Longitudinal changes in dietary fat intake and associated changes in cardiovascular risk factors in adults with type 2 diabetes: the ACCORD trial

Diabetes Res Clin Pract. 2013 Apr;100(1):61-8. doi: 10.1016/j.diabres.2013.02.001. Epub 2013 Mar 13.

Abstract

Aims: To measure dietary fat intake using the Puget Sound Eating Patterns (PEP) questionnaire, a validated 19-item food questionnaire, and to quantify how reduced dietary fat intake affects cardiovascular risk factors in adults with type 2 diabetes.

Methods: Randomized controlled trial including a subsample of 1781 Action to Control Cardiovascular Risk in Diabetes (ACCORD) participants. Participants received dietary counseling to consume a reduced-fat diet. Outcome measures included HbA1c, fasting lipid profile, blood pressure, and weight. Longitudinal linear regression analyses were used to evaluate relationships between baseline and follow-up PEP scores and cardiovascular risk factors.

Results: PEP scores decreased significantly from baseline to 12-month follow up with a mean difference of -0.09 ± 0.39, P<0.001. All of the fat intake subscales showed significant improvement at 12 months from baseline. White race, female gender, and more hours per week of physical activity were correlated with a decline in PEP scores at 1-year. A longitudinal decrease in dietary fat intake was associated with significantly less weight gain at 12- and 36-months and lower serum triglycerides at 1 year.

Conclusions: Reduced fat intake as measured by a brief questionnaire was associated with significant improvement in some cardiovascular risk factors (triglycerides and weight), but not in others.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Blood Glucose / metabolism*
  • Blood Pressure
  • Body Mass Index
  • Body Weight
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / metabolism*
  • Cardiovascular Diseases / prevention & control
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / metabolism*
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / metabolism*
  • Diabetic Angiopathies / prevention & control
  • Dietary Fats / metabolism*
  • Energy Intake
  • Female
  • Glycated Hemoglobin
  • Humans
  • Linear Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Motor Activity
  • Patient Compliance
  • Patient Outcome Assessment
  • Surveys and Questionnaires
  • United States / epidemiology
  • Weight Gain

Substances

  • Blood Glucose
  • Dietary Fats
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human