ラダークにおける住民の栄養摂取量と糖尿病との関連

Abstract

Background and aim: Highland is one of the most severe places to get enough foods in the world. However, our current study found relatively high prevalence of lifestyle-related diseases such as obesity, hypertension and diabetes even in such remote highland. Assessing dietary status is important to show one of the backgrounds of these lifestyle-related diseases. This study aims to reveal the nutritional intake of the people living in Ladakh and analyze the relation between nutritional intake and diabetes. Settings and subjects: In July 2010, we conducted health check-up including nutritional assessment in Leh, the central city of Ladakh, and in Domkhar village located about 120km northwest of Leh. Study subject was people aged 40 years and older who joined health check-up and answered nutritional assessment (Leh: 109, Domkhar: 40). Methods: Diabetic status was diagnosed by 75g oral glucoses tolerance test. Total energy intake was estimated using 24h recall method. Food quality was determined using an 11-item Food Diversity Score Kyoto (FDSK-11). Body mass index were determined by measuring height and body weight. Results: Mean of total energy intake per day was; Leh: men 2305kcal/day (N=51), women 1933 kcal/day (N=58), Domkhar: men 2272 kcal/day (N=18), women 2226 kcal/day (N=22). When we divided subjects into 3 groups; 1) people who had low energy intake than the energy requirement by the guideline, 2) those who had adequate energy intake (up to standard requirement plus 300 kcal/day and 3) those who took high total energy intake (more than the 2) level) for statistical analysis. We found higher prevalence of diabetes in not only high energy intake group, but in low energy intake group, compared to adequate energy intake group. Food diversity was low in the low energy intake group in Leh, which can be considered as unbalanced diet such as carbohydrate excessive dietary style and that might lead to be diabetic status. Conclusion: Low energy intake can be also one of the risks of diabetes, with the background of poor food variety in highland.