O-43: The role of dietary macronutrient composition in vascular function and myocardial structure in type 1 diabetes: the CARDEA study
C Savard, S Harnois-Leblanc, F Luterbacher, V Drapeau, A M Nuyt, M Domaltov, M G Friedrich, J -L Bigras, A Van Hulst, T A Barnett, A Benedetti, M -È Matthieu, M HendersonAbstract
Introduction
The role of diet in the prevention of adult cardiovascular disease (CVD) is well recognised, but evidence of its impact on early markers of CVD in youth with type 1 diabetes (T1D) is scarce.
Objectives
To investigate associations between macronutrient intake and vascular function and myocardial structure in adolescents with T1D and healthy controls.
Methods
In this cross-sectional study, we recruited 100 participants with T1D aged 14-18 years and 97 age and sex-matched healthy controls, in Montreal, Canada. Early markers of CVD include arterial stiffness (pulse wave velocity), endothelial function (velocity-time integral and acceleration during a flow-mediated dilation test) and myocardial structure using MRI (left ventricular (LV) mass/height, papillary mass, and LV wall thickness). We investigated % total energy intake (TEI) from carbohydrate, fat, saturated fat, total sugar, and fiber intake (g), derived from 3 × 24-h dietary recalls. Linear regression models were adjusted for age, sex, ethnicity, parental education, physical activity, sedentary time and heart rate (vascular outcomes), stratified by T1D status.
Results
Mean (SD) daily TEI was lower in youth with T1D compared to controls (1861 (540) vs 2098 (684) kcal), with similar macronutrient distribution across groups. Higher %TEI from carbohydrate was associated with lower acceleration (β [ 95% CI] per %TEI: -9.25 [-15.47; -3.04] cm/s2), and greater %TEI from fat and saturated fat intake were associated with higher acceleration (11.44 (3.46; 19.42) cm/s2) and 24.16 (7.32; 41.00) cm/s2, respectively). Higher %TEI from protein was associated with a higher LV wall thickness (0.15 [0.04; 0.27] mm). We found these associations in youth with T1D only.
Conclusions
Our findings suggest that lower carbohydrate and higher fat intake, relative to TEI, may benefit endothelial function based on acceleration in youth with T1D. Similar associations for arterial stiffness in adults support a potential role of macronutrient composition in vascular health in T1D.