | 200 (87.3) | 146 (90.7) | 1.411 (0.730–2.727) | 0.305 |
Body fat (%) | 35.1 ± 6.7 | 47.0 ± 6.3 | 1.379 (1.289–1.475) | <0.0001 |
Fat mass index (kg/m2) | 9.2 ± 2.3 | 16.2 ± 3.7 | 3.674 (2.694–5.010) | <0.0001 |
Physical activity level | ||||
Low | 115 (50.2) | 123 (76.4) | 1 | |
Moderate | 102 (44.5) | 34 (21.1) | 0.312 (0.196–0.496) | <0.0001 |
High | 12 (5.2) | 4 (2.5) | 0.312 (0.098–0.994) | 0.049 |
All Patients (n = 390) | Non-Obese (n = 229) | Obese (n = 161) | p | |
---|---|---|---|---|
Proportion consuming | ||||
Meat group | 272 (69.7) | 152 (66.4) | 120 (74.5) | 0.084 |
Fruit group | 362 (92.8) | 212 (92.6) | 150 (93.2) | 0.824 |
Vegetable group | 377 (96.7) | 219 (95.6) | 158 (98.1) | 0.175 |
Dairy group | 350 (89.7) | 200 (87.3) | 150 (93.2) | 0.062 |
Grain group | 381 (97.7) | 226 (98.7) | 155 (96.3) | 0.118 |
Average grams consumed | ||||
Meat group | 87.6 ± 82.7 | 80.2 ± 78.7 | 98.1 ± 87.1 | 0.049 |
Fruit group | 140.1 ± 94.2 | 144.8 ± 100.2 | 133.3 ± 84.7 | 0.508 |
Vegetable group | 253.4 ± 168.4 | 260.9 ± 180.3 | 242.7 ± 149.9 | 0.612 |
Dairy group | 207.6 ± 141.3 | 197.6 ± 139.9 | 221.9 ± 142.6 | 0.154 |
Grain group | 290.5 ± 140.4 | 287.7 ± 143.2 | 294.3 ± 136.6 | 0.588 |
All Patients (n = 390) | Non-Obese (n = 229) | Obese (n = 161) | p | |
---|---|---|---|---|
Energy intake (EI) (Kcal/d) | 1411.4 ± 378.9 | 1401.3 ± 399.6 | 1425.8 ± 348.0 | 0.318 |
Carbohydrate (g/d) | 209.6 ± 53.2 | 210.6 ± 57.9 | 208.1 ± 45.8 | 0.940 |
Carbohydrate (%EI) | 60.6 ± 9.9 | 61.3 ± 10.2 | 59.5 ± 9.3 | 0.075 |
%EI from carbohydrate (45–60) | 169 (43.3) | 89 (38.9) | 80 (49.7) | 0.034 |
Protein (g/d) | 43.5 ± 22.6 | 41.2 ± 22.8 | 46.6 ± 22.2 | 0.023 |
Protein (%EI) | 12.3 ± 5.6 | 11.5 ± 5.5 | 13.3 ± 5.6 | 0.006 |
%EI from protein (10–20) | 212 (54.4) | 122 (53.3) | 90 (55.9) | 0.608 |
Fat (g/d) | 44.3 ± 25.7 | 43.7 ± 26.3 | 45.1 ± 25.0 | 0.347 |
Fat (%EI) | 27.1 ± 10.2 | 27.0 ± 10.4 | 27.2 ± 9.9 | 0.882 |
%EI from fat (<35) | 301 (77.2) | 176 (76.9) | 125 (77.6) | 0.856 |
Crude Model | p | Model 1 | p | Model 2 | p | Model 3 | p | |
---|---|---|---|---|---|---|---|---|
DDS | ||||||||
Non-obese | 1 | 1 | 1 | 1 | ||||
Obese | 1.335 (0.997–1.786) | 0.052 | 1.376 (1.020–1.855) | 0.037 | 1.458 (1.073–1.981) | 0.016 | 1.426 (1.029–1.974) | 0.033 |
Meat group | ||||||||
Non-obese | 1 | 1 | 1 | 1 | ||||
Obese | 1.003 (1.000–1.005) | 0.036 | 1.003 (1.001–1.006) | 0.017 | 1.003 (1.001–1.006) | 0.017 | 1.003 (1.000–1.006) | 0.032 |
Fruit group | ||||||||
Non-obese | 1 | 1 | 1 | 1 | ||||
Obese | 0.999 (0.996–1.001) | 0.238 | 0.999 (0.997–1.001) | 0.439 | 0.999 (0.997–1.002) | 0.543 | 0.999 (0.996–1.001) | 0.382 |
Vegetable group | ||||||||
Non-obese | 1 | 1 | 1 | 1 | ||||
Obese | 0.999 (0.998–1.001) | 0.293 | 1.000 (0.998–1.001) | 0.536 | 1.000 (0.998–1.001) | 0.649 | 1.000 (0.998–1.001) | 0.473 |
Dairy group | ||||||||
Non-obese | 1 | 1 | 1 | 1 | ||||
Obese | 1.001 (1.000–1.003) | 0.097 | 1.001 (0.999–1.002) | 0.281 | 1.001 (0.999–1.002) | 0.379 | 1.000 (0.999–1.002) | 0.627 |
Grain group | ||||||||
Non-obese | 1 | 1 | 1 | 1 | ||||
Obese | 1.000 (0.999–1.002) | 0.649 | 1.001 (0.999–1.003) | 0.213 | 1.001 (1.000–1.003) | 0.125 | 1.000 (0.999–1.003) | 0.289 |
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Bounihi, A.; Saidi, H.; Bouazza, A.; Benbaibeche, H.; Azzouz, M.; Koceir, E.A. Dietary Diversity as a Risk Factor for Obesity in Algerian Patients with Type 2 Diabetes Mellitus. Healthcare 2021, 9, 1229. https://doi.org/10.3390/healthcare9091229
Bounihi A, Saidi H, Bouazza A, Benbaibeche H, Azzouz M, Koceir EA. Dietary Diversity as a Risk Factor for Obesity in Algerian Patients with Type 2 Diabetes Mellitus. Healthcare. 2021; 9(9):1229. https://doi.org/10.3390/healthcare9091229
Chicago/Turabian StyleBounihi, Abdenour, Hamza Saidi, Asma Bouazza, Hassiba Benbaibeche, Malha Azzouz, and Elhadj Ahmed Koceir. 2021. "Dietary Diversity as a Risk Factor for Obesity in Algerian Patients with Type 2 Diabetes Mellitus" Healthcare 9, no. 9: 1229. https://doi.org/10.3390/healthcare9091229