Food and Nutrient Intake of Filipinos with Diabetes

Imelda Angeles-Agdeppa^1,

¹Department of Science and Technology, Food and Nutrition Research Institute, 1631, Taguig City, Philippines

Cite this paper:
Imelda Angeles-Agdeppa. Food and Nutrient Intake of Filipinos with Diabetes. Journal of Food and Nutrition Research. 2020; 8(6):258-267. doi: 10.12691/jfnr-8-6-3

Abstract

Diabetes is considered as a worldwide public health problem and its prevalence in the Philippines has been increasing throughout the past decade. Dietary intake is a leading factor that affects diabetes development. Thus, the aim of the study is to analyze the food and nutrient intakes of Filipino adults with type 2 diabetes and to determine the underlying relationship between diabetes and dietary intake. The participants were 1,087 Filipinos with diabetes, ages 18 years and over from the 2013 National Nutrition Survey. In this study, two non-consecutive 24-hour dietary recalls were administered through face-to-face interviews by registered nutritionist-dietitians. The amount of consumed foods and beverages were estimated through standard household measures or food weighing. The energy and nutrient content of foods were assessed by utilizing the FNRI-Individual Dietary Evaluation System (IDES). Mean and usual energy and nutrient intake distributions were assessed using software established by Iowa State University (PC-SIDE version 1.02) and the evaluation of each macronutrient’s percentage contribution to total energy intake was done using the Acceptable Macronutrient Distribution Ranges (AMDR). Results of the study showed that Filipinos with diabetes have inadequate protein intake (53%) as well as micronutrient intake, including vitamin C (96%), thiamin (78%), riboflavin (85%), folate (87%), calcium (96%) and vitamin A (66%). Major sources of energy were mainly from carbohydrates (70.1%) consisting of rice, sugar-sweetened beverages, bread and sugar. A weak positive correlation was found between energy, macronutrient intake and fasting blood glucose. Findings of the study indicate that diabetes is affected by one’s dietary intake yet further research is required to define the role of micronutrients in diabetes management.

Keywords:
diabetes food intake nutrient intake food sources fasting blood glucose

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References:

[1]	International Diabetes Federation, What is diabetes, 2020. [Online] Available: https://www.idf.org/aboutdiabetes/what-is- diabetes.html?gclid=EAIaIQobChMI1eXu2qDH6AIVE6yWCh1H bQLaEAAYASAAEgIGC_D_BwE [Accessed Mar. 25, 2020].
[2]	International Diabetes Federation, IDF Diabetes Atlas 2019 (9th ed.), 2019. [E-book] Available: https://www.diabetesatlas.org/en/resources/.
[3]	World Health Organization, Diabetes, 30 Oct. 2018. (2018, October 30). [Online] Available: https://www.who.int/news- room/fact-sheets/detail/diabetes [Accessed Mar. 25, 2020].
[4]	Department of Science and Technology - Food and Nutrition Research Institute, Expanded National Nutrition Survey Health and Nutritional Status of Filipino Adults, 20-59 years old, 2018. [Online] Available: https://www.fnri.dost.gov.ph/images//sources/eNNS2018/Adults_ and_Elderly.pdf [Accessed Mar. 25, 2020].
[5]	Department of Science and Technology - Food and Nutrition Research Institute, 8th National Nutrition Survey Facts and Figures Clinical and Health Survey, Jul. 2015. [E-book] Available: http://enutrition.fnri.dost.gov.ph/site/preview.php?xx= uploads/2013_FaF_Clinical_and_Health_Survey.pdf
[6]	Breen, C., Ryan, M., Gibney, M. J. and O’Shea, D., “Diabetes-related nutrition knowledge and dietary intake among adults with type 2 diabetes,” British Journal of Nutrition, 114(3), 2015.
[7]	American Diabetes Association, “Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes-2018,” Diabetes Care, 41(Supplement 1), S28-S37, 2018.
[8]	Yokoyama, H., Araki, S., Kawai, K., Yamazaki, K., Tomonaga, O., Shirabe, S. and Maegawa, H., “Declining trends of diabetic nephropathy, retinopathy and neuropathy with improving diabetes care indicators in Japanese patients with type 2 and type 1 diabetes (JDDM 46),” BMJ Open Diabetes Research & Care, 6(1), e000521, 2018.
[9]	Pamungkas, R., Chamroonsawasdi, K. and Vatanasomboon, P., “A Systematic Review: Family Support Integrated with Diabetes Self-Management among Uncontrolled Type II Diabetes Mellitus Patients,” Behavioral Sciences, 7(4), 62, 2017.
[10]	Feigin, V. L., Roth, G. A., Naghavi, M., Parmar, P., Krishnamurthi, R., Chugh, S., … Forouzanfar, M. H., “Global burden of stroke and risk factors in 188 countries, during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013,” The Lancet Neurology, 15(9), 913-924, 2016.
[11]	Thewjitcharoen, Y., Chotwanvirat, P., Jantawan, A., Siwasaranond, N., Saetung, S., Nimitphong, H., … Reutrakul, S., “Evaluation of Dietary Intakes and Nutritional Knowledge in Thai Patients with Type 2 Diabetes Mellitus,” Journal of Diabetes Research, 2018.
[12]	Lopez-Olmedo, N., Carriquiry, L., Rodriguez-Ramirez, S…et al., ”Usual intake of added sugars and saturated fats is high while dietary fiber is low in the Mexican population,” Journal of Nutrition, 24(3), 395-406, 2018.
[13]	Food and Agriculture Organization of the United Nations. FAO/INFOODS Analytical Food Composition Database Version 1.1 - AnFooD1.1.2016
[14]	United States Department of Agriculture, What We Eat in America Food Categories. [Online] Available: https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/1516/food _category_list.pdf [Accessed May 16, 2019]
[15]	Carriquiry, A.L., "Assessing the Prevalence of Nutrient Inadequacy", Public Health Nutrition, 2(1), 23-33, 1999.
[16]	National Research Council, Subcommittee on Criteria for Dietary Evaluation, Nutrient Adequacy: Assessment Using Food Consumption Surveys, 1986. Washington: National Academy Press. [E-book] Available: https://www.nap.edu/catalog/618/nutrient-adequacy-assessment-using-food-consumption-surveys
[17]	Sami, W., Ansari, T., Butt, N. S. and Hamid, M., “Effect of diet on type 2 diabetes mellitus: A review,” International Journal of Health Sciences, 11(2), 65-71, 2017.
[18]	Pezeshki, A., Zapata, R. C., Singh, A., Yee, N. J. and Chelikani, P. K., “Low protein diets produce divergent effects on energy balance,” Scientific Reports, 6(1), 2016.
[19]	Deger, S. M., Hung, A. M., Gamboa, J. L., Siew, E. D., Ellis, C. D., Booker, C., Sha, F., Li, H., Bian, A., Stewart, T. G., Zent, R., Mitch, W. E., Abumrad, N. N. and Ikizler, T. A. “Systemic inflammation is associated with exaggerated skeletal muscle protein catabolism in maintenance hemodialysis patients,” JCI insight, 2(22), e95185, 2017.
[20]	Dittmar, M., Reber, H., & Kahaly, G. J., “Bioimpedance phase angle indicates catabolism in Type 2 diabetes,” Diabetic Medicine, 32(9), 1177-1185, 2015.
[21]	Drummen, M., Tischmann, L., Gatta-Cherifi, B., Adam, T., & Westerterp-Plantenga, M., “Dietary Protein and Energy Balance in Relation to Obesity and Co-morbidities,” Frontiers in Endocrinology, 9, 2018.
[22]	Yanase, T., Yanagita, I., Muta, K., & Nawata, H., “Frailty in elderly diabetes patients,” Endocrine Journal, 65(1), 1-11, 2017
[23]	Rahi, B., Morais, J. A., Gaudreau, P., Payette, H., & Shatenstein, B., “Energy and protein intakes and their association with a decline in functional capacity among diabetic older adults from the NuAge cohort," European Journal of Nutrition, 55(4), 1729-1739, 2015.
[24]	Ang, T., Bruce, C. R. and Kowalski, G.M., “Postprandial Aminogenic Insulin and Glucagon Secretion Can Stimulate Glucose Flux in Humans,” Diabetes, 68(5), 939-946, 2019.
[25]	Kitada, M., Ogura, Y., Suzuki, T., Monno, I., Kanasaki, K., Watanabe, A. and Koya, D., “A low-protein diet exerts a beneficial effect on diabetic status and prevents diabetic nephropathy in Wistar fatty rats, an animal model of type 2 diabetes and obesity,” Nutrition & Metabolism, 15(1), 1-11, 2018.
[26]	Brownlee, M., Aiello, L. P., Cooper, M. E., Vinik, A. I., Plutzky, J. and Boulton, A.J.M., “Chapter 33 - Complications of Diabetes Mellitus,” William’s textbook of endocrinology (13th ed.), pp. 1484-1581, 2016.
[27]	Kamrul Hasan, A.B.M., Islam, A., Islam, M. and Selim, S., “Vitamins and type 2 diabetes mellitus,” Journal of Clinical Diabetology, 4(1), 3-9, 2017.
[28]	Balbi, M. E., Tonin, F. S., Mendes, A. M., Borba, H. H., Wiens, A., Fernandez-Llimos, F. and Pontarolo, R., “Antioxidant effects of vitamins in type 2 diabetes: a meta-analysis of randomized controlled trials,” Diabetology & Metabolic Syndrome, 10(1), 1-12, 2018.
[29]	Valdés-Ramos, R., Guadarrama-López, A. L., Martínez-Carrillo, B. E. and Benítez-Arciniega, A. D., “Vitamins and type 2 diabetes mellitus,” Endocrine, metabolic & immune disorders drug targets, 15(1), 54-63, 2015.
[30]	Kuroda, M. and Sakaue, H., “Role of vitamin D and calcium in obesity and type 2 diabetes,” Clinical Calcium, 26(3): 349-354, 2016.
[31]	Zhou, C., Na, L., Shan, R., Cheng, Y., Li, Y., Wu, X. and Sun, C., “Dietary Vitamin C Intake Reduces the Risk of Type 2 Diabetes in Chinese Adults: HOMA-IR and T-AOC as Potential Mediators,” PloS one, 11(9), e0163571, 2016.
[32]	Ullah, A, Khan, A, and Khan, I., “Diabetes mellitus and oxidative stress—A concise review,” Saudi Pharmaceutical Journal, 24(5), 547-553, 2016.
[33]	Ellulu, M. S., Rahmat, A., Patimah, I., Khaza'ai, H. and Abed, Y. “Effect of vitamin C on inflammation and metabolic markers in hypertensive and/or diabetic obese adults: a randomized controlled trial,” Drug design, development and therapy, 9, 3405-3412, 2015.
[34]	Teshima, N., Shimo, M., Miyazawa, K., Konegawa, S., Matsumoto, A., Onishi, Y., … Sumida, Y., “Effects of Sugar-Sweetened Beverage Intake on the Development of Type 2 Diabetes Mellitus in Subjects with Impaired Glucose Tolerance: the Mihama Diabetes Prevention Study,” Journal of Nutritional Science and Vitaminology, 61(1), 14-19, 2015.
[35]	Anari, R., Amani, R. and Veissi, M., "Sugar-sweetened beverages consumption is associated with abdominal obesity risk in diabetic patients,” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 11, S675-S678, 2017.
[36]	Wang, P.Y., Fang, J.C., Gao, Z.H., Zhang, C. and Xie, S.Y., Higher intake of fruits, vegetables or their fiber reduces the risk of type 2 diabetes: A meta-analysis. Journal of Diabetes Investigation, 7(1), 56-69, 2015.
[37]	Kim, Y., Keogh, J., and Clifton, P., “A review of potential metabolic etiologies of the observed association between red meat consumption and development of type 2 diabetes mellitus,” Metabolism, 64(7), 768-779, 2015.
[38]	Mazidi, M., Kengne, A. P., George, E. S. and Siervo, M., “The Association of Red Meat Intake with Inflammation and Circulating Intermediate Biomarkers of Type 2 Diabetes Is Mediated by Central Adiposity,” British Journal of Nutrition, 1-20, 2019.
[39]	Kouvari, M., Notara, V., Kalogeropoulos, N. and Panagiotakos, D. B., “Diabetes mellitus associated with processed and unprocessed red meat: an overview. International Journal of Food Sciences and Nutrition,” 67(7), 735-743, 2016.
[40]	Wang, X., Lin, X., Ouyang, Y.Y., Liu, J., Zhao, G., Pan, A. and Hu, F.B., “Red and processed meat consumption and mortality: dose-response meta-analysis of prospective cohort studies,” Public Health Nutrition. 6:1-13, 2015.
[41]	Galani, J. H. Y., Patel, J. S., Patel, N. J. and Talati, J. G., “Storage of Fruits and Vegetables in Refrigerator Increases their Phenolic Acids but Decreases the Total Phenolics, Anthocyanins and Vitamin C with Subsequent Loss of their Antioxidant Capacity,” Antioxidants, 6(3), 59, 2017.
[42]	Polegato, B. F., Pereira, A. G., Azevedo, P. S., Costa, N. A., Zornoff, L. A. M., Paiva, S. A. R. and Minicucci, M. F., “Role of Thiamin in Health and Disease,” Nutrition in Clinical Practice, 2019.
[43]	Kerns, J. C., Arundel, C. and Chawla, L. S., “Thiamin Deficiency in People with Obesity,” Advances in Nutrition, 6(2), 147-153, 2015.
[44]	Saedisomeolia, A. and Ashoori, M., “Riboflavin in Human Health: A Review of Current Evidences,” New Research and Developments of Water-Soluble Vitamins, 57-81, 2018.
[45]	Thakur, K., Tomar, S. K., Singh, A. K., Mandal, S. and Arora, S., “Riboflavin and health: A review of recent human research,” Critical Reviews in Food Science and Nutrition, 57(17), 3650-3660, 2016.
[46]	Ashoori, M. and Saedisomeolia, A., “Riboflavin (vitamin B2) and oxidative stress: a review,” British Journal of Nutrition, 20: 1-7, 2014.
[47]	Alam, M. M., Iqbal, S. and Naseem, I., “Ameliorative effect of riboflavin on hyperglycemia, oxidative stress and DNA damage in type-2 diabetic mice: Mechanistic and therapeutic strategies,” Archives of Biochemistry and Biophysics, 584, 10-19, 2015.
[48]	Wang, Z., Xing, W., Song, Y., Li, H., Liu, Y., Wang, Y., … Han, J., “Folic Acid Has a Protective Effect on Retinal Vascular Endothelial Cells against High Glucose,” Molecules, 23(9), 2326, 2018.
[49]	Santulli, G., Pagano, G., Sardu, C., Xie, W., Reiken, S., D'Ascia, S.L., et al., “Calcium release channel RyR2 regulates insulin release and glucose homeostasis,” Journal of Clinical Investigation. 125:1968-78, 2015.
[50]	Soares, J., Pereira Leal, A., Silva, J. C., Almeida, J. and de Oliveira, H. P., “Influence of Flavonoids on Mechanism of Modulation of Insulin Secretion,” Pharmacognosy magazine, 13(52), 639-646, 2017.
[51]	Talaei, M., Pan, A., Yuan, J.M. and Koh, W.P., “Dairy intake and risk of type 2 diabetes,” Clinical Nutrition. 37, 712-718, 2018.
[52]	Kim, K.N., Oh, S.Y. and Hong, Y.C., “Associations of serum calcium levels and dietary calcium intake with incident type 2 diabetes over 10 years: The Korean Genome and Epidemiology Study (KoGES),” Diabetology & Metabolic Syndrome. 10, 50, 2018.
[53]	Sluijs, I., Cadier, E., Beulens, J.W., Van Der, A.D.L., Spijkerman, A.M., and Van Der Schouw, Y.T., “Dietary intake of carotenoids and risk of Type 2 diabetes,” Nutrition, Metabolism & Cardiovascular Diseases. 25(4), pp. 376-381, 2015.
[54]	Suniyadewi, N.W. and Pinatih, G.I., “Correlation between intakes of carbohydrates, protein, and fat with random blood sugar levels in menopausal women,” Frontiers of Nursing, 6(1), 77-80, 2019.
[55]	Cloete, L., Mitchell, B. and Morton, D., “The role of obesity in the onset of type 2 diabetes mellitus,” Nursing Standard, 31(22), 59-71, 2017.