Dietary Macronutrient Intakes and Mortality among Patients with Type 2 Diabetes
Open Access
- 3 June 2020
- Vol. 12 (6), 1665
- https://doi.org/10.3390/nu12061665
Abstract
The best macronutrient percentages of dietary intake supporting longevity remains unclear. The strength of association between dietary intake and mortality in patients with type 2 diabetes (T2DM) should be quantified as a basis for dietary recommendations. Our study cohort consisted of 15,289 type 2 diabetic patients aged 30 years and older in Taiwan during 2001–2014 and was followed up through 2016. Percentages of macronutrient intakes were calculated as dietary energy intake contributed by carbohydrate, protein, and fat, divided by the total energy intake using a 24 h food diary recall approach. Cox proportional hazard models were applied to examine the temporal relation of macronutrient intakes with all-cause and cause-specific mortality. The average follow-up time was 7.4 years, during which 2784 adults with T2DM died. After multivariable adjustment, people with fourth and fifth quintiles of total energy, second and third quintiles of carbohydrate, and fourth quintiles of protein intakes were likely to have lower risks of all-cause and expanded cardiovascular disease (CVD) mortality. People with fifth quintiles of total energy intake were likely to have decreased non-expanded CVD mortality. We found a significant interaction between gender and fat intake on all-cause and expanded CVD mortality. Fat intake was associated with all-cause, expanded and non-expanded CVD mortality among males with T2DM. Total energy, carbohydrate, and protein intakes were associated with lower risks of all-cause and expanded CVD mortality, with minimal risks observed at ≥1673 Kcal total energy, 43–52% carbohydrate intake, and 15–16% protein intake among people with T2DM.Keywords
This publication has 30 references indexed in Scilit:
- IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045Diabetes Research and Clinical Practice, 2018
- The cost of diabetes in Latin America and the Caribbean in 2015: Evidence for decision and policy makersJournal of Global Health, 2017
- Diabetes in Asia and the Pacific: Implications for the Global EpidemicDiabetes Care, 2016
- Appropriate physical activity and dietary intake achieve optimal metabolic control in older type 2 diabetes patientsJournal of Diabetes Investigation, 2013
- Total Energy Intake May Be More Associated with Glycemic Control Compared to Each Proportion of Macronutrients in the Korean Diabetic PopulationDiabetes & Metabolism Journal, 2012
- Globalization of DiabetesDiabetes Care, 2011
- Diabetes in AsiaThe Lancet, 2009
- Ten-Year Mortality and Cardiovascular Morbidity in the Finnish Diabetes Prevention Study—Secondary Analysis of the Randomized TrialPLOS ONE, 2009
- Epidemiology of Diabetes and Diabetes-Related ComplicationsPTJ: Physical Therapy & Rehabilitation Journal, 2008
- Multifactorial Intervention and Cardiovascular Disease in Patients with Type 2 DiabetesThe New England Journal of Medicine, 2003