1372-P: Association between Fat Intake as the Percent of Total Energy and Incidence of Cardiovascular Disease in Persons with Type 2 Diabetes—Japan Diabetes Complication and Its Prevention Prospective Study (JDCP Study)

Previous systematic reviews showed benefits of low-carbohydrate eating plans compared with low-fat eating plans in the treatment of diabetes (T2D) on parameters of cardiovascular disease (CVD) risk. However, studies on the relationship between fat intake as the % of total energy (F%E) and incidence of CVD in persons with T2D are insufficient. Therefore, we investigated this relationship as part of the JDCP study, a nationwide study launched in 2007. A total of 1477 persons with T2D aged 40-75 years completed a brief self-administered Diet History Questionnaire at baseline, and we analyzed the resultant data. Primary outcome was the 7-year risk of a CVD event. Hazard ratios for CVD according to quartiles of F%E (Q1-4) were estimated by Cox regression adjusted for confounders including sex, age, various laboratory tests, medication use, smoking history, drinking habits, physical activity, energy intake, protein intake, dietary fiber intake, and sodium intake. Mean F%E in Q1 to Q4 were 16.6%E, 21.8%E, 25.4%E, and 30.9%E, respectively. HbA1c, body mass index, triglycerides, and blood pressure were well controlled. No significant associations between F%E and incidence of CVD were shown for Q2, Q3, and Q4 relative to Q1 (Q2: 1.03 [95% CI, 0.47-2.28], Q3: 1.27 [0.58-2.76], and Q4: 1.10 [0.44-2.73]). Stratified analysis by sex and age also showed no significant difference between F%E and incidence of CVD. When %E from saturated fatty acids (SFA%E) was analyzed according to quartiles 1 and 4 SFA%E values were 4.9%E and 7.1%E, respectively. There were no significant differences in incidence of CVD among quartiles (Q1: Reference, Q2: 1.31 [0.66-2.61], Q3: 0.47 [0.18-1.25], and Q4: 1.02 [0.44-2.39]). Findings suggested that most Japanese with T2D during the study period consumed < 30% of F%E and <10% of SFA%E. No significant differences in incident CVD were observed within these ranges.