| Abstract | Cilj istraživanja: Cilj istraživanja bio je ispitati postoji li povezanost između mediteranske prehrane i učestalosti dijabetesa tipa 2 u populaciji grada Splita i otoka Korčule te uz to ispitati koliko se stanovnici istraživanih područja pridržavaju tradicionalne mediteranske prehrane.
Materijali i metode: Presječnim istraživanjem obuhvaćeno je 2.153 ispitanika koji su podijeljeni u 3 skupine s obzirom na područje u kojemu je provedeno istraživanje. Prva skupina dolazi iz grada Splita gdje je uzorkovanje provedeno tijekom svibnja 2013. godine (n=246). Druga skupina dolazi s otoka Korčule, gdje se uzorkovanje provodilo od travnja do prosinca 2012. godine (naselje Smokvica; n=958) te treća skupina uzorkovana od rujna 2013. do veljače 2014. godine u Blatu na Korčuli (n=981). Prikupljanje podataka provedeno je u okviru projekta „10.001 Dalmatinac – Hrvatska Biobanka“ (MZOŠ 216-1080315-0302). Ispitanici su s obzirom na svoje zdravstveno stanje bili podijeljeni u 3 skupine: prva skupina uključivala je sve ispitanike bez obzira na dijagnozu dijabetesa tipa 2 i kronične bolesti, drugu skupinu činili su ispitanici bez kroničnih bolesti, ali s ranije dijagnosticiranim dijabetesom i treća skupina su bili zdravi ispitanici (bez dijagnosticirane kronične bolesti i dijabetesa tipa 2). U analizu su uključeni dob, spol, mjesto gdje ispitanici žive, razina obrazovanja, i ponašajni čimbenici rizika: pušenje, način prehrane i tjelesna aktivnost. Za procjenu načina prehrane koji se smatra tradicionalnom mediteranskom prehranom korišten je MDSS zbroj (engl. Mediterranean Diet Serving Score) (8). U analizi podataka korišten je χ2 test, Mann-Whitney U test, Kruskal-Wallis test i Spearmanov test rang korelacije. Razina statističke značajnosti postavljena je na P<0,05.
Rezultati: Medijan indeksa mediteranske prehrane u ukupnom uzorku iznosio je 8 bodova (od maksimalnih 24 boda), pri čemu su ispitanici iz Splita imali veću prosječnu vrijednost indeksa mediteranske prehrane (medijan 9, IKR 6), od stanovnika otoka Korčule (medijan 8, IKR 5; P=0,007). Veća vrijednost tog indeksa bila je kod osoba ženskog spola, starijih osoba i osoba s kroničnim bolestima. Nije postojala korelacija između koncentracije glukoze natašte i indeksa mediteranske prehrane niti u ukupnom uzorku niti u poduzorku ispitanika bez kroničnih bolesti, kao ni onih koji nisu imali niti kroničnu bolest niti dijabetes u anamnezi. U logističkoj regresiji, koja je kontrolirala učinak spola, dobi, pripadnosti kohorti ispitanika (prema mjestu prikupljanja uzorka), obrazovanja (mjerenog brojem razreda završene škole), ITM-a, pušenja i tjelesne aktivnost, dobiven je statistički značajan rezultat samo u analizi u kojoj je bio uključen ukupan uzorak, a rezultat je ukazivao kako su ispitanici koji su imali veću vrijednost indeksa mediteranske prehrane imali za 6% veću vjerojatnost za istovremeno prisutan dijabetes (OR=1,06; 95% CI 1,02 – 1,11).
Zaključak: Potrebni su daljnji napori u promoviranju mediteranske prehrane kao jednog od načina zdravog života, a ne samo kao terapijske mogućnosti kod već oboljelih osoba. Unatoč poimanju kako se stanovnici hrvatskih otoka i priobalja hrane prema principima mediteranske prehrane, u ovom istraživanju dobiveni su rezultati koji ukazuju upravo na suprotno. |
| Abstract (english) | Objective: The aim of this study was to examine whether there is a link between the Mediterranean diet and the incidence of type 2 diabetes in the population of the city of Split and Korčula, and in addition to examine how the inhabitants of the areas are sticking to the traditional Mediterranean diet.
Materials and Methods: A cross-sectional study included 2,153 patients who were divided into 3 groups according to the area where the research was conducted. The first group comes from the city of Split, where the sampling conducted during May 2013 (n = 246). Another group comes from the island of Korčula, where sampling was conducted from April to December 2012 (Smokvica; n = 958) and the third group sampled from September 2013 to February 2014 in the town of Blato (n = 981). Respondents were then, given their state of health, divided into 3 groups: the first group included all respondents, regardless of diagnosis of type 2 diabetes and chronic diseases, the second group were patients with no chronic diseases, but were previously diagnosed diabetes and a third group were healthy subjects (with no diagnosed chronic disease and type 2 diabetes). The analysis included age, gender, their residency, level of education, and behavioral risk factors: smoking, diet and physical activity. For the assessment of diet that is considered a traditional Mediterranean diet was used MDSS sum (Eng. Serving Mediterranean Diet Score) (8). In analyzing the data, the χ2 test, Mann-Whitney U test, Kruskal-Wallis test and Spearman rank correlation were used. The level of significance was set at P <0.05.
Results: The median index of the Mediterranean diet in the total sample was 8 points (out of a maximum 24 points), while respondents from Split had a higher average value of the index of Mediterranean diet (median 9, IKR 6), than the residents of the island of Korčula (median 8, IKR 5; P = 0.007). Females, the elderly and people with chronic diseases had higher value of the Mediterranean diet index. There was no correlation between FPG and index of the Mediterranean diet, nor in the total sample or the subsample of respondents with no chronic diseases, as well as those who had neither chronic disease nor diabetes history. In logistic regression, which is controlled by the effect of gender, age, belonging to a cohort of subjects (according to the place of collection of the sample), education (measured by number of completed grade school), BMI, smoking and physical activity, statistically significant results were obtained only in the analysis of the total sample, the results indicated that respondents who had higher index value of the Mediterranean diet were 6% more likely to have coexisting diabetes (OR = 1.06; 95% CI 1.02 to 1.11).
Conclusion: Further efforts are needed to promote the Mediterranean diet as one of the ways of a healthy life, not only as a therapeutic options for people that are already diagnosed with a chronic disease. Despite the perception of how people on the Croatian islands and coastal areas are maintaining their diet according to the principles of the Mediterranean diet, in this study were obtained results that indicate just the opposite. |
