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Diaz M, Braxton ME, Owolabi EO, Godfrey TM, Singh M, Rascón AM, Shaibi GQ. Adapting the NIMHD Research Framework for Type 2 Diabetes-Related Disparities. Curr Diab Rep 2025; 25:24. [PMID: 40048005 DOI: 10.1007/s11892-025-01580-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2025] [Indexed: 05/13/2025]
Abstract
PURPOSE OF REVIEW Type 2 diabetes (T2D) disproportionately impacts minority populations. The National Institute on Minority Health and Health Disparities (NIMHD) developed a research framework to encourage health disparities research that considers a multi-level, multi-domain perspective. The purpose of this review was to describe evidence on the levels and domains that influence T2D disparities among minority populations and use this information to adapt the NIMHD Research Framework for T2D. RECENT FINDINGS Screening identified 108 articles published between 2017 and 2023 covering 74,354,597 participants. Articles were classified under the following domains, Biological (18), Behavioral (22), Physical/Built Environment (19), Sociocultural Environment (42), and Health Care System (31). Article levels of influence included Individual (73), Interpersonal (18), Community (36), and Societal (10). Findings were used to adapt the NIMHD Research Framework with an eye towards advancing T2D-related health equity. The results of this review confirm the complex nature of T2D-related disparities and support the notion that drivers operate within and between multiple levels and multiple domains to influence T2D-related outcomes across the lifespan.
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Affiliation(s)
- Monica Diaz
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N 3rd Street, Health North Suite 300, Phoenix, AZ, 85004, USA
| | - Morgan E Braxton
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N 3rd Street, Health North Suite 300, Phoenix, AZ, 85004, USA
| | - Eyitayo O Owolabi
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N 3rd Street, Health North Suite 300, Phoenix, AZ, 85004, USA
| | - Timian M Godfrey
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N 3rd Street, Health North Suite 300, Phoenix, AZ, 85004, USA
| | - Mantej Singh
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N 3rd Street, Health North Suite 300, Phoenix, AZ, 85004, USA
| | - Aliria M Rascón
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N 3rd Street, Health North Suite 300, Phoenix, AZ, 85004, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N 3rd Street, Health North Suite 300, Phoenix, AZ, 85004, USA.
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Nikooyeh B, Zargaraan A, Ebrahimof S, Kalayi A, Zahedirad M, Yazdani H, Rismanchi M, Karami T, Khazraei M, Jafarpour A, Neyestani TR. Daily consumption of γ-oryzanol-fortified canola oil, compared with unfortified canola and sunflower oils, resulted in a better improvement of certain cardiometabolic biomarkers of adult subjects with type 2 diabetes: a randomized controlled clinical trial. Eur J Med Res 2023; 28:416. [PMID: 37817285 PMCID: PMC10563320 DOI: 10.1186/s40001-023-01409-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND This study was undertaken to examine the effects of daily consumption of γ-oryzanol (ORZ)-fortified canola oil, as compared with plain canola and sunflower oils, on certain cardiometabolic indicators. METHODS Ninety-two adult subjects from both sexes with T2D were randomly assigned to one of the three groups to receive: (a) ORZ-fortified canola oil (Group 1; n1 = 30); (b) unfortified canola oil (Group 2; n2 = 32); or (c) sunflower oil (Group 3; n3 = 30) for 12 weeks. The participants were instructed to use only the given oils for all cooking (but frying) purposes. Anthropometric, dietary and biochemical assessments were done initially and finally. RESULTS Though body mass index (BMI) significantly decreased in all three groups, only in Groups 1 and 2 waist circumference (WC) showed a significant decrement (-2.6 ± 0.1 and -2.2 ± 0.1 cm in Groups 1 and 2 respectively, p < 0.001 for both) which was accompanied by a significant reduction of blood pressure just in Group 1. Fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) showed a significant decrease only in ORZ-fortified canola oil group (-7.7 ± 0.4 mg/dL, p = 0.039 and -0.7 ± 0.1%, p < 0.001, respectively). However, insulin resistance, as judged by HOMA-IR, did not change significantly. In addition, serum triglyceride (TG) concentrations decreased in all three groups but only in ORZ-fortified canola oil was this decrement statistically significant (-17.9 ± 2.1 mg/dL, p = 0.005). Other components of serum lipid profile did not change significantly in either group. CONCLUSIONS Consumption of either sunflower or canola oils for 12 weeks improved certain studied biomarkers. However, only ORZ-fortified canola oil resulted in a significant decrease of blood pressure, WC, FBG, HbA1c and TG. These findings can help both clinicians and public health authorities for dietary recommendations to subjects with T2D and presumably the whole community. TRIAL REGISTRATION number at clinicaltrials.gov (NCT05271045).
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Affiliation(s)
- Bahareh Nikooyeh
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azizollaah Zargaraan
- Department of Food and Nutrition Policy and Planning Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition and Food Science, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran
| | - Samira Ebrahimof
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Kalayi
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maliheh Zahedirad
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hootan Yazdani
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marjan Rismanchi
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Taher Karami
- Department of Research and Development, Kourosh Food Industry, Tehran, Iran
| | | | - Ali Jafarpour
- Quality Assurance Unit, Kourosh Food Industry, Tehran, Iran
| | - Tirang R Neyestani
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Alvear Durán S, Sanchez-Del-Hierro G, Gomez-Correa D, Enriquez A, Sanchez E, Belec M, Casapulla S, Grijalva MJ, Shubrook JH. A pilot of a modified diabetes prevention program in Quito, Ecuador. J Osteopath Med 2021; 121:905-911. [PMID: 34668365 DOI: 10.1515/jom-2020-0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 07/12/2021] [Indexed: 11/15/2022]
Abstract
CONTEXT Diabetes has become a global noninfectious pandemic with rates rapidly rising around the globe. The major drivers of this increase in type 2 diabetes are obesity, an increase in processed foods, and a decrease in physical activity. In the United States, the National Diabetes Prevention Program (NDPP) has proven to be an effective lifestyle intervention to delay or prevent new-onset type 2 diabetes. However, there is limited evidence that such a lifestyle program will work in a South American community. OBJECTIVES This pilot program aims to determine if a modified version of the Centers for Disease Control and Prevention (CDC) Diabetes Prevention Program (DPP) would be feasible in an Ecuadorian population. The goals of this pilot program were a 7% weight loss, >150 min of physical activity per week, and a reduction of fat calories to yield a reduced risk of type 2 diabetes. This program was led by family medicine physicians and was offered to people with prediabetes in Quito, Ecuador. METHODS The program was modified to include only the first half of the DPP curriculum, which included a schedule of 16 classes in the first 6 months. Further, the program was provided in Spanish and modified to be more culturally specific to this population. Participants were recruited from the faculty and staff of Pontifical Catholic University of Ecuador (Pontificia Universidad Católica del Ecuador [PUCE]) in Quito. Outcomes measured included A1c reduction, weight loss, increase in physical activity minutes, and progression to type 2 diabetes mellitus (T2DM). RESULTS The sample included 33 people with prediabetes. The mean age of the participants was 52 years (range, 41-66 years), the mean body mass index (BMI) was 27.6 kg/m2 (range, 21.0-40.3 kg/m2), and the mean HbA1C was 6.2% (range, 5.7-6.4%). The attendance was 97.8% at 6 months. The mean weight loss was 3.4 kg per participant (range, 1.5 kg weight gain to 8.3 kg weight loss); in percentage points, this was a mean weight loss of 3.6% (range, 2.3% gain to 11.8% weight loss). Three-fourths of the participants lost weight (78.3%). The majority of participants (75.8%) met the target physical activity level of 150 min per week, and all participants increased their physical activity levels from baseline. No participants progressed to type 2 diabetes during this study. CONCLUSIONS The DPP 6 month pilot was effective in this population with prediabetes in Ecuador. The largest changes were made in physical activity time. Holding the program at worksites and providing lunch were key factors in the very high retention rate in this study.
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Affiliation(s)
- Susana Alvear Durán
- Facultad de Medicina, Center for Research on Health in Latin America, Pontifical Catholic University of Ecuador, Quito, Ecuador
| | - Galo Sanchez-Del-Hierro
- Facultad de Medicina, Center for Research on Health in Latin America, Pontifical Catholic University of Ecuador, Quito, Ecuador.,Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Diego Gomez-Correa
- Family Practice Resident, Facultad de Medicina, Hospital Vozandes Quito, Pontifical Catholic University of Ecuador, Quito, Ecuador
| | - Andrés Enriquez
- Family Practice Resident, Facultad de Medicina, Hospital Un Canto a la Vida, Pontifical Catholic University of Ecuador, Quito, Ecuador
| | - Enver Sanchez
- Family Practice Resident, Facultad de Medicina, Hospital Un Canto a la Vida, Pontifical Catholic University of Ecuador, Quito, Ecuador
| | - Melissa Belec
- Family Practice Resident, University of Minnesota - North Memorial, Minneapolis, MN, USA
| | - Sharon Casapulla
- Department of Primary Care, Office of Rural and Underserved Programs, Diabetes Institute, Infectious and Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Mario J Grijalva
- Department of Biomedical Sciences, Infectious and Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA.,Center for Research on Health in Latin America, School of Biological Sciences, Pontifical Catholic University of Ecuador, Quito, Ecuador
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