Associations of Dietary Intake and Sociodemographic Factors with the Incidence of T2DM among Obese Adults
Abstract
Type 2 diabetes mellitus (T2DM) is a major public health concern, particularly among obese individuals. Dietary intake, including energy, protein, and fiber consumption plays a key role in metabolic health, with sociodemographic factors influencing its mechanisms. Objective: This study aimed to analyze the associations of these dietary factors and T2DM incidence in obese adults in Surakarta city. This cross-sectional study included 100 obese adults from Surakarta. T2DM status was determined based on their medical records. Dietary intake data were collected using Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Sociodemographic data were collected by interview. Multiple binary logistic regression was performed to analyze the association between dietary intake and T2DM with p<0.05. The most participants were female (75.0%) and Javanese (82.0%). Daily fiber intake was significantly associated with a lower risk of T2DM (OR=0.04, 95%CI=0.01–0.14, p<0.001), while ethnicity, educational history, occupation, and monthly personal expenses were identified as significant risk factors (p<0.05). Further analysis, only daily fiber intake (aOR=0.06, 95%CI=0.01–0.29, p<0.001) and occupation (aOR=16.81, 95%CI=3.98–71.08, p<0.001) remained significantly associated with T2DM. Adequate daily fiber intake was the strongest protective factor, while individuals engaged in work were the strongest predictor of T2DM among obese adults in Surakarta city.
References
Akhavan, N. S., Pourafshar, S., Johnson, S. A., Foley, E. M., George, K. S., Munoz, J., Siebert, S., Clark, E. A., Basiri, R., Hickner, R. C., Navaei, N., Levenson, C. W., Panton, L. B., Daggy, B. P., & Arjmandi, B. H. (2020). The Relationship between Protein Intake and Source on Factors Associated with Glycemic Control in Individuals with Prediabetes and Type 2 Diabetes. Nutrients, 12(7), 1–17. https://doi.org/10.3390/NU12072031
Ancu, O., Mickute, M., Guess, N. D., Hurren, N. M., Burd, N. A., & Mackenzie, R. W. (2021). Does high dietary protein intake contribute to the increased risk of developing prediabetes and type 2 diabetes? Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition et Metabolisme, 46(1), 1–9. https://doi.org/10.1139/APNM-2020-0396
Azizi Fard, N., De Francisci Morales, G., Mejova, Y., & Schifanella, R. (2021). On the interplay between educational attainment and nutrition: a spatially-aware perspective. EPJ Data Science 2021 10:1, 10(1), 1–21. https://doi.org/10.1140/EPJDS/S13688-021-00273-Y
Badan Kebijakan Pembangunan Kesehatan RI. (2023). SKI 2023 dalam Angka. https://www.badankebijakan.kemkes.go.id/ski-2023-dalam-angka/.
Badan Pusat Statistik Kota Surakarta. (2021). Distribusi Pengeluaran Penduduk Menurut Pengelompokan Bank Dunia. https://surakartakota.bps.go.id/id/statistics-table/2/NDQ0IzI=/population-expenditure-distribution-according-to-world-bank-groupings.html
Badan Pusat Statistik Kota Surakarta. (2023a). Jumlah Penduduk Menurut Kelompok Umur dan Jenis Kelamin. https://surakartakota.bps.go.id/id/statistics-table/2/MzE5IzI=/jumlah-penduduk-menurut-kelompok-umur-dan-jenis-kelamin.html
Badan Pusat Statistik Kota Surakarta. (2023b). Kota Surakarta dalam Angka 2023.
Bulsiewicz, W. J. (2023). The Importance of Dietary Fiber for Metabolic Health. American Journal of Lifestyle Medicine, 17(5), 639–648. https://doi.org/10.1177/15598276231167778
Cao, X., Yu, H., Quan, Y., Qin, J., Zhao, Y., Yang, X., & Gao, S. (2024). An overview of environmental risk factors for type 2 diabetes research using network science tools. Digital Health, 10. https://doi.org/10.1177/20552076241271722
Choi, J. (2020). Impact of Stress Levels on Eating Behaviors among College Students. Nutrients, 12(5). https://doi.org/10.3390/NU12051241
Clemente-Suárez, V. J., Redondo-Flórez, L., Beltrán-Velasco, A. I., Martín-Rodríguez, A., Martínez-Guardado, I., Navarro-Jiménez, E., Laborde-Cárdenas, C. C., & Tornero-Aguilera, J. F. (2023). The Role of Adipokines in Health and Disease. Biomedicines, 11(5), 1290. https://doi.org/10.3390/BIOMEDICINES11051290
Dean, A. G., Sullivan, K. M., & Soe, M. M. (2013). OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version 3. https://www.openepi.com/Menu/OE_Menu.htm
Estoppey, P., Clair, C., Auderset, D., & Puder, J. J. (2023). Sex differences in type 2 diabetes. Cardiovascular Medicine, 26(3), 96–99. https://doi.org/10.4414/CVM.2023.02273
Fappi, A., & Mittendorfer, B. (2020). Dietary protein intake and obesity-associated cardiometabolic function. Current Opinion in Clinical Nutrition and Metabolic Care, 23(6), 380–386. https://doi.org/10.1097/MCO.0000000000000689
Grjibovski, A., Grjibovski, A. M., Usynina, A. A., Postoev, V. A., Kharkova, O. A., Odland, J. Ø., Quattrocchi, A., Quattrocchi, A., Kolokotroni, O., Demetriou, C. A., Charalambous, A., Heraclides, A., Safieddine, B., Safieddine, B., Sperlich, S., Beller, J., Lange, K., Epping, J., Tetzlaff, J., … Geyer, S. (2020). Socioeconomic inequalities in type 2 diabetes among different population subgroups. European Journal of Public Health, 30(Supplement_5). https://doi.org/10.1093/EURPUB/CKAA165.1044
Hansen, T. T., Astrup, A., & Sjödin, A. (2021). Are Dietary Proteins the Key to Successful Body Weight Management? A Systematic Review and Meta-Analysis of Studies Assessing Body Weight Outcomes after Interventions with Increased Dietary Protein. Nutrients, 13(9). https://doi.org/10.3390/NU13093193
He, J., Zhang, P., Shen, L., Niu, L., Tan, Y., Chen, L., Zhao, Y., Bai, L., Hao, X., Li, X., Zhang, S., & Zhu, L. (2020). Short-Chain Fatty Acids and Their Association with Signalling Pathways in Inflammation, Glucose and Lipid Metabolism. International Journal of Molecular Sciences 2020, Vol. 21, Page 6356, 21(17), 6356. https://doi.org/10.3390/IJMS21176356
Hemiö, K., Lindström, J., Peltonen, M., Härmä, M., Viitasalo, K., & Puttonen, S. (2020). The association of work stress and night work with nutrient intake - a prospective cohort study. Scandinavian Journal of Work, Environment & Health, 46(5), 533–541. https://doi.org/10.5271/SJWEH.3899
Hernández-Teixidó, C., López-Simarro, F., Arranz Martínez, E., Escobar Lavado, F. J., & Miravet Jiménez, S. (2023). [Vulnerability and social determinants in diabetes]. Semergen, 49(8). https://doi.org/10.1016/J.SEMERG.2023.102044
Hoffmann Sarda, F. A., & Giuntini, E. B. (2023). Carbohydrates for glycemic control: functional and microbiome aspects. Current Opinion in Clinical Nutrition and Metabolic Care, 26(4), 341–346. https://doi.org/10.1097/MCO.0000000000000935
Janssen, J. A. M. J. L. (2024). Overnutrition, Hyperinsulinemia and Ectopic Fat: It Is Time for A Paradigm Shift in the Management of Type 2 Diabetes. https://doi.org/10.3390/ijms25105488
Kementrian Kesehatan Republik Indonesia. (2019). Peraturan Menteri Kesehatan Republik Indonesia. 28.
Kendrick, K. N., Bode Padron, K. J., Bomani, N. Z., German, J. C., Nyanyo, D. D., Varriano, B., Tu, L., & Stanford, F. C. (2023). Equity in Obesity Review. Endocrinology and Metabolism Clinics of North America, 52(4), 617–627. https://doi.org/10.1016/J.ECL.2023.05.003
Kheriji, N., Boukhalfa, W., Mahjoub, F., Hechmi, M., Dakhlaoui, T., Mrad, M., Bahlous, A. H. S., Amor, N. Ben, Jamoussi, H., & Kefi, R. (2022). The Role of Dietary Intake in Type 2 Diabetes Mellitus: Importance of Macro and Micronutrients in Glucose Homeostasis. Nutrients, 14(10). https://doi.org/10.3390/nu14102132
McCurley, J. L., Levy, D. E., Dashti, H. S., Gelsomin, E., Anderson, E., Sonnenblick, R., Rimm, E. B., & Thorndike, A. N. (2022). Association of Employees’ Meal Skipping Patterns with Workplace Food Purchases, Dietary Quality, and Cardiometabolic Risk: A Secondary Analysis from the ChooseWell 365 Trial. Journal of the Academy of Nutrition and Dietetics, 122(1), 110-120.e2. https://doi.org/10.1016/J.JAND.2021.08.109
Mensink, M. (2024). Dietary protein, amino acids and type 2 diabetes mellitus: a short review. Frontiers in Nutrition, 11. https://doi.org/10.3389/FNUT.2024.1445981
Park, Y. J., Chung, S., Hwang, J. T., Shon, J., & Kim, E. (2022). A review of recent evidence of dietary protein intake and health. Nutrition Research and Practice, 16(Suppl 1), S37–S46. https://doi.org/10.4162/NRP.2022.16.S1.S37
Patel, M. R. (2020). Social Determinants of Poor Management of Type 2 Diabetes Among the Insured. Current Diabetes Reports, 20(11), 1–6. https://doi.org/10.1007/S11892-020-01354-4/METRICS
Petroni, M. L., Brodosi, L., Marchignoli, F., Sasdelli, A. S., Caraceni, P., Marchesini, G., & Ravaioli, F. (2021). Nutrition in Patients with Type 2 Diabetes: Present Knowledge and Remaining Challenges. Nutrients, 13(8). https://doi.org/10.3390/NU13082748
Reynolds, A. N., Akerman, A. P., & Mann, J. (2020). Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses. PLoS Medicine, 17(3), e1003053. https://doi.org/10.1371/JOURNAL.PMED.1003053
Seo, E., Lee, Y., Mun, E., Kim, D. H., Jeong, Y., Lee, J., Jeong, J., & Lee, W. (2022). The effect of long working hours on developing type 2 diabetes in adults with prediabetes: The Kangbuk Samsung Cohort Study. Annals of Occupational and Environmental Medicine, 34(1). https://doi.org/10.35371/AOEM.2022.34.E4
Sirdah, M. M., & Reading, N. S. (2020). Genetic predisposition in type 2 diabetes: A promising approach toward a personalized management of diabetes. Clinical Genetics, 98(6), 525–547. https://doi.org/10.1111/CGE.13772
Waddell, I. S., & Orfila, C. (2023). Dietary fiber in the prevention of obesity and obesity-related chronic diseases: From epidemiological evidence to potential molecular mechanisms. Critical Reviews in Food Science and Nutrition, 63(27), 8752–8767. https://doi.org/10.1080/10408398.2022.2061909
World Health Organization. (2000). The Asia-Pacific perspective : redefining obesity and its treatment. Sydney : Health Communications Australia.
World Health Organization. (2021). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
World Health Organization. (2024). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Zhu, M., Liu, X., Liu, W., Lu, Y., Cheng, J., & Chen, Y. (2021). β cell aging and age-related diabetes. Aging, 13(5), 7691–7706. https://doi.org/10.18632/AGING.202593.
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