Dietary habits and nutritional biomarkers in Italian type 1 diabetes families: evidence of unhealthy diet and combined-vitamin-deficient intakes

Abstract

Objective: Nutritional status and lifestyle can have profound effects on health. To analyse behaviour patterns in population subgroups of public health importance, we compared lifestyle, dietary intake of energy and selected nutrients, and nutritional biomarkers of type 1 diabetes (T1DM) patients and nondiabetic first-degree relatives against control subjects with no family history of T1DM. Design: A cross-sectional study. Setting: Department of Internal Medicine, University of Pisa, Italy. Subjects: A total of 209 individuals including 38 type 1 patients, 76 relatives, and 95 healthy subjects. Interventions: We used the European Prospective Investigation of Cancer and Nutrition questionnaires to assess dietary intake and lifestyle. Anthropometric indices and nutritional biomarkers (such as plasma levels of albumin, iron, lipids, homocysteine, vitamin B 9 and vitamin B 12 as well as urinary outputs of nitrogen, sodium and potassium) were evaluated. Results: Emerging health issues: (1) In total, 45% of controls were overweight. Increasing age was associated with increasing body mass and decreasing activity in sport in front of an unchanged energy intake.(2) The distribution of energy sources was incorrect. The proportion of caloric intake derived from total fat and cholesterol did not match general guidelines. Total dietary fibre consumption was assessed to be adequate (25 g/day) in only 27% of all the participants. (3) Estimated daily intakes of water-soluble vitamin B 9 and fat-soluble vitamin D and vitamin E were deficient in comparison with dietary reference intakes. (4) The prevalence of adoption and maintenance of healthful eating and physical activity habits was higher in women and T1DM patients (probably as a consequence of the medical educational intervention). On the contrary, supportiveness of the family in term of changing the undesirable behaviours at home seemed to fail. Conclusions: This study provides first evidence indicating unhealthy dietary behaviours, which could even predispose to the development of diabetes and cardiovascular complications, in subjects living in Pisa. The combination of vitamin B 9 and vitamin E deprivation could be deleterious for endothelial function, since these antioxidants have been implicated in the modulation of nitric oxide and eicosanoid signalling.

The Enlarging List of Phenotypic Characteristics That Might Allow the Clinical Identification of Families at Risk for Type 1 Diabetes

“…In recent years, on the contrary, the difference in BMI between unaffected siblings of type 1 diabetic probands and healthy control subjects has reached the statistical significance ( Figure 1, . This finding probably reflects the trend toward increasing body weight and obesity in the general population, declining physical activity and unhealthy dietary habits that we have documented (Matteucci et al, 2004b(Matteucci et al, , 2007(Matteucci et al, , 2008. However, the emerging difference in BMI between unaffected relatives and control subjects suggests that additional factors are operative in type 1 diabetes families, which remain unknown.…”

“…We concluded that anthropometric and anamnestic data on child and family yield more accurate estimates of risk profile: fat distribution seems relevant for metabolic and cardiovascular disorders. Since our initial investigations on type 1 diabetes families, we found that first degree relatives' BMI tended to be higher when compared with healthy control subjects who had no first-degree relative with type 1 diabetes, although the difference did not always reach statistical significance (Matteucci & Giampietro, 2000a;Matteucci et al 2004aMatteucci et al , 2004bMatteucci et al 2006). In recent years, on the contrary, the difference in BMI between unaffected siblings of type 1 diabetic probands and healthy control subjects has reached the statistical significance ( Figure 1, .…”

Building a Bridge Between Clinical and Basic Research: The Phenotypic Elements of Familial Predisposition to Type 1 Diabetes

“…Our studies of case-families with population-based controls recruited unaffected first-degree relatives of sporadic T1D cases and population-based controls without family history of T1D [42,[44][45][46][47][48][49][50]; participants were both interviewed and provided biological material for functional biochemical characterisation. Unlike multiple-case families, our families are those less likely to carry a strong genetic predisposition.…”

Cardiovascular Risk by Gender in an Italian Pilot Study

“…Plasma thiols (P SH), erythrocyte glutathione (RBC GSH), plasma and erythrocyte membrane malondialdehyde (P and RBC MDA), RBC NHE activity, and RBC vfcy were measured as previously reported [3][4][5][6][7]11].…”

“…Demographic, socio-economic and lifestyle information was obtained by Lifestyle European Prospective Investigation of Cancer and Nutrition questionnaire (EPIC) [6]. Subjects reported the daily number of hours they engaged in housework and the weekly number of hours they engaged in physical activities during leisure and during work.…”