Dietary Fat Intake as Risk Factor for the Development of Diabetes
Multinational, multicenter study of the Mediterranean Group for the Study of Diabetes (MGSD)
- Anastasia C. Thanopoulou, MD1,
- Basil G. Karamanos, MD1,
- Francesco V. Angelico, MD2,
- Samir H. Assaad-Khalil, MD3,
- Alfredo F. Barbato, MD2,
- Maria P. Del Ben, MD2,
- Predrag B. Djordjevic, MD4,
- Vesna S. Dimitrijevic-Sreckovic, MD4,
- Cristina A. Gallotti, MD9,
- Nikolaos L. Katsilambros, MD5,
- Ilias N. Migdalis, MD6,
- Mansouria M. Mrabet, MD7,
- Malina K. Petkova, MD, PHD8,
- Demetra P. Roussi, RD1 and
- Maria-Teresa P. Tenconi, MD9
- 1Diabetes Center, 2nd Medical Department, Athens University Medical School, Hippokration Hospital, Athens, Greece
- 2Department of Clinics and Applied Medical Therapy, University “La Sapienza,” Rome, Italy
- 3Department of Internal Medicine, Alexandria Faculty of Medicine, Alexandria, Egypt
- 4Diabetes Center, Institute for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Yugoslavia
- 5Diabetes Center, 1st Department of Propedeutic Medicine, Athens University School of Medicine, Laiko General Hospital, Athens, Greece
- 6Diabetes Center, “NIMTS” Hospital, Athens, Greece
- 7Service de Medicine Interne “A” C.H.U., Oran, Algeria
- 8Diabetes Center “St. Luca,” Sofia, Bulgaria
- 9Dipartimento di Medicina Preventiva, Occupazionale e di Communita, Sezione di Igiene, Università degli studi di Pavia, Italy
OBJECTIVE—To investigate the role of dietary factors in the development of type 2 diabetes.
RESEARCH DESIGN AND METHODS—In the context of the Multinational MGSD Nutrition Study, three groups of subjects were studied: 204 subjects with recently diagnosed diabetes (RDM), 42 subjects with undiagnosed diabetes (UDM) (American Diabetes Association criteria—fasting plasma glucose [FPG] ≥126 mg/dl), and 55 subjects with impaired fasting glucose (IFG) (FPG ≥110 and <126 mg/dl). Each group was compared with a control group of nondiabetic subjects, matched one by one for center, sex, age, and BMI. Nutritional habits were evaluated by a dietary history method, validated against the 3-day diet diary. In RDM, the questionnaire referred to the nutritional habits before the diagnosis of diabetes. Demographic data were collected, and anthropometrical and biochemical measurements were taken.
RESULTS—Compared with control subjects, RDM more frequently had a family history of diabetes (49.0 vs. 14.2%; P < 0.001), exercised less (exercise index 53.5 vs. 64.4; P < 0.01), and more frequently had sedentary professions (47.5 vs. 27.4%; P < 0.001). Carbohydrates contributed less to their energy intake (53.5 vs. 55.1%; P < 0.05), whereas total fat (30.2 ± 0.5 vs. 27.8 ± 0.5%; P < 0.001) and animal fat (12.2 ± 0.3 vs. 10.8 ± 0.3%; P < 0.01) contributed more and the plant-to-animal fat ratio was lower (1.5 ± 0.1 vs. 1.8 ± 0.1; P < 0.01). UDM more frequently had a family history of diabetes (38.1 vs. 19.0%; P < 0.05) and sedentary professions (58.5 vs. 34.1%; P < 0.05), carbohydrates contributed less to their energy intake (47.6 ± 1.7 vs. 52.8 ± 1.4%; P < 0.05), total fat (34.7 ± 1.5 vs. 30.4 ± 1.2%; P < 0.05) and animal fat (14.2 ± 0.9 vs. 10.6 ± 0.7%; P < 0.05) contributed more, and the plant-to-animal fat ratio was lower (1.6 ± 0.2 vs. 2.3 ± 0.4; P < 0.05). IFG differed only in the prevalence of family history of diabetes (32.7 vs. 16.4%; P < 0.05).
CONCLUSIONS—Our data support the view that increased animal fat intake is associated with the presence of diabetes.
- 3-DDD, 3-Day Diet Diary
- FPG, fasting plasma glucose
- IGT, impaired glucose tolerance
- IFG, impaired fasting glucose
- RDM, recently diagnosed diabetes
- UDM, unknown diabetes
Address correspondence and reprint requests to B. Karamanos, MD, Athens University, Diabetes Centre, Hippokration Hospital, Vas. Sofias 114, Athens 115 27 Greece. E-mail:.
Received for publication 5 August 2002 and accepted in revised form 30 October 2002.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
- DIABETES CARE