Cross-sectional associations between dietary intake and carotid intima media thickness in type 2 diabetes: baseline data from a randomised trial

Objective: To assess associations between dietary intake and carotid intima media thickness (CIMT) by carotid ultrasound (CUS), a surrogate marker of cardiovascular disease (CVD) risk, in those with type 2 diabetes. Design: Cross-sectional analysis of baseline data from 325 participants from three randomised controlled trials collected in the same way. Setting: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada. Participants: 325 participants with type 2 diabetes, taking oral antidiabetic agents, with an HbA1c between 6.5% and 8.0% at screening, without a recent cardiovascular event. Main outcome measures: CIMT by CUS and associations with dietary intake from 7-day food records, as well as anthropometric measures and fasting serum samples. Results: CIMT was significantly inversely associated with dietary pulse intake (beta=-0.019, p=0.009), available carbohydrate (beta=-0.004, p=0.008), glycaemic load (beta=-0.001, p=0.007) and starch (beta=-0.126, p=0.010), and directly associated with total (beta=0.004, p=0.028) and saturated (beta=0.012, p=0.006) fat intake in multivariate regression models adjusted for age, smoking, previous CVD event, blood pressure medication, antidiabetic medication and ultrasonographer. Conclusions: Lower CIMT was significantly associated with greater consumption of dietary pulses and carbohydrates and lower total and saturated fat intake, suggesting a potential role for diet in CVD risk management in type 2 diabetes. Randomised controlled trials are anticipated to explore these associations further.