Mediterranean, DASH Diets May Lower Risk of Cardiovascular Disease in Patients with T1D

Patients with type 1 diabetes who have higher adherence to guidelines from the Mediterranean or dietary approaches to stop hypertension (DASH) diets may have a lower risk of cardiovascular disease, according to new data. The study builds on earlier work from the researchers and was presented at Nutrition 2024, the American Society for Nutrition’s annual meeting held June 29 to July 2 in Chicago, Illinois.¹

Cardiovascular disease is the leading cause of death in patients with diabetes and results in two-thirds of deaths in those with type 2 diabetes.² Patients with diabetes are also 2 to 4 times more likely to develop cardiovascular disease, including heart disease and stroke.³ However, research has shown that lifestyle changes, such as exercise and eating a healthy diet, can reduce the risk of cardiovascular disease in patients with diabetes.⁴

“There is an urgent need to address dietary quality in adults with type 1 diabetes,” Arpita Basu, PhD, RD, lead author on the study, said in a release.⁵ “In a clinical setting, assessing dietary intakes using the DASH and Mediterranean dietary checklists could be an effective way to identify gaps and improve intakes. Specific foods that are part of these dietary patterns, such as olives and nuts in the Mediterranean diet, could be added to the diet even if the entire diet cannot be altered.”

READ MORE: GLP-1 Use and Risk of Cardiovascular Events in Different Patient Populations

A team of investigators from the University of Nevada at Las Vegas conducted a study to assess the association between inflammation and diet in patients with type 1 diabetes. Data for the 6-year longitudinal analysis was gathered from the Coronary Artery Calcification in Type 1 Diabetes study, which examined risk factors and incidence of cardiovascular complications in those with type 1 diabetes.

The study cohort included 1255 participants, of which 563 had type 1 diabetes and 692 did not have diabetes. The participants completed a validated food frequency questionnaire, as well as a physical examination and a fasting biochemical analyses. Serum samples were collected at baseline, year 3, and year 6 to determine biomarkers of inflammation and atherosclerosis, including C-reactive protein (CRP), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), and homocysteine (Hcy).

Dietary scores were calculated using 3 diets: the alternative healthy eating index (AHEI), DASH, and Mediterranean.

Investigators found that patients who ate diets that aligned closer to DASH and Mediterranean guidelines had lower levels of both Hcy and PAI-1. However, the were no associations with AHEI and any of the biomarkers. Additionally, the data showed that patients with type 1 diabetes are more likely to consume a higher fat diet, due to cutting out carbohydrates and increasing intake of animal protein sources.

The authors noted that the findings support the role of the studied dietary patterns in reducing the risk of atherosclerosis, particularly in patients with type 1 diabetes.

“Both DASH and Mediterranean diets revealed protective associations, which means these dietary patterns can make a difference when consumed regularly,” Basu said.⁵ “Our findings are more practical than those from clinical studies of these diets because those usually manipulate dietary behavior in a way that may not be sustainable in daily life. This new study reports the protective associations of these diets with selected blood cardiovascular disease markers that may explain our previous findings and provide new data on how diet affects inflammation in type 1 diabetes.”

READ MORE: Diabetes Resource Center

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References

1. Basu A, Richardson LA, Alman AC, et al. Longitudinal Associations of Healthy Dietary Patterns With Biomarkers of Inflammation and Atherosclerosis in Adults With and Without Type 1 Diabetes. Presented at: Nutrition 2024; June 29-July 2, 2024; Chicago, IL. Abstract P13-008-24.

2. Cardiovascular Disease. American Diabetes Association. Accessed July 3, 2024. https://diabetes.org/about-diabetes/complications/cardiovascular-disease

3. Diabetes and Heart Disease. Johns Hopkins Medicine. Accessed Jul 3, 2024. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/diabetes-and-heart-disease

4. AlAufi NS, Chan YM, Waly MI. Application of Mediterranean Diet in Cardiovascular Diseases and Type 2 Diabetes Mellitus: Motivations and Challenges. Nutrients. 2022 Jul 5;14(13):2777. doi: 10.3390/nu14132777. PMID: 35807957; PMCID: PMC9268986.

5. Research Uncovers Heart-Protective Eating Patterns for Type 1 Diabetes. News Release. American Society for Nutrition. June 30, 2024. Accessed July 3, 2024. https://www.eurekalert.org/news-releases/1048928