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Effect of improving dietary quality on carotid intima media thickness in subjects with type 1 and type 2 diabetes: a 12-mo randomized controlled trial.
Am J Clin Nutr 2015; 102(4):771-9AJ

Abstract

BACKGROUND

People with diabetes are at a heightened risk of cardiovascular disease compared with the general population. To our knowledge, randomized controlled trials investigating the effect of improving dietary quality on carotid intima media thickness, a marker of subclinical atherosclerosis and predictor of cardiovascular disease, have not been conducted in populations with diabetes.

OBJECTIVE

We aimed to determine whether increasing fruit (+1 serving; 150 g/d), vegetable (+2 servings; 150 g/d), and dairy (+1 serving; 200-250 g/d) intakes slows 12-mo common carotid artery intima media thickness (CCA IMT) progression, compared with a control group continuing to consume their usual diet, in people with type 1 and type 2 diabetes.

DESIGN

A 12-mo randomized controlled trial was conducted. The primary outcome was mean CCA IMT, measured at baseline and 12 mo, with B-mode ultrasound. Participants in the intervention group received counseling from a dietitian at baseline and 1, 3, 6, and 9 mo, and compliance was measured with a food-frequency questionnaire at baseline, 3 mo, and 12 mo. The control group continued consuming their usual diet.

RESULTS

In total, 118 participants completed the study. Vegetable (46 g/d; 95% CI: 14, 77 g/d; P < 0.001) and fruit (179 g/d; 95% CI: 119, 239 g/d; P < 0.001) intakes were increased at 3 mo in the intervention group compared with the control group. This increase was not maintained at 12 mo, but intake increased overall in the cohort (fruit, 48 g/d; vegetables, 14 g/d). An increase in dairy consumption was not achieved, but yogurt intake was higher in the intervention group at 3 mo (38 g; 95% CI: 12, 65 g; P < 0.001); this was not maintained at 12 mo. At 12 mo, CCA IMT regressed (mean ± SD: -0.01 ± 0.04 mm; P < 0.001), with a greater effect in the treatment group (mean ± SD: -0.02 ± 0.04 mm compared with -0.004 ± 0.04 mm; P = 0.009).

CONCLUSION

Improving dietary quality in people with well-controlled type 1 and type 2 diabetes may slow CCA IMT progression. This trial was registered at https://www.anzctr.org.au as ACTRN12613000251729.

Authors+Show Affiliations

School of Pharmacy and Medical Sciences & Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.School of Pharmacy and Medical Sciences & Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.School of Pharmacy and Medical Sciences & Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.School of Pharmacy and Medical Sciences & Sansom Institute for Health Research, University of South Australia, Adelaide, Australia jennifer.keogh@unisa.edu.au.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26354542

Citation

Petersen, Kristina S., et al. "Effect of Improving Dietary Quality On Carotid Intima Media Thickness in Subjects With Type 1 and Type 2 Diabetes: a 12-mo Randomized Controlled Trial." The American Journal of Clinical Nutrition, vol. 102, no. 4, 2015, pp. 771-9.
Petersen KS, Clifton PM, Blanch N, et al. Effect of improving dietary quality on carotid intima media thickness in subjects with type 1 and type 2 diabetes: a 12-mo randomized controlled trial. Am J Clin Nutr. 2015;102(4):771-9.
Petersen, K. S., Clifton, P. M., Blanch, N., & Keogh, J. B. (2015). Effect of improving dietary quality on carotid intima media thickness in subjects with type 1 and type 2 diabetes: a 12-mo randomized controlled trial. The American Journal of Clinical Nutrition, 102(4), pp. 771-9. doi:10.3945/ajcn.115.112151.
Petersen KS, et al. Effect of Improving Dietary Quality On Carotid Intima Media Thickness in Subjects With Type 1 and Type 2 Diabetes: a 12-mo Randomized Controlled Trial. Am J Clin Nutr. 2015;102(4):771-9. PubMed PMID: 26354542.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of improving dietary quality on carotid intima media thickness in subjects with type 1 and type 2 diabetes: a 12-mo randomized controlled trial. AU - Petersen,Kristina S, AU - Clifton,Peter M, AU - Blanch,Natalie, AU - Keogh,Jennifer B, Y1 - 2015/09/09/ PY - 2015/03/29/received PY - 2015/08/04/accepted PY - 2015/9/11/entrez PY - 2015/9/12/pubmed PY - 2016/1/6/medline KW - carotid intima media thickness KW - dairy KW - diabetes KW - dietary quality KW - fruit KW - randomized controlled trial KW - vegetables SP - 771 EP - 9 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 102 IS - 4 N2 - BACKGROUND: People with diabetes are at a heightened risk of cardiovascular disease compared with the general population. To our knowledge, randomized controlled trials investigating the effect of improving dietary quality on carotid intima media thickness, a marker of subclinical atherosclerosis and predictor of cardiovascular disease, have not been conducted in populations with diabetes. OBJECTIVE: We aimed to determine whether increasing fruit (+1 serving; 150 g/d), vegetable (+2 servings; 150 g/d), and dairy (+1 serving; 200-250 g/d) intakes slows 12-mo common carotid artery intima media thickness (CCA IMT) progression, compared with a control group continuing to consume their usual diet, in people with type 1 and type 2 diabetes. DESIGN: A 12-mo randomized controlled trial was conducted. The primary outcome was mean CCA IMT, measured at baseline and 12 mo, with B-mode ultrasound. Participants in the intervention group received counseling from a dietitian at baseline and 1, 3, 6, and 9 mo, and compliance was measured with a food-frequency questionnaire at baseline, 3 mo, and 12 mo. The control group continued consuming their usual diet. RESULTS: In total, 118 participants completed the study. Vegetable (46 g/d; 95% CI: 14, 77 g/d; P < 0.001) and fruit (179 g/d; 95% CI: 119, 239 g/d; P < 0.001) intakes were increased at 3 mo in the intervention group compared with the control group. This increase was not maintained at 12 mo, but intake increased overall in the cohort (fruit, 48 g/d; vegetables, 14 g/d). An increase in dairy consumption was not achieved, but yogurt intake was higher in the intervention group at 3 mo (38 g; 95% CI: 12, 65 g; P < 0.001); this was not maintained at 12 mo. At 12 mo, CCA IMT regressed (mean ± SD: -0.01 ± 0.04 mm; P < 0.001), with a greater effect in the treatment group (mean ± SD: -0.02 ± 0.04 mm compared with -0.004 ± 0.04 mm; P = 0.009). CONCLUSION: Improving dietary quality in people with well-controlled type 1 and type 2 diabetes may slow CCA IMT progression. This trial was registered at https://www.anzctr.org.au as ACTRN12613000251729. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26354542/Effect_of_improving_dietary_quality_on_carotid_intima_media_thickness_in_subjects_with_type_1_and_type_2_diabetes:_a_12_mo_randomized_controlled_trial_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.115.112151 DB - PRIME DP - Unbound Medicine ER -