Dietary profile of urban adult population in South India in the context of chronic disease epidemiology (CURES-68).

OBJECTIVE: Few dietary surveys have been done with reference to chronic diseases, such as diabetes, in India, which is considered to be the diabetes capital of the world. We report on the dietary intake of urban adults living in Chennai, South India. DESIGN: A population-based cross-sectional study. SETTING: A representative population of urban Chennai in southern India. SUBJECTS: The study population comprised 2042 individuals aged≥20 years selected from the Chennai Urban Rural Epidemiological Study (CURES). Dietary intake was measured using a validated and previously published interviewer-administered semi-quantitative meal-based FFQ. RESULTS: The mean daily energy intake was 10,393 (sd 2347) kJ (male: 10953 (sd 2364) kJ v. female: 9832 (sd 233) kJ). Carbohydrates were the major source of energy (64%), followed by fat (24%) and protein (12%). Refined cereals contributed to the bulk of the energy (45.8%), followed by visible fats and oils (12.4%) and pulses and legumes (7.8%). However, energy supply from sugar and sweetened beverages was within the recommended levels. Intake of micronutrient-rich foods, such as fruit and vegetable consumption (265 g/d), and fish and seafoods (20 g/d), was far below the FAO/WHO recommendation. Dairy and meat products intake was within the national recommended intake. CONCLUSIONS: The diet of this urban South Indian population consists mainly of refined cereals with low intake of fish, fruit and vegetables, and all of these could possibly contribute to the risk of non-communicable diseases such as diabetes in this population.

Glycaemic index of Indian flatbreads (rotis) prepared using whole wheat flour and 'atta mix'-added whole wheat flour.

To compare the glycaemic index (GI) of newly developed 'atta mix' roti with whole wheat flour roti. Eighteen healthy non-diabetic subjects consumed 50 g available carbohydrate portions of a reference food (glucose) and two test foods (whole wheat flour roti and atta mix roti) in random order after an overnight fast. The reference food was tested on three separate occasions, while the test foods were each tested once. Capillary blood samples were measured from finger-prick samples in fasted subjects ( - 5 and 0 min) and at 15, 30, 45, 60, 90 and 120 min from the start of each food. No significant difference was observed between roti prepared from whole wheat flour and atta mix in terms of appearance, texture, flavour, taste or acceptability. For each test food, the incremental area under the curve and GI values were determined. The GI of atta mix roti (27.3 (sem 2.2)) was considerably lower than the whole wheat flour roti (45.1 (sem 3.5), P < 0.001). Development of foods with lower dietary glycaemic load such as the atta mix roti could help in the prevention and control of diabetes in South Asian populations, which habitually consume very high glycaemic load diets.

Dietary carbohydrates, glycaemic load, food groups and newly detected type 2 diabetes among urban Asian Indian population in Chennai, India (Chennai Urban Rural Epidemiology Study 59).

The aim of the study was to examine the association of dietary carbohydrates and glycaemic load with the risk of type 2 diabetes among an urban adult Asian Indian population. Adult subjects aged >20 years (n 1843) were randomly selected from the Chennai Urban Rural Epidemiology Study, in Chennai city in southern India. Dietary carbohydrates, glycaemic load and food groups were assessed using FFQ. Oral glucose tolerance tests were performed using 75 g glucose in all subjects. Diagnosis of diabetes was based on WHO Consulting Group criteria. OR for newly detected diabetes were calculated for carbohydrates, glycaemic load and specific food groups comparing subjects in the highest with those in the lowest quartiles, after adjustment for potential confounders such as age, sex, BMI, family history of diabetes, physical activity, current smoking, alcohol consumption and relevant dietary factors. We identified 156 (8.5 %) newly diagnosed cases of type 2 diabetes. Refined grain intake was positively associated with the risk of type 2 diabetes (OR 5.31 (95 % CI 2.98, 9.45); P < 0.001). In the multivariate model, after adjustment for potential confounders, total carbohydrate (OR 4.98 (95 % CI 2.69, 9.19), P < 0.001), glycaemic load (OR 4.25 (95 % CI 2.33, 7.77); P < 0.001) and glycaemic index (OR 2.51 (95 % CI 1.42, 4.43); P = 0.006) were associated with type 2 diabetes. Dietary fibre intake was inversely associated with diabetes (OR 0.31 (95 % CI 0.15, 0.62); P < 0.001). In urban south Indians, total dietary carbohydrate and glycaemic load are associated with increased, and dietary fibre with decreased, risk of type 2 diabetes.

Refined grain consumption and the metabolic syndrome in urban Asian Indians (Chennai Urban Rural Epidemiology Study 57).

The objective of the study was to evaluate the association of refined grains consumption with insulin resistance and the metabolic syndrome in an urban south Indian population. The study population comprised 2042 individuals aged > or = 20 years randomly selected from the Chennai Urban Rural Epidemiology Study (CURES), a cross-sectional study on a representative population of Chennai, southern India. The metabolic syndrome was defined according to modified Adult Treatment Panel III guidelines; and insulin resistance, by the homeostasis assessment model. The mean refined grain intake was 333 g/d (46.9% of total calories) in this population. After adjustment for age, sex, body mass index, metabolic equivalent, total energy intake, and other dietary factors, higher refined grain intake was significantly associated with higher waist circumference (8% higher for the highest vs the lowest quartile, P for trend < .0001), systolic blood pressure (2.9%, P for trend < .0001), diastolic blood pressure (1.7%, P for trend = .03), fasting blood glucose (7.9%, P for trend = .007), serum triglyceride (36.5%, P for trend < .0001), low high-density lipoprotein cholesterol (-10.1%, P for trend < .0001), and insulin resistance (13.6%, P < .001). Compared with participants in the bottom quartile, participants who were in the highest quartile of refined grain intake were significantly more likely to have the metabolic syndrome (odds ratio, 7.83; 95% confidence interval, 4.72-12.99). Higher intake of refined grains was associated with insulin resistance and the metabolic syndrome in this population of Asian Indians who habitually consume high-carbohydrate diets.

Association of fruit and vegetable intake with cardiovascular risk factors in urban south Indians.

The study examines the relationship between fruit and vegetable intake (g/d) and CVD risk factors in urban south Indians. The study population comprised of 983 individuals aged > or = 20 years selected from the Chennai Urban Rural Epidemiological Study (CURES), a population-based cross-sectional study on a representative population of Chennai in southern India. Fruit and vegetable intake (g/d) was measured using a validated semi-quantitative FFQ. Linear regression analysis revealed that after adjusting for potential confounders such as age, sex, smoking, alcohol, BMI and total energy intake, the highest quartile of fruit and vegetable intake (g/d) showed a significant inverse association with systolic blood pressure (beta = - 2.6 (95 % CI - 5.92, - 1.02) mmHg; P = 0.027), BMI (beta = - 2.3 (95 % CI - 2.96, - 1.57) kg/m2; P < 0.0001), waist circumference (beta = - 2.6 (95 % CI - 3.69, - 1.46) cm; P < 0.0001), total cholesterol (beta = - 50 (95 % CI - 113.9, - 13.6) mg/l; P = 0.017) and LDL-cholesterol concentration (beta = - 55 (95 % CI - 110.8, - 11.1) mg/l; P = 0.039) when compared with the lowest quartile. A higher intake of fruit and vegetables explained 48 % of the protective effect against CVD risk factors. Increased intake of fruits and vegetables could play a protective role against CVD in Asian Indians who have high rates of premature coronary artery disease.