Association Between Dietary Habits and Type 2 Diabetes Mellitus in Thai Adults: A Case-Control Study

Makhbuba Kalandarova,1 Ishtiaq Ahmad,1 Thin Nyein Nyein Aung,2 Saiyud Moolphate,3 Yoshihisa Shirayama,1,4 Miyoko Okamoto,1 Myo Nyein Aung,1,4,5 Motoyuki Yuasa1,4 1Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan; 2Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; 3Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, 50300, Thailand; 4Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan; 5Juntendo Advanced Research Institute for Health Sciences, Juntendo University, Tokyo, 113-8421, JapanCorrespondence: Ishtiaq Ahmad; Myo Nyein Aung, Department of Global Health Research, Juntendo University Graduate School of Medicine, Bunkyo City, Hongo, 2 Chome-1-1, Tokyo, 113-8421, Japan, Email ahmad@juntendo.ac.jp; myo@juntendo.ac.jpBackground: The prevalence of T2DM is escalating in Thailand affecting over 10% of adults aged 20– 79 years old. It is imperative to identify modifiable risk factors that can potentially help mitigate the risk of developing diabetes.Objective: This study aimed to investigate the relationship between dietary habits and type 2 diabetes in Chiang Mai, Thailand.Methods: This case-control study involved 300 individuals aged 25– 74 years residing in Chiang Mai, Thailand including 150 newly diagnosed T2DM patients (cases) and 150 community residents without diabetes (controls). Dietary habits were assessed based on Food Frequency Questionnaire (FFQ). Socio-demographic characteristics and anthropometric information of the participants were collected. Data analysis was performed using the STATA-17.Results: The case group participants were older and had a higher proportion of males compared to the control group. The case group exhibited a significantly higher consumption of meat, beans, nuts, soft drinks, and topping seasonings (p< 0.001), conversely, a lower intake of vegetables (p< 0.001), fruits (p=0.006), fish, rice (p< 0.001), eggs (p=0.032), milk products, coffee, and tea (p< 0.001) compared to the control group. Furthermore, the case group demonstrated a higher level of certain dietary practices such as a greater frequency of having meals with family, not removing visible fat from food (p< 0.001), and eating snacks between meals compared to controls. Multiple logistic regression analysis showed that after adjusting for potential confounding factors not removing visible fat from food (aOR 5.61, 95% CI: 2.29– 13.7, p< 0.001) and using topping seasonings (aOR 3.52 95% CI: 1.69– 7.32 p=0.001) were significantly associated with the risk of T2DM, whereas daily vegetable intake (aOR 0.32 95% CI: 0.15– 0.68 p=0.003) was inversely associated with T2DM.Conclusion: The study findings caution against the consumption of food rich in fat and using salty seasonings, while advocating for an increased intake of vegetables to prevent the prevalence of T2DM.Keywords: Thailand, T2DM, dietary habits, food frequency questionnaire, diabetes prevention, global health