Diabetes, diet-health behavior, and obesity

Sven Anders, Christiane Schroeter, Sven Anders, Christiane Schroeter

Abstract

High-quality diets play an important role in diabetes prevention. Appropriate dietary adherence can improve insulin sensitivity and glycemic control, and thus contribute to lifestyle improvement. However, previous research suggests that dietary adherence is arguably among the most difficult cornerstones of diabetes management. The objectives of this study are (1) to estimate whether and to what extent individuals diagnosed with diabetes show significant differences in diet quality [healthy eating index (HEI)] compared to healthy individuals, (2) to quantify whether and to what extent diabetics experience significantly higher outcomes of body mass index (BMI), and (3) to estimate whether and to what extent dietary supplementation impacts diabetes patient's diet quality and/or BMI outcomes. We use data from the 2007-2008 U.S. National Health and Nutrition Examination Survey (NHANES). The NHANES is the primary, randomized, and nationally representative survey used to assess the health and nutritional status in the U.S. We apply propensity score matching (PSM) to account for selection bias and endogeneity between self-reported diet and health behavir (treatment) and BMI outcomes. We control for an individual's BMI as to capture the impact of past dietary behavior in its impact on HEI. Matching results suggest that regular dietary supplement consumption is associated with significant lower BMI outcomes of almost 1 kg/m(2). The close relationship between diabetes and obesity has been at the center of the diet-health policy debate across Canada and the U.S. Knowledge about this linkage may help to improve the understanding of the factors that impact dietary choices and their overall health outcomes, which may lead to a more efficient and effective promotion of dietary guidelines, healthy food choices, and targeted consumer health and lifestyle policies.

Keywords: diabetes management; diet quality; healthy eating index (2010); nutrition supplement intake; obesity.

References

    1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes. Diabetes Care (2004) 27(5):1047–5310.2337/diacare.27.5.1047
    1. Chou S-Y, Grossman M, Saffer H. An economic analysis of adult obesity: results from the behavioral risk factor surveillance system. J Health Econ (2004) 23(3):565–8710.1016/j.jhealeco.2003.10.003
    1. Andreas C, Drichoutis J, Nayga RM, Lazaridis P. Can nutritional label use influence body weight outcomes? Kyklos (2009) 62(4):500–2510.1111/j.1467-6435.2009.00448.x
    1. Etilé F. Food consumption and health. In: Lusk JL, Roosen J, Shogren J, editors. The Oxford Handbook of the Economics of Food Conumption and Policy. New York, NY: Oxford University Press; (2011). p. 717–46.
    1. Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA (2003) 289(1):76–9.10.1001/jama.289.1.76
    1. Obesity and Overweight. World Health Organization; (2015). Available from:
    1. Rahati S, Sharaki M, Arjomand G, Shahraki T. Food pattern, lifestyle, and diabetes mellitus. Int J High Risk Behav Addict (2014) 3(1):1–5.10.5812/ijhrba.8725
    1. Kastorini CM, Panagiotakos DB. Dietary patterns and prevention of type 2 diabetes: from research to clinical practice; a systematic review. Curr Diabetes Rev (2009) 5:221–7.10.2174/157339909789804341
    1. Berry TR, Anders S, Chan CB, Bell RC. Communicating diabetes best practices to clients: a preliminary investigation of educator perspective. Health Promot Pract (2011) 13(3):388–94.10.1177/1524839911404225
    1. DeKoning L, Chiuve SE, Fung TT, Wilettt WC, Rimm EB, Hu FB. Diet-quality scores and the risk of type 2 diabetes in men. Diabetes Care (2011) 34:1150–6.10.2337/dc10-2352
    1. Guenther PM, Casavale KO, Reedy J, Kirkpatrick SI, Hiza HAB, Kuczynski KJ, et al. Healthy Eating Index [Fact Sheet No 2]. Alexandria: USDA – Center for Nutrition Policy and Promotion; (2013).
    1. Agudo A. Measuring intake of fruit and vegetables. Joint FAO/WHO Workshop on Fruit and Vegetables for Health; September 1-3, 2004. Kobe: (2005). Available from:
    1. Keen CL, Zidenberg-Cherr S. Should vitamin-mineral supplements be recommended for all women with childbearing potential? Am J Clin Nutr (1994) 59(2):532S–8S.
    1. Guenther PM, Krebs-Smith S, Reedy J, Britten P, Juan W, Lino M, et al. Healthy Eating Index-2005 Fact Sheet No. 1. Alexandria: Center for Nutrition Policy and Promotion; (2006).
    1. Schroeter C, Anders S, Carlson A. The economics of health and vitamin consumption. Appl Econ Perspect Policy (2013) 35(1):125–4910.1093/aepp/pps040
    1. Pole K. We truly are what we eat. Med Post (2007) 43(20):20.
    1. Office USGA. Herbal Dietary Supplements: Examples of Deceptive or Questionable Marketing Practices and Potentially Dangerous Advice [Contract No.: GAO-10-662T]. Washington, DC: United States Government Accountability Office; (2010). Available from:
    1. García-Pérez L-E, Alvarez M, Dilla T, Gil-Guillén V, Orozco-Beltrán D. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther (2013) 4(2):175–94.10.1007/s13300-013-0034-y
    1. Anderson A, Dewar J, Marshall D, Cummins S, Taylor M, Dawson J, et al. The development of a healthy eating indicator shopping basket tool (HEISB) for use in food access studies – identification of key food items. Public Health Nutr (2006) 10(12):1440–7.10.1017/S1368980007000092
    1. Berkowitz SA, Gao X, Tucker KL. Food-insecure dietary patterns are associated with poor longitudinal glycemic control in diabetes: results from the Boston Puerto Rican Health Study. Diabetes Care (2014) 37:2587–92.10.2337/dc14-0753
    1. DeJong N, Ocke MC, Branderhorst HAC, Friele R. Demographic and lifestyle characteristics of functional food consumers and dietary supplement users. Br J Nutr (2003) 89:273–81.10.1079/BJN2002772
    1. Frazão E, Allshouse J. Strategies for intervention: commentary and debate. J Nutr (2003) 133:844–7.
    1. Bailey RL, Gahche JJ, Lentino CV, Dwyer JT, Engel JS, Thomas PR, et al. Dietary supplement use in the United States, 2003–2006. J Nutr (2011) 141(2):261–610.3945/jn.110.133025
    1. Balluz LS, Kieszak SM, Philen RM, Mulinare J. Vitamin and mineral supplement use in the united states: results from the third national health and nutrition examination survey. Arch Fam Med (2000) 9(3):258.10.1001/archfami.9.3.258
    1. Ervin BR, Wright JD, Reed-Gillette D. Prevalence of Leading Types of Dietary Supplements Used in the Third National Health and Nutrition Examination Survey, 1988-94. Atlanta: National Center for Health Statistics; (2004).
    1. Gahche J, Bailey R, Burt V, Hughes J, Yetley E, Dwyer J, et al. Dietary Supplement Use among US Adults has Increased since NHANES III (1988-1994). Atlanta: National Center for Health Statistics; (2011).
    1. Rock CL. Multivitamin-multimineral supplements: who uses them? Am J Clin Nutr (2007) 85(1):277S–9S.10.3945/ajcn.2009.28837
    1. Expert Panel on Detection E, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). J Am Med Assoc (2001) 285(19):2486–9710.1001/jama.285.19.2486
    1. Park J, Davis GC. The theory and econometrics of health information in cross-sectional nutrient demand analysis. Am J Agric Econ (2001) 83(4):840–5110.1111/0002-9092.00213
    1. Kahle L, Buckman D. Calculation of Mean Healthy Eating Index-2010 Component and Total Scores and Corresponding Standard Errors and Confidence Intervals for a Population, Subpopulation, or Group. In: Inc. IMS editor. Alexandria: Center for Nutrition Policy and Promotion; (2013).
    1. Prevention CfDCa. National Health and Nutrition Examination Survey 2007-2008. Atlanta: CDC/National Center for Health Statistics; (2014).
    1. Services USDoAUSDoHaH. Dietary Guidelines for Americans 2010. Washington, DC: U.S. Government Printing Office; (2010).
    1. Cawley J, Ruhm CJ. The Economics of Risky Health Behaviors. Bonn: Institute for the Study of Labor (IZA) (2011).
    1. Todd JE, Mancino L, Lin B-H. The Impact of Food Away from Home on Adult Diet Quality [Contract No.: ERR-90]. Washington, DC: U.S. Department of Agriculture, Economic Research Service; (2010).
    1. Variyam JN, Blaylock J, Smallwood D, Basiotis PP. USDA’s Healthy Eating Index and Nutrition Information, Technical Bulletin. Washington, DC: U.S. Department of Agriculture, Economic Research Service; (1998). Available from:
    1. Becker GS. Habits, addictions, and traditions. Kyklos (1992) 45(3):327–4610.1111/j.1467-6435.1992.tb02119.x
    1. Huston SJ, Finke MS. Diet choice and the role of time preference. J Consum Aff (2003) 37:143–6010.1111/j.1745-6606.2003.tb00444.x
    1. Mancino L, Todd J, Lin BH. Separating what we eat from where: measuring the effect of food away from home on diet quality. Food Policy (2009) 34:557–6210.1016/j.foodpol.2009.09.003
    1. Bogue J, Coleman T, Sorenson D. Determinants of consumers’ dietary behavior for health-enhancing foods. Br Food J (2005) 107(1):4–1610.1108/00070700510573168
    1. Petrovici DA, Ritson C. Factors influencing consumer dietary health preventative behaviours. BMC Public Health (2006) 6(1):222.10.1186/1471-2458-6-222
    1. Jeffrey RW, Rick AM. Cross-sectional and longitudinal associations between body mass index and marriage-related factors. Obes Res (2002) 10(8):809.10.1038/oby.2002.109
    1. Grossman M. On the concept of health capital and the demand for health. J Polit Econ (1972) 80(2):223–5510.1086/259880
    1. Grilli L, Rampichini C, editors. Propensity scores for the estimation of average treatment effects in observational studies. Training Sessions on Causal Inference. Bristol: (2011). Available from:
    1. Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika (1983) 70(1):41–55.10.1093/biomet/70.1.41
    1. Becker SO, Ichino A. Estimation of average treatment effects based on propensity scores. Stata J (2002) 2(4):358–77.
    1. Abebaw D, Fentie Y, Kassa B. The impact of a food security program on household food consumption in northwestern Ethiopia: a matching estimator approach. Food Policy (2010) 35(4):286–9310.1016/j.foodpol.2010.01.002
    1. Campbell BL, Nayga RM, Park JL, Silva A. Does the national school lunch program improve children’s dietary outcomes? Am J Agric Econ (2011) 93(4):1099–13010.1093/ajae/aar031
    1. Caliendo M, Kopeinig S. Some practical guidance for the implementation of propensity score matching. J Econ Surv (2008) 22(1):31–7210.1111/j.1467-6419.2007.00527.x
    1. Clinic M. Diseases and Conditions: Metabolic Syndrome. (2015). Available from:
    1. Drenowski A, Eichelsdoerfer P. The mediterranean diet: does it have to cost more? Public Health Nutr (2009) 12(9A):1621–8.10.1017/S1368980009990462

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera