Dietary pattern and mortality in Japanese elderly patients with type2 diabetes mellitus: Does a vegetable- and fish-rich diet improve mortality? An explanatory study

摘要

Aim: To assess the effect of dietary patterns on all deaths and diabetes-related deaths in the Japanese Elderly Diabetes Intervention Trial (J-EDIT). Methods: We investigated relationships between that of overall mortality and dietary pattern, and diabetes-related deaths and dietary pattern as observed among 912 registered cases of the J-EDIT study, which is a prospective follow-up study of elderly Japanese type2 diabetic patients. Results: Factor analysis with the factor number 3 led to deriving three dietary patterns (healthy type, snack type and greasy type). The relationship between these patterns and overall mortality or diabetes-related death was investigated. Although not statistically significant, there was a lower tendency of overall mortality and diabetes-related deaths for the healthy type dietary pattern. When the tendencies of overall mortality were analyzed for "young-old," who are younger than 75years-of age, and "old-old" of over 75years-of-age, the mortality rate for the greasy type and healthy type dietary patterns were nearly the same and higher than the snack type dietary pattern in young-old. In contrast, in old-old, a higher mortality rate was reported for the greasy type dietary pattern and a lower mortality rate was reported for the healthy type dietary pattern. The hazard ratio by Cox regression analysis for greasy type to healthy type in old-old was 3.03 (P=0.04, CI 1.07-8.57). Furthermore, in old-old, as vegetable consumption increased, the lower the tendency foroverall mortality, and the more fish that was consumed, the overall mortality significantly decreased (P=0.020) in the tertile. Conclusions: The greasy type dietary pattern with an increased amount of sugar, fat and meat led to poor life prognosis for elderly Japanese type2 diabetic patients. The healthy type dietary pattern rich in vegetable and fish, which is similar to the Mediterranean diet and Dietary Approach to Stop Hypertension diet, was suggested to improve life prognosis.