Fat intake in patients newly diagnosed with type 2 diabetes: a 4-year follow-up study in general practice

Although treatment targets for the consumption of dietary fat in patients with type 2 diabetes mellitus are well accepted, little is known about the actual fat consumption by newly diagnosed patients or the dietary adjustments that they make in the following years. To measure fat intake in patients with type 2 diabetes in general practice at diagnosis, shortly after dietary consultation, and after 4 years. A prospective cohort study. Thirty-three general practices in The Netherlands. One hundred and forty-four patients with newly diagnosed type 2 diabetes were referred to a dietician, and fat consumption (the main outcome measure) was assessed with a 104-item food frequency questionnaire at diagnosis, 8 weeks following diagnosis, and after 4 years. Reference values for fat consumption were obtained from an age-matched sample of a population-based survey. At diagnosis, total energy intake was 10.6 MJ/day and cholesterol intake was 300 mg/day. Total fat consumption was 40.9% of energy intake, with saturated fatty acids 15.0%, monounsaturated fatty acids 14.3%, and polyunsaturated fatty acids 9.2% of energy intake. All levels, except for polyunsaturated fatty acids, were significantly unfavourable compared with those for the general population. After 8 weeks, consumption of saturated fatty acids had decreased to a lower level than in the general population and all other levels measured were similar to those for the general population. After 4 years there was a slight increase in the consumption of total fat and monounsaturated fatty acids, but cholesterol and saturated fatty acid consumption had decreased further. Patients with newly diagnosed type 2 diabetes have an unfavourable fat consumption at diagnosis. They adapt to a more desirable consumption shortly after diagnosis, and this improved dietary behaviour is sustained for 4 years. Recommendations regarding consumption of total and saturated fat are, in contrast to those for cholesterol, not met by patients in general practice.