Effect of Meat Consumption on the Glycaemic Control, Obesity and Blood Pressure in Patients with Type 2 DiabetesCorrespondence Address :
Dr. Aswini Dutt R.
Assistant Professor, Department of Physiology,
Yenepoya Medical College, Deralakatte,
Mangalore-575018. Karnataka, India.
Phone: +91 9845035530; Fax: +91 8242204667
Obesity and Diabetes mellitus have become major public health threats across the globe. A high calorie food consumption and the lack of physical exercise are producing generations that are increasingly obese and diabetic. Diet plays an important role in the causation, management and complications of obesity and type 2 diabetes.
To compare meat consumption with the glycaemic control, BMI and blood pressure in patients with type 2 diabetes.
Materials and Methods:
This was a retrospective study which was done on the medical records of the patients with type 2 diabetes, who attended the Medicine OPD of a medical college hospital in Mangalore. The study group consisted of 110 male diabetic patients who were on treatment, who were aged between 45 and 65 years. They were divided into two groups, based on their food habits with respect to the type of meat which was consumed (viz. red meat consumers, white meat consumers). Their FBS, PPBS, BMI, blood pressure and diet history were noted. These parameters between the red meat and the white meat consumers were compared by the unpaired t-test.
The results revealed that red meat consumption was positively associated with a poor glycaemic control in terms of both FBS and PPBS (p < 0.0005). There was a significant association of the red meat consumption with the BMI and blood pressure (p < 0.0005 and p< 0.004 respectively).
This study indicated that the consumption of red meat may aggravate the indices of glycaemic control, obesity and blood pressure in patients with type 2 diabetes. A moderation of red meat consumption should be advocated to patients with type 2 diabetes.
Red meat, White meat, Type 2 Diabetes, Blood Pressure, BMI, Saturated fat
Aswini Dutt R., Satish Kumar N.S., Shankar Bhat K., M. Bhima Bhat, Neevan D.R. D S’ouza. EFFECT OF MEAT CONSUMPTION ON THE
GLYCAEMIC CONTROL, OBESITY AND BLOOD
PRESSURE IN PATIENTS WITH TYPE 2 DIABETES. Journal of Clinical and Diagnostic Research [serial online] 2012 May [cited: 2016 Feb 11 ]; 6:441-444. Available from
Globalization has created rapid changes in the urban lifestyles. This has resulted in the emergence of obesity and diabetes mellitus, that are growing realities among people worldwide. These epidemics have created a huge financial burden on the economic growth. There are about 171 million diabetic cases worldwide, of which 31 million persons with diabetes are in India (2000) and this number is predicted to rise to almost 366 million globally and 79.4 million in India by 2030, according to the Diabetes prevalence predictions (1). A proper dietary management can help in the treatment and prevention of various metabolic disorders such as insulin resistance, obesity, type 2 diabetes mellitus (DM) and the resultant cardiovascular diseases (2). High intake of red meat like beef and mutton, sweets and oily foods are associated with an increased incidence of DM worldwide (3). A diet which is rich in vegetables, fruits, whole grains, a limited amount of dairy products, fish and lesser red meat can reduce the incidence of cardio metabolic disorders (4). Insulin resistance has been associated with the development of the cardio metabolic syndrome (5). Recent studies have shown that food habits are linked to the risk of insulin resistance, DM and cardiovascular disease (2),(3),(4),(5). Red meat consumption may lead to insulin resistance and hyper-insulinaemia in susceptible persons (6). Other studies have suggested that that more consumption of fish, seafood and white meat may reduce the risk of DM in populations with a prevalence of obesity (7) and hypertension (8). Original Article Metabolic Section As the meat consumption alters their diabetic status, we sought to find out the association of the meat intake and the glycaemic control, Body Mass Index (BMI) and the blood pressure in patients with DM.
This was a retrospective study which was done from the medical records of the patients with DM, who attended the Medicine Department of a medical college hospital in Mangalore, Karnataka, India, who lived around this coastal area. Ethical clearance was obtained for this project. The study group consisted of 110 male diabetic patients who were aged between 45 and 65years. They were divided into two groups based on their predominant food habits, with respect to the type of meat which was consumed. (Viz. red meat consumers, white meat consumers). One group consisted of 50 subjects who predominantly consumed red meat for at least 5 days a week. The other group had 60 age matched subjects; exclusively white meat consumers for at least 5 days a week. The cases were chosen randomly for the red meat consuming group. Their diet histories were collected from the dietician’s record, that included the amount of food which was consumed everyday for one week for the individual patients. We have plotted the different food items which were consumed along with the meat intake. (grams/week) Their anthropometric measurements, blood pressure (BP) recordings, fasting blood sugar (FBS) and post prandial blood sugar (PPBS) values and the duration of diabetes and hypertension were noted. The body mass index (BMI) was calculated as weight (in kilograms) divided by standing height (in meters squared). Those with a BMI which was greater than 24.9 kg/m2 were defined as overweight and those with a BMI which was greater than 29.9 kg/ m2 were defined as obese. People with systolic/diastolic blood pressure levels of >/= 140/90 mmHg were defined as having hypertension as per the JNC 7 criteria. These parameters between the red meat and the white meat consumers were compared by the unpaired t-test. The statistical software, SPSS, ver17 and MS Excel (2007) was used for the statistical analysis. The data were analyzed for the normal distribution and descriptive statistics were used. All the tests were two-tailed and they were conducted at a 0.05 significance level.
(Table/Fig 1) shows the mean± SD of the age of the patients and of the duration of the diabetes, the mean± SD of the fasting blood sugar (FBS) and of the post-prandial blood sugar (PPBS), of BMI, of the systolic blood pressure (SBP) and of the diastolic blood pressure (DBP) of the two groups.FBS (p<.0005), PPBS (p<.0005), BMI (p<.0005), SBP (p<.0005) and DBP (p=.004) were significantly higher in the red meat diet group in comparison with those in the white meat diet group. (Table/Fig 2) depicts the average diet pattern of the predominant red meat consumers. In a week, there was a consumption of 1558.3 grams of red meat that included beef and mutton, amidst other regular food items of costal Karnataka. This group also consumed a small amount of white meat (66grams/week) (Table/Fig 3) shows the average diet pattern of the exclusive white meat consumers. This group consumed 2000grams of white meat in the form of fish and chicken exclusively in a week’s time.
This study showed that a relatively higher consumption of red meat may aggravate the indices of the glycaemic control, blood pressure and BMI in Diabetes mellitus. This coincided with the findings of earlier studies, which revealed that a diet which was rich in red meat increased the blood glucose levels (9). The saturated fat content of the red meat was the main causative factor for the emergence of insulin resistance in DM (10). Regular chicken intake (white meat) was associated with a moderately decreased risk of DM, as was shown in Nurses’ Health Study (11).The consumption of a diet which contained fish, which was a white meat, could prevent or control the emergence of DM (12).The presence of the omega-3 fatty acids which were present in fish could decrease the occurrence of DM and heart diseases (13). Insulin resistance which is linked with obesity and cardiovascular abnormality is known as ‘the metabolic syndrome’. Over the years, the tissues fail to respond to the increasing insulin levels. Increased levels of triglycerides in the muscle tissue and free fatty acids are seen in the patients of DM (14). Later, the beta cells of the pancreas get exhausted and they cease production, resulting in clinical DM (15). Insulin resistance causes glycogenesis and an increased glucose uptake in the muscle cells. The circulating free fatty acid concentration is increased in adipocytes as a result of increased lipolysis (16). The higher the saturated fatty acid content of the dietary fat which results in higher plasma membrane fatty acid profiles, the more insulin action is impaired (17). High fat consumption causes obesity and insulin resistance (18). There exists a clear association between the dietary fats, lipid profiles and the insulin resistance (19). Fish oil prevented the development of insulin resistance in experimental rats which were earlier fed with safflower oil (20). Poly unsaturated fatty acids (PUFAs) regulate the insulin sensitive glucose uptake (ISGU) in isolated adipocytes (21). In animals, an isocaloric, saturated fat diet was found to enhance the weight more than the unsaturated fats which were present in white meat could enhance it (22). Similar results were found in humans (23), which were demonstrated by the increasing waistline measurements (24). The meta-analyses of randomized trials have shown decreased blood pressure levels in hypertensives who consumed fish oil which had PUFAs. An enhanced endothelial vasodilator function, the reduced reactivity of the resistant vessel vascular smooth muscle and an increased vascular compliance could be the underlying causes for the beneficial effect of the PUFAs on blood pressure, as was depicted in animal studies (25), (26), (27). Recent research data has indicated that multiple improvements in the food intake lowered the BP levels of adults, both in pre hypertensives and hypertensives. PUFAs offered more benefits than the known benefits of reduced sodium chloride, increased potassium, prevention of obesity and excess alcohol intake in reducing the BP. This finding was consistent with meta-analytic data of the RCTs. Thus, these results on a major coronary vascular disease risk factor has lent good support to the current recommendations for the increased ingestion of PUFAs from marine and vegetable sources (28).
Limitations of the study
1. Retrospective study
2. Small study group
3. Limited variables
4. Gender limitation.
A relatively higher consumption of red meat may lead to hyperglycaemia, hypertension and obesity. The consumption of white meat can lower the complications which arise from DM. It lowers the risk of the development of obesity and hypertension and their complications in DM.
Dr. Moosabba, Professor and Head of the Department of General Surgery, Medical Superintendent, Yenepoya Medical College, Mangalore.
Financial OR OTHER COMPETING INTERESTS:
Date of Submission: Sep 17, 2011
Date of Peer Review: Jan 01, 2012
Date of Acceptance: Jan 16, 2012
Date of Publishing: May 01, 2012
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