Adherence to Mediterranean diet and advanced glycation endproducts in patients with diabetes

Table 1 Baseline parameters analysis according to cardiovascular risk groups derived from advanced glycation endproducts result

Parameter	None/limited CV risk (n = 99)	Increased/definite CV risk (n = 174)	Total (n = 273)	P value1
Male gender, n (%)	41 (41.4)	96 (55.2)	137 (50.2)	0.029
Age (yr)	67.6 ± 12.4	69.1 ± 11.8	68.5 ± 12.1	0.313
Disease duration (yr)	9.0 (3.0-18.0)	14.0 (6.0-21.0)	12.0 (5.0-20.0)	0.005
BMI (kg/m2)	29.2 ± 4.96	29.1 ± 4.85	29.2 ± 4.88	0.900
Neck circumference (cm)	38.7 ± 4.01	39.1 ± 4.17	38.9 ± 4.11	0.409
Waist circumference (cm)	98.1 ± 12.7	97.8 ± 12.7	97.9 ± 12.6	0.870
Hip circumference (cm)	106.3 ± 9.5	105.5 ±10.5	105.8 ± 10.1	0.531
WHR	0.92 ± 0.07	0.93 ± 0.08	0.92 ± 0.08	0.575
Smokers, n (%)	12 (12.1)	41 (23.6)	53 (19.4)	0.022
Physical activity, n (%)
Not physically active	15 (15.2)	56 (32.2)	71 (26.0)	0.008
1-4 ×/mo	24 (24.2)	36 (20.7)	60 (22.0)
> 4 ×/mo	60 (60.6)	82 (47.1)	142 (52.0)
Therapy, n (%)
OHA	56 (56.6)	90 (51.7)	146 (53.5)	0.619
Insulin	14 (14.1)	26 (14.9)	40 (14.7)
OHA + insulin	23 (23.2)	49 (28.2)	72 (26.4)
GLP-1 based therapy	2 (2.0)	6 (3.4)	8 (2.9)
No medications	4 (4.0)	3 (1.7)	7 (2.6)
HbA1c (%)	7.2 (6.5-8.5)	7.65 (6.8-8.8)	7.4 (6.7-8.8)	0.041

¹Chi-square test, Mann-Whitney test/t-test for independent samples. Data are presented as whole numbers (%), median (IQR) or mean ± SD. Bolded parameters signify statistically significant difference. AGE: Advanced glycation endproducts; OHA: Oral hypoglycemic agents; GLP: Glucagon-like peptide; HbA1c: Glycated haemoglobin.

Table 2 Adherence to individual food groups and total Mediterranean diet guidelines according to cardiovascular risk groups derived from advanced glycation endproducts levels

Parameter, n (%)	None/limited CV risk (n = 99)	Increased/definite CV risk (n = 174)	Total (n = 273)	P value1
Cereals	60 (60.6)	113 (64.9)	173 (63.4)	0.475
Potato	87 (87.9)	153 (87.9)	240 (87.9)	0.989
Olive oil	28 (28.3)	45 (25.9)	73 (26.7)	0.664
Nuts	23 (23.2)	22 (12.6)	45 (16.5)	0.023
Fresh fruit	36 (36.4)	57 (32.8)	93 (34.1)	0.546
Vegetables	10 (10.1)	13 (7.5)	23 (8.4)	0.453
Milk and dairy products	14 (14.1)	44 (25.3)	58 (21.2)	0.031
Legumes	40 (40.4)	45 (25.9)	85 (31.1)	0.013
Eggs	40 (40.4)	63 (36.2)	103 (37.7)	0.492
Fish	32 (32.3)	50 (28.7)	82 (30.0)	0.535
White meat	34 (34.3)	53 (30.5)	87 (31.9)	0.509
Red meat	39 (39.4)	88 (50.6)	127 (46.5)	0.075
Sweets	77 (77.8)	137 (78.7)	214 (78.4)	0.854
Wine	19 (19.2)	37 (21.3)	56 (20.5)	0.684
Total MDSS points	7.0 (6.0-10.75)	8.0 (6.0-10.0)	8.0 (6.0-10.0)	0.959

¹Chi-square test or Mann-Whitney test. Data are presented as whole numbers (%) or median (IQR). Bolded parameters signify statistically significant difference. MDSS: Mediterranean diet serving score.

Table 3 Adherence to individual food groups and total Mediterranean diet guidelines according to diabetes management

Parameter, n (%)	HbA1c > 7 % (n = 179)	HbA1c < 7 % (n = 94)	Total (n = 273)	P value1
Cereals	113 (63.1)	60 (63.8)	173 (63.4)	0.909
Potato	159 (88.8)	81 (86.2)	240 (87.9)	0.523
Olive oil	48 (26.8)	25 (26.6)	73 (26.7)	0.969
Nuts	27 (15.1)	18 (19.1)	45 (16.5)	0.390
Fresh fruit	57 (31.8)	36 (38.3)	93 (34.1)	0.286
Vegetables	15 (8.4)	8 (8.5)	23 (8.4)	0.971
Milk and dairy products	38 (21.2)	20 (21.3)	58 (21.2)	0.993
Legumes	50 (27.9)	35 (37.2)	85 (31.1)	0.115
Eggs	59 (33.0)	44 (46.8)	103 (37.7)	0.025
Fish	51 (28.5)	31 (33.0)	82 (30.0)	0.443
White meat	60 (33.5)	27 (28.7)	87 (31.9)	0.419
Red meat	86 (48.0)	41 (43.6)	127 (46.5)	0.487
Sweets	144 (80.4)	70 (74.5)	214 (78.4)	0.255
Wine	28 (15.6)	28 (29.8)	56 (20.5)	0.006
Total MDSS points	8.0 (6.0-10.0)	8.0 (6.0-11.0)	8.0 (6.0-11.0)	0.261

¹Chi-square test or Mann-Whitney test. Data are presented as whole numbers (%) or median (IQR). Bolded parameters signify statistically significant difference. MDSS: Mediterranean diet serving score.

Table 4 Adherence to individual food groups and total Mediterranean diet guidelines according to gender

Parameter, n (%)	Men (n = 137)	Women (n = 136)	Total (n = 273)	P value1
Cereals	97 (70.8)	76 (55.9)	173 (63.4)	0.011
Potato	120 (87.6)	120 (88.2)	240 (87.9)	0.871
Olive oil	37 (27.0)	36 (26.5)	73 (26.7)	0.920
Nuts	18 (13.1)	27 (19.9)	45 (16.5)	0.135
Fresh fruit	42 (30.7)	51 (37.5)	93 (34.1)	0.234
Vegetables	9 (6.6)	14 (10.3)	23 (8.4)	0.269
Milk and dairy products	33 (24.1)	25 (18.4)	58 (21.2)	0.250
Legumes	38 (27.7)	47 (34.6)	85 (31.1)	0.224
Eggs	59 (43.1)	44 (32.4)	103 (37.7)	0.068
Fish	43 (31.4)	39 (28.7)	82 (30.0)	0.626
White meat	43 (31.4)	44 (32.4)	87 (31.9)	0.864
Red meat	47 (34.3)	80 (58.8)	127 (46.5)	< 0.001
Sweets	103 (75.2)	111 (81.6)	214 (78.4)	0.197
Wine	46 (33.6)	10 (7.4)	56 (20.5)	< 0.001
Total MDSS points	8.0 (6.0-10.0)	8.0 (6.0-11.0)	8.0 (6.0-10.0)	0.485
Adherence to Mediterranean Diet	12 (8.8)	15 (11.0)	27 (9.9)	0.530

¹Chi-square test or Mann-Whitney test. Data are presented as whole numbers (%) or median (IQR). Bolded parameters signify statistically significant difference. MDSS: Mediterranean diet serving score.

Table 5 Correlation of Mediterranean diet serving score with selected parameters in study population (n = 273)

Parameter	MDSS score, r (P value1)
Age (yr)	0.054 (0.372)
Disease duration (yr)	0.179 (0.003)
BMI (kg/m2)	-0.159 (0.008)
Neck circumference (cm)	-0.001 (0.991)
Waist circumference (cm)	-0.010 (0.872)
Hip circumference (cm)	-0.017 (0.779)
WHR	-0.022 (0.723)
HbA1c (%)	-0.074 (0.220)
AGEs levels	-0.012 (0.839)

¹Spearman’s correlation coefficient. AGE: Advanced glycation endproducts; MDSS: Mediterranean diet serving score; BMI: Body mass index; WHR: Waist-to-hip ratio; HbA1c: Glycated hemoglobin.

Table 6 Multiple linear regression model of independent predictors for Mediterranean diet service score

Variable	Β1	SE2	t value	P value
Gender	-0.39	0.43	-0.92	0.354
Age (yr)	-0.002	0.02	-0.13	0.895
Disease duration (yr)	0.07	0.02	3.42	< 0.001
Body mass index (kg/m2)	-0.09	0.04	-2.11	0.037
HbA1c (%)	-0.07	0.13	-0.59	0.554
AGEs levels	-0.31	0.31	-1.05	0.311

¹Unstandardized coefficient β.

²Standard error.

AGE: Advanced glycation endproducts; HbA1c: Glycated hemoglobin.

Table 7 Dietary attitudes of studied population according to diabetes management

Questions	HbA1c > 7% (n = 179)	HbA1c < 7% (n = 94)	Total (n = 273)	P value1
Did you get diet information according to your illness from your physician (yes)	172 (96.1)	91 (96.8)	263 (96.3)	0.764
Have you visited a nutritionist to advise you on nutrition (yes)	26 (14.5)	20 (21.4)	46 (16.8)	0.157
Have you informed yourself on the Internet about the diet related to your illness (yes)	29 (16.2)	20 (21.4)	49 (17.9)	0.300
Do you think that a better and more controlled diet could reduce your health problems (yes)	156 (87.2)	86 (91.5)	242 (88.6)	0.331
Do you consider educational programs on nutrition to be useful for patients (yes)	177 (98.9)	87 (92.6)	264 (96.7)	0.009
If educational programs on nutrition existed in your community, would you visit them (yes)	145 (81.0)	78 (83.0)	223 (81.7)	0.689

Data are presented as whole numbers (%).

¹Chi-square test.

HbA1c: Glycated hemoglobin.