Examining the impact of dietary diversity and sugar-rich food intake on diabetes prevalence: a cross-sectional study in Asir region of Saudi Arabia

Background: type 2 diabetes mellitus (T2DM) represents a growing public health challenge in Saudi Arabia, with increasing prevalence linked to lifestyle and dietary shifts. While dietary diversity is often promoted for nutritional adequacy, its relationship with T2DM risk remains unclear, particularly in the Asir region. Objective: this study aimed to examine the associations between dietary diversity, frequency of sugar-rich food intake, and T2DM prevalence among adults in the Asir region of Saudi Arabia. Methods: a cross-sectional study was conducted among 430 adults recruited via online platforms. Dietary diversity and frequency of specific food group consumption including sugary food consumption were assessed using a validated food frequency questionnaire. Bivariate analyses and binary logistic regression were performed to explore associations between dietary habits and self-reported T2DM, adjusting for sociodemographic and lifestyle confounders. Results: T2DM prevalence in the study population was 10.5%. Frequent sugary food consumption was significantly associated with increased odds of diabetes. Participants consuming sugary foods daily had an adjusted odds ratio (OR) of 11.18 (95% CI: 1.18–105.69; p = 0.035), and those consuming more than once per daily had an OR of 14.58 (95% CI: 1.35–157.64; p = 0.027) compared to rare consumers. No significant associations were found between T2DM and dietary diversity, frequency of fruit, vegetables, grain, or fast-food consumption. Middle-aged adults (36–45 years) exhibited borderline increased odds of diabetes (OR = 2.88; p = 0.056). Conclusion: frequent consumption of sugar-rich foods is a strong, independent predictor of T2DM in the Asir region, while overall dietary diversity does not appear to significantly influence diabetes prevalence. These findings highlight the need for targeted public health interventions to reduce sugar intake as a primary strategy for prevention of diabetes in the population.