Modification of fat intake in type II-diabetics: What can be achieved?

Abstract

Within the framework of a multi-center study [4] in newly-manifested type II-diabetics, who were initially treatable with diet alone, special attention has been paid to the modification of fat intake. The patients have been repeatedly informed with respect to the necessary reduction in the intake of animal fats and the increase in the intake of vegetable oil. — During 5 years, the adherence to the dietary recommendations has been checked by food records (3 days annually, including one weekend day). We compared the patients having documented an increase in the P/S ratio > 0.4 (Group B; mean P/S ratio > 0.5) with those patients who failed to change their fat intake (Group A; mean P/S ratio 0.28). Biochemical parameters, blood pressure, physical activity, alcohol consumption, smoking habits, and the current drug therapy have been taken into consideration. — An increase in the intake of vegetable oils (Group B) was associated with a decreased consumption of saturated fats, of cholesterol, and of carbohydrates; the total energy ingested was lower in these patients. The diabetics of this Group B had lower fasting blood glucose levels, lower cholesterol concentrations (significant difference in men only) and diastolic blood pressure readings. The triglyceride levels were not different. Physical activity in Group B was clearly higher. No important differences for antidiabetic, lipid-lowering (clofibric acid) or antihypertensive drug therapy were found. — These results point to the practical difficulties with implementing a diet modification and evaluating its effect. But it could be shown that those diabetics adhering to recommendations given in the intensified health education program (including physical activity) show better metabolic parameters and blood pressure.

Zusammenfassung

Moderne Diätempfehlungen für Typ II-Diabetiker beinhalten eine Fettmodifikation mit der Reduzierung des Konsums tierischer Fette und der Anhebung der Aufnahme pflanzlicher Öle [2, 5]. Angaben in der Literatur zu Diäteffekten beziehen sich oft auf experimentelle Kostformen mit extremen Nährstoffrelationen und sind meist zeitlich sehr begrenzt. Gemäßigte und praktikable Diätänderungen lassen weniger ausgeprägte Effekte erwarten [7, 8]. Deshalb ist es von besonderem Interesse, im Rahmen einer prospektiven Interventionsstudie die Durchführbarkeit der Fettmodifikation in der Diät und ihre Effekte zu untersuchen.