BACKGROUND AND PURPOSE:

• Cardiovascular disease is the leading cause of death in adults with diabetes
• Current guidelines recommend that patients with diabetes limit their intake of saturated fatty acids, trans fats, and cholesterol, and consume more omega-3s
  • Recommendations based on general population with limited data from individuals with type 2 diabetes
• Jiao et al. (BMJ, 2019) sought to determine the association between dietary fatty acids, CVD mortality, and total mortality among patients with type 2 diabetes

METHODS:

• Prospective, longitudinal cohort study
• Participants: Patients with type 2 diabetes
  • Females: Nurses’ Health Study (1980-2014)
  • Males: Health Professionals Follow-Up Study (1986-2014)
• Exposures
  • Dietary fat intake assessed using validated food frequency questionnaires
  • Updated every 2 to 4 years
• Primary outcomes
  • Total mortality
  • CVD mortality

RESULTS:

• 11,264 participants included in the 2 cohorts
• Mortality risk was calculated using hazard ratio (HRs) across quarters of PUFA intake (multivariate analysis model)
  • HR ratios for mortality trended down with increasing polyunsaturated fatty acids (PUFA) intake for both CVD mortality (P for trend=0.03) and total mortality (P for trend<0.001)
• Inverse associations with total mortality were also observed for intakes of total PUFAs, marine n-3 PUFAs, and linoleic acid
• Monounsaturated fatty acids of animal, but not plant, origin associated with a higher total mortality
• Theoretical models: Substituting PUFAs for other fats (same calories) demonstrated that replacing 2% of energy from saturated fatty acids with total PUFAs or linoleic acid was associated with lower CVD mortality
  • Total PUFAs: 13% lower CVD mortality (HR 0.87, 95% CI, 0.77 to 0.99)
  • Linoleic acid: 15% lower CVD mortality (HR 0.85, 95% CI, 0.73 to 0.99)
• A 2% replacement of energy from saturated fatty acids with total PUFAs was associated with lower total mortality
  • Total PUFAs: 12% lower total mortality (HR 0.88, 95% CI, 0.83 to 0.94)

CONCLUSION:

• Authors conclude that PUFAs, primarily linoleic acid and marine n-3 PUFAs, are preferable to saturated fats and carbohydrates for those individuals with type 2 diabetes

Our results suggest that dietary PUFAs, in replacement of saturated fatty acids or carbohydrates, may facilitate long term survival among adults with type 2 diabetes

Learn More – Primary Sources:

Dietary fats and mortality among patients with type 2 diabetes: analysis in two population based cohort studies

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