Dietary intake among urban adults with diabetes: COPEN (Colombian Nutritional Profiles), a cross-sectional study

Objectives: The prevalence of diabetes is increasing rapidly in developing
countries. We aimed to estimate the prevalence of diabetes and to describe
its main correlates and associated dietary intake in urban adults from
Colombia. Setting: The Colombian Study of Nutritional Profiles (COPEN) was
a population-based, cross-sectional, multi-stage probabilistic sampling
survey designed to represent the five main Colombian cities. Participants:
Between June and November 2018, we studied 736 non-pregnant participants
aged 18 or older. Diabetes was defined as a random plasma glucose ˃= 200
mg/dL, self-reported prior diagnosis of diabetes or use of any oral or
injectable antidiabetic agent(s). Participants also fulfilled a detailed
157-item food frequency questionnaire (FFQ). Primary and secondary outcome
measures: Prevalence of diabetes, dietary intake of key nutrients,
achievement of dietary goals among individuals with diabetes. Results: The
overall estimated prevalence of diabetes was 10.1%, with no difference by
sex (9.6% in women, 10.8% in men, p=0.43). Socioeconomic level (SEL)
correlated positively with diabetes prevalence, the absolute difference in
prevalence for the highest vs lowest SEL was 5.6%. The association between
diabetes and education level depended on sex, diabetes was more prevalent
among more educated men and less educated women. Abdominal obesity was
associated with a 65% increase in diabetes prevalence among men, and a
163% increase in women. The proportion of non-achievement of dietary
intake goals among participants with diabetes was 94.4% for saturated
fats, 86.7% for sodium, 84.4% for fiber and 80% for trans fats. In
multivariate logistical regression models, age was the strongest
independent correlate of diabetes. Conclusions: Self-reported
diabetes was highly prevalent among Colombian adults, much more than
described in most official reports. There were large differences by
abdominal obesity status, region of residence, SEL and educational level.
The proportion of individuals with diabetes meeting dietary
recommendations was alarmingly low.