Eating patterns aligning with the Mediterranean or DASH diet may reduce cardiovascular disease risk in adults with type 1 diabetes, according to a six-year study.
The DASH and Mediterranean diets are both considered heart-healthy. They emphasize plant-based foods, healthy fats, lean proteins, and low intake of processed foods and sugars.
“Individuals with type 1 diabetes are at a higher risk of developing cardiovascular disease, which increases the chances of experiencing heart attacks, strokes, and other serious health issues,” explained Dr. Arpita Basu, who is an associate professor in the Department of Kinesiology and Nutrition Sciences at the University of Nevada. “Our study aimed to understand the impact of people’s regular eating habits on blood inflammatory markers, which can predict the risk of cardiovascular disease in adults with type 1 diabetes.”
“Both the DASH and Mediterranean diets showed protective associations, indicating that these dietary patterns can make a difference when consumed regularly,” said Basu. “Our findings are more practical than those from clinical studies of these diets because they typically involve manipulating dietary behaviour in a way that may not be sustainable in daily life.”
The new study builds on previous research that demonstrated a connection between DASH and Mediterranean dietary patterns and reduced fat accumulation around the heart in adults, both with and without type 1 diabetes. These dietary patterns were also linked to lower chances of coronary artery calcification, an advanced form of heart disease, in adults without diabetes.
“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,” Basu said.
During the six-year study, 1,255 adults were involved, including 563 with type 1 diabetes and 692 without diabetes. Researchers used a food frequency questionnaire to assess their diet to gather information on different food groups. This data was then used to calculate nutrient intake over the six-year period and evaluate how closely participants’ dietary patterns matched three commonly used diets for managing cardiovascular disease: the Mediterranean diet, the alternative healthy eating index (AHEI), and DASH.
The researchers also analyzed a variety of blood markers commonly used in clinical settings to assess cardiovascular disease risk and inflammation. These markers included C-reactive protein (CRP), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), and homocysteine (Hcy).
The study found that people who followed diets more in line with the DASH and Mediterranean patterns and therefore scored higher on those indices had lower levels of Hcy and PAI-1. This was after taking into account other demographic and lifestyle factors such as body mass index, age, total caloric intake, blood lipids, blood pressure, smoking, and physical activity. However, no associations were found between AHEI scores and any of the biomarkers studied.
The researchers note that although Hcy has been consistently shown to increase cardiovascular disease risk, its association with dietary patterns has not been previously studied in type 1 diabetes.
The analysis also revealed that adults with type 1 diabetes generally consume a high-fat diet, mostly as a consequence of decreasing carbohydrates and increasing animal protein foods that are high in saturated fats and cholesterol.
Basu emphasized the critical importance of addressing dietary quality in adults with type 1 diabetes. In a clinical setting, using the DASH and Mediterranean dietary checklists to assess dietary intakes 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 incorporated into the diet even if the entire diet cannot be altered.