Non‐diabetic relatives of Type 2 diabetic families: dietary intake contributes to the increased risk of diabetes

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Abstract
Aims Non‐diabetic first degree relatives of Type 2 diabetic patients are at increased risk of developing diabetes and cardiovascular disease. This is assumed to reflect a shared genetic predisposition. The aim of this study was to test the hypothesis that lifestyle factors, specifically dietary factors, are also important to the increased risk in non‐diabetic relatives. Methods Dietary intake was assessed using a validated food frequency questionnaire in 149 non‐diabetic first degree relatives (age 20–65 years) from families of North European extraction with two or more living Type 2 diabetic family members, and 143 age‐ and sex‐matched control subjects from the background population with no family history of diabetes. Results Relatives reported higher absolute intakes of total fat (mean (95% confidence intervals) 83 (76–91) vs. 71 (66–76) g/day, P = 0.01), saturated fat (SFA; 39 (36–43) vs. 33 (30–36) g/day, P < 0.01) and cholesterol (391 (354–427) vs. 318 (287–349) mg/day, P < 0.01), and a lower intake of non‐starch polysaccharide (P < 0.05). Considered as percentage of total daily energy intake, relatives had higher intakes of total fat (P < 0.01) and SFA (P < 0.02), and a lower intake of carbohydrate (P < 0.02). These differences remained after exclusion of suspected under‐ and over‐reporters of dietary intake. Conclusions Non‐diabetic relatives of Type 2 diabetic patients were found to consume diets that will promote rather than prevent the development of diabetes and cardiovascular disease. This suggests that the increased risk to non‐diabetic relatives is therefore not entirely genetic, and there is scope for decreasing the risk through lifestyle modification. Diabet. Med. 18, 984–990 (2001)