Influence of Nutritional Factors on Prevalence of Diabetes

Twelve age-matched populations of eleven countries were tested by standardized methods to determine associations between prevalence of hyperglycemia and certain epidemiologic variables, including several nutritional factors. There were great differences among some of these populations in socioeconomic status, diet, adiposity, and race. Environmental and demographic circumstances varied widely and prevalence of diabetes differed as much as ten-fold. There was in general a positive association between prevalence of diabetes and dietary intake of fat and of sugar, and a negative association between prevalence of diabetes and total carbohydrate consumption; but some inconsistencies in these associations suggested that they may have been partly or completely coincidental. Prevalence of diabetes correlated well with serum cholesterol levels, both among and within populations. Thejnost impressive and consistent association in these studies was between prevalence of diabetes and fatness (as estimated by weight in relation to height). Both within and among countries and races, this association was observed to a high degree. Interracial differences in prevalence of diabetes were small when racial groups were matched for adiposity. In a group of 1,645 subjects from the general population of Central America, those with abnormal glucose tolerance had a substantially higher prevalence of electrocardiographic abnormalities than those with normal tolerance.