Nutritional habits of subjects with Type 2 diabetes mellitus in the Mediterranean Basin: comparison with the non-diabetic population and the dietary recommendations. Multi-Centre Study of the Mediterranean Group for the Study of Diabetes (MGSD).
OBJECTIVE
The aim of this study was to compare the nutritional habits of Type 2 diabetic patients among Mediterranean countries and also with those of their background population and with the nutritional recommendations of the Diabetes and Nutrition Study Group.


METHODS
We did a cross-sectional study of 1833 non-diabetic subjects and 1895 patients with Type 2 diabetes, in nine centres in six Mediterranean countries. A dietary questionnaire validated against the 3-Day Diet Diary was used.


RESULTS
In diabetic patients the contribution of proteins, carbohydrates and fat to the energy intake varied greatly among centres, ranging from 17.6% to 21.0% for protein, from 37.7% to 53.0% for carbohydrates and from 27.2% to 40.8% for fat, following in every centre the trends of the non-diabetic population. Furthermore, diabetic patients compared to the corresponding background population had: (i). lower energy intake, (ii). lower carbohydrate and higher protein contribution to the energy intake, (iii). higher prevalence of obesity, ranging from 9 to 50%. The adherence to the nutritional recommendations for proteins, carbohydrate and fat was very low ranging from 1.4 to 23.6%, and still decreased when fibre was also considered.


CONCLUSIONS
In diabetic patients of the Mediterranean area: (i). dietary habits vary greatly among countries, according to the same trends of the background population; (ii). the prevalence of obesity is much lower than the 80% reported for patients with diabetes in Western countries; (iii). Carbohydrate intake is decreased with a complementary increase of protein and fat consumption, resulting to a poor compliance with the nutritional recommendations.
Thanopoulou
A
A
Diabetes Centre, 2nd Medical Department, Athens University Medical School, Hippokration Hospital, Vas. Sofias 114, Athens, 115 27, Greece.
Karamanos
B
B
Diabetes Centre, 2nd Medical Department, Athens University Medical School, Hippokration Hospital, Vas. Sofias 114, Athens, 115 27, Greece. ippokratio@aias.gr.
Angelico
F
F
Department of Medical Therapy, University "La Sapienza", Rome, Italy.
Assaad-Khalil
S
S
Department of Internal Medicine, Alexandria Faculty of Medicine, Alexandria, Egypt.
Barbato
A
A
Department of Medical Therapy, University "La Sapienza", Rome, Italy.
Del Ben
M
M
Department of Medical Therapy, University "La Sapienza", Rome, Italy.
Djordjevic
P
P
Diabetes Centre, Institute for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia and Montenegro.
Dimitrijevic-Sreckovic
V
V
Diabetes Centre, Institute for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia and Montenegro.
Gallotti
C
C
Department of Preventive, Occupational and Community Medicine. Section of Hygiene, University of Studies of Pavia, Pavia, Italy.
Katsilambros
N
N
Diabetes Centre, 1st Department of Medicine, Athens University School of Medicine, "Laiko" General Hospital, Athens, Greece.
Migdalis
I
I
Diabetes Centre, "NIMTS" Hospital, Athens, Greece.
Mrabet
M
M
Service of Internal Medicine "A", C.H.U., Oran, Algeria.
Petkova
M
M
Diabetes Centre "St. Luca", Sofia, Bulgaria.
Roussi
D
D
Diabetes Centre, 2nd Medical Department, Athens University Medical School, Hippokration Hospital, Vas. Sofias 114, Athens, 115 27, Greece.
Tenconi
M T
MT
Department of Preventive, Occupational and Community Medicine. Section of Hygiene, University of Studies of Pavia, Pavia, Italy.
D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004032:Diet; D015930:Diet Records; D003927:Diet, Diabetic; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D019083:Mediterranean Region; D008875:Middle Aged; D012016:Reference Values