title: Missed opportunities for providing low-fat dietary advice to people with diabetes.
abstract: BACKGROUND
  Because cardiovascular disease is closely linked to diabetes, national guidelines recommend low-fat dietary advice for patients who have cardiovascular disease or are at risk for diabetes. The prevalence of receiving such advice is not known. We assessed the lifetime prevalence rates of receiving low-fat dietary advice from a health professional and the relationship between having diabetes or risk factors for diabetes and receiving low-fat dietary advice.
  
  
  METHODS
  From 2002 through 2009, 188,006 adults answered the following question in the Medical Expenditure Panel Survey: "Has a doctor or other health professional ever advised you to eat fewer high-fat or high-cholesterol foods?" We assessed the association between receiving advice and the following predictors: a diabetes diagnosis, 7 single risk factors for type 2 diabetes, and total number of risk factors.
  
  
  RESULTS
  Among respondents without diabetes or risk factors for diabetes, 7.4% received low-fat dietary advice; 70.6% of respondents with diabetes received advice. Respondents with diabetes were almost twice as likely to receive advice as respondents without diabetes or its risk factors. As the number of risk factors increased, the likelihood of receiving low-fat dietary advice increased. Although unadjusted advice rates increased during the study period, the likelihood of receiving advice decreased.
  
  
  CONCLUSIONS
  Although most participants with diabetes received low-fat dietary advice, almost one-third did not. Low-fat dietary advice was more closely associated with the total number of diabetes risk factors than the presence of diabetes. Increasing rates of diabetes and diabetes risk factors are outpacing increases in provision of low-fat dietary advice.
authors.affiliation: University of Colorado School of Medicine, Division of General Internal Medicine, 1635 Aurora Ct, Mailstop F729, Aurora, CO 80045, USA. ingrid.lobo@ucdenver.edu
authors.forename: Ingrid E
authors.initials: IE
authors.lastname: Lobo
authors.forename: Danielle F
authors.initials: DF
authors.lastname: Loeb
authors.forename: Vahram
authors.initials: V
authors.lastname: Ghushchyan
authors.forename: Irene E
authors.initials: IE
authors.lastname: Schauer
authors.forename: Amy G
authors.initials: AG
authors.lastname: Huebschmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000178:diet therapy* / Q000209:etiology / Q000517:prevention & control; D003376:Counseling / Q000592:standards / Q000600:supply & distribution*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy* / Q000517:prevention & control; D004040:Dietary Carbohydrates / Q000097:blood; D004041:Dietary Fats / Q000009:adverse effects; D005260:Female; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data; D019538:Health Care Surveys; D005102:Health Expenditures; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000592:standards*; D011369:Professional-Patient Relations; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats