Dietary habits in type II diabetes mellitus: how is adherence to dietary recommendations?

Objective: To clarify adherence of type II diabetic patients to dietary recommendations. Subjects and methods: The dietary habits of a group of 540 patients, with type II diabetes (male 322/female 218, mean age 61 +/- 75 years, body mass index (BMI) 29.7 +/- 5.2 kg/m(2); mean +/- s.d.) referring to six Italian diabetes centres were evaluated by means of a 3-day diet record (2 workdays, 1 holiday). Diet records were analysed according to Italian food composition tables and compared with the dietary recommendations of the Diabetes and Nutrition Study Group of the European Association for the study of Diabetes. Results: Calorie intake was 1725 +/- 497 kcal (1800 for men, 1610 for women). Mean intake for each nutrient was close to the recommended amount, except for fibre (12/1000 vs 20 g/1000 kcal). Calculating the percentage of patients who complied with each recommendation, the intakes of saturated fat and fibre least reflected the dietary target: in 43% of patients saturated fat was >10% of total calories, in only 6% was fibre intake >= 20 g/1000 kcal (considered ideal), and in 25% it was >= 15 g/1000 kcal (acceptable). Conclusions: These results indicate that compliance to dietary recommendations is not completely satisfactory, even in Italy. Calorie intake is a bit elevated, given the high BMI of our diabetic population. As to dietary composition, there are two crucial issues: the high intake of saturated fat and - most importantly - the low intake of fibre. All strategies aiming to a proper implementation of guidelines should take these results into due account.