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01-03-2004 | Article

Nutritional habits of subjects with Type 2 diabetes mellitus in the Mediterranean Basin: comparison with the non-diabetic population and the dietary recommendations. Multi-Centre Study of the Mediterranean Group for the Study of Diabetes (MGSD)

Authors: A. Thanopoulou, B. Karamanos, MD, F. Angelico, S. Assaad-Khalil, A. Barbato, M. Del Ben, P. Djordjevic, V. Dimitrijevic-Sreckovic, C. Gallotti, N. Katsilambros, I. Migdalis, M. Mrabet, M. Petkova, D. Roussi, M. T. Tenconi

Published in: Diabetologia | Issue 3/2004

Abstract

Aims/hypothesis

The aim of this study was to compare the nutritional habits of Type 2 diabetic patients among Mediterranean countries and also with those of their background population and with the nutritional recommendations of the Diabetes and Nutrition Study Group.

Methods

We did a cross-sectional study of 1833 non-diabetic subjects and 1895 patients with Type 2 diabetes, in nine centres in six Mediterranean countries. A dietary questionnaire validated against the 3-Day Diet Diary was used.

Results

In diabetic patients the contribution of proteins, carbohydrates and fat to the energy intake varied greatly among centres, ranging from 17.6% to 21.0% for protein, from 37.7% to 53.0% for carbohydrates and from 27.2% to 40.8% for fat, following in every centre the trends of the non-diabetic population. Furthermore, diabetic patients compared to the corresponding background population had: (i) lower energy intake, (ii) lower carbohydrate and higher protein contribution to the energy intake, (iii) higher prevalence of obesity, ranging from 9 to 50%. The adherence to the nutritional recommendations for proteins, carbohydrate and fat was very low ranging from 1.4 to 23.6%, and still decreased when fibre was also considered.

Conclusion/interpretation

In diabetic patients of the Mediterranean area: (i) dietary habits vary greatly among countries, according to the same trends of the background population; (ii) the prevalence of obesity is much lower than the 80% reported for patients with diabetes in Western countries; (iii) Carbohydrate intake is decreased with a complementary increase of protein and fat consumption, resulting to a poor compliance with the nutritional recommendations.

Ringrose H, Zimmet P (1979) Nutrient intakes in an urbanized Micronesian population with a high diabetes prevalence. Am J Clin Nutr 32:1334–1341PubMed

Lillioja S, Mott D, Spraul M et al. (1993) Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus: Prospective studies of Pima Indians. N Engl J Med 329:1988–1992CrossRefPubMed

Dam RM van, Rimm EB, Willett WC, Stampfer MJ, Hu FB (2002) Dietary patterns and risk for type 2 diabetes mellitus in U.S. men. Ann Intern Med 136:201–209CrossRefPubMed

Keys A (1970) Coronary heart disease in seven countries. Circulation 41 [Suppl 1]:1–191

Keys A (1980) Seven countries: a multivariate analysis of death and coronary heart disease. Harvard University Press, Cambridge

Keys A, Menotti A, Karvonen MJ et al. (1986) The diet and 15-year death rate in the Seven Countries Study. Am J Epidemiol 124:903–915CrossRefPubMed

Helsing E, Trichopoulou A (eds) (1989) The Mediterranean diet and food culture: a symposium. Eur J Clin Nutr 43 [Suppl 2]:1–92

Kromhout D, Keys A, Aravanis C, Buzina R, Fidanza F, Giampaoli S (1989) Food consumption patterns in the 1960s in seven countries. Am J Clin Nutr 49:889–894PubMed

Kafatos A, Kouroumalis I, Vlahonikolis C, Labadarios D (1991) Coronary heart disease risk factor status of the Cretan urban population in 1980s. Am J Clin Nutr 54:591–598PubMed

10.

Trichopoulou A, Katsouyanni K, Gnardellis Ch (1993) The traditional Greek diet. Eur J Clin Nutr 47 [Suppl 1]:S76–S81

11.

Diabetes and Nutrition Study Group of the European Association for the Study of Diabetes (2000) Nutritional recommendations for individuals with diabetes mellitus. Eur J Clin Nutr 54:353–355CrossRef

12.

Karamanos B, Thanopoulou A, Angelico F et al. (2002) Nutritional Habits in the Mediterranean Basin. The macronutrient composition of diet and its relation with the traditional Mediterranean diet. Multi-Centre Study of the Mediterranean Group for the Study of Diabetes (MGSD). Eur J Clin Nutr 56:983–991CrossRefPubMed

13.

Toeller M, Klischan A, Heitkamp G et al. and the EURODIAB IDDM Complications Study Group (1996) Nutritional intake of 2868 IDDM patients from 30 centres in Europe. Diabetologia 39:929–939CrossRefPubMed

14.

Hartman AM, Brown CC, Palmgren J et al. (1990) Variability in nutrient and food intakes among older middle-aged men. Implications for design of epidemiologic and validation studies using food recording. Am J Epidemiol 132:999–1012CrossRefPubMed

15.

Karamanos B (1993) Diet and diabetes. In: Williams R, Papoz L, Fuller J (eds) Diabetes in Europe. John Libbey and Co., p 78

16.

Klaver W, Burema J, Van Staveren WA, Kuniman JT (1998) Definition of terms. In: Cameron ME, Van Staveren WA (eds) Manual for methodology for food consumption studies. Oxford University Press, New York, p 11

17.

Paul AA, Southgate DAT (eds) (1985) McCance and Widdowson’s The composition of foods, 4th edn. Elsevier, Amsterdam

18.

Trichopoulou A (ed.) (1992) Food composition tables, 2nd edn. Athens Medical School, Athens, pp 1–179

19.

Toeller M, Buyeken A, Heitcamp G, Milne R, Klischan A, Gries FA and the EURODIAB IDDM Complications Study Group (1997) Repeatability of three-day dietary records in the Gries FA and the EURODIAB IDDM Complications Study. Eur J Clin Nutr 51:74–80CrossRefPubMed

20.

The Diebetes and Nutrition Study Group of the Spanish Diabetes Association (GSEDNu) (1997) Diet and day-to-day variability in a sample of Spanish adults with IDDM or NIDDM. Horm Metab Res 29:450–453CrossRef

21.

Nthangeni G, Steyn NP, Alberts M et al. (2002) Dietary intake and barriers to dietary compliance in black type 2 diabetic patients attending primary health-care services. Public Health Nutr 5:329–338CrossRefPubMed

22.

Bingha S, Nelson M, Paul A, Haraldsdottir J, Bjorge Loken E, Staveren W van (1988) Methods for data collection at an individual level. In: Cameron M, Staveren W van (eds) Manual of methodology for food consumption studies. Oxford Medical Publications, Oxford, pp 53–106

23.

World Health Organization Study Group on Diet, nutrition and the prevention of chronic disease (1990)Technical report series No 797. WHO, Geneva

24.

Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC (1994) Obesity, fat distribution and weight gain as risk factors for clinical diabetes in men. Diabetes Care 17:961–969CrossRefPubMed

25.

Willett W (1991) Chewing the fat. How much and what kind. N Engl J Med 324:121–123CrossRefPubMed

26.

EURONUT SENECA investigators (1991) Intake of energy and nutrients. Eur J Clin Nutr 45 [Suppl 3]:105–119

27.

Trichopoulou A, Costacou T, Bamia C, Trichopoulos D (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348:2599–2608CrossRefPubMed

28.

Mann JI (2000) Can dietary intervention produce long-term reduction in insulin resistance? Br J Nutr 83 [Suppl 1]:S169–S172

29.

Perez-Jimenez F, Lopez-Mranda J, Pinillos MD et al. (2001) A Mediterranean and a high-carbohydrate diet improve glucose metabolism in healthy young persons. Diabetologia 44:2038–2043CrossRefPubMed

30.

ADA (2003) Translation of the diabetes nutrition recommendations for health care institutions. Diabetes Care 26 [Suppl 1]:S70–S72

31.

Buyken A, Toeller M, Heitkamp G et al. and the EURODIAB IDDM Complications Study Group (2001) Glycemic index in the diet of European outpatients with type 1 diabetes: relations to glycated hemoglobin and serum lipids. Am J Clin Nutr 73:574–581PubMed

32.

Buyken A, Toeller M, Heitkamp G et al. and the EURODIAB IDDM Complications Study Group (1998) Relation of fiber intake to HbA_1c and the prevalence of severe ketoacidosis and severe hypoglycaemia. Diabetologia 41:882–890CrossRefPubMed

33.

Close EJ, Wiles PG, Lockton JA, Walmsley D, Oldham J, Wales JK (1992) Diabetic diets and nutritional recommendations: what happens in real life? Diabet Med 9:181–188CrossRefPubMed

Title: Nutritional habits of subjects with Type 2 diabetes mellitus in the Mediterranean Basin: comparison with the non-diabetic population and the dietary recommendations. Multi-Centre Study of the Mediterranean Group for the Study of Diabetes (MGSD)
Authors: A. Thanopoulou
B. Karamanos, MD
F. Angelico
S. Assaad-Khalil
A. Barbato
M. Del Ben
P. Djordjevic
V. Dimitrijevic-Sreckovic
C. Gallotti
N. Katsilambros
I. Migdalis
M. Mrabet
M. Petkova
D. Roussi
M. T. Tenconi
Publication date: 01-03-2004
Publisher: Springer Berlin Heidelberg
Published in: Diabetologia / Issue 3/2004
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-003-1316-0

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Nutritional habits of subjects with Type 2 diabetes mellitus in the Mediterranean Basin: comparison with the non-diabetic population and the dietary recommendations. Multi-Centre Study of the Mediterranean Group for the Study of Diabetes (MGSD)

Abstract

Aims/hypothesis

Methods

Results

Conclusion/interpretation

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