|Van Rompay, Maria -|
|Mckeown, Nicola -|
|Castaneda-Sceppa, Carmen -|
|Ordovas, Jose -|
|Tucker, Katherine -|
Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: November 16, 2012
Publication Date: February 1, 2013
Citation: Van Rompay, M.I., Mckeown, N.M., Castaneda-Sceppa, C., Ordovas, J.M., Tucker, K.L. 2013. Carbohydrate nutrition differs by diabetes status and is associated with dyslipidemia in Boston Puerto Rican adults without diabetes. Journal of Nutrition. 143(2):182-199. Interpretive Summary: Diabetes is a major and growing global health problem and this is especially evident for minorities in the US. Specifically, Puerto Rican adults have a greater prevalence of type 2 diabetes (T2D) and lower HDL-cholesterol (HDL-C , also known as the ‘good’ cholesterol) than the general U.S. population and both genetic and environmental factors may play a role in this excess of risk. In order to tease out the contribution of diet and more specifically, carbohydrate consumption we carried out cross-sectional analyses using data from 1219 Puerto Ricans enrolled in the Boston Puerto Rican Health Study. Lifestyle characteristics and dietary intake were compared by T2D status. Individuals with T2D (39.5%) had lower dietary carbohydrate, dietary glycemic load (GL), and total sugar intake (from sugar, fruit drinks, and soda) compared with those without T2D. In individuals without T2D, dietary carbohydrate and GL were inversely associated with HDL-C. In conclusion, individuals with T2D showed evidence of dietary modification as reflected by healthier carbohydrate consumption. However, among those without diabetes, a high intake of refined carbohydrates was associated with decreased HDL-C.
Technical Abstract: Puerto Rican adults have a greater prevalence of type 2 diabetes (T2D) and lower HDL-cholesterol (HDL-C) than the general U.S. population. Carbohydrate nutrition may play a role in this disparity. Cross-sectional analyses included data from 1219 Puerto Ricans aged 45-75 y enrolled in the Boston Puerto Rican Health Study. Using the Pearson chi-square test and ANCOVA, lifestyle characteristics and dietary intake, as assessed by semiquantitative FFQ, were compared by T2D status based on fasting plasma glucose concentration and medication use. Food source rankings for carbohydrate, dietary glycemic load (GL), and fiber were obtained using the SAS procedure PROC RANK. Geometric mean plasma HDL-C and TG concentrations were compared across quintiles of dietary carbohydrate, glycemic index (GI), GL, and fiber by using ANCOVA and tests for linear trend. In multivariable analyses, individuals with T2D (39.5%) had lower dietary carbohydrate, GL, and total sugar intake from lower intake of sugar, fruit drinks, and soda compared with those without T2D. In individuals without T2D, dietary carbohydrate and GL were inversely associated with HDL-C (P < 0.0001). Associations between dietary fiber and HDL-C were confounded by carbohydrate intake, apparently from concurrent consumption of legumes with white rice, a refined carbohydrate food. No associations were observed between carbohydrate, dietary GI, GL, or fiber and TG. In conclusion, individuals with T2D showed evidence of dietary modification. Among those without diabetes, a high intake of refined carbohydrates was associated with decreased HDL-C. Longitudinal research on carbohydrate nutrition in relation to diabetes risk factors and blood lipids in Puerto Ricans is warranted.