Unhealthy dietary patterns associated with inflammation and endothelial dysfunction in type 1 diabetes: the EURODIAB study.
OBJECTIVE
A healthy diet has been inversely associated with endothelial dysfunction (ED) and low-grade inflammation (LGI). We investigated the association between nutrient consumption and biomarkers of ED and LGI in type 1 diabetes.


RESULTS
We investigated 491 individuals. Nutrient consumption and lifestyle risk factors were measured in 1989 and 1997. Biomarkers of ED (von Willebrand factor, soluble vascular cell adhesion molecule-1 and soluble endothelial selectin) and LGI (C-reactive protein, interleukin 6 and tumour necrosis factor α) were measured in 1997 and averaged into Z-scores. The nutrient residual method was used to adjust individual nutrient intake for energy intake. Data were analysed with generalised estimation equations. We report increments/decrements in nutrient consumption, averaged over time, per +1 standard deviation (SD) of 1997 ED or LGI Z-scores, after adjustment for sex, age, duration of diabetes, investigation centre, body mass index, energy intake, smoking behaviour, alcohol consumption, and each of the other nutrients. One SD elevation in ED Z-score was associated with a diet lower in fibre [β(95%CI);-0.09(-0.18;-0.004)], polyunsaturated fat [-0.18(-0.31;-0.05)] and vegetable protein [-0.10(-0.20;-0.001)]. For the LGI Z-score results showed associations with fibre [-0.09(-0.17;-0.01)], polyunsaturated fat [-0.14(-0.24;-0.03)] and cholesterol [0.10(0.01; 0.18)].


CONCLUSIONS
In type 1 diabetes, consumption of less fibre, polyunsaturated fat and vegetable protein, and more cholesterol over the study period was associated with more ED and LGI. Following dietary guidelines in type 1 diabetes may reduce cardiovascular disease risk by favourably affecting ED and LGI.
Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands. b.vanbussel@maastrichtuniversity.nl
B C T
BC
van Bussel
S S
SS
Soedamah-Muthu
R M A
RM
Henry
C G
CG
Schalkwijk
I
I
Ferreira
N
N
Chaturvedi
M
M
Toeller
J H
JH
Fuller
C D A
CD
Stehouwer
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology* / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D004727:Endothelium / Q000503:physiopathology; D002149:Energy Intake; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000503:physiopathology*; D015850:Interleukin-6 / Q000097:blood; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014675:Vegetables; D055815:Young Adult
D015415:Biomarkers; D004043:Dietary Fiber; D004044:Dietary Proteins; D005231:Fatty Acids, Unsaturated; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein