PP.02.41: THE EFFECT OF IMPROVING DIETARY QUALITY ON MEASURES OF VASCULAR STRUCTURE AND FUNCTION IN A WELL-CONTROLLED POPULATION WITH DIABETES. (June 2015)

• Record Type: Journal Article
• Authors: Petersen, K.; Keogh, J.; Blanch, N.; Clifton, P.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000467781.40035.36
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: The aim was to determine if increasing fruit (+1 serve; 150 g/day), vegetable (+2 serves; 150 g/day) and dairy (+1 serve; 200–250 g/day) intake slows carotid intima media thickness (cIMT) progression, compared to a control group continuing on their usual diet, in people with type 1 and type 2 diabetes after 12 months. Secondary outcome measures were peripheral and central blood pressure, augmentation index (AI) and pulse wave velocity (PWV). Design and method: A 12 month randomized controlled trial was conducted. The primary outcome was mean cIMT, measured at baseline and 12 months using B mode ultrasound. Secondary outcomes were peripheral and central blood pressure, AI and PWV, measured at baseline, 3, 6, 9 and 12 months. Participants in the intervention group received dietary counselling from a dietitian at baseline, 1, 3, 6, 9 and 12 months and compliance was measured using a food frequency questionnaire administered at baseline, 3 and 12 months. Data were analysed using mixed effect modelling. Results: Ninety- five participants completed the study. At baseline mean HbA1c was 7.2±1.4% and blood pressure (127/71mmHg), total (3.5±0.9mmol/L) and LDL cholesterol (1.7±0.7mmol/L) were within the recommendations as defined by the 2013 ESC/EASD guidelines and approximately 60% of the cohort was taking an anti-hypertensive or lipid lowering medication. Vegetable (59 g; 95% CI 25, 94 g; p=0.001) and fruit (197 g; 95% CI 130, 264 g; p=0.0001) intake were increased at 3 months in the intervention group, compared to the control group. This increase was not maintained at 12 months but intake increased overall in the cohort (fruit 53 g/day; vegetables 17 g/day; p<0.01). An increase in dairy consumption was not achieved but yogurt intake was higher in the intervention group at 3 months (36 g; 95% CI 6, 66 g; p=0.02); this was not maintained at 12 months. At 12 months cIMT regressed (-0.01±0.04 mm; p<0.001) with a greater effect in the treatment group (-0.02±0.04 mm vs. -0.005±0.04 mm; p=0.045). Baseline HbA1c was an independent predictor of cIMT change. There was no time by treatment effect for peripheral and central blood pressure, AI or PWV. Conclusions: Improving dietary quality in well-controlled people with diabetes may slow cIMT progression.