M Vitale1, M Masulli1, S Cocozza1, R Anichini2, A C Babini3, M Boemi4, E Bonora5, R Buzzetti6, R Carpinteri7, C Caselli8, E Ceccarelli9, M Cignarelli10, G Citro11, G Clemente1, A Consoli12, L Corsi13, A De Gregorio14, P Di Bartolo15, G Di Cianni16, L Fontana17, M Garofolo18, C B Giorda19, C Giordano20, S Grioni21, C Iovine1, S Longhitano22, G Mancastroppa23, C Mazzucchelli24, V Montani25, M Mori26, G Perriello27, M E Rinaldi28, M C Ruffo29, L Salvi30, G Sartore31, C Scaranna32, L Tonutti33, C Zamboni34, A Zogheri35, V Krogh21, F Cappellini36, S Signorini36, G Riccardi1, O Vaccaro37. 1. Dipartimento di Medicina Clinica e Chirurgia, Università "Federico II" di Napoli, Italy. 2. UO di Diabetologia, USL 3, Pistoia, Italy. 3. Diabetologia, Ospedale Infermi, Rimini, Italy. 4. UOC Malattie Metaboliche e Diabetologia, Istituto INRCA-IRCCS, Ancona, Italy. 5. Dipartimento di Medicina, Divisione di Endocrinologia, Diabete e Metabolismo, Università di Verona, Italy. 6. UOC di Diabetologia Universitaria, Ospedale Santa Maria Goretti, Latina, Italy. 7. UO di Malattie Metaboliche e Diabetologia, AO Treviglio, Italy. 8. UOD Endocrinologia e Diabetologia, AUSL della Romagna, Cesena, Italy. 9. UOC Diabetologia, Dipartimento di Medicina, Chirurgia e Neuroscienze, Università di Siena, Italy. 10. Endocrinologia, OORR di Foggia, Italy. 11. UO Endocrinologia e Diabetologia, ASP, Potenza, Italy. 12. DMSI e CeSI-Met, Università di Chieti-Pescara, Italy. 13. SSD Diabetologia e Malattie Metaboliche, ASL 4 Chiavarese, Genova, Italy. 14. UOSD Diabetologia, Ospedale San Salvatore, L'Aquila, Italy. 15. UO di Diabetologia Ravenna, A. Usl Romagna, Italy. 16. UOC Diabetologia, ASL 6, Livorno, Italy. 17. UOC Diabetologia e Dietologia, Ospedale S. Pertini, Roma, Italy. 18. Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Italy. 19. ASL Torino 5, Chieri, Italy. 20. Endocrinologia e Malattie Metaboliche, Università di Palermo, Italy. 21. Unità di Epidemiologia e Prevenzione, Fondazione IRCCS, Istituto Nazionale Tumori, Milano, Italy. 22. Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Italy. 23. Dipartimento di Medicina Clinica e Sperimentale, Università di Parma, Italy. 24. DIMI, Università di Genova, IRCCS San Martino, Italy. 25. UOSD, Presidio Ospedaliero di Atri, Italy. 26. SSD Diabetologia, ASL 1, Massa Carrara, Italy. 27. MISEM, Università di Perugia, Italy. 28. Dipartimento di Medicina dei Sistemi, Università degli Studi di Roma "Tor Vergata", Italy. 29. Dipartimento di Medicina Interna, Policlinico di Messina, Italy. 30. Dipartimento di Medicina Clinica e Molecolare, Università "La Sapienza", Roma, Italy. 31. DPT Medicina, Università degli Studi di Padova, Italy. 32. USC Malattie Endocrine e Diabetologia, AO Papa Giovanni XXIII, Bergamo, Italy. 33. SOC di Endocrinologia e Malattie del Metabolismo, AOU S. Maria della Misericordia, Udine, Italy. 34. UO Malattie Metaboliche, Dietologia e Nutrizione Clinica, AOU Arcispedale S. Anna, Ferrara, Italy. 35. UO di Diabetologia, Ospedale di Prato, Italy. 36. Dipartimento di Patologia Sperimentale, Ospedale di Desio, Università di Milano Bicocca, Italy. 37. Dipartimento di Medicina Clinica e Chirurgia, Università "Federico II" di Napoli, Italy. Electronic address: ovaccaro@unina.it.
Abstract
BACKGROUND AND AIMS: Diabetic women have a more adverse plasma lipid profile than men. Sex differences in dietary habits may play a role, but are little investigated. The study evaluates the quality of diet, adherence to the nutritional recommendations of the Diabetes and Nutrition Study Group and their relation with plasma lipid in men and women with diabetes. METHODS AND RESULTS: We studied 2573 people, aged 50-75, enrolled in the TOSCA.IT study (clinicaltrials.gov; NCT00700856). Plasma lipids were measured centrally. Diet was assessed with a semi-quantitative food frequency questionnaire. Women had a more adverse plasma lipid profile than men. Women consumed significantly more legumes, vegetables, fruits, eggs, milk, vegetable oils, and added sugar, whereas men consumed more starchy foods, soft drinks and alcoholic beverages. This stands for a higher proportion (%) of energy intake from saturated fat and added sugar (12.0 ± 2.4 vs 11.5 ± 2.5 and 3.4 ± 3.2 vs 2.3 ± 3.2, P < 0.04), and a higher intake of fiber (11.2 ± 2.8 vs 10.4 ± 2.6 g/1000 Kcal/day) in women. Adherence to the recommendations for saturated fat and fiber consumption was associated with significantly lower LDL-cholesterol regardless of sex. Adherence to the recommendations for added sugars was associated with significantly lower triglycerides and higher HDL-cholesterol in men and women. CONCLUSIONS:Men and women with diabetes show significant differences in adherence to nutritional recommendations, but sex differences in plasma lipid profile are unlikely to be explained by nutritional factors. Adherence to the nutritional recommendations is associated with a better plasma lipid profile regardless of sex, thus reinforcing the importance of substituting saturated for unsaturated fat sources, increasing fiber and reducing added sugar intake.
RCT Entities:
BACKGROUND AND AIMS: Diabeticwomen have a more adverse plasma lipid profile than men. Sex differences in dietary habits may play a role, but are little investigated. The study evaluates the quality of diet, adherence to the nutritional recommendations of the Diabetes and Nutrition Study Group and their relation with plasma lipid in men and women with diabetes. METHODS AND RESULTS: We studied 2573 people, aged 50-75, enrolled in the TOSCA.IT study (clinicaltrials.gov; NCT00700856). Plasma lipids were measured centrally. Diet was assessed with a semi-quantitative food frequency questionnaire. Women had a more adverse plasma lipid profile than men. Women consumed significantly more legumes, vegetables, fruits, eggs, milk, vegetable oils, and added sugar, whereas men consumed more starchy foods, soft drinks and alcoholic beverages. This stands for a higher proportion (%) of energy intake from saturated fat and added sugar (12.0 ± 2.4 vs 11.5 ± 2.5 and 3.4 ± 3.2 vs 2.3 ± 3.2, P < 0.04), and a higher intake of fiber (11.2 ± 2.8 vs 10.4 ± 2.6 g/1000 Kcal/day) in women. Adherence to the recommendations for saturated fat and fiber consumption was associated with significantly lower LDL-cholesterol regardless of sex. Adherence to the recommendations for added sugars was associated with significantly lower triglycerides and higher HDL-cholesterol in men and women. CONCLUSIONS:Men and women with diabetes show significant differences in adherence to nutritional recommendations, but sex differences in plasma lipid profile are unlikely to be explained by nutritional factors. Adherence to the nutritional recommendations is associated with a better plasma lipid profile regardless of sex, thus reinforcing the importance of substituting saturated for unsaturated fat sources, increasing fiber and reducing added sugar intake.
Authors: M Vitale; M Masulli; A A Rivellese; E Bonora; F Cappellini; A Nicolucci; S Squatrito; D Antenucci; A Barrea; C Bianchi; F Bianchini; L Fontana; P Fornengo; F Giorgino; A Gnasso; E Mannucci; A Mazzotti; R Nappo; A P Palena; P Pata; G Perriello; S Potenziani; R Radin; L Ricci; F Romeo; C Santini; M Scarponi; R Serra; A Timi; A A Turco; M Vedovato; D Zavaroni; S Grioni; G Riccardi; O Vaccaro Journal: Eur J Nutr Date: 2016-12-21 Impact factor: 5.614
Authors: Michelle M Keck; Helize Vivier; Jeffrey E Cassisi; Robert D Dvorak; Michael E Dunn; Sandra M Neer; Emily J Ross Journal: Nutrients Date: 2020-07-11 Impact factor: 5.717