Temporal trends in dietary intake among US adults with type 2 diabetes

Trends in dietary intake among adults with type 2 diabetes: NHANES 1988–2012

Casagrande and Cowie, JHND Early View


Dietary recommendations for adults with diabetes are to follow a healthy diet in appropriate portion sizes. We determined recent trends in energy and nutrient intakes among a nationally representative sample of US adults with and without type 2 diabetes.


Participants were adults aged ≥20 years from the cross-sectional National Health and Nutrition Examination Surveys, 1988–2012 (N = 49 770). Diabetes was determined by self-report of a physician’s diagnosis (n = 4885). Intake of energy and nutrients were determined from a 24-h recall by participants of all food consumed. Linear regression was used to test for trends in mean intake over time for all participants and by demographic characteristics.


Among adults with diabetes, overall total energy intake increased between 1988–1994 and 2011–2012 (1689 kcal versus 1895 kcal; Ptrend < 0.001) with evidence of a plateau between 2003–2006 and 2011–2012. In 2007–2012, energy intake was greater for younger than older adults, for men than women, and for non-Hispanic whites versus non-Hispanic blacks. There was no change in the percentage of calories from carbohydrate, total fat or protein. Percentage of calories from saturated fat was similar across study periods but remained above recommendations (11.2% in 2011–2012). Fibre intake significantly decreased and remained below recommendations (Ptrend = 0.002). Sodium, cholesterol and calcium intakes increased. There was no change in energy intake among adults without diabetes and dietary trends were similar to those with diabetes.


Future data are needed to confirm a plateau in energy intake among adults with diabetes, although the opportunity exists to increase fibre and reduce saturated fat.



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