Abstract

AimsTo describe change in self-reported diet and plasma vitamin C, and to examine associations between change in diet and cardiovascular disease risk factors and modelled 10-year cardiovascular disease risk in the year following diagnosis of Type 2 diabetes.MethodsEight hundred and sixty-seven individuals with screen-detected diabetes underwent assessment of self-reported diet, plasma vitamin C, cardiovascular disease risk factors and modelled cardiovascular disease risk at baseline and 1 year (n = 736) in the ADDITION-Cambridge trial. Multivariable linear regression was used to quantify the association between change in diet and cardiovascular disease risk at 1 year, adjusting for change in physical activity and cardio-protective medication.ResultsParticipants reported significant reductions in energy, fat and sodium intake, and increases in fruit, vegetable and fibre intake over 1 year. The reduction in energy was equivalent to an average-sized chocolate bar; the increase in fruit was equal to one plum per day. There was a small increase in plasma vitamin C levels. Increases in fruit intake and plasma vitamin C were associated with small reductions in anthropometric and metabolic risk factors. Increased vegetable intake was associated with an increase in BMI and waist circumference. Reductions in fat, energy and sodium intake were associated with reduction in HbA1c, waist circumference and total cholesterol/modelled cardiovascular disease risk, respectively.ConclusionsImprovements in dietary behaviour in this screen-detected population were associated with small reductions in cardiovascular disease risk, independently of change in cardio-protective medication and physical activity. Dietary change may have a role to play in the reduction of cardiovascular disease risk following diagnosis of diabetes.

Highlights

  • Type 2 diabetes is a growing public health problem, associated with a substantial burden of morbidity and mortality [1]

  • Improvements in dietary behaviour in this screen-detected population were associated with small reductions in cardiovascular disease risk, independently of change in cardio-protective medication and physical activity

  • Dietary change may have a role to play in the reduction of cardiovascular disease risk following diagnosis of diabetes

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Summary

Introduction

Type 2 diabetes is a growing public health problem, associated with a substantial burden of morbidity and mortality [1]. Lifestyle behaviours, including diet, are strongly associated with risk of incident diabetes and other cardiovascular disease risk factors. Dietary modification for weight management and for controlling blood glucose, blood pressure and blood lipid levels, is an important first-line treatment option for newly diagnosed patients. Such individuals will be given physical activity advice and may be considered for pharmacotherapy. Randomized trials of lifestyle interventions including dietary modification have demonstrated reduced incidence of diabetes in high-risk individuals [5] and improved cardiovascular disease risk factors in those with established diabetes [6,7]. Research suggests that dietary changes in individuals with newly or recently diag-

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