title: Sex differences in food choices, adherence to dietary recommendations and plasma lipid profile in type 2 diabetes - The TOSCA.IT study.
abstract: Diabetic women have a more adverse plasma lipid profile than men. Sex differences in dietary habits may play a role, but are little investigated. The study evaluates the quality of diet, adherence to the nutritional recommendations of the Diabetes and Nutrition Study Group and their relation with plasma lipid in men and women with diabetes.
  
  
  
  We studied 2573 people, aged 50-75, enrolled in the TOSCA.IT study (clinicaltrials.gov; NCT00700856). Plasma lipids were measured centrally. Diet was assessed with a semi-quantitative food frequency questionnaire. Women had a more adverse plasma lipid profile than men. Women consumed significantly more legumes, vegetables, fruits, eggs, milk, vegetable oils, and added sugar, whereas men consumed more starchy foods, soft drinks and alcoholic beverages. This stands for a higher proportion (%) of energy intake from saturated fat and added sugar (12.0 ± 2.4 vs 11.5 ± 2.5 and 3.4 ± 3.2 vs 2.3 ± 3.2, P < 0.04), and a higher intake of fiber (11.2 ± 2.8 vs 10.4 ± 2.6 g/1000 Kcal/day) in women. Adherence to the recommendations for saturated fat and fiber consumption was associated with significantly lower LDL-cholesterol regardless of sex. Adherence to the recommendations for added sugars was associated with significantly lower triglycerides and higher HDL-cholesterol in men and women.
  
  
  
  Men and women with diabetes show significant differences in adherence to nutritional recommendations, but sex differences in plasma lipid profile are unlikely to be explained by nutritional factors. Adherence to the nutritional recommendations is associated with a better plasma lipid profile regardless of sex, thus reinforcing the importance of substituting saturated for unsaturated fat sources, increasing fiber and reducing added sugar intake.
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università "Federico II" di Napoli, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Vitale
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università "Federico II" di Napoli, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Masulli
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università "Federico II" di Napoli, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cocozza
authors.affiliation: UO di Diabetologia, USL 3, Pistoia, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Anichini
authors.affiliation: Diabetologia, Ospedale Infermi, Rimini, Italy.
authors.forename: A C
authors.initials: AC
authors.lastname: Babini
authors.affiliation: UOC Malattie Metaboliche e Diabetologia, Istituto INRCA-IRCCS, Ancona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Boemi
authors.affiliation: Dipartimento di Medicina, Divisione di Endocrinologia, Diabete e Metabolismo, Università di Verona, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bonora
authors.affiliation: UOC di Diabetologia Universitaria, Ospedale Santa Maria Goretti, Latina, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Buzzetti
authors.affiliation: UO di Malattie Metaboliche e Diabetologia, AO Treviglio, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Carpinteri
authors.affiliation: UOD Endocrinologia e Diabetologia, AUSL della Romagna, Cesena, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Caselli
authors.affiliation: UOC Diabetologia, Dipartimento di Medicina, Chirurgia e Neuroscienze, Università di Siena, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Ceccarelli
authors.affiliation: Endocrinologia, OORR di Foggia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cignarelli
authors.affiliation: UO Endocrinologia e Diabetologia, ASP, Potenza, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Citro
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università "Federico II" di Napoli, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Clemente
authors.affiliation: DMSI e CeSI-Met, Università di Chieti-Pescara, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Consoli
authors.affiliation: SSD Diabetologia e Malattie Metaboliche, ASL 4 Chiavarese, Genova, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Corsi
authors.affiliation: UOSD Diabetologia, Ospedale San Salvatore, L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: De Gregorio
authors.affiliation: UO di Diabetologia Ravenna, A. Usl Romagna, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Di Bartolo
authors.affiliation: UOC Diabetologia, ASL 6, Livorno, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Di Cianni
authors.affiliation: UOC Diabetologia e Dietologia, Ospedale S. Pertini, Roma, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Fontana
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Garofolo
authors.affiliation: ASL Torino 5, Chieri, Italy.
authors.forename: C B
authors.initials: CB
authors.lastname: Giorda
authors.affiliation: Endocrinologia e Malattie Metaboliche, Università di Palermo, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Giordano
authors.affiliation: Unità di Epidemiologia e Prevenzione, Fondazione IRCCS, Istituto Nazionale Tumori, Milano, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Grioni
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università "Federico II" di Napoli, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Iovine
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Longhitano
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, Università di Parma, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mancastroppa
authors.affiliation: DIMI, Università di Genova, IRCCS San Martino, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Mazzucchelli
authors.affiliation: UOSD, Presidio Ospedaliero di Atri, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Montani
authors.affiliation: SSD Diabetologia, ASL 1, Massa Carrara, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mori
authors.affiliation: MISEM, Università di Perugia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Perriello
authors.affiliation: Dipartimento di Medicina dei Sistemi, Università degli Studi di Roma "Tor Vergata", Italy.
authors.forename: M E
authors.initials: ME
authors.lastname: Rinaldi
authors.affiliation: Dipartimento di Medicina Interna, Policlinico di Messina, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Ruffo
authors.affiliation: Dipartimento di Medicina Clinica e Molecolare, Università "La Sapienza", Roma, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Salvi
authors.affiliation: DPT Medicina, Università degli Studi di Padova, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sartore
authors.affiliation: USC Malattie Endocrine e Diabetologia, AO Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Scaranna
authors.affiliation: SOC di Endocrinologia e Malattie del Metabolismo, AOU S. Maria della Misericordia, Udine, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Tonutti
authors.affiliation: UO Malattie Metaboliche, Dietologia e Nutrizione Clinica, AOU Arcispedale S. Anna, Ferrara, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Zamboni
authors.affiliation: UO di Diabetologia, Ospedale di Prato, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Zogheri
authors.affiliation: Unità di Epidemiologia e Prevenzione, Fondazione IRCCS, Istituto Nazionale Tumori, Milano, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Krogh
authors.affiliation: Dipartimento di Patologia Sperimentale, Ospedale di Desio, Università di Milano Bicocca, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cappellini
authors.affiliation: Dipartimento di Patologia Sperimentale, Ospedale di Desio, Università di Milano Bicocca, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Signorini
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università "Federico II" di Napoli, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Riccardi
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università "Federico II" di Napoli, Italy. Electronic address: ovaccaro@unina.it.
authors.forename: O
authors.initials: O
authors.lastname: Vaccaro
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002755:Choice Behavior; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy* / Q000523:psychology; D000072001:Diet, Healthy; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences; D006801:Humans; D007558:Italy; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D010349:Patient Compliance; D064167:Recommended Dietary Allowances; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008055:Lipids
keywords: Cardiovascular risk factors; Diabetes; Dietary habits; Men; Nutritional recommendations; Sex differences; Women