%0 Generic
%A Osei, Tracy Bonsu
%C Heidelberg
%D 2025
%F heidok:35419
%R 10.11588/heidok.00035419
%T Dietary behaviour and type 2 diabetes mellitus among sub-Saharan African populations under transition
%U https://archiv.ub.uni-heidelberg.de/volltextserver/35419/
%X One of the major contributing factors to the increase in type 2 diabetes mellitus is nutrition transition which is described as the change in dietary patterns and nutrient intake when communities embrace contemporary lifestyle during economic and social development. For sub-Sahara Africa population under transition, the contribution of dietary factors in the development of type 2 diabetes and its complication is unclear. This study therefore aimed at gaining insight into the relationships of dietary behaviour with type 2 diabetes mellitus among African populations under transition. The main objectives included (i) to synthesise population-based studies focusing on health exposure–outcome relationships among migrant groups in Germany, (ii) to identify a dietary pattern related with biomarkers of non-alcoholic fatty liver diseases and to evaluate the association of this dietary pattern with type 2 diabetes among adults from Ghana (iii) to determine the associations of low-carbohydrate diets with glycaemic control and diabetic complications among adults from Ghana.  In answering objective one, a systematic search was conducted on the relevant existing evidence on population-based studies focusing on health exposure–outcome relationships among migrant groups in Germany.  While the second and third studies used data from the multi-country Research on Obesity and Diabetes among African Migrants study. Objective two used reduced ranked regression to derive sex-specific dietary patterns associated with fatty liver Index and evaluated the association between these dietary patterns with type 2 diabetes mellitus using logistic regression. While objective three calculated low-carbohydrate diet score and identify the association between dietary pattern with microvascular (nephropathy) and macrovascular (coronary artery disease, peripheral artery disease, stroke) complications using logistic regression.    The following findings were made:  First, the systematic review included 68 publications. In these articles, 56 were cross-sectional studies, 11 cohort studies, and one intervention study. Also, health outcome under studies were particular to population groups under studies. And the demographic and socioeconomic characteristics showed consistent association to poor health among immigrants in Germany while other risk factors did not. Second, dietary pattern scores in males explained 16.0% of the variation in the fatty liver index and 9.9% of the variation in food consumption. This dietary pattern was characterized by high intakes of poultry, whole-grain cereals, coffee and tea, condiments, and potatoes and the odds of type 2 diabetes was 45% higher per 1 dietary pattern score-standard deviation while dietary patterns had inconsistent associations with type 2 diabetes mellitus among women.   Third, the low-carbohydrate diet score was associated with glycated haemoglobin among individuals with type 2 diabetes. While among individuals without type 2 diabetes, the beta coefficients varied between |0.01| and |0.04|, yet the relevant associations were statistically significant. In terms of complications, there was a negative correlation between the low-carbohydrate diet score and self-reported stroke (adjusted OR: 0.95; 95% CI: 0.91, 0.99). Other diabetic complications had no associations with low-carbohydrate diet score.  Although findings from the systematic review gave a valuable insight on risk-factor diseases association among migrants, low quality of evidence on chronic diseases demonstrated the lack of investment in research. And this may be the reason for the lack of clarity on the pattern on the relationship between a large variety of risk factors and disease grouping. Again, dietary patterns generated among these African under transition showed a nutritional shift from typical traditional diet to modernised diet. The changes seen may be associated with acculturation following urbanisation or migration. Finally, the lack of association seen between low-carbohydrate diet and glycated haemoglobin among participant with type 2 diabetes as well as inconsistent association with the complication may reaffirm the evidence that glycaemic control lies not only on the reduction of carbohydrate but rather the quality of the entire diet.  To conclude, the findings of the study contribute to a wide range of different insight on the aetiological study on migrant health. Again, this study promotes the idea that that metabolic pathway leading to non-alcoholic fatty liver diseases and type 2 diabetes mellitus maybe supported by modernized dietary practices among transitioning Ghanaians. As well as adds to the body of evidence that have proofing that low carbohydrate could support blood glucose control.