Unhealthy dietary patterns associated with inflammation and endothelial dysfunction in type 1 diabetes: the EURODIAB study

Nutr Metab Cardiovasc Dis. 2013 Aug;23(8):758-64. doi: 10.1016/j.numecd.2012.04.005. Epub 2012 Jul 12.

Abstract

Background and aims: A healthy diet has been inversely associated with endothelial dysfunction (ED) and low-grade inflammation (LGI). We investigated the association between nutrient consumption and biomarkers of ED and LGI in type 1 diabetes.

Methods and results: We investigated 491 individuals. Nutrient consumption and lifestyle risk factors were measured in 1989 and 1997. Biomarkers of ED (von Willebrand factor, soluble vascular cell adhesion molecule-1 and soluble endothelial selectin) and LGI (C-reactive protein, interleukin 6 and tumour necrosis factor α) were measured in 1997 and averaged into Z-scores. The nutrient residual method was used to adjust individual nutrient intake for energy intake. Data were analysed with generalised estimation equations. We report increments/decrements in nutrient consumption, averaged over time, per +1 standard deviation (SD) of 1997 ED or LGI Z-scores, after adjustment for sex, age, duration of diabetes, investigation centre, body mass index, energy intake, smoking behaviour, alcohol consumption, and each of the other nutrients. One SD elevation in ED Z-score was associated with a diet lower in fibre [β(95%CI);-0.09(-0.18;-0.004)], polyunsaturated fat [-0.18(-0.31;-0.05)] and vegetable protein [-0.10(-0.20;-0.001)]. For the LGI Z-score results showed associations with fibre [-0.09(-0.17;-0.01)], polyunsaturated fat [-0.14(-0.24;-0.03)] and cholesterol [0.10(0.01; 0.18)].

Conclusion: In type 1 diabetes, consumption of less fibre, polyunsaturated fat and vegetable protein, and more cholesterol over the study period was associated with more ED and LGI. Following dietary guidelines in type 1 diabetes may reduce cardiovascular disease risk by favourably affecting ED and LGI.

Keywords: Diet; Endothelial dysfunction; Epidemiology; Inflammation; Type 1 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / physiopathology*
  • Cardiovascular Diseases / prevention & control
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Dietary Fiber / administration & dosage
  • Dietary Proteins / administration & dosage
  • Endothelium / physiopathology
  • Energy Intake
  • Fatty Acids, Unsaturated / administration & dosage
  • Feeding Behavior*
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation / complications
  • Inflammation / physiopathology*
  • Interleukin-6 / blood
  • Life Style
  • Male
  • Middle Aged
  • Nutrition Assessment
  • Prospective Studies
  • Risk Factors
  • Surveys and Questionnaires
  • Tumor Necrosis Factor-alpha / blood
  • Vegetables
  • Young Adult

Substances

  • Biomarkers
  • Dietary Fiber
  • Dietary Proteins
  • Fatty Acids, Unsaturated
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein