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European Journal of Nutrition

, Volume 55, Issue 4, pp 1645–1651 | Cite as

Influence of dietary fat and carbohydrates proportions on plasma lipids, glucose control and low-grade inflammation in patients with type 2 diabetes—The TOSCA.IT Study

  • M. Vitale
  • M. Masulli
  • A. A. Rivellese
  • A. C. Babini
  • M. Boemi
  • E. Bonora
  • R. Buzzetti
  • O. Ciano
  • M. Cignarelli
  • M. Cigolini
  • G. Clemente
  • G. Citro
  • L. Corsi
  • E. Dall’Aglio
  • S. Del Prato
  • G. Di Cianni
  • M. A. Dolci
  • C. Giordano
  • R. Iannarelli
  • C. Iovine
  • A. Lapolla
  • D. Lauro
  • S. Leotta
  • C. Mazzucchelli
  • V. Montani
  • G. Perriello
  • G. Romano
  • F. Romeo
  • L. Santarelli
  • R. Schiano di Cola
  • S. Squatrito
  • L. Tonutti
  • R. Trevisan
  • A. A. Turco
  • C. Zamboni
  • G. Riccardi
  • O. Vaccaro
Original Contribution

Abstract

Purpose

The optimal macronutrient composition of the diet for the management of type 2 diabetes is debated, particularly with regard to the ideal proportion of fat and carbohydrates. The aim of the study was to explore the association of different proportions of fat and carbohydrates of the diet—within the ranges recommended by different guidelines—with metabolic risk factors.

Methods

We studied 1785 people with type 2 diabetes, aged 50–75, enrolled in the TOSCA.IT Study. Dietary habits were assessed using a validated food-frequency questionnaire (EPIC). Anthropometry, fasting lipids, HbA1c and C-reactive protein (CRP) were measured.

Results

Increasing fat intake from <25 to ≥35 % is associated with a significant increase in LDL-cholesterol, triglycerides, HbA1c and CRP (p < 0.05). Increasing carbohydrates intake from <45 to ≥60 % is associated with significantly lower triglycerides, HbA1c and CRP (p < 0.05). A fiber intake ≥15 g/1000 kcal is associated with a better plasma lipids profile and lower HbA1c and CRP than lower fiber consumption. A consumption of added sugars of ≥10 % of the energy intake is associated with a more adverse plasma lipids profile and higher CRP than lower intake.

Conclusions

In people with type 2 diabetes, variations in the proportion of fat and carbohydrates of the diet, within the relatively narrow ranges recommended by different nutritional guidelines, significantly impact on the metabolic profile and markers of low-grade inflammation. The data support the potential for reducing the intake of fat and added sugars, preferring complex, slowly absorbable, carbohydrates.

Keywords

Diet Carbohydrates Fat Glucose control HDL-cholesterol Triglycerides Type 2 diabetes Nutritional guidelines 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

The study is supported by the Italian Medicines Agency (AIFA) within the Independent Drug Research Program contract n°. FARM6T9CET and by Diabete Ricerca, the no profit Research Foundation of the Italian Diabetes Society.

Supplementary material

394_2015_983_MOESM1_ESM.doc (36 kb)
Supplementary material 1 (DOC 35 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • M. Vitale
    • 1
  • M. Masulli
    • 1
  • A. A. Rivellese
    • 1
  • A. C. Babini
    • 2
  • M. Boemi
    • 3
  • E. Bonora
    • 4
  • R. Buzzetti
    • 5
  • O. Ciano
    • 1
  • M. Cignarelli
    • 6
  • M. Cigolini
    • 4
  • G. Clemente
    • 1
  • G. Citro
    • 7
  • L. Corsi
    • 8
  • E. Dall’Aglio
    • 9
  • S. Del Prato
    • 10
  • G. Di Cianni
    • 11
  • M. A. Dolci
    • 12
  • C. Giordano
    • 13
  • R. Iannarelli
    • 14
  • C. Iovine
    • 1
  • A. Lapolla
    • 15
  • D. Lauro
    • 16
  • S. Leotta
    • 17
  • C. Mazzucchelli
    • 18
  • V. Montani
    • 19
  • G. Perriello
    • 20
  • G. Romano
    • 1
  • F. Romeo
    • 21
  • L. Santarelli
    • 22
  • R. Schiano di Cola
    • 1
  • S. Squatrito
    • 23
  • L. Tonutti
    • 24
  • R. Trevisan
    • 25
  • A. A. Turco
    • 1
  • C. Zamboni
    • 26
  • G. Riccardi
    • 1
  • O. Vaccaro
    • 1
  1. 1.Department of Clinical Medicine and SurgeryUniversity “Federico II” of NaplesNaplesItaly
  2. 2.Diabetology, Infermi HospitalRiminiItaly
  3. 3.UOC Malattie Metaboliche e Diabetologia, INRCA-IRCCS InstituteAnconaItaly
  4. 4.Department of Medicine, Division of Endocrinology, Diabetes and MetabolismUniversity of VeronaVeronaItaly
  5. 5.UOC di Diabetologia Universitaria, Ospedale Santa Maria GorettiLatinaItaly
  6. 6.Division of Endocrinology and MetabolismUniversity of FoggiaFoggiaItaly
  7. 7.UO Endocrinologia e Diabetologia, ASPPotenzaItaly
  8. 8.SSD Diabetologia e Malattie del MetabolismoASL 4 ChiavareseGenovaItaly
  9. 9.Clinical and Experimental Medicine, University of ParmaParmaItaly
  10. 10.Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
  11. 11.UOC Diabetologia, ASL 6LivornoItaly
  12. 12.UO Diabetologia, USL 1Massa e CarraraItaly
  13. 13.Endocrinology and Metabolic DiseasesUniversity of PalermoPalermoItaly
  14. 14.UO DiabetologiaOspedale San SalvatoreL’AquilaItaly
  15. 15.Department of MedicineUniversity of PadovaPadovaItaly
  16. 16.Department of Internal MedicineTor Vergata UniversityRomeItaly
  17. 17.Unit of DiabetologySandro Pertini HospitalRomeItaly
  18. 18.Department of Internal MedicineUniversity of Genova, IRCCS San MartinoGenovaItaly
  19. 19.UOSDPresidio Ospedaliero di AtriAtriItaly
  20. 20.MISEMUniversity of PerugiaPerugiaItaly
  21. 21.DiabetologiaASL Torino 5TorinoItaly
  22. 22.Presidio Ospedaliero di LancianoLancianoItaly
  23. 23.Department of Clinical and Experimental MedicineUniversity of CataniaCataniaItaly
  24. 24.SOC di Endocrinologia e Malattie del MetabolismoAOU “S. Maria della Misericordia”UdineItaly
  25. 25.Endocrinology and Diabetes UnitAO Papa Giovanni XXIIIBergamoItaly
  26. 26.Unità Operativa di Malattie Metaboliche, Dietologia e Nutrizione ClinicaAOU Arcispedale “S. Anna”FerraraItaly

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