Nutritional Assessment and Estimation of the Attributable Risk of Diabetes Mellitus to Simple Sugar Intake in Northern Iran: The PERSIAN Guilan Cohort Study

Background: Diabetes Mellitus (DM) is a non-communicable disease with an increasing rate across all age groups worldwide. It makes the body vulnerable to other chronic diseases. Besides medication therapy, DM can be controlled by following a healthy lifestyle. In this study, the dietary patterns of diabetic individuals assessed in the Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study (PGCS) population. Methods: A comprehensive survey was conducted over three years among 10,276 individuals aged 35 to 70 in the PGCS population. Socio-demographic and food intake information of 2,531 diabetic patients was collected using a food frequency questionnaire (FFQ). Data analysis was conducted with SPSS software. The estimation of the attributable risk of DM related to the intake of simple sugars was performed using the population attributable risk (PAR) equation. Results: The intake of dietary fibers was lower than the recommended 25-38 g/day in these patients, while they consumed high carbohydrates (more than 65% of total calories/day) and simple sugars (more than 10% of total calories/day). More than 15% of total energy was provided by simple sugars in these patients. The average population attributable risk of DM (PARDM) in the total population was 17.84% based on the intake of fructose and glucose, which was close to the proportion of diabetic patients in this survey by considering the proportion of pre-diabetic patients. Conclusions: Regarding the significant effect of dietary patterns on the development of DM, the authors suggest developing educational programs to help individuals maintain a balanced diet to decrease the rate of DM in the coming years.