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

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.