title: Dietary fat composition and cardiac events in patients with type 2 diabetes.
abstract: OBJECTIVE
  To evaluate associations of dietary fat composition with the development of cardiac events in patients with type 2 diabetes, without ischemic heart disease who were followed for at least 12 months.
  
  
  METHODS
  In this prospective cohort study the usual diet of patients was retrospectively assessed by a 3-day weighed diet record (WDR). Compliance with the WDR technique was assessed by comparing protein intake estimated from 3-day WDR and 24-h urinary nitrogen output. The following were considered cardiac events: myocardial infarction, myocardial revascularization procedures, congestive heart failure, new-onset angina pectoris, and sudden death.
  
  
  RESULTS
  A total of 227 patients with type 2 diabetes (aged 59 ± 10 years; 46.0% male), were followed during 4.6 years. In a multivariate Cox regression analysis, the intake of polyunsaturated fatty acids had a protective effect for cardiac events (HR = 0.31, 95% CI: 0.11-0.89; P = 0.03) adjusted for age, gender, duration of diabetes, smoking, compliance with WDR, using hypolipidemic agents, and the presence of hypertension and diabetic nephropathy. When the fat intake was divided into quartiles, the highest intake of α-linolenic acid (>1.25% of energy) was negatively associated with cardiac events (HR = 0.58, 95% CI: 0.39-0.85; P = 0.006), adjusted for the same covariates..
  
  
  CONCLUSIONS
  In patients with type 2 diabetes without ischemic heart disease, a high intake of polyunsaturated fatty acids, especially alpha linolenic acid, was protective for the development of cardiac events..
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350/ Prédio 12, 4° andar, CEP 90035-003 Porto Alegre, RS, Brazil. Electronic address: aninha.lu@terra.com.br.
authors.forename: Ana Luiza Teixeira
authors.initials: AL
authors.lastname: dos Santos
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350/ Prédio 12, 4° andar, CEP 90035-003 Porto Alegre, RS, Brazil. Electronic address: tweiss@terra.com.br.
authors.forename: Tanara
authors.initials: T
authors.lastname: Weiss
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350/ Prédio 12, 4° andar, CEP 90035-003 Porto Alegre, RS, Brazil. Electronic address: camila.kummel@gmail.com.
authors.forename: Camila Kümmel
authors.initials: CK
authors.lastname: Duarte
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350/ Prédio 12, 4° andar, CEP 90035-003 Porto Alegre, RS, Brazil. Electronic address: jorgeluizgross@gmail.com.
authors.forename: Jorge Luiz
authors.initials: JL
authors.lastname: Gross
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350/ Prédio 12, 4° andar, CEP 90035-003 Porto Alegre, RS, Brazil. Electronic address: mirelajobimazevedo@gmail.com.
authors.forename: Mirela Jobim
authors.initials: MJ
authors.lastname: de Azevedo
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350/ Prédio 12, 4° andar, CEP 90035-003 Porto Alegre, RS, Brazil. Electronic address: themis.voy@terra.com.br.
authors.forename: Themis
authors.initials: T
authors.lastname: Zelmanovitz
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology / Q000209:etiology; D000886:Anthropometry; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003645:Death, Sudden; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D058065:Diabetic Cardiomyopathies / Q000453:epidemiology; D015930:Diet Records; D004041:Dietary Fats / Q000032:analysis; D005231:Fatty Acids, Unsaturated; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006331:Heart Diseases / Q000453:epidemiology* / Q000517:prevention & control; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D010938:Plant Oils; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D017962:alpha-Linolenic Acid
chemical_list: D004041:Dietary Fats; D005231:Fatty Acids, Unsaturated; D006442:Glycated Hemoglobin; D000960:Hypolipidemic Agents; D010938:Plant Oils; D017962:alpha-Linolenic Acid
keywords: Cardiac events; Dietary fatty acids; Type 2 diabetes