NET Working Group

The Nutritional and Epidemiologic Transition (NET) Working Group is a collaborative initiative launched by researchers from the Departments of Epidemiology and Nutrition at HSPH, led by Drs. Donna Spiegelman, Frank Hu, and Walter Willett, with the overarching mission of preventing the global diabetes epidemic by improving the carbohydrate quality of staple foods in the diets of people from around the world.

As global free trade continues to fuel rapid economic and nutritional transitions, Type 2 diabetes has reached epidemic proportions in many countries around the world. Traditional staple foods, once rich in whole grains and dietary fiber, have been replaced by highly refined carbohydrates such as polished white rice, thus reducing the overall carbohydrate quality of the diet. Research has shown that consumption of higher quality carbohydrates such as whole grains can reduce diabetes risk by improving glycemic control. Therefore, adopting a diet that is rich in whole grains represents a cost-effective, feasible and sustainable approach to diabetes prevention, particularly in low and middle- income countries, which must manage co-existing infectious disease and malnutrition.

Pilot projects are ongoing in a number of countries, including China, India, Tanzania, Nigeria, Costa Rica and Puerto Rico. These studies aim to assess the effect of substituting culturally-specific whole grain alternatives for refined carbohydrate staples on intermediate markers of diabetes risk in high-risk populations, and to assess the acceptability and taste preferences of such interventions in local communities using focus group discussions. Findings from these pilot studies will form the basis of larger-scale trials that will test whether dietary modifications of this nature can have a long-lasting measurable impact on reducing diabetes risk.