title: Diabetes in Asian Indians-How much is preventable? Ten-year follow-up of the Chennai Urban Rural Epidemiology Study (CURES-142).
abstract: We sought to evaluate the contribution of various modifiable risk factors to the partial population attributable risk (PARp) for diabetes in an Asian Indian population. Of a cohort of 3589 individuals, representative of Chennai, India, followed up after a period of ten years, we analyzed data from 1376 individuals who were free of diabetes at baseline. A diet risk score was computed incorporating intake of refined cereals, fruits and vegetables, dairy products, and monounsaturated fatty acid. Abdominal obesity was found to contribute the most to incident diabetes [Relative Risk (RR) 1.63(95%CI 1.21-2.20)]; (PARp 41.1% (95%CI 28.1-52.6)]. The risk for diabetes increased with increasing quartiles of the diet risk score [highest quartile RR 2.14(95% CI 1.26-3.63)] and time spent viewing television [(RR 1.84(95%CI 1.36-2.49] and sitting [(RR 2.09(95%CI 1.42-3.05)]. The combination of five risk factors (obesity, physical inactivity, unfavorable diet risk score, hypertriglyceridemia and low HDL cholesterol) could explain 80.7% of all incident diabetes (95%CI 53.8-92.7). Modifying these easily identifiable risk factors could therefore prevent the majority of cases of incident diabetes in the Asian Indian population. Translation of these findings into public health practice will go a long way in arresting the progress of the diabetes epidemic in this region.
authors.affiliation: Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India. Electronic address: dranjana@drmohans.com.
authors.forename: Ranjit Mohan
authors.initials: RM
authors.lastname: Anjana
authors.affiliation: Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India.
authors.forename: Vasudevan
authors.initials: V
authors.lastname: Sudha
authors.affiliation: Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India.
authors.forename: Divya H
authors.initials: DH
authors.lastname: Nair
authors.affiliation: Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India.
authors.forename: Nagarajan
authors.initials: N
authors.lastname: Lakshmipriya
authors.affiliation: Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Deepa
authors.affiliation: Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Pradeepa
authors.affiliation: Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India.
authors.forename: Coimbatore S
authors.initials: CS
authors.lastname: Shanthirani
authors.affiliation: Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India.
authors.forename: Sivasankaran
authors.initials: S
authors.lastname: Subhashini
authors.affiliation: Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Vasanti
authors.initials: V
authors.lastname: Malik
authors.affiliation: Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Unnikrishnan
authors.affiliation: Department of Statistics, Manipal University, Manipal, India.
authors.forename: Valsalakumari S
authors.initials: VS
authors.lastname: Binu
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Shivani A
authors.initials: SA
authors.lastname: Patel
authors.affiliation: Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.affiliation: Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India.
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000517:prevention & control; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D012424:Rural Population; D014505:Urban Population
keywords: Asian Indians; Diabetes; Diet risk score; Obesity; Physical inactivity; Population attributable risk