Background: Insulin resistance
(IR) is the backbone of cardiovascular diseases (CVDs). The latter are the most
common non-communicable diseases globally. Diet is an important determinant of
CVDs. The link between diet and cardiovascular health could be explained by an
association between diet pattern and IR. Aims: To investigate the
association between salt and specific food consumption as well as different
diet patterns (Mediterranean, westernized, and intermediate dietary patterns)
with HOMAIR as a surrogate marker of IR, and fasting insulin in Black,
sub-Saharan essential hypertensive patients. Methods: The
multicentric, cross-sectional analysis involved 77 Congolese Black hypertensive
participants with no history of cardiovascular disease. Daily sodium chloride
intake (NaCl g/24h) was estimated from 24-hour urine collection. Dietary behaviours were evaluated through a
semi-quantitative food frequency questionnaire (FFQ). Homeostatic model
assessment of insulin resistance (HOMAIR) ≥ 2.5 was used as surrogate marker of
IR. Results: A decrease in weekly consumption of fruits, vegetables and
fish would significantly explain an increase of 29% (r = 0.292; p = 0.010), 24%
(r = 0.242; p = 0.034) and 23% (r = 0.226; p = 0.048) of the value of HOMAIR
respectively. In contrast, an increase in daily sodium chloride intake was
associated with 28% (r = 0.283, p = 0.027) of the increase in HOMAIR. Also, a
decrease in the average weekly consumption of fruit, vegetables and fish would
significantly explain an increase of 25% (r = 0.247; p = 0.030), 30% (r =
0.302; p = 0.008) and 31% (r = 0.313; p = 0.006) of fasting insulin. In
contrast, an increase in red meat consumption was associated with a 26%
increase (r = 0.257, p = 0.024) in fasting insulin. In multivariable adjusted
analysis 45% of variation in fasting insulin (R2 = 0.452; overall p =
0.005) were explained by fruits, vegetables and fish consumption. 38% of
variation in HOMAIR (R2 = 0.379; overall p = 0.047) were explained
by fruits and vegetable consumption and daily sodium chloride intake (NaCl g/24h). Conclusions: In hypertensive Black sub-Saharan Africans, Salt intake and
westernized diet seem to promote insulin resistance whereas Mediterranean diet,
fruits, vegetables and fish consumption enhance insulin sensitivity.