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Dietary fat and cholesterol and the risk of cardiovascular disease among women with type 2 diabetes.

Abstract

BACKGROUND

Nutritional therapy is a cornerstone of diabetes management, but no epidemiologic studies have investigated the relation between specific dietary fatty acids and cholesterol and cardiovascular disease (CVD) risk among diabetic patients.

OBJECTIVE

This study assessed the relation between specific dietary fatty acids and cholesterol and CVD risk among women with type 2 diabetes.

DESIGN

Among 5672 women with type 2 diabetes from the Nurses' Health Study, diet was assessed prospectively and updated periodically. Relative risks of CVD were estimated from Cox proportional hazards analysis after adjustment for potential confounders.

RESULTS

Between 1980 and 1998, we identified 619 new cases of CVD (nonfatal myocardial infarction, fatal coronary heart disease, and stroke). The relative risk (RR) of CVD for an increase of 200 mg cholesterol/1000 kcal was 1.37 (95% CI: 1.12, 1.68; P = 0.003). Each 5% of energy intake from saturated fat, as compared with equivalent energy from carbohydrates, was associated with a 29% greater risk of CVD (RR: 1.29; 95% CI: 1.02, 1.63; P = 0.04). The ratio of polyunsaturated to saturated fat (P:S) was inversely associated with the risk of fatal CVD. We estimated that replacement of 5% of energy from saturated fat with equivalent energy from carbohydrates or monounsaturated fat was associated with a 22% or 37% lower risk of CVD, respectively.

CONCLUSIONS

A higher intake of cholesterol and saturated fat and a low P:S were related to increased CVD risk among women with type 2 diabetes. Among diabetic persons, replacement of saturated fat with monounsaturated fat may be more effective in lowering CVD risk than is replacement with carbohydrates.

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  • Authors+Show Affiliations

    ,

    Department of Nutrition, Harvard School of Public Health, the Channing Laboratory, Boston, USA. mtanasescu@tourou.edu

    , ,

    Source

    MeSH

    Cardiovascular Diseases
    Cholesterol, Dietary
    Diabetes Mellitus, Type 2
    Diet Surveys
    Dietary Fats
    Fatty Acids
    Female
    Humans
    Middle Aged
    Prospective Studies
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    15159229

    Citation

    Tanasescu, Mihaela, et al. "Dietary Fat and Cholesterol and the Risk of Cardiovascular Disease Among Women With Type 2 Diabetes." The American Journal of Clinical Nutrition, vol. 79, no. 6, 2004, pp. 999-1005.
    Tanasescu M, Cho E, Manson JE, et al. Dietary fat and cholesterol and the risk of cardiovascular disease among women with type 2 diabetes. Am J Clin Nutr. 2004;79(6):999-1005.
    Tanasescu, M., Cho, E., Manson, J. E., & Hu, F. B. (2004). Dietary fat and cholesterol and the risk of cardiovascular disease among women with type 2 diabetes. The American Journal of Clinical Nutrition, 79(6), pp. 999-1005.
    Tanasescu M, et al. Dietary Fat and Cholesterol and the Risk of Cardiovascular Disease Among Women With Type 2 Diabetes. Am J Clin Nutr. 2004;79(6):999-1005. PubMed PMID: 15159229.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary fat and cholesterol and the risk of cardiovascular disease among women with type 2 diabetes. AU - Tanasescu,Mihaela, AU - Cho,Eunyoung, AU - Manson,JoAnn E, AU - Hu,Frank B, PY - 2004/5/26/pubmed PY - 2004/6/16/medline PY - 2004/5/26/entrez SP - 999 EP - 1005 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 79 IS - 6 N2 - BACKGROUND: Nutritional therapy is a cornerstone of diabetes management, but no epidemiologic studies have investigated the relation between specific dietary fatty acids and cholesterol and cardiovascular disease (CVD) risk among diabetic patients. OBJECTIVE: This study assessed the relation between specific dietary fatty acids and cholesterol and CVD risk among women with type 2 diabetes. DESIGN: Among 5672 women with type 2 diabetes from the Nurses' Health Study, diet was assessed prospectively and updated periodically. Relative risks of CVD were estimated from Cox proportional hazards analysis after adjustment for potential confounders. RESULTS: Between 1980 and 1998, we identified 619 new cases of CVD (nonfatal myocardial infarction, fatal coronary heart disease, and stroke). The relative risk (RR) of CVD for an increase of 200 mg cholesterol/1000 kcal was 1.37 (95% CI: 1.12, 1.68; P = 0.003). Each 5% of energy intake from saturated fat, as compared with equivalent energy from carbohydrates, was associated with a 29% greater risk of CVD (RR: 1.29; 95% CI: 1.02, 1.63; P = 0.04). The ratio of polyunsaturated to saturated fat (P:S) was inversely associated with the risk of fatal CVD. We estimated that replacement of 5% of energy from saturated fat with equivalent energy from carbohydrates or monounsaturated fat was associated with a 22% or 37% lower risk of CVD, respectively. CONCLUSIONS: A higher intake of cholesterol and saturated fat and a low P:S were related to increased CVD risk among women with type 2 diabetes. Among diabetic persons, replacement of saturated fat with monounsaturated fat may be more effective in lowering CVD risk than is replacement with carbohydrates. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/15159229/full_citation L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/79.6.999 DB - PRIME DP - Unbound Medicine ER -