title: Comparable Dietary Patterns Describe Dietary Behavior across Ethnic Groups in the Netherlands, but Different Elements in the Diet Are Associated with Glycated Hemoglobin and Fasting Glucose Concentrations.
abstract: BACKGROUND
  Ethnic minority populations in Western societies suffer from a disproportionate burden of type 2 diabetes (T2D). Insight into the role of dietary patterns in T2D may assist public health nutrition efforts in addressing these health disparities.
  
  
  OBJECTIVE
  We explored the association between dietary patterns and biomarkers of T2D in 5 ethnic groups living in Amsterdam, Netherlands.
  
  
  METHODS
  A total of 3776 men and women aged 18-70 y of Dutch, South Asian Surinamese, African-Surinamese, Turkish, and Moroccan origin from the HELIUS (HEalthy LIfe in an Urban Setting) study were included. Diet was assessed by using a food-frequency questionnaire, and dietary patterns were derived separately per ethnic group. First, food group-based dietary patterns were derived by using principal components analysis and the association with glycated hemoglobin (HbA1c) and plasma fasting glucose was assessed by using multivariable linear regression. Second, biomarker-driven dietary patterns based on HbA1c and fasting glucose concentrations were derived by applying reduced rank regression.
  
  
  RESULTS
  Two comparable food group-based dietary patterns were identified in each ethnic group: a "meat and snack" pattern and a "vegetable" pattern. The meat-and-snack pattern derived within the Dutch origin population was significantly associated with HbA1c (β = 0.09; 95% CI: 0.00, 0.19) and fasting glucose (β = 0.18; 95% CI: 0.09, 0.26) concentrations. A biomarker-derived pattern characterized by red and processed meat was observed among Dutch-origin participants; however, among ethnic minority groups, this pattern was characterized by other foods including ethnicity-specific foods (e.g., roti, couscous).
  
  
  CONCLUSIONS
  Although similar food group dietary patterns were derived within 5 ethnic groups, the association of the meat-and-snack pattern with fasting glucose concentrations differed by ethnicity. Taken together with the finding of ethnic differences in biomarker-driven dietary patterns, our results imply that addressing T2D risk in multiethnic populations requires ethnicity-specific approaches.
authors.affiliation: Departments of Public Health and l.h.dekker@amc.uva.nl.
authors.forename: Louise H
authors.initials: LH
authors.lastname: Dekker
authors.affiliation: Saw Swee Hock School of Public Health and Departments of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore;
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
authors.affiliation: Departments of Public Health and.
authors.forename: Marieke B
authors.initials: MB
authors.lastname: Snijder
authors.affiliation: Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands;
authors.forename: Ron J G
authors.initials: RJ
authors.lastname: Peters
authors.affiliation: Department of Epidemiology and Biostatistics and EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam, Netherlands;
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Dekker
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, Netherlands;
authors.forename: Jeanne H M
authors.initials: JH
authors.lastname: de Vries
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Center for Nutrition, Prevention, and Health Services, Bilthoven, Netherlands; and.
authors.forename: Evelien J
authors.initials: EJ
authors.lastname: de Boer
authors.affiliation: Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
authors.forename: Matthias B
authors.initials: MB
authors.lastname: Schulze
authors.affiliation: Departments of Public Health and.
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
authors.affiliation: Departments of Public Health and.
authors.forename: Mary
authors.initials: M
authors.lastname: Nicolaou
mesh_terms: D015415:Biomarkers; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D004032:Diet; D005006:Ethnicity; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D008297:Male; D008913:Minority Groups; D009426:Netherlands / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: diabetes; dietary patterns; ethnicity; principal component analysis; reduced rank regression analysis