High saturated-fat and low-fibre intake: a comparative analysis of nutrient intake in individuals with and without type 2 diabetes

Abstract

Objective:The aim of dietary modification, as a cornerstone of type 2 diabetes (T2DM) management, is to optimise metabolic control and overall health. This study describes food and nutrient intake in a sample of adults with T2DM, and compares this to recommendations, and to intake in age, sex, body mass index (BMI) and social-class matched adults without T2DM.Design:A cross-sectional analysis of food and nutrient intake in 124 T2DM individuals (64% male; age 57.4±5.6 years, BMI 32.5±5.8 kg m−2) and 124 adults (age 57.4±7.0 years, BMI 31.2±5.0 kg m−2) with no diabetes (ND) was undertaken using a 4-day semiweighed food diary. Biochemical and anthropometric variables were also measured.Results:While reported energy intake was similar in T2DM vs ND (1954 vs 2004 kcal per day, P=0.99), T2DM subjects consumed more total-fat (38.8% vs 35%, P⩽0.001), monounsaturated-fat (13.3% vs 12.2% P=0.004), polyunsaturated-fat (6.7% vs 5.9% P<0.001) and protein (18.6% vs 17.5%, P⩽0.01). Both groups exceeded saturated-fat recommendations (14.0% vs 13.8%). T2DM intakes of carbohydrate (39.5% vs 42.9%), non-milk sugar (10.4% vs 15.0%) and fibre (14.4 vs 18.9 g) were significantly lower (P<0.001). Dietary glycaemic load (GL) was also lower in T2DM (120.8 vs 129.2; P=0.02), despite a similar glycaemic index (59.7 vs 60.1; P=0.48). T2DM individuals reported consuming significantly more wholemeal/brown/wholegrain breads, eggs, oils, vegetables, meat/meat products, savoury snacks and soups/sauces and less white breads, breakfast cereals, cakes/buns, full-fat dairy, chocolate, fruit juices, oily fish and alcohol than ND controls.Conclusion:Adults with T2DM made different food choices to ND adults. This resulted in a high saturated-fat diet, with a higher total-fat, monounsaturated-fat, polyunsaturated-fat and protein content and a lower GL, carbohydrate, fibre and non-milk sugar content. Dietary education should emphasise and reinforce the importance of higher fibre, fruit, vegetable and wholegrain intake and the substitution of monounsaturated for saturated-fat sources, in energy balanced conditions.

Dietary habits and adherence to dietary recommendations in patients with type 1 and type 2 diabetes compared with the general population in Denmark

“…Less than 10% of patients with diabetes and of the general population fulfilled the recommendations for intake of SFA, reflecting a general problem of the abundance of SFA (and refined carbohydrates) in the western diet. Our findings are in accordance with findings in several observational studies, where intakes of total fat and saturated fat exceed recommendations, while the opposite goes for the intake of fibre in patients with diabetes (6,7,10,11).…”

“…The latest national survey of dietary habits in Denmark (2011 -13) concluded that the Danish diet was too high in fat and carbohydrates (added sugar) and too low in dietary fibre compared to the dietary guidelines (5). Only a few studies have investigated dietary intake and adherence to the recommendations in patients with diabetes (6)(7)(8)(9)(10)(11), in general reporting poor adherence for most macronutrients. Dietary studies comparing patients with diabetes with the general population have not previously been reported.…”

Association of dietary intake and BMI among newly diagnosed type 2 diabetes patients attending diabetic clinics in Kampala

“…Compared to studies elsewhere, this study has reported the highest energy contribution from carbohydrate (73.0%) among any type 2 diabetic population [10,24,25]. This can be explained by the fact that the usual Ugandan diet comprises of starches as the staple foods on the plate, accompanied by small amounts or infrequent sauce/relish which is usually a plant protein, animal protein or a vegetable [26].…”

Compliance with Nutritional and Lifestyle Recommendations in 13,000 Patients with a Cardiometabolic Disease from the Nutrinet-Santé Study

“…Castetbon et al showed that diabetes patients had higher intakes of proteins and lower intakes of sugars and total carbohydrates while they consumed fewer calories and globally exhibited a healthier diet [32]. Many studies have shown that individuals with diabetes consumed more proteins [33,34,35], meats [32,33,34,35,36], sodium [37,38] and also more fat, saturated, monounsaturated and polyunsaturated fat and cholesterol and lower sugars, than individuals without diabetes [21,22,35,36,37,38,39], which is consistent with our findings. In contrast, in our study, the higher consumption of fat was mainly from polyunsaturated fat.…”