Associations of fat and cholesterol intake with serum lipid levels and cardiovascular disease: The EURODIAB IDDM Complications Study

The EURODIAB IDDM Complications Study, a cross-sectional, clinic-based stud y examined the fat and cholesterol intakes of European individuals with typ e 1 diabetes for possible relations to serum lipid levels (total cholestero l, HDL- and LDL-cholesterol, fasting triglycerides) and to the prevalence o f cardiovascular disease (past history or electrocardiogram abnormalities). Fat intake (total fat, saturated fat, cholesterol) from 2868 subjects with type 1 diabetes (mean age 32.9 +/- 10.2 years (range: 14-61 years), mean d iabetes duration 14.7 +/- 9.4 years (range: 1-56 years)) was assessed by a standardized S-day dietary record at the Nutrition Co-Ordinating Centre (Du sseldori). Serum lipid levels were determined in the central laboratory (Lo ndon) by standard enzymatic methods. Energy-adjusted total and LDL-choleste rol levels increased significantly with higher intakes of total fat, satura ted fat and cholesterol. However, these relations were largely explained by concomitant decreases in dietary fibre intake. For levels of HDL-cholester ol and triglycerides no independent associations were observed with fat or cholesterol intake. Increased intakes of total fat, saturated fat and chole sterol were also related to higher prevalences of cardiovascular disease. T hese associations were, however, no longer significant after adjustment for dietary fibre intake for which we previously demonstrated independent asso ciations with the serum cholesterol pattern and CVD. Since higher fat intak es are commonly accompanied by lower carbohydrate and fibre intakes we conc lude that restricted intakes of cholesterol, saturated fat and total fat co mbined with higher fibre intakes beneficially affect both the levels of tot al and LDL-cholesterol and the risk for cardiovascular disease in European individuals with type 1 diabetes.