Associations of low-carb diets with glycaemic control and diabetic complications among adult Ghanaians: the RODAM study

Tracy B Osei*, Hibbah Osei-Kwasi, Mary Nicolaou, Erik Beune, Charles Agyemang, Karlijn A C Meeks, Silver Bahendeka, Matthias B Schulze, Kerstin Klipstein-Grobusch, Juliet Addo, Charles F Hayfron-Benjamin, Ina Danquah

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

PURPOSE: We aimed to determine the associations of low-carb diets with glycated haemoglobin (HbA1c) and diabetes complications among Ghanaian adults, who traditionally rely on carbohydrate-dense diets and experience a high prevalence of type 2 diabetes (T2DM).

METHODS: This analysis used baseline data of the multi-centre RODAM (Research on Obesity and Diabetes among African Migrants) Study among Ghanaian adults (N = 5,898; 18-96 years) living in Ghana and Europe. Energy (kcal/d) and macronutrient intakes (energy%) were computed from the semi-quantitative Ghana Food Propensity Questionnaire. A low-carb diet score (0-30 points) was calculated as the sum of 0-10 points for 11 strata of carbohydrate, protein and fat intakes, respectively. For the associations with ln-transformed HbA1c, we calculated multiple-adjusted beta coefficients, 95% confidence intervals (CIs), and p-values by linear regressions and stratified by T2DM status. Among participants with T2DM, multiple-adjusted odds ratios (OR), 95% CIs, and p-values were computed by logistic regression for the associations of the low-carb diet score with microvascular and macrovascular complications.

RESULTS: Neither macronutrient intakes nor the low-carb diet score were associated with ln (HbA1c) among individuals with T2DM. Among individuals without T2DM, the corresponding associations were statistically significant with marginal beta coefficients between|0.01| and|0.04|. Regarding diabetes complications, we observed an inverse association of the low-carb diet score with self-reported stroke (adjusted OR: 0.95; 95% CI: 0.91, 0.99).

CONCLUSION: Using a low-carb diet score, our results from this Ghanaian study population do neither support the hypothesis that low-carb diets improve blood glucose control, nor that low-carb diets are associated with diabetes complications.

Original languageEnglish
Article number207
JournalEuropean Journal of Nutrition
Volume64
Issue number5
DOIs
Publication statusPublished - 7 Jun 2025

Keywords

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Diabetes Complications/epidemiology
  • Diabetes Mellitus, Type 2/epidemiology
  • Diet, Carbohydrate-Restricted/methods
  • Female
  • Ghana/epidemiology
  • Glycated Hemoglobin/analysis
  • Glycemic Control/methods
  • Humans
  • Male
  • Middle Aged
  • Young Adult

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