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Author Notes:

Correspondence: matt.gribble@emory.edu

Conceptualization, M.O.G., J.R.H., D.M., V.M., S.V., K.M.V.N., S.A.P. and L.M.J.; data curation, D.M., S.V. and S.A.P.; formal analysis, M.O.G., J.R.H., S.A.P. and L.M.J.; funding acquisition, M.O.G., D.P., V.M., M.M.K., N.T. and K.M.V.N.;

Investigation, M.O.G., D.P., D.M., V.M., S.V. and L.M.J.; methodology, M.O.G., D.M., S.V., S.A.P. and L.M.J.; project administration, M.O.G., D.P., D.M., N.T., K.M.V.N. and L.M.J.; resources, M.O.G., D.M. and V.M.; software, M.O.G., S.A.P. and L.M.J.; supervision, D.M. and L.M.J.

Validation, D.M. and S.V.; visualization, M.O.G.; writing—original draft, M.O.G., J.R.H. and L.M.J.; writing—review and editing, M.O.G., J.R.H., D.P., D.K., V.G., D.M., R.M.A., V.M., S.V., M.M.K., N.T., K.M.V.N., S.A.P. and L.M.J.

All authors have read and agreed to the published version of the manuscript.

Disclosure: The authors declare no conflicts of interest.

Subjects:

Research Funding:

Gribble’s effort was supported in part by funding from the National Institute of Environmental Health Sciences (P30 ES019776) and by an Institutional Grant (NA10OAR4170084) to the Georgia Sea Grant College Program from the National Sea Grant Office, National Oceanic and Atmospheric Administration, United States Department of Commerce.

The CARRS Study was funded by the National Heart, Lung, and Blood Institute at the National Institutes of Health (HHSN2682009900026C) and the Oxford Health Alliance Vision 2020 of the UnitedHealth Group (Minneapolis, MN, U.S.).

Additional support was provided by the Fogarty International Center and the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health (1 D43 HD065249), and the Emory Global Health Institute.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Environmental Sciences
  • Public, Environmental & Occupational Health
  • Environmental Sciences & Ecology
  • diabetes mellitus
  • glycated hemoglobin A
  • blood glucose
  • seafood
  • shellfish
  • diet
  • diet surveys
  • India
  • Pakistan
  • Persistent organic pollutants
  • Dietary patterns
  • Organochlorine contaminants
  • Pesticide residues
  • Fish consumption
  • Risk
  • India
  • River
  • Congeners
  • Pakistan

Potentially Heterogeneous Cross-Sectional Associations of Seafood Consumption with Diabetes and Glycemia in Urban South Asia

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Journal Title:

International Journal of Environmental Research and Public Health

Volume:

Volume 17, Number 2

Publisher:

, Pages 1-14

Type of Work:

Article | Final Publisher PDF

Abstract:

Aims: In this study, we aimed to estimate cross-sectional associations of fish or shellfish consumption with diabetes and glycemia in three South Asian mega-cities. Methods: We analyzed baseline data from 2010–2011 of a cohort (n = 16,287) representing the population ≥20 years old that was neither pregnant nor on bedrest from Karachi (unweighted n = 4017), Delhi (unweighted n = 5364), and Chennai (unweighted n = 6906). Diabetes was defined as self-reported physician-diagnosed diabetes, fasting plasma glucose ≥126 mg/dL (7.0 mmol/L), or glycated hemoglobin A1c (HbA1c) ≥6.5% (48 mmol/mol). We estimated adjusted and unadjusted odds ratios for diabetes using survey estimation logistic regression for each city, and differences in glucose and HbA1c using survey estimation linear regression for each city. Adjusted models controlled for age, gender, body mass index, waist–height ratio, sedentary lifestyle, educational attainment, tobacco use, an unhealthy diet index score, income, self-reported physician diagnosis of high blood pressure, and self-reported physician diagnosis of high cholesterol. Results: The prevalence of diabetes was 26.7% (95% confidence interval: 24.8, 28.6) in Chennai, 36.7% (32.9, 40.5) in Delhi, and 24.3% (22.0, 26.6) in Karachi. Fish and shellfish were consumed more frequently in Chennai than in the other two cities. In Chennai, the adjusted odds ratio for diabetes, comparing more than weekly vs. less than weekly fish consumption, was 0.81 (0.61, 1.08); in Delhi, it was 1.18 (0.87, 1.58), and, in Karachi, it was 1.30 (0.94, 1.80). In Chennai, the adjusted odds ratio of prevalent diabetes among persons consuming shellfish more than weekly versus less than weekly was 1.08 (95% CI: 0.90, 1.30); in Delhi, it was 1.35 (0.90, 2.01), and, in Karachi, it was 1.68 (0.98, 2.86). Conclusions: Both the direction and the magnitude of association between seafood consumption and glycemia may vary by city. Further investigation into specific locally consumed seafoods and their prospective associations with incident diabetes and related pathophysiology are warranted.

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© 2020 by the authors. Licensee MDPI, Basel, Switzerland.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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