scholarly journals Dietary Macronutrient Intakes and Mortality among Patients with Type 2 Diabetes

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1665 ◽  
Author(s):  
Cheng-Chieh Lin ◽  
Chiu-Shong Liu ◽  
Chia-Ing Li ◽  
Chih-Hsueh Lin ◽  
Wen-Yuan Lin ◽  
...  

The best macronutrient percentages of dietary intake supporting longevity remains unclear. The strength of association between dietary intake and mortality in patients with type 2 diabetes (T2DM) should be quantified as a basis for dietary recommendations. Our study cohort consisted of 15,289 type 2 diabetic patients aged 30 years and older in Taiwan during 2001–2014 and was followed up through 2016. Percentages of macronutrient intakes were calculated as dietary energy intake contributed by carbohydrate, protein, and fat, divided by the total energy intake using a 24 h food diary recall approach. Cox proportional hazard models were applied to examine the temporal relation of macronutrient intakes with all-cause and cause-specific mortality. The average follow-up time was 7.4 years, during which 2784 adults with T2DM died. After multivariable adjustment, people with fourth and fifth quintiles of total energy, second and third quintiles of carbohydrate, and fourth quintiles of protein intakes were likely to have lower risks of all-cause and expanded cardiovascular disease (CVD) mortality. People with fifth quintiles of total energy intake were likely to have decreased non-expanded CVD mortality. We found a significant interaction between gender and fat intake on all-cause and expanded CVD mortality. Fat intake was associated with all-cause, expanded and non-expanded CVD mortality among males with T2DM. Total energy, carbohydrate, and protein intakes were associated with lower risks of all-cause and expanded CVD mortality, with minimal risks observed at ≥1673 Kcal total energy, 43–52% carbohydrate intake, and 15–16% protein intake among people with T2DM.

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1629 ◽  
Author(s):  
Takuya Yamaoka ◽  
Atsushi Araki ◽  
Yoshiaki Tamura ◽  
Shiro Tanaka ◽  
Kazuya Fujihara ◽  
...  

The aim of this study was to investigate the association between protein intake and mortality risk in patients with type 2 diabetes. We analyzed a pooled data of 2494 diabetic patients from two prospective longitudinal studies. Nutritional intake was assessed using a Food Frequency Questionnaire at baseline. Protein intake per body weight (kg) per day was categorized into quartile groups. Adjusted hazard ratios (HRs) and 95% confidence interval (CI) were calculated using Cox regression analysis. During the six-year follow-up, there were 152 incidents of all-cause mortality. The HR for mortality in the lowest quartile of protein intake per body weight compared with the highest quartile was 2.26 (95% CI: 1.34–3.82, p = 0.002) after adjustment for covariates. Subgroup analyses revealed significant associations between low protein intake and mortality in patients aged over 75 years or under 65 years. After further adjustment of the total energy intake, a significant association between protein intake and mortality remained in patients aged ≥ 75 years, whereas the association was attenuated in those aged < 65 years. Our results suggest that adequate protein intake is necessary in older diabetic patients over 75 years, whereas with diabetes, whereas whole optimal total energy intake is required in younger patients with type 2 diabetes.


Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3365
Author(s):  
Kyuho Kim ◽  
YoonJu Song ◽  
Tae Jung Oh ◽  
Sung Hee Choi ◽  
Hak Chul Jang

We aimed to investigate the association of iron and polyunsaturated fatty acid (PUFA) intake with diabetic peripheral neuropathy (DPN) in individuals with type 2 diabetes. This cross-sectional study included 147 individuals with type 2 diabetes. Dietary intake was assessed using three-day food records. DPN was diagnosed on the basis of a Michigan Neuropathy Screening Instrument—Physical Examination score ≥2.5. Adjusted for total energy intake, iron intake was significantly higher in individuals with DPN than in those without DPN (10.9 ± 4.0 mg vs. 9.9 ± 3.6 mg, p = 0.041). In addition, the iron/PUFA ratio was significantly higher in individuals with DPN (1.4 ± 0.8 vs. 1.1 ± 0.4, p = 0.005). Logistic regression analyses showed that iron intake (odds ratio (OR): 1.152; 95% confidence interval (CI): 1.012, 1.311) and iron/PUFA ratio (OR: 2.283; 95% CI: 1.066, 4.887) were associated with DPN after adjustment for total energy intake, sex, age, body mass index, systolic blood pressure, diabetes duration, estimated glomerular filtration rate, glycated hemoglobin, low-density lipoprotein cholesterol, and smoking. In conclusion, high dietary iron intake and an elevated iron/PUFA ratio were associated with the presence of DPN. The present study suggests the importance of the dietary pattern of iron and PUFA intake in individuals with type 2 diabetes.


2010 ◽  
Vol 104 (2) ◽  
pp. 276-285 ◽  
Author(s):  
A. S. Donin ◽  
C. M. Nightingale ◽  
C. G. Owen ◽  
A. R. Rudnicka ◽  
M. C. McNamara ◽  
...  

In the UK, South Asian adults have increased risks of CHD, type 2 diabetes and central obesity. Black African-Caribbeans, in contrast, have increased risks of type 2 diabetes and general obesity but lower CHD risk. There is growing evidence that these risk differences emerge in early life and that nutritional factors may be important. We have therefore examined the variations in nutritional composition of the diets of South Asian, black African-Caribbean and white European children, using 24 h recalls of dietary intake collected during a cross-sectional survey of cardiovascular health in eighty-five primary schools in London, Birmingham and Leicester. In all, 2209 children aged 9–10 years took part, including 558 of South Asian, 560 of black African-Caribbean and 543 of white European ethnicity. Compared with white Europeans, South Asian children reported higher mean total energy intake; their intakes of total fat, polyunsaturated fat and protein (both absolute and as proportions of total energy intake) were higher and their intakes of carbohydrate as a proportion of energy (particularly sugars), vitamin C and D, Ca and haem Fe were lower. These differences were especially marked for Bangladeshi children. Black African-Caribbean children had lower intakes of total and saturated fat (both absolute and as proportions of energy intake), NSP, vitamin D and Ca. The lower total and saturated fat intakes were particularly marked among black African children. Appreciable ethnic differences exist in the nutritional composition of children's diets, which may contribute to future differences in chronic disease risk.


Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2476
Author(s):  
Wang ◽  
Almoosawi ◽  
Palla

This study aims at combining time and quantity of carbohydrate (CH) intake in the definition of eating patterns in UK adults and investigating the association of the derived patterns with type 2 diabetes (T2D). The National Diet and Nutrition Survey (NDNS) Rolling Program included 6155 adults in the UK. Time of the day was categorized into 7 pre-defined time slots: 6–9 am, 9–12 noon, 12–2 pm, 2–5 pm, 5–8 pm, 8–10 pm, and 10 pm–6 am. Responses for CH intake were categorized into: no energy intake, CH <50% or ≥50% of total energy. Non-parametric multilevel latent class analysis (MLCA) was applied to identify eating patterns of CH consumption across day-time, as a novel method accounting for the repeated measurements of intake over 3–4 days nested within individuals. Survey-designed multivariable regression was used to assess the associations of CH eating patterns with T2D. Three CH eating day patterns (low, high CH percentage and frequent CH intake day) emerged from 24,483 observation days; based on which three classes of CH eaters were identified and characterized as: low (28.1%), moderate (28.8%) and high (43.1%) CH eaters. On average, low-CH eaters consumed the highest amount of total energy intake (7985.8 kJ) and had higher percentages of energy contributed by fat and alcohol, especially after 8 pm. Moderate-CH eaters consumed the lowest amount of total energy (7341.8 kJ) while they tended to have their meals later in the day. High-CH eaters consumed most of their carbohydrates and energy earlier in the day and within the time slots of 6–9 am, 12–2 pm and 5–8 pm, which correspond to traditional mealtimes. The high-CH eaters profile had the highest daily intake of CH and fiber and the lowest intake of protein and fat. Low-CH eaters had greater odds than high-CH eaters of having T2D in self-reported but not in previously undiagnosed diabetics. Further research using prospective longitudinal studies is warranted to ascertain the direction of causality in the association of CH patterns with type 2 diabetes.


Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3228 ◽  
Author(s):  
Evelyn B. Parr ◽  
Brooke L. Devlin ◽  
Karen H. C. Lim ◽  
Laura N. Z. Moresi ◽  
Claudia Geils ◽  
...  

Individuals with type 2 diabetes (T2D) require a long-term dietary strategy for blood glucose management and may benefit from time-restricted eating (TRE, where the duration between the first and last energy intake is restricted to 8–10 h/day). We aimed to determine the feasibility of TRE for individuals with T2D. Participants with T2D (HbA1c >6.5 to <9%, eating window >12 h/day) were recruited to a pre-post, non-randomised intervention consisting of a 2-week Habitual period to establish baseline dietary intake, followed by a 4-weeks TRE intervention during which they were instructed to limit all eating occasions to between 10:00 and 19:00 h on as many days of each week as possible. Recruitment, retention, acceptability, and safety were recorded throughout the study as indicators of feasibility. Dietary intake, glycaemic control, psychological well-being, acceptability, cognitive outcomes, and physiological measures were explored as secondary outcomes. From 594 interested persons, and 27 eligible individuals, 24 participants enrolled and 19 participants (mean ± SD; age: 50 ± 9 years, BMI: 34 ± 5 kg/m2, HbA1c: 7.6 ± 1.1%) completed the 6-week study. Overall daily dietary intake did not change between Habitual (~8400 kJ/d; 35% carbohydrate, 20% protein, 41% fat, 1% alcohol) and TRE periods (~8500 kJ/d; 35% carbohydrate, 19% protein, 42% fat, 1% alcohol). Compliance to the 9 h TRE period was 72 ± 24% of 28 days (i.e., ~5 days/week), with varied adherence (range: 4–100%). Comparisons of adherent vs. non-adherent TRE days showed that adherence to the 9-h TRE window reduced daily energy intake through lower absolute carbohydrate and alcohol intakes. Overall, TRE did not significantly improve measures of glycaemic control (HbA1c −0.2 ± 0.4%; p = 0.053) or reduce body mass. TRE did not impair or improve psychological well-being, with variable effects on cognitive function. Participants described hunger, daily stressors, and emotions as the main barriers to adherence. We demonstrate that 4-weeks of TRE is feasible and achievable for these individuals with T2D to adhere to for at least 5 days/week. The degree of adherence to TRE strongly influenced daily energy intake. Future trials may benefit from supporting participants to incorporate TRE in regular daily life and to overcome barriers to adherence.


2021 ◽  
pp. 1-24
Author(s):  
Jackie Shinwell ◽  
Melissa Bateson ◽  
Daniel Nettle ◽  
Gillian V. Pepper

Abstract The aim of this study was to identify the dietary-intake correlates of food insecurity in UK adults. We recruited groups of low-income participants who were classified as food insecure (n = 196) or food secure (n = 198). Participants completed up to five 24h dietary recalls. There was no difference in total energy intake by food insecurity status (βFI = −0.06, 95% CI −0.25 to 0.13). Food insecure participants consumed a less diverse diet, as evidenced by fewer distinct foods per meal (βFI = −0.27, 95% CI −0.47 to −0.07), and had more variable time gaps between meals (βFI = 0.21, 95% CI 0.01 to 0.41). These associations corresponded closely to those found in a recent U.S. study using similar measures, suggesting that the dietary intake signature of food insecurity generalizes across populations. The findings suggest that the consequences of food insecurity for weight gain and health are not due to increased energy intake. We suggest that there may be important health and metabolic effects of temporal irregularity in dietary intake, which appears to be an important component of food insecurity.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Yong Zhu ◽  
Jessica Smith ◽  
Vipra Vanage ◽  
Neha Jain ◽  
Mitesh Sharma ◽  
...  

Abstract Objectives To understand consumption pattern of ready to eat cereal (RTEC) in the Hispanic population in the United States and investigate associations between RTEC consumption and dietary intake as well as diet quality in this population. Methods Children aged between 2–17 years old (N = 899) and adults aged 18 years or older (N = 1593) who were Mexican American or other Hispanics from the National Health and Nutrition Examination Survey 2015–2016 were included in the study. Day 1 dietary data were used to determine RTEC consumption status, energy intake, nutrient and food group intake. Diet quality was measured as the Healthy Eating Index 2015 (HEI-2015). Multiple linear regression analyses for surveys were conducted to estimate covariates-adjusted associations between RTEC consumption and dietary intake, as well as diet quality. Results About 40% of Hispanic children reported RTEC consumption whereas only 14% of Hispanic adults were RTEC eaters. RTEC eaters were more likely from lower income families. Compared to non-eaters, both children and adults who reported RTEC consumption had significantly higher intake of whole grains, dairy products, and vitamins and minerals such as calcium, iron, zinc, folate, thiamin, riboflavin, niacin, vitamin B12, vitamin B6, vitamin A, vitamin D; as well as significantly lower intake of sodium and dietary cholesterol (P < 0.05 for all). Total energy intake and added sugar intake did not differ by RTEC consumption status in both age groups. HEI-2015 total score was significantly higher in RTEC eaters than non-eaters in both Hispanic children and adults (P < 0.05 for both). Conclusions Consumption of RTEC is associated with improved diet quality including higher intake of whole grain and dairy products, as well as several vitamins and minerals in both Hispanic children and adults. Consumption of RTEC is not associated with total energy intake or added sugar in the Hispanic population. Funding Sources The study was funded by General Mills, Inc.


1993 ◽  
Vol 76 (6) ◽  
pp. 1206-1213 ◽  
Author(s):  
Junshi Chen ◽  
Junquan Gao

Abstract This paper reports the intakes of 72 nutrients and their dietary sources obtained from the Chinese total diet study in 1990. Most of the nutrient intakes are close or equal to their corresponding recommended daily allowances (RDAs). Both the total energy intake (2203 kcal) and the proportions contributed by protein, fat, and carbohydrate meet the current Chinese RDAs and the World Health Organization (WHO) nutrient goals. The average protein intake was 64 g/day. The intake of essential amino acids all exceeded the Chinese RDA, and their proportions were generally consistent with the WHO recommended pattern. The average fat intake was 51.2 g/day (21.2% of the total energy intake). However, the dietary fat intake has been increasing significantly in the Chinese diet and the proportion of animal fat has reached 53% of the total fat intake. The total saturated:total monounsaturated:total polyunsaturated fatty acid ratio was 1.0:1.5:1.0. Although the average cholesterol intake was only 179 mg/day, it was 248 mg/day in the South 1 region. The intakes of thiamine and riboflavin were below the RDA. Retinol intakes in all the 4 regions were low. Most (80%) of the retinol (equivalent) intakes were from carotenoids. The average intake of total tocopherol was 89% of the RDA, and among the 4 regions, only the South 2 region has relatively low intake. The intakes of iron, copper, manganese, sodium, and phosphorus were adequate. The intakes of calcium, zinc, and potassium were insufficient, and intakes of selenium and magnesium were a little low. High sodium and low potassium intake is a traditional problem in the Chinese diet.


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