Adults with type 1 diabetes eat a high-fat atherogenic diet that is associated with coronary artery calcium

Diabetologia. 2009 May;52(5):801-9. doi: 10.1007/s00125-009-1280-4. Epub 2009 Feb 14.


Aims/hypothesis: Coronary heart disease is the leading cause of mortality among people with type 1 diabetes. Diet is an important lifestyle factor that relates to risk of CHD. The aim of this study was to examine how diet and adherence to dietary guidelines differ between adults with and without type 1 diabetes, and their correlation with CHD risk factors and coronary artery calcium (CAC).

Methods: The study involved 571 people with type 1 diabetes and 696 controls, aged 19 to 56 years, who were asymptomatic for CHD. CAC was measured by electron-beam computed tomography.

Results: Compared with the controls, adults with type 1 diabetes reported a diet higher in fat, saturated fat and protein but lower in carbohydrates. Fewer than half of those with type 1 diabetes met dietary guidelines for fat and carbohydrate intake, and only 16% restricted saturated fat to less than 10% of daily energy intake. Adults with type 1 diabetes were significantly less likely to meet dietary guidelines than controls. Fat and saturated fat intakes were positively correlated, but carbohydrate intake was negatively correlated with CHD risk factors and HbA(1c). A high-fat diet and higher intake of protein were associated with greater odds of CAC, while higher carbohydrate intake was associated with reduced odds of CAC.

Conclusions/interpretation: Adults with type 1 diabetes reported consuming higher than recommended levels of fat and saturated fat. High fat intake was associated with increased CHD risk factors, worse glycaemic control and CAC. An atherogenic diet may contribute to the risk of CHD in adults with type 1 diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Atherosclerosis / epidemiology
  • Calcinosis / epidemiology
  • Calcinosis / mortality
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / etiology*
  • Coronary Disease / mortality
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / diagnostic imaging
  • Diabetes Mellitus, Type 1 / mortality
  • Diabetic Angiopathies / epidemiology*
  • Diet, Ketogenic / adverse effects*
  • Dietary Fats / adverse effects*
  • Feeding Behavior
  • Female
  • Humans
  • Insulin / therapeutic use
  • Lipids / blood
  • Male
  • Middle Aged
  • Risk Factors
  • Surveys and Questionnaires
  • Tomography, X-Ray Computed
  • Young Adult


  • Dietary Fats
  • Insulin
  • Lipids