title: Higher protein intake is associated with diabetes risk in South Asian Indians: the Metabolic Syndrome and Atherosclerosis in South Asians Living in America (MASALA) study.
abstract: OBJECTIVE
  Despite a high prevalence of type 2 diabetes in South Asian Indians, the impact of diet in this high-risk ethnic group has not been fully explored. The association of macronutrient intake and diabetes in South Asian Indians was examined in this cross-sectional study.
  
  
  METHODS
  A population-based cohort of 146 South Asian Indians aged 45-79 years without existing cardiovascular disease living in the San Francisco Bay Area was recruited between August 2006 and October 2007. Macronutrient intake was assessed with a food-frequency questionnaire developed and validated in South Asians. Diabetes was defined by use of a hypoglycemic medication, a fasting plasma glucose level > or =126 mg/dL, or a 2-hour post-challenge glucose level > or =200 mg/dL. The association between energy-adjusted macronutrient intake and diabetes was explored using multivariable logistic regression models.
  
  
  RESULTS
  Forty-one (28%) participants had type 2 diabetes; 20 were unaware of this diagnosis and were classified as having diabetes by laboratory testing. In a model fully adjusted for age, sex, waist circumference, and hypertension, there was a 70% increase in the odds of diabetes per standard deviation in gram of protein intake/day (standardized OR 1.70 [95% CI 1.08, 2.68], p = 0.02). There was a trend toward increased protein intake and diabetes in the subset of participants with previously unknown, laboratory-diagnosed diabetes. Results did not vary significantly by sex, body mass index, or dietary pattern.
  
  
  CONCLUSIONS
  Higher level of protein intake was associated with increased odds of diabetes in this cohort of South Asian Indians. Diet may be a modifiable lifestyle factor in this high-risk ethnic group.
authors.affiliation: University of California, San Francisco, 4150 Clement Street, Section 111A1, San Francisco, CA 94121, USA. erica.wang@ucsf.edu
authors.forename: Erica T
authors.initials: ET
authors.lastname: Wang
authors.forename: Lawrence
authors.initials: L
authors.lastname: de Koning
authors.forename: Alka M
authors.initials: AM
authors.lastname: Kanaya
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D004032:Diet / Q000009:adverse effects; D004044:Dietary Proteins / Q000009:adverse effects*; D002149:Energy Intake; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D004044:Dietary Proteins