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Do European people with type 1 diabetes consume a high atherogenic diet? 7-year follow-up of the EURODIAB Prospective Complications Study

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Abstract

Background/objectives

Individuals with type 1 diabetes have a high risk of developing cardiovascular diseases, and it has been reported that they consume a high atherogenic diet. We examined how nutrient intake and adherence to current European nutritional recommendations evolved in a large cohort of European individuals with type 1 diabetes over a period of 7 years.

Subjects/methods

We analysed data from the EURODIAB Prospective Complications Study, a European multicentre prospective cohort study. Standardized 3-day dietary records were employed in individuals with type 1 diabetes. One thousand one hundred and two patients (553 men, 549 women, baseline age 33 ± 10 years, duration 15 ± 9 years) had complete nutritional data available at baseline and after 7 years. We calculated mean differences in reported nutrients over time and adjusted these for age, gender, HbA1c and BMI with ANOVA models.

Results

Compared to baseline, there were minor changes in nutrients. Reported protein (−0.35 % energy (en), fat (−1.07 % en), saturated fat (−0.25 % en) and cholesterol (−7.42 mg/1000 kcal) intakes were lower, whereas carbohydrate (+1.23 % en) and fibre (+0.46 g/1000 kcal) intakes were higher at the 7-year follow-up. European recommendations for adequate nutrient intakes were followed in individuals with type 1 diabetes for protein (76 % at baseline and 78 % at follow-up), moderately for fat (34, 40 %), carbohydrate (34, 41 %) and cholesterol (39, 47 %), but poorly for fibre (1.4, 2.4 %) and saturated fat (11, 13 %).

Conclusion

European individuals with type 1 diabetes consume a high atherogenic diet as few patients met recommendations for dietary fibre and saturated fat. This study showed minor changes in dietary nutrients and energy intakes over a period of 7 years. Nutrition education needs particular focus on strategies to increase dietary fibre and reduce saturated fat to exploit their potential benefit.

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Abbreviations

ANOVA:

Analysis of variance

BMI:

Body mass index

BMR:

Basic metabolic rate

DCCT:

Diabetes control and complications trial

DNSG:

Diabetes and nutrition study group

EASD:

European Association for the Study of Diabetes

HbA1c:

Glycated haemoglobin

PCS:

Prospective complications study

WHO:

World Health Organization

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Acknowledgments

The participation of the patients in the study is gratefully acknowledged. We thank all investigators, dieticians and nutritionists in the EURODIAB Centres for their excellent co-operation. The study was part of the EURODIAB Concerted Action Programme financially supported by the Commission of the European Union. Financial support for the analysis of the nutritional data came from the research funds of the Nutrition Co-ordinating Centre (M. Toeller) at the German Diabetes Research Institute at Düsseldorf University, Germany.

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Human Nutrition, Wageningen University, 6700 EV, PO Box 8129, Wageningen, The Netherlands

    Sabita S. Soedamah-Muthu

  2. International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, UK

    Nish Chaturvedi

  3. Department of Epidemiology and Public Health, University College London, London, UK

    John H. Fuller

  4. Department of Endocrinology, Diabetology and Rheumatology, University Hospital, Heinrich-Heine-University, Düsseldorf, Germany

    Monika Toeller

Authors
  1. Sabita S. Soedamah-Muthu
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  2. Nish Chaturvedi
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  3. John H. Fuller
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  4. Monika Toeller
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Consortia

EURODIAB Prospective Complications Study Group

Corresponding author

Correspondence to Sabita S. Soedamah-Muthu.

Additional information

See “Appendix” for complete list of participating investigators and centres.

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Appendix: EURODIAB Prospective Complication Study Group, centres and Investigators

Appendix: EURODIAB Prospective Complication Study Group, centres and Investigators

B. Karamanos, A. Kofinis, K. Petrou (Hippokration Hospital, Athens, Greece); F. Giorgino, G. Picca, A. Angarano, G. De Pergola, L. Laviola, R. Giorgino (Internal Medicine, Endocrinology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy); C. Ionescu-Tirgoviste, A. Coszma, C. Guja (Clinic of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania); M. Songini, A. Casu, M. Pedron, S. Pintus, M. Fossarello (Diabetes Unit Ospedale San Michele, Cagliari, Italy); J. B. Ferriss, G. Grealy, D. O’Keefe (Cork University Hospital, Cork, Ireland); M. Toeller, C. Arden (Diabetes Research Institute, Heinrich-Heine University, Duesseldorf, Germany); R. Rottiers, C. Tuyttens, H. Priem (University Hospital of Gent, Belgium); P. Ebeling, M. Kylliäinen, V. A. Koivisto (University Hospital of Helsinki, Finland); B. Idzior-Walus, J. Sieradzki, K. Cyganek, B. Solnica (Department of Metabolic Diseases, Jagiellonian University, Krakow, Poland); H. H. P. J. Lemkes, J. C. Lemkes-Stuffken (Leiden University Medical Centre, the Netherlands); J. Nunes-Correa, M. C. Rogado, L. Gardete-Correia, M. C. Cardoso, A. Silva, J. Boavida, M. Machado Sa Marques (Portuguese Diabetic Association, Lisbon, Portugal); G. Michel, R. Wirion, S. Cardillo (Centre Hospitalier, Luxembourg); G. Pozza, R. Mangili, V. Asnaghi (Ospedale San Raffaele, Milan, Italy); E. Standl, B. Schaffler, H. Brand, A. Harms (City Hospital Schwabing, Munich, Germany); D. Ben Soussan, O. Verier-Mine, P. Fallas, M. C. Fallas (Centre Hospitalier de Valenciennes, France); J. H. Fuller, J. Holloway, L. Asbury, D. J. Betteridge (University College London, UK); G. Cathelineau, A. Bouallouche, B. Villatte Cathelineau (Hospital Saint-Louis, Paris, France); F. Santeusanio, G. Rosi, V. D’Alessandro, C. Cagini, P. Bottini, G. P. Reboldi (Dipartimento di Medicina Interna, Perugia, Italy); R. Navalesi, G. Penno, S. Bandinelli, R. Miccoli, M. Nannipieri (Dipartimento di Endocrinologia e Metabolismo, Pisa, Italy); G. Ghirlanda, C. Saponara, P. Cotroneo, A. Manto, A. Minnella (Universita Cattolica del Sacro Cuore, Rome, Italy); J. D. Ward, S. Tesfaye, S. Eaton, C. Mody (Royal Hallamshire Hospital, Sheffield, UK); M. Borra, P. Cavallo Perin, S. Giunti, G. Grassi, G. F. Pagano, M. Porta, R. Sivieri,

F. Vitelli, M. Veglio (Dipartimento di Medicina Interna, Università di Torino and ASO CTO/CRF/Maria Adelaide, Turin, Italy); N. Papazoglou, G. Manes (General Hospital Papageorgiou, Diabetes Unit, Thessaloniki, Greece); M. Muggeo, M. Iagulli, V. Cacciatori (V. Cattedra di Malattie del Metabolismo, Verona, Italy); K. Irsigler, H. Abrahamian (Hospital Vienna Lainz, Austria); S. Walford, J. Sinclair, S. Hughes, V. McLelland, J. Ward (New Cross Hospital, Wolverhampton, UK); G. Roglic, Z. Metelko, Z. R. Pepeonik (Vuk Vrhovac Institute for Diabetes, Zagreb, Croatia);

Steering Committee members

J. H. Fuller (London),B. Karamanos, Chairman (Athens), A.-K. Sjolie (Odense), N. Chaturvedi (London), M. Toeller (Duesseldorf), G. Pozza Co-chairman (Milan), B. Ferriss (Cork), M. Porta (Turin), R. Rottiers (Gent), G. Michel (Luxembourg)

Co-ordinating Centre

J. H. Fuller, N. Chaturvedi, J. Holloway, D. Webb, L. Asbury, University College London, UK

Central laboratories

G.-C. Viberti, R. Swaminathan, P. Lumb, A. Collins, S. Sankaralingham, MA Crook, Guy’s and St Thomas Hospital, London, UK

Retinopathy Grading Centre

S. Aldington, T. Mortemore, H. Lipinski, Royal Postgraduate Medical School of Imperial College London, London, UK

Nutrition Co-ordinating Centre

M. Toeller, W.A. Scherbaum, F.A. Gries, Heinrich-Heine-University, Diabetes Research Institute and Department of Endocrinology, Diabetology and Rheumatology, Duesseldorf, Germany

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Soedamah-Muthu, S.S., Chaturvedi, N., Fuller, J.H. et al. Do European people with type 1 diabetes consume a high atherogenic diet? 7-year follow-up of the EURODIAB Prospective Complications Study. Eur J Nutr 52, 1701–1710 (2013). https://doi.org/10.1007/s00394-012-0473-7

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