title: Do improvements in dietary behaviour contribute to cardiovascular risk factor reduction over and above cardio-protective medication in newly diagnosed diabetes patients?
abstract: OBJECTIVE
  A healthy diet is an integral component of successful diabetes management. However, the comparative importance of adopting a healthy diet for cardiovascular risk factor reduction over and above medication use among newly diagnosed diabetes patients remains unclear.
  
  
  METHODS
  We computed a dietary score consistent with American Diabetes Association and Diabetes UK recommendations in 574 newly diagnosed diabetes patients by summing standardised values for the intake of total energy, saturated fat, sodium, fibre and plasma vitamin C. In linear regression analyses, stratified by cardio-protective medication use (yes/no), we quantified the comparative longitudinal associations of baseline diet and change in diet over 1 year with change in blood pressure, HbA1c and lipids.
  
  
  RESULTS
  Baseline diet was generally not predictive of change in cardiovascular risk factor levels at 1 year. In contrast, dietary change over 1 year among patients prescribed and not prescribed cardio-protective medication after baseline was associated with comparative (p-interaction all ⩾0.95) reductions in diastolic blood pressure (-2.38 vs -2.93 mm Hg, respectively) and triglycerides (-0.31 vs -0.21 mmol/l, respectively), independent of potential confounding factors and change from baseline to follow-up in physical activity and smoking status.
  
  
  CONCLUSIONS
  Modest dietary change over the first year following diagnosis of diabetes was associated with reductions in blood pressure and triglycerides, over and above the effects of cardio-protective medication. Our findings support the notion that dietary change should be viewed as an integral component of successful diabetes self-management, irrespective of medication use.
authors.affiliation: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK.
authors.forename: A J M
authors.initials: AJ
authors.lastname: Cooper
authors.affiliation: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK.
authors.forename: D
authors.initials: D
authors.lastname: Schliemann
authors.affiliation: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK.
authors.forename: G H
authors.initials: GH
authors.lastname: Long
authors.affiliation: 1] MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK [2] Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Griffin
authors.affiliation: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK.
authors.forename: R K
authors.initials: RK
authors.lastname: Simmons
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000188:drug therapy; D005260:Female; D006331:Heart Diseases / Q000517:prevention & control*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D008055:Lipids; D014280:Triglycerides