The Carbohydrate-to-fiber ratio (CFR) is a useful marker of central obesity in patients with type 2 diabetes: a cross-sectional study

Abstract

Abstract (1) Background: The carbohydrate-to-fiber ratio (CFR) is an important indicator of dietary carbohydrate quality. However, few studies have focused on obesity in patients with type 2 diabetes. Therefore, the aim of this study was to investigate the association between the CFR and central obesity in type 2 diabetic patients in the community. (2) Methods: This was a cross-sectional study. A general demographic information questionnaire and a semiquantitative food frequency questionnaire were used to investigate the demographic characteristics and dietary intake information of type 2 diabetic patients in the community, and the daily amounts of carbohydrates and dietary fiber were obtained by calculating the carbohydrate-to-fiber ratio (CFR) using Nutrition Calculator (v2.7.3k) software. Participants' CFR was categorized into Q1, Q2, and Q3 groups from high to low. Central obesity was defined as a waist circumference ≥90 cm for men and ≥85 cm for women. (3) Results: The prevalence of central obesity in community-dwelling type 2 diabetic patients was 66.77%. The CFR was associated with waist circumference (r=0.153, p=0.008), insulin (r=0.118, p=0.040), high-density lipoprotein cholesterol (r=-0.126, p=0.028), and diabetes distress (r=0.197, p=0.001). With Q1 as a reference, the CFR was still significantly associated with central obesity in the Q3 after adjusting for variables (OR=2.166, 95% CI: 1.083-4.334). Carbohydrate intake was not associated with central obesity (OR=1.003, 95% CI: 0.998-1.007). The CFR is a stronger protective factor against central obesity than either fiber or carbohydrate alone. (4) Conclusions: A higher CFR leads to increased central obesity in patients with type 2 diabetes. Diets with a low CFR can be recommended for the dietary management of patients with type 2 diabetes.