Association of the DASH dietary pattern with insulin resistance and diabetes in US Hispanic/Latino adults: results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Leonor Corsino, Daniela Sotres-Alvarez, Nicole M Butera, Anna María Siega-Riz, Cristina Palacios, Cynthia M Pérez, Sandra S Albrecht, Rebecca A Espinoza Giacinto, Marisa Judith Perera, Linda Van Horn, M Larissa Avilés-Santa, Leonor Corsino, Daniela Sotres-Alvarez, Nicole M Butera, Anna María Siega-Riz, Cristina Palacios, Cynthia M Pérez, Sandra S Albrecht, Rebecca A Espinoza Giacinto, Marisa Judith Perera, Linda Van Horn, M Larissa Avilés-Santa

Abstract

Objective: To examine the association between diet quality and both diabetes status and insulin resistance in Hispanic/Latino adults, and the extent to which differences in diet quality contribute to differences in outcomes across Hispanic/Latino heritage.

Research design and methods: Cross-sectional study. Data are from 15 942 individuals enrolled in the Hispanic Community Health Study/Study of Latinos. Diet was ascertained using two 24-hour dietary recalls, and diet quality was measured using the Dietary Approaches to Stop Hypertension (DASH) score (range: 0-80, lowest to highest). Diabetes status was defined based on self-reported diagnosis, use of antihyperglycemic medications, or unrecognized diabetes (determined by baseline laboratory measures). Insulin resistance was determined using homeostatic model assessment of β-cell function and insulin resistance (HOMA-IR). The association between DASH and diabetes status was examined using multinomial logistic regression. The association between DASH and HOMA-IR was assessed using linear regression, and we tested whether the association was modified by Hispanic/Latino heritage or diabetes status.

Results: DASH score was highest in those with self-reported diabetes (controlled) and no medications (44.8%). A higher DASH score was associated with a lower HOMA-IR, and the association was the same regardless of diabetes status (p>0.8 for the interaction).

Conclusions: The association between DASH and diabetes status was strongest for those with controlled self-reported diabetes and who were not taking antihyperglycemic medications. A higher DASH score was associated with less insulin resistance among Hispanics/Latinos. Differences in DASH scores by Hispanic/Latino heritage did not explain the differences in prevalence of diabetes and insulin resistance reported in the diverse Hispanic/Latino population.

Clinical trial number: NCT02060344.

Keywords: DASH diet; Hispanic; Latino; diabetes; insulin resistance.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
DASH component score by Hispanic/Latino heritage adjusted by age and sex. 1Adjusted by age and sex (mean age: 41.07, % male: 47.71). 2Each component ranges from 0 to 10, except for grains and dairy, for which each subcomponent ranges from 0 to 5. Data are presented as means±SE. DASH, Dietary Approaches to Stop Hypertension.

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