Savory L A, Griffin S J, Williams K M, Prevost A T, Kinmonth A-L, Wareham N J, Simmons R K
MRC Epidemiology Unit, Cambridge Institute of Public Health, Cambridge, UK; East of England Multi-Professional Deanery, Cambridge Institute of Public Health, Cambridge, UK.
Diabet Med. 2014 Feb;31(2):148-55. doi: 10.1111/dme.12316. Epub 2013 Oct 21.
To 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.
Eight 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.
Participants 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.
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.
描述自我报告的饮食和血浆维生素C的变化,并研究饮食变化与心血管疾病风险因素之间的关联,以及在2型糖尿病诊断后的一年内模拟10年心血管疾病风险。
在ADDITION - 剑桥试验中,867名经筛查发现患有糖尿病的个体在基线和1年时(n = 736)接受了自我报告饮食、血浆维生素C、心血管疾病风险因素和模拟心血管疾病风险的评估。使用多变量线性回归来量化饮食变化与1年时心血管疾病风险之间的关联,并对身体活动和心脏保护药物的变化进行调整。
参与者报告在1年中能量、脂肪和钠的摄入量显著减少,水果、蔬菜和纤维的摄入量增加。能量的减少相当于一块普通大小的巧克力棒;水果摄入量的增加相当于每天一个李子。血浆维生素C水平有小幅上升。水果摄入量和血浆维生素C的增加与人体测量和代谢风险因素的小幅降低有关。蔬菜摄入量的增加与体重指数和腰围的增加有关。脂肪、能量和钠摄入量的减少分别与糖化血红蛋白、腰围和总胆固醇/模拟心血管疾病风险的降低有关。
在这个经筛查发现的人群中,饮食行为的改善与心血管疾病风险的小幅降低有关,这与心脏保护药物和身体活动的变化无关。饮食改变在糖尿病诊断后降低心血管疾病风险方面可能发挥作用。