Division of Human Nutrition, Wageningen University, 6700 EV, PO Box 8129, Wageningen, The Netherlands,
Eur J Nutr. 2013 Oct;52(7):1701-10. doi: 10.1007/s00394-012-0473-7. Epub 2012 Dec 7.
BACKGROUND/OBJECTIVES: Individuals with type 1 diabetes have a high risk of developing cardiovascular diseases, and it has been reported that they consume a high atherogenic diet. We examined how nutrient intake and adherence to current European nutritional recommendations evolved in a large cohort of European individuals with type 1 diabetes over a period of 7 years.
SUBJECTS/METHODS: We analysed data from the EURODIAB Prospective Complications Study, a European multicentre prospective cohort study. Standardized 3-day dietary records were employed in individuals with type 1 diabetes. One thousand one hundred and two patients (553 men, 549 women, baseline age 33 ± 10 years, duration 15 ± 9 years) had complete nutritional data available at baseline and after 7 years. We calculated mean differences in reported nutrients over time and adjusted these for age, gender, HbA1c and BMI with ANOVA models.
Compared to baseline, there were minor changes in nutrients. Reported protein (-0.35% energy (en), fat (-1.07% en), saturated fat (-0.25% en) and cholesterol (-7.42 mg/1000 kcal) intakes were lower, whereas carbohydrate (+1.23% en) and fibre (+0.46 g/1000 kcal) intakes were higher at the 7-year follow-up. European recommendations for adequate nutrient intakes were followed in individuals with type 1 diabetes for protein (76% at baseline and 78% at follow-up), moderately for fat (34, 40%), carbohydrate (34, 41%) and cholesterol (39, 47%), but poorly for fibre (1.4, 2.4%) and saturated fat (11, 13%).
European individuals with type 1 diabetes consume a high atherogenic diet as few patients met recommendations for dietary fibre and saturated fat. This study showed minor changes in dietary nutrients and energy intakes over a period of 7 years. Nutrition education needs particular focus on strategies to increase dietary fibre and reduce saturated fat to exploit their potential benefit.
背景/目的：1 型糖尿病患者患心血管疾病的风险较高，据报道他们的饮食具有较高的动脉粥样硬化风险。我们研究了在 7 年的时间里，大量欧洲 1 型糖尿病患者的营养摄入和对当前欧洲营养建议的依从性如何变化。
受试者/方法：我们分析了 EURODIAB 前瞻性并发症研究（一项欧洲多中心前瞻性队列研究）的数据。1 型糖尿病患者采用标准化的 3 天饮食记录。共有 1102 名患者（553 名男性，549 名女性，基线年龄 33±10 岁，病程 15±9 年）在基线和 7 年后有完整的营养数据。我们计算了随着时间的推移报告的营养素的平均差异，并使用方差分析模型根据年龄、性别、HbA1c 和 BMI 对这些差异进行了调整。
与基线相比，营养素的变化较小。报告的蛋白质（能量的-0.35%）、脂肪（能量的-1.07%）、饱和脂肪（能量的-0.25%）和胆固醇（每 1000 千卡 7.42 毫克）摄入量较低，而碳水化合物（能量的+1.23%）和膳食纤维（每 1000 千卡 0.46 克）摄入量在 7 年随访时较高。1 型糖尿病患者的蛋白质（基线时为 76%，随访时为 78%）、脂肪（34%、40%）、碳水化合物（34%、41%）和胆固醇（39%、47%）摄入基本符合欧洲适当营养摄入量建议，但膳食纤维（1.4%、2.4%）和饱和脂肪（11%、13%）摄入较差。
欧洲 1 型糖尿病患者摄入高动脉粥样硬化饮食，因为很少有患者符合膳食纤维和饱和脂肪的建议。本研究显示，在 7 年的时间里，饮食营养素和能量摄入的变化很小。营养教育需要特别关注增加膳食纤维和减少饱和脂肪的策略，以发挥其潜在益处。
