Abstract
The aim of this study was to assess the dietary pattern (i.e., Mediterranean Diet (MedDiet) and healthy eating) in people with type 2 diabetes (T2D) compared with those without diabetes. In addition, we explored clinical factors associated with the dietary pattern. This cross-sectional study was performed with a sample of 476 participants (238 with T2D and 238 participants without diabetes, matched for age and sex). The alternate Mediterranean Diet (aMED) score and the alternate Healthy Eating Index (aHEI) were calculated. Statistical analysis included comparison between groups and multivariable models. Participants with T2D showed higher aMED and aHEI scores (mean (SD): 4.3 (1.5) and 43.9 (6.5), respectively) in comparison with the control group (3.5 (1.8) and 39.4 (7.4), respectively; p < 0.001). In addition, a higher proportion of participants with T2D in higher tertiles of aMED (21.8%) and aHEI (39.9%) was observed compared with participants without diabetes (11.3% for the aMED, and 19.3% for the aHEI; p < 0.001). The adjusted multivariable analysis revealed that T2D (p < 0.001), increasing age (p = 0.006 and p = 0.030, respectively), and physical activity (p = 0.009) were positively associated with higher aMED and aHEI scores. Dyslipidemia and female gender were positively associated with aMED and aHEI (p = 0.031 and p < 0.001, respectively). The specific multivariable analysis for the group with T2D yielded a positive association of age (p < 0.001) and dyslipidemia (p = 0.021) with aMED. Regarding the aHEI, only female gender was positively related with this score in diabetes participants (p = 0.025). Participants with T2D showed a higher adherence to the MedDiet and a healthier eating pattern.
Highlights
The American Diabetes Association (ADA) has established that lifestyle management is a key element in the treatment of people with diabetes to ensure an optimal control of the disease [1]
A total sample of 238 participants with type 2 diabetes mellitus (T2D) and 238 sex- and age-matched participants without diabetes were recruited. This was a sub-study using the cohorts of two previously published studies [20,21]: the first one included a cohort of subjects with T2D designed to assess their quality of life and treatment satisfaction; the second study was a population-based cohort study designed to assess the prevalence of prediabetes, and risk factors associated with this condition
Participants with T2D had a higher adherence to the Mediterranean Diet (MedDiet) and a healthier eating pattern with higher alternate Mediterranean Diet (aMED) and alternate Healthy Eating Index (aHEI) scores (mean (SD): 4.3 (1.5) and 43.9 (6.5), respectively) in comparison with the control group (3.5 (1.8) and 39.4 (7.4), respectively; p < 0.001)
Summary
The American Diabetes Association (ADA) has established that lifestyle management is a key element in the treatment of people with diabetes to ensure an optimal control of the disease [1]. This includes diabetes self-management education and support (DSMES), medical nutrition therapy (MNT), physical activity, smoking cessation counseling, and psychosocial care. DSMES provides people with diabetes with the essential tools to adopt self-management decisions; DSMES has been shown to be associated with optimal management of the disease, lowering glycated hemoglobin (HbA1c) and body weight, reducing all-cause mortality risk and improving the quality of life of this population [1].
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