medwireNews: Increasing polyunsaturated fatty acid (PUFA) intake may decrease all-cause and cardiovascular mortality risk in people with type 2 diabetes, shows research published in The BMJ.
Qi Sun (Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA) and co-authors say their findings “highlight the important role of quality of dietary fat in the prevention of cardiovascular disease and total mortality among adults with type 2 diabetes.”
The analysis was based on food frequency questionnaire data for 11,264 people with type 2 diabetes who were participating in the Nurses’ Health Study (1980–2014) or Health Professionals Follow-Up Study (1986–2014).
During a mean follow-up period of 11 years, 2502 participants died, including 646 who died of cardiovascular causes.
After adjustment for age and sex, increasing PUFA intake was associated with decreasing cardiovascular and all cause mortality risk, such that people in the highest quartile of intake had significant 26% and 39% lower risks for death, respectively, relative to those in the lowest quartile.
Similar results were observed when the researchers further adjusted the analysis for several more potential confounders including BMI, smoking status, family history of diabetes and heart disease, and total energy intake, using a model that that assumed increased fat intake would substitute an equivalent proportion of calories from carbohydrates.
Intakes of saturated and trans FAs were positively associated with cardiovascular and all-cause mortality risk in the age- and sex-adjusted model, but not in the fully adjusted model.
Monounsaturated (MU)FAs were not significantly associated with either outcome overall but higher intake of MUFAs from animal sources was associated with a significantly increased risk for all-cause mortality and a nonsignificantly increased risk for cardiovascular disease mortality.
Among the specific PUFAs measured, having a marine n-3 PUFA intake in the highest quartile was associated with a 29% lower risk for all-cause mortality and a 31% lower risk for cardiovascular mortality compared with the lowest quartile, after full multivariate adjustment.
The highest level of linoleic acid intake was associated with a significant 19% reduction in all-cause mortality risk relative to the lowest intake but was not associated with a significant reduction in cardiovascular mortality risk in the fully adjusted analysis.
When the researchers investigated the theoretical effects of substituting energy from saturated fats with equivalent energy from other fats, they found that all-cause and cardiovascular mortality rates were a significant 12% and 13% lower when 2% of energy from saturated FAs was isocalorically replaced with total PUFAs.
They also report that replacing saturated FAs with linoleic acid lowered cardiovascular mortality risk by a significant 15%.
Sun et al therefore conclude: “Increasing dietary PUFAs, especially linoleic acid and marine n-3 PUFAs, in replacement of saturated fatty acids, may facilitate long term survival among patients with diabetes.”
By Laura Cowen
medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group
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