title: A high-score Mediterranean dietary pattern is associated with a reduced risk of peripheral arterial disease in Italian patients with Type 2 diabetes.
abstract: BACKGROUND
  The 'Mediterranean diet' is considered to exert protective effects on cardiovascular disease, although a wide range of dietary patterns exists among subjects living even in the same Mediterranean country.
  
  
  OBJECTIVE
  To investigate the association between specific dietary patterns and peripheral arterial disease (PAD) in Italian Type 2 diabetes patients.
  
  
  METHODS
  From a cohort of 944 patients with Type 2 diabetes, 144 patients with PAD were selected, and matched for age and sex with 288 Type 2 diabetic control patients without macrovascular complications. A dietary score was elaborated from a semiquantitative food frequency questionnaire. The higher the final score, the healthier the eating habit.
  
  
  RESULTS
  In multivariate analysis, a higher score was independently associated with a significant reduction in PAD risk [odds ratio (OR) = 0.44; 95% confidence interval (CI) 0.24, 0.83]. Diabetes duration (OR > 15 years = 2.49; 95% CI 1.45, 4.25), hypertension (OR = 2.12; 95% CI 1.31, 3.45) and butter consumption (OR = 2.6; 95% CI 1.15, 3.68) were also significantly associated with PAD. The dietary score significantly improved the predictive value of models based on duration of diabetes and hypertension. (LSR = 2.19, DF = 7, P < 0.001). The effect of a high dietary score on the risk of PAD was independent of diabetes duration and hypertension.
  
  
  CONCLUSIONS
  In Italian Type 2 diabetics, a higher dietary score has a protective role against PAD. The use of butter increases the risk of PAD even in patients regularly consuming olive oil. Dietary advice may be helpful for the prevention of PAD in diabetics even in populations traditionally accustomed to a Mediterranean dietary habit.
authors.affiliation: 'Angela Valenti' Laboratory of Genetic and Environmental Risk Factors for Thrombotic Disease, Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Ciccarone
authors.forename: A
authors.initials: A
authors.lastname: Di Castelnuovo
authors.forename: M
authors.initials: M
authors.lastname: Salcuni
authors.forename: A
authors.initials: A
authors.lastname: Siani
authors.forename: A
authors.initials: A
authors.lastname: Giacco
authors.forename: M B
authors.initials: MB
authors.lastname: Donati
authors.forename: G
authors.initials: G
authors.lastname: De Gaetano
authors.forename: F
authors.initials: F
authors.lastname: Capani
authors.forename: L
authors.initials: L
authors.lastname: Iacoviello
mesh_terms: D000368:Aged; D000428:Alcohol Drinking; D001158:Arteries / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology; D038441:Diet, Mediterranean; D004041:Dietary Fats; D005260:Female; D005638:Fruit; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D010938:Plant Oils; D013997:Time Factors; D014675:Vegetables; D014920:Wine
chemical_list: D004041:Dietary Fats; D010938:Plant Oils