School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan.
Department of Family Medicine, China Medical University Hospital, Taichung 404, Taiwan.
Nutrients. 2020 Jun 3;12(6):1665. doi: 10.3390/nu12061665.
The best macronutrient percentages of dietary intake supporting longevity remains unclear. The strength of association between dietary intake and mortality in patients with type 2 diabetes (T2DM) should be quantified as a basis for dietary recommendations. Our study cohort consisted of 15,289 type 2 diabetic patients aged 30 years and older in Taiwan during 2001-2014 and was followed up through 2016. Percentages of macronutrient intakes were calculated as dietary energy intake contributed by carbohydrate, protein, and fat, divided by the total energy intake using a 24 h food diary recall approach. Cox proportional hazard models were applied to examine the temporal relation of macronutrient intakes with all-cause and cause-specific mortality. The average follow-up time was 7.4 years, during which 2,784 adults with T2DM died. After multivariable adjustment, people with fourth and fifth quintiles of total energy, second and third quintiles of carbohydrate, and fourth quintiles of protein intakes were likely to have lower risks of all-cause and expanded cardiovascular disease (CVD) mortality. People with fifth quintiles of total energy intake were likely to have decreased non-expanded CVD mortality. We found a significant interaction between gender and fat intake on all-cause and expanded CVD mortality. Fat intake was associated with all-cause, expanded and non-expanded CVD mortality among males with T2DM. Total energy, carbohydrate, and protein intakes were associated with lower risks of all-cause and expanded CVD mortality, with minimal risks observed at ≥1673 Kcal total energy, 43-52% carbohydrate intake, and 15-16% protein intake among people with T2DM.
支持长寿的最佳膳食摄入宏量营养素比例仍不清楚。应量化 2 型糖尿病 (T2DM) 患者饮食摄入与死亡率之间的关联强度，作为饮食建议的基础。我们的研究队列包括 2001 年至 2014 年期间台湾年龄在 30 岁及以上的 15289 名 2 型糖尿病患者，并随访至 2016 年。宏量营养素摄入量的百分比计算为通过 24 小时食物日记回顾法，用碳水化合物、蛋白质和脂肪的膳食能量摄入量除以总能量摄入量。应用 Cox 比例风险模型检查宏量营养素摄入量与全因和特定原因死亡率的时间关系。平均随访时间为 7.4 年，期间有 2784 名 T2DM 患者死亡。在多变量调整后，总能量的第四和第五五分位数、碳水化合物的第二和第三五分位数以及蛋白质摄入量的第四五分位数的人，全因和扩展心血管疾病 (CVD) 死亡率的风险较低。总能量摄入量第五五分位数的人，非扩展 CVD 死亡率可能降低。我们发现性别和脂肪摄入量与全因和扩展 CVD 死亡率之间存在显著交互作用。脂肪摄入量与男性 T2DM 患者的全因、扩展和非扩展 CVD 死亡率有关。总能量、碳水化合物和蛋白质摄入量与全因和扩展 CVD 死亡率的风险降低有关，在 T2DM 患者中，总能量≥1673kcal、碳水化合物摄入量 43-52%和蛋白质摄入量 15-16%时，观察到的风险最小。
