Dietary fat composition and cardiac events in patients with type 2 diabetes

Santos, Ana Luiza Teixeira dos; Weiss, Tanara; Duarte, Camila Kümmel; Gross, Jorge Luiz; Azevedo, Mirela Jobim de; Zelmanovitz, Themis

doi:10.1016/j.atherosclerosis.2014.06.014

Cited by 10 publications

(10 citation statements)

References 51 publications

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“…In a prospective cohort analysis of 227 patients with type 2 diabetes, dos Santos et al (33) found that dietary PUFA intake >9.0% of total energy was associated with an up to 70% risk reduction for cardiac events. The protective role of PUFAs was especially significant for ALA, with the highest intake of ALA (highest quartile: >1.25% of energy) being associated with a 42% reduction in risk of cardiac events.…”

Section: Unsaturated Fasmentioning

confidence: 98%

Emerging Nutrition Science on Fatty Acids and Cardiovascular Disease: Nutritionists' Perspectives

Kris-Etherton

Fleming

2015

Advances in Nutrition

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Recent dietary guidance for heart health recommends a reduction (by ∼50%) in saturated fatty acid (SFA) intake to reduce LDL cholesterol and to decrease risk of cardiovascular disease (CVD). The 2010 Dietary Guidelines for Americans recommends substituting unsaturated fat [both polyunsaturated and monounsaturated fatty acids (PUFAs and MUFAs, respectively)] for SFAs. There are many dietary options that can be implemented to replace SFAs, given the different sources of unsaturated fats in the food supply. Compelling evidence exists for the cardioprotective benefits of n-3 (ω-3) PUFAs, both marine- and plant-derived. In addition, the evidence of cardioprotective benefits of n-6 (ω-6) PUFAs is strong, whereas that for MUFAs is mixed, although there is emerging evidence of benefits. Quantitatively, lowering SFAs by 50% will require, in part, substituting food sources of n-6 and n-3 PUFAs and MUFAs for food sources of SFAs. The use of n-3 PUFAs as a replacement for SFAs will result in a shortfall in reaching the SFA goal because of the relatively low amounts that can be incorporated in the diet, even with very high n-3 PUFA substitution. SFAs also can be replaced with dietary carbohydrate and/or protein. Replacing SFAs with carbohydrate, specifically refined sources, however, has little impact on reducing CVD risk. There is evidence about the health benefits of dietary protein on CVD risk, which merits study. Dietary guidelines have advanced considerably with the "replacement of SFA with unsaturated fat message" instead of recommending decreasing SFAs alone. A key question that remains is what is the optimal mix of macronutrients to maximally reduce CVD risk.

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Section: Unsaturated Fasmentioning

confidence: 98%

Emerging Nutrition Science on Fatty Acids and Cardiovascular Disease: Nutritionists' Perspectives

Kris-Etherton

Fleming

2015

Advances in Nutrition

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“…Another possible reason is differences in the baseline dietary n-3 PUFA intake among the populations. In fact, in the present study, the mean EPA and DHA intake was low because less than 15% of our population consumes marine foods [ 27 ]. Thus, the main source of PUFA in the present study population was derived from vegetable oils, especially soybean oil.…”

Section: Discussionmentioning

confidence: 87%

“…However, the ALA itself could have beneficial effects, such as, anti-inflammatory properties that may be the link between this FA and the cardiometabolic risk [ 25 , 26 ]. In fact, in a recent cohort study of patients with type 2 diabetes without ischemic heart disease, a high intake of PUFA, especially ALA, was protective for the development of cardiac events [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, we used a standardized 3-day WDR, including a 24-h urinary urea measurement to confirm dietary intake estimated from records [ 34 ], which is more accurate than food frequency questionnaires. This dietary tool has been largely used to confirm dietary compliance in studies with diabetic patients [ 6 , 22 , 27 , 35 ]. Another aspect is that detailed attention was given to the evaluation of oil consumption, which was the main source of dietary PUFA.…”

Section: Discussionmentioning

confidence: 99%

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Low linolenic and linoleic acid consumption are associated with chronic kidney disease in patients with type 2 diabetes

et al. 2018

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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.

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“…It is well known that unsaturated fatty acids play important roles in membrane fluidity, and as mediators of signal transduction, cellular differentiation, and metabolic homeostasis . Increased MUFA, n ‐3 PUFAs, and an n ‐3/ n ‐6 ratio have been found related to the prevention of cardiovascular events . This increase in the content of unsaturated fatty acids was even found in the heart of male offspring from control rats fed the olive oil enriched diet, although not in the female group fed the same diet, and the putative transgenerational, dietary‐ and sex‐dependent mechanisms involved will require further research.…”

Section: Discussionmentioning

confidence: 98%

Intrauterine programming of lipid metabolic alterations in the heart of the offspring of diabetic rats is prevented by maternal diets enriched in olive oil

Capobianco

Pelesson

Careaga

et al. 2015

Molecular Nutrition Food Res

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Dietary fat composition and cardiac events in patients with type 2 diabetes

Abstract: 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..

Cited by 10 publications

References 51 publications

Emerging Nutrition Science on Fatty Acids and Cardiovascular Disease: Nutritionists' Perspectives

Emerging Nutrition Science on Fatty Acids and Cardiovascular Disease: Nutritionists' Perspectives

Low linolenic and linoleic acid consumption are associated with chronic kidney disease in patients with type 2 diabetes

Intrauterine programming of lipid metabolic alterations in the heart of the offspring of diabetic rats is prevented by maternal diets enriched in olive oil

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