141st APHA Annual Meeting

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Are vegetarian Asian Indians at lower risk for diabetes and metabolic syndrome than non-vegetarians?

Monday, November 4, 2013

Ranjita Misra, PhD, CHES, FASHA , Social and Behavioral Health Sciences, West Virginia University, School of Public Health, Morgantown, WV
Padmini Balagopal, PhD RD , Private Practice, Private Practice, Philadelphia, PA
Thakor Patel, MD , Nephrology, Uniformed Services University of Health Sciences, Virginia 22039, VA
Sudha Raj, PhD, RD , Department of Public Health, Food Studies and Nutrition, Syracuse University, Syracuse, NY
Dustin Long, PhD , Department of Biostatistics, West Virginia University, Morgantown, WV
Background/Significance: Research studies have shown that plant-based diets confer cardiovascular and metabolic health benefits. Asian Indians [AIs] in the United States have elevated risk for chronic diseases such as diabetes, metabolic syndrome and obesity suggesting an ethnic vulnerability that may have genetic and/or lifestyle causative links.

Objective: The data from Diabetes among India Americans [DIA] study was used to explore if vegetarian AIs were at lower risk for diabetes, metabolic syndrome and obesity as compared to the non-vegetarian AIs, after controlling for demographics [age, gender, income, education, tobacco use, access to health care, marital status, obesity, family history of diabetes], dietary habits, physical activity, acculturation [years of residency, English language proficiency, ethnic language/food preference] and clinical risk factors [blood pressure, homocysteine, lipoprotein a, C Reactive Protein, HDL and LDL].

Methods: The sample comprised of 1038 randomly selected Asian Indian immigrants, aged 18 years and older in seven US sites. Prevalence of diabetes and metabolic syndrome was estimated and Obesity was calculated using the WHO Asian criteria. Multivariate analysis included binomial and multinomial logistic regression.

Results: The mean age was 48.2 years. The majority of respondents were vegetarians [62%], married, educated, and with some form of health insurance. Prevalence of diabetes was 17.4%, metabolic syndrome was 38.2% [International Diabetes Federation criteria], and 48% were obese. Vegetarian status was a protective factor and lowered the risk for diabetes and metabolic syndrome, but not obesity. The other variables that were significantly protective in lowering the risk factors for chronic diseases were higher income, HDL cholesterol, a healthy dietary habit, lower blood pressure and lipoprotein a; risk factors included older age, family history of diabetes and higher C Reactive Protein.

Conclusion: A vegetarian diet was a protective factor for chronic diseases in this high-risk group. Results provide a firm basis for future interventional studies.

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Chronic disease management and prevention
Program planning
Public health or related education
Social and behavioral sciences

Learning Objectives:
Describe the vegetarian dietary patterns among immigrant Asian Indians in the U.S. List the differences in chronic diseases among vegetarian and non-vegetarian Asian Indians. Discuss if vegetarian dietary patter is a protective factor in reducing diabetes, metabolic syndrome and obesity among participants.

Keywords: Chronic Diseases, Dietary Assessment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Misra is a Professor and Director of the Public Health Practice program at West Virginia University School of Public Health. She is a well-known international health disparities researcher with a background in nutrition and terminal degree in Public Health. Her research investigations include clinical and non-clinical risk factors (individual, psychosocial, environmental/ contextual) that impact disparities in prevalence and management of diabetes, metabolic syndrome, and cardiovascular disease in multi-ethnic populations (Asians, Hispanics, and African Americans).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.