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Macronutrient Intake, Diagnosis Status, and Glycemic Control Among US Hispanics/Latinos With Diabetes
Xueyin Wang1, Molly Jung1, Yasmin Mossavar-Rahmani1
1Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824.
Context:
Diet modification is a mainstay of diabetes management. US Hispanics/Latinos are disproportionately affected by diabetes, but few studies have examined dietary intake among US Hispanics/Latinos with diabetes, and little is known regarding the influence of diabetes awareness on dietary intake.
Objective:
We evaluated macronutrient intake and its associations with diabetes awareness and glycemic control among US Hispanics/Latinos with diabetes.
Participants:
This analysis included 3310 diabetic adults aged 18–74 years from the Hispanic Community Health Study/Study of Latinos (2008–2011).
Main Outcome Measures:
Diabetes was defined as diagnosed (based on medical history or antihyperglycemic medication use) or undiagnosed diabetes (based on fasting glucose ≥ 126 mg/dL, glycated hemoglobin [HbA1c] ≥ 6.5%, or 2 h glucose ≥ 200 mg/dL in the absence of a physician diagnosis). Dietary intake was assessed using two 24-hour recalls.
Results:
Among Hispanic/Latino adults with diabetes, 21.2%, 55.7%, and 71.2% met the American Diabetes Association recommendations for fiber (≥14 g per 1000 kcal), saturated fat (<10% of total energy), and cholesterol intake (<300 mg), respectively. Compared with those with undiagnosed diabetes, people with diagnosed diabetes consumed less carbohydrate (50.3 vs 52.4% of total energy; P = .017), total sugar (19.1 vs 21.5% of total energy; P = .002), added sugar (9.8 vs 12.1% of total energy; P < .001), and more total fat (30.7 vs 29.3% of total energy; P = .048) and monounsaturated fat (11.5 vs 10.7% of total energy; P = .021). Association between diabetes awareness and low total and added sugar intake was observed in individuals of Mexican and Puerto Rican background but not in other groups (P for interaction < .05). Among people with diagnosed diabetes, those with HbA1c of 7% or greater consumed more total fat, saturated fat, and cholesterol than those with HbA1c less than 7% (all P < .05).
Conclusions:
Among US Hispanics/Latinos with diabetes, fiber intake is low, and diabetes awareness is associated with reduced carbohydrate and sugar intake and increased monounsaturated fat intake. Sugar intake may require special attention in certain Hispanic/Latino background groups.
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