title: Do European people with type 1 diabetes consume a high atherogenic diet? 7-year follow-up of the EURODIAB Prospective Complications Study.
abstract: OBJECTIVE
  Individuals with type 1 diabetes have a high risk of developing cardiovascular diseases, and it has been reported that they consume a high atherogenic diet. We examined how nutrient intake and adherence to current European nutritional recommendations evolved in a large cohort of European individuals with type 1 diabetes over a period of 7 years.
  
  
  METHODS
  We analysed data from the EURODIAB Prospective Complications Study, a European multicentre prospective cohort study. Standardized 3-day dietary records were employed in individuals with type 1 diabetes. One thousand one hundred and two patients (553 men, 549 women, baseline age 33 ± 10 years, duration 15 ± 9 years) had complete nutritional data available at baseline and after 7 years. We calculated mean differences in reported nutrients over time and adjusted these for age, gender, HbA1c and BMI with ANOVA models.
  
  
  RESULTS
  Compared to baseline, there were minor changes in nutrients. Reported protein (-0.35% energy (en), fat (-1.07% en), saturated fat (-0.25% en) and cholesterol (-7.42 mg/1000 kcal) intakes were lower, whereas carbohydrate (+1.23% en) and fibre (+0.46 g/1000 kcal) intakes were higher at the 7-year follow-up. European recommendations for adequate nutrient intakes were followed in individuals with type 1 diabetes for protein (76% at baseline and 78% at follow-up), moderately for fat (34, 40%), carbohydrate (34, 41%) and cholesterol (39, 47%), but poorly for fibre (1.4, 2.4%) and saturated fat (11, 13%).
  
  
  CONCLUSIONS
  European individuals with type 1 diabetes consume a high atherogenic diet as few patients met recommendations for dietary fibre and saturated fat. This study showed minor changes in dietary nutrients and energy intakes over a period of 7 years. Nutrition education needs particular focus on strategies to increase dietary fibre and reduce saturated fat to exploit their potential benefit.
authors.affiliation: Division of Human Nutrition, Wageningen University, 6700 EV, PO Box 8129, Wageningen, The Netherlands, sabita.soedamah-muthu@wur.nl.
authors.forename: Sabita S
authors.initials: SS
authors.lastname: Soedamah-Muthu
authors.forename: Nish
authors.initials: N
authors.lastname: Chaturvedi
authors.forename: John H
authors.initials: JH
authors.lastname: Fuller
authors.forename: Monika
authors.initials: M
authors.lastname: Toeller
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood; D002791:Cholesterol, Dietary / Q000008:administration & dosage; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology*; D015930:Diet Records; D004036:Diet, Atherogenic; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015596:Nutrition Assessment; D009752:Nutritional Status; D011446:Prospective Studies; D064167:Recommended Dietary Allowances; D044465:White People; D055815:Young Adult
chemical_list: D002791:Cholesterol, Dietary; D004040:Dietary Carbohydrates; D004043:Dietary Fiber; D004044:Dietary Proteins; D007328:Insulin; D002784:Cholesterol