title: Dietary saturated fat and fibre and risk of cardiovascular disease and all-cause mortality among type 1 diabetic patients: the EURODIAB Prospective Complications Study.
abstract: OBJECTIVE
  Low adherence to recommendations for dietary saturated fatty acid (SFA) and fibre intake in patients with type 1 diabetes mellitus may heighten their increased risk of cardiovascular disease (CVD) and mortality. We examined the relationship of SFA and total, soluble and insoluble fibre with incident CVD and all-cause mortality in type 1 diabetic patients.
  
  
  METHODS
  A prospective cohort analysis was performed in 2,108 European type 1 diabetic patients aged 15-60 years who were free of CVD at baseline and enrolled in the EURODIAB Prospective Complications Study (51% male). Diet was assessed from a standardised 3 day dietary record. HR were calculated using Cox proportional hazards models.
  
  
  RESULTS
  During a mean follow-up of 7.3 years, 148 incident cases of fatal and non-fatal CVD and 46 all-cause deaths were documented. No statistically significant association was found between SFA and CVD and all-cause mortality. Total dietary fibre, per 5 g/day, was associated with lower all-cause mortality risk (HR 0.72; 95% CI 0.55, 0.95). This association was stronger for soluble fibre (per 5 g/day, HR 0.34; 95% CI 0.14, 0.80) compared with insoluble fibre (per 5 g/day; HR 0.66; 95% CI 0.45, 0.97). Similar results were found for the association with CVD.
  
  
  CONCLUSIONS
  This study suggests that reported dietary SFA is not significantly associated with CVD and all-cause mortality in type 1 diabetic patients. On the contrary, higher dietary fibre consumption, especially soluble fibre, within the range commonly consumed by type 1 diabetic patients, may contribute to the prevention of CVD and all-cause mortality in type 1 diabetic patients.
authors.affiliation: Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands.
authors.forename: D A J M
authors.initials: DA
authors.lastname: Schoenaker
authors.forename: M
authors.initials: M
authors.lastname: Toeller
authors.forename: N
authors.initials: N
authors.lastname: Chaturvedi
authors.forename: J H
authors.initials: JH
authors.lastname: Fuller
authors.forename: S S
authors.initials: SS
authors.lastname: Soedamah-Muthu
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000401:mortality*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000401:mortality*; D003925:Diabetic Angiopathies / Q000097:blood / Q000209:etiology / Q000401:mortality*; D015930:Diet Records; D004041:Dietary Fats / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage*; D002149:Energy Intake; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000401:mortality*; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004041:Dietary Fats; D004043:Dietary Fiber