Type 2 diabetes and dietary behaviours in rural and remote Australia: results from National Health Survey, 2017-18 — The Association Specialists
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Type 2 diabetes and dietary behaviours in rural and remote Australia: results from National Health Survey, 2017-18 (23969)

Anayochukwu E Anyasodor 1 , Uchechukwu Levi Osuagwu 2 , Shumirai Mushangwe 1 , M.Mamun Huda 3 , Victor M Oguoma 4 , Allen G Ross 5
  1. Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
  2. Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Bathurst, NSW, Australia
  3. School of Rural Medicine, Charles Sturt University, Orange, NSW, Australia
  4. Thompson Institute, University of Sunshine Coast, Birtinya, QLD, Australia
  5. College of Medicine, Ajman University, Ajman, United Arab Emirates

Introduction:Type 2 diabetes (T2D) is a growing global public health challenge, with rising prevalence in Australia linked to dietary behaviour. This study examined the association between T2D and dietary behaviours in rural and remote communities of Australia, utilising the National Health Survey.

Methods: The cross-sectional data of 16,370 adults aged 18 and over were analysed using the 2017–2018 Australian National Health Survey. The primary outcome was T2D, and the exposure variables included geographic remoteness and adherence to national dietary guidelines for fruit and vegetable intake. The associated odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. We also calculated predicted probabilities to understand the interaction terms between dietary behaviour and remoteness to explore effect modifications.  

Results: The majority of participants were female (53.7%), aged between 45-64 years (34.1%), and residing in cities (61.2%). The reported prevalence of T2D was 5.5%. Forty-eight percent of subjects did not meet the recommended fruit intake, and 91.7% did not meet the recommended vegetable intake. It is noteworthy that this disparity was the most pronounced in Remote and Very Remote communities. Non-adherence to fruit intake guidelines was associated with lower odds of T2D (AOR=0.86, 95% CI: 0.72–1.04), while non-adherence to vegetable consumption was associated with higher odds (AOR=1.07, 95% CI: 0.77–1.49). Predicted probability analyses showed a modest protective effect of fruit intake in Remote/Very Remote areas (9.7% vs. 10.2% for non-adherence), while there was minimal difference in vegetable intake between residents of Major Cities and those in Inner Regional locations.

Conclusion: Improving access to fresh fruit and vegetables in rural and remote communities will help combat central obesity and the emerging epidemic of T2D. Presently most rural communities in Australia do not have such access. Policy needs to be created to address this disparity.