Ej. Mayer-davis et al., Heterogeneity in associations between macronutrient intake and lipoproteinprofile in individuals with type 2 diabetes, DIABET CARE, 22(10), 1999, pp. 1632-1639
OBJECTIVE - To evaluate associations between macronutrient intake and lipop
rotein profile among individuals with type 2 diabetes who participated in t
he San Luis Valley Diabetes Study (SLVDS) or the Insulin Resistance Atheros
clerosis Study (IRAS),
RESEARCH DESIGN AND METHODS- Diet was assessed by 24-h recall in the SLVDS
(n = 421) and by validated food frequency interview in the IRAS (n = 437).
Analyses adjusted for kilocalories, age, sex, and other covariates were con
ducted separately for the two study groups. For the SLVDS, repeated observa
tions were included in mixed model analyses (865 observations). For the IRA
S, standard regression analyses were conducted. Recent weight history and l
ime of diabetes diagnosis were evaluated as possible modifiers of associati
ons between nutrient intake and lipoprotein profile.
RESULTS - Higher reported intake of total dietary fat was related to signif
icantly higher levels of LDL cholesterol (P < 0.05) in both studies and in
all subgroups. Reported intake of total and saturated fat was associated po
sitively with total cholesterol, although statistical significance was not
reached for all subgroups. Higher reported carbohydrate intake was associat
ed with increased triglyceride concentrations (P < 0.01) only among individ
uals with previously undiagnosed diabetes in the SLVDS (n = 69) and only am
ong individuals who gained weight (>5 lb, n = 87) during the previous year
in the IRAS.
CONCLUSIONS - Toward the goal of optimizing the lipoprotein profile of indi
viduals with diabetes, these results emphasize the potential importance of
reducing fat intake while recognizing that individualized approaches to die
t are important to minimize the risk of cardiovascular disease.