Shifts in dietary patterns and risk of type-2 diabetes in a Caribbean adult population: ways to address diabetes burden.

Purpose: As the French West Indies are facing an ongoing nutrition transition with increasing type-2 diabetes mellitus (T2DM) prevalence, our study aimed to evaluate the effect of potential shifts in dietary patterns on T2DM risk in French West Indian adults according to several scenarios.

Methods: We used a cross-sectional multistage sampling survey on dietary intake conducted in 2013 on a representative sample of Guadeloupeans and Martinicans adults (n = 1063). From previously identified current dietary patterns, we used PRIME-Diabetes, a comparative risk assessment model, to estimate the effect of potential shifts from the "transitioning" pattern to the "convenient," the "prudent," and the "traditional" ones on T2DM risks.

Results: Potential shift in dietary intakes from the "transitioning" pattern to the "traditional" one reduced the T2DM risk in women (- 16% [- 22; - 10]) and in men - 14% [- 21; - 7]), as the shift in dietary intakes toward the "prudent" pattern (- 23% [- 29; - 17] and - 19% - 23; - 14], respectively). These risk reductions were mostly driven by increased whole grains, fruits, green leafy vegetable intakes, and decreases in potatoes, red meats, processed meats, and sugar-sweetened beverages. The shift in dietary intakes toward the "convenient" pattern did not affect the T2DM risks.

Conclusion: To curb the increase in T2DM prevalence and reduce this burden, one public health action could be to target transitioning adults and help them to shift towards a diet associated with a reduced risk of T2DM as a prudent or a traditional diet.