Food intake of individuals with and without diabetes across different countries and ethnic groups

Background: Given the importance of nutrition therapy in diabetes management, we hypothesized that food intake differs between individuals with and without diabetes. We investigated this hypothesis in two large studies including different countries and ethnic groups. Material and methods: Study populations were the EPIC (European Prospective Investigation into Cancer and Nutrition)-Study and the Multiethnic Cohort Study (MEC). Dietary intake was assessed via food frequency questionnaires, and calibrated using 24h-recall information for the EPIC-Study. Only confirmed self-reports of diabetes at cohort entry were included. In EPIC, 6,192 diabetes patients and in the MEC 13,776 diabetes patients were matched on age, sex, country/ethnic group and 2.5kg/m² body mass index (BMI)-category to individuals without diabetes to compare food group intake. We matched on BMI to control for measurement error in our comparison. Results: The most prominent differences between individuals with diabetes and without diabetes refer to higher intake of softdrinks (by 13 and 44% in the EPIC and MEC, respectively), and lower consumption of sweets, juice, wine, and beer (>10% difference) in individuals with diabetes. Consumption of vegetables, fish and meat was slightly higher in individuals with diabetes compared to those without in both studies, but the differences were less than 10%. Surprisingly, despite different ethnic groups and countries, the study populations showed largely similar patterns. Conclusions: Although diabetes patients are expected to undergo nutritional education, we found only small differences in dietary behavior in comparison to cohort members without diabetes. These findings suggest that more education is needed to improve the current behaviors in order to assist in the prevention of complications.