AimThis cross-sectional study aimed to assess the association of the fat content in the diet with Diabetic Kidney Disease (DKD) in patients with type 2 diabetes.MethodologyPatients from the Diabetes research clinic at Hospital de Clínicas de Porto Alegre (Brazil) were consecutively recruited. The inclusion criterion was the diagnosis of type 2 diabetes. The exclusion criteria were as follows: body mass index >40 kg/m2, heart failure, gastroparesis, diabetic diarrhea, dietary counseling by a registered dietitian during the previous 12 months, and inability to perform the weighed diet records (WDR). The dietary fatty acids (saturated, monounsaturated and polyunsaturated) consumption was estimated by 3-day WDR. Compliance with the WDR technique was assessed by comparison of protein intake estimated from the 3-day WDR and from the 24-h urinary nitrogen output performed on the third day of the WDR period. The presence of DKD was defined as urinary albumin excretion (UAE) ≥ 30 mg / 24 h or/and glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Urinary albumin was measured twice and eGFR was estimated by using the CKD-EPI equation.ResultsA total of 366 patients were evaluated; of these, 33% (n = 121) had DKD. Multivariate analysis showed that the intake of linolenic acid was negatively associated with DKD (OR = 0.57; 95% CI 0.35–0.93; P = 0.024), adjusted for gender, smoking, cardiovascular disease, ACE inhibitors and/or angiotensin receptor blocker use, systolic blood pressure, fasting plasma glucose and HDL cholesterol. In a separate model, similar results were observed for linoleic acid, adjusting to the same co-variables (OR = 0.95; 95% CI 0.91–0.99; P = 0.006).ConclusionThe lower intake of polyunsaturated fatty acids, especially linolenic and linoleic acid, is associated with chronic kidney disease in patients with type 2 diabetes.

In patients with type 2 diabetes without ischemic heart disease, a high intake of polyunsaturated fatty acids, especially alpha linolenic acid, was protective for the development of cardiac events..

ResumoA doença cardiovascular (DCV) é a principal causa de mortalidade em pacientes com diabetes melito (DM), sendo essencial a intervenção dietética no manejo dessa complicação. O objetivo deste manuscrito foi revisar as evidências científicas que fundamentam as recomendações dietéticas da American Diabetes Association (ADA) para prevenção e tratamento da DCV nos pacientes com DM. As diretrizes da ADA baseiam-se, em sua maioria, em estudos com pacientes com DCV, porém sem DM. Nos pacientes com DM, um aumento na ingestão de peixe e de fibras solúveis são as recomendações dietéticas com benefício comprovado. Embora o DM possa ser considerado um equivalente de DCV estabelecida, a adoção das recomendações dietéticas de pacientes sem DM e com DCV para todos pacientes com DM é questionável -em especial quando são consideradas as peculiaridades da DCV no DM. Ensaios clínicos aleatorizados em pacientes com DM deverão fundamentar melhor os benefícios das intervenções dietéticas sobre a DCV. Arq Bras Endocrinol Metab. 2009;53(5):657-66. DescritoresDiabetes melito; doença cardiovascular; fatores de risco; intervenção dietética AbstRAct Cardiovascular disease (CVD) is the main cause of mortality among patients with diabetes mellitus (DM), and dietary intervention is an essential measure to prevent and treat this complication. The aim of this manuscript was to review scientific evidence that underlies the dietetic recommendations of the American Diabetes Association (ADA) for prevention and treatment of CVD in patients with DM. The ADA guidelines are mostly based on studies performed on patients with CVD and without DM. The evidence-based dietary recommendations for patients with DM are to increase the intake of fish and soluble fibers. Although DM has been considered as an equivalent of established CVD, the adoption of the same dietary recommendations for patients without DM and with CVD for all patients with DM is still questionable -especially considering the peculiarities of CVD in DM. Randomized clinical trials including patients with DM should provide further information regarding the benefits of these dietary interventions for CVD.

BackgroundThe influence of dietary fat on the body fat of patients with diabetes is not well established. This cross‐sectional study aimed to analyze the association between percentage body fat (PBF) and dietary sources of fat from the usual diet of patients with type 2 diabetes.MethodsOutpatients were submitted to PBF evaluation estimated by bioelectrical impedance. The patient's usual diet was assessed by a 3‐day weighed diet record (WDR), and compliance was analyzed by comparing the protein intake estimated from the WDR and that from 24‐hr urinary nitrogen output.ResultsA total of 188 patients with type 2 diabetes (aged 62.5 ± 8.8 years; 57% female, body mass index [BMI] 29.3 ± 3.8 kg/m²) were analyzed and divided into groups with high and low PBF according to mean PBF (men: 26.6 ± 7.1%; women: 39.8 ± 5.9%). Patients with high PBF consumed an increased proportion of red meat (52.0% of total meat), processed meat (5.4%), and saturated fat from red meat (2.1% of energy) compared to low PBF individuals (42.3% [p = 0.036]; 3.0% [p = 0.010]; 1.5% of energy [p = 0.032], respectively). According to Poisson's regression, the consumption of red meat (PR = 1.008 [95% CI = 1.002–1.013]; p = 0.006) and the reuse of frying oil (PR = 1.670 [95% CI = 1.240–2.249]; p = 0.001) were associated with higher PBF. In the adjusted analysis, the upper tertile of processed meat intake was associated with higher PBF (PR = 1.522 [95% CI = 1.226–1.891]; p = 0.001) compared to the lower tertile.ConclusionsThe present study suggested that a higher ingestion of dietary sources of saturated fat was associated with high PBF in patients with type 2 diabetes.

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Cite this article as: dos Santos et al.: Fatty acid composition in serum lipids and the renal function of type 2 diabetes mellitus patients.