title: Longitudinal changes in dietary fat intake and associated changes in cardiovascular risk factors in adults with type 2 diabetes: the ACCORD trial.
abstract: OBJECTIVE
  To measure dietary fat intake using the Puget Sound Eating Patterns (PEP) questionnaire, a validated 19-item food questionnaire, and to quantify how reduced dietary fat intake affects cardiovascular risk factors in adults with type 2 diabetes.
  
  
  METHODS
  Randomized controlled trial including a subsample of 1781 Action to Control Cardiovascular Risk in Diabetes (ACCORD) participants. Participants received dietary counseling to consume a reduced-fat diet. Outcome measures included HbA1c, fasting lipid profile, blood pressure, and weight. Longitudinal linear regression analyses were used to evaluate relationships between baseline and follow-up PEP scores and cardiovascular risk factors.
  
  
  RESULTS
  PEP scores decreased significantly from baseline to 12-month follow up with a mean difference of -0.09 ± 0.39, P<0.001. All of the fat intake subscales showed significant improvement at 12 months from baseline. White race, female gender, and more hours per week of physical activity were correlated with a decline in PEP scores at 1-year. A longitudinal decrease in dietary fat intake was associated with significantly less weight gain at 12- and 36-months and lower serum triglycerides at 1 year.
  
  
  CONCLUSIONS
  Reduced fat intake as measured by a brief questionnaire was associated with significant improvement in some cardiovascular risk factors (triglycerides and weight), but not in others.
authors.affiliation: Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1084, United States.jkirk@wakehealth.edu
authors.forename: Julienne K
authors.initials: JK
authors.lastname: Kirk
authors.forename: Timothy
authors.initials: T
authors.lastname: Craven
authors.forename: Edward W
authors.initials: EW
authors.lastname: Lipkin
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Katula
authors.forename: Carolyn
authors.initials: C
authors.lastname: Pedley
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: O'Connor
authors.forename: Karen L
authors.initials: KL
authors.lastname: Margolis
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000378:metabolism*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000378:metabolism* / Q000517:prevention & control; D004041:Dietary Fats / Q000378:metabolism*; D002149:Energy Intake; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010349:Patient Compliance; D063868:Patient Outcome Assessment; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D015430:Weight Gain
chemical_list: D001786:Blood Glucose; D004041:Dietary Fats; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human