Nutritional habits of subjects with Type 2 diabetes mellitus in the Mediterranean basin: comparison with the non-diabetic population and the dietary recommendations. Multi-centre study of the Mediterranean group for the study of Diabetes (MGSD)

Aims/hypothesis. The aim of this study was to compare the nutritional habits of Type 2 diabetic patients among Mediterranean countries and also with those of their background population and with the nutritional recommendations of the Diabetes and Nutrition Study Group. Methods. We did a cross-sectional study of 1833 nondiabetic subjects and 1895 patients with Type 2 diabetes, in nine centres in six Mediterranean countries. A dietary questionnaire validated against the 3-Day Diet Diary was used. Results. In diabetic patients the contribution of proteins, carbohydrates and fat to the energy intake varied greatly among centres, ranging from 17.6% to 21.0% for protein, from 37.7% to 53.0% for carbohydrates and from 27.2% to 40.8% for fat, following in every centre the trends of the non-diabetic population. Furthermore, diabetic patients compared to the corresponding background population had: (i) lower energy intake, (ii) lower carbohydrate and higher protein contribution to the energy intake, (iii) higher prevalence of obesity, ranging from 9 to 50%. The adherence to the nutritional recommendations for proteins, carbohydrate and fat was very low ranging from 1.4 to 23.6%, and still decreased when fibre was also considered. Conclusion/interpretation. In diabetic patients of the Mediterranean area: (i) dietary habits vary greatly among countries, according to the same trends of the background population; (ii) the prevalence of obesity is much lower than the 80% reported for patients with diabetes in Western countries; (iii) Carbohydrate intake is decreased with a complementary increase of protein and fat consumption, resulting to a poor compliance with the nutritional recommendations.