Non-diabetic relatives of Type 2 diabetic families: dietary intake contributes to the increased risk of diabetes A. J. Adamson, E. Foster, T. J. Butler, S. Bennet* and M. Walker* Abstract Aims Non-diabetic ®rst degree relatives of Type 2 diabetic patients are at increased risk of developing diabetes and cardiovascular disease. This is assumed to re¯ect a shared genetic predisposition. The aim of this study was to test the hypothesis that lifestyle factors, speci®cally 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 ®rst 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% con®dence 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 modi®cation. Diabet. Med. 18, 984±990 (2001) Keywords dietary intake, lifestyle, cardiovascular risk, pre-diabetes Abbreviations BMI, body mass index; WHR, waist±hip ratio; BMR, basal metabolic rate; EI, energy intake; FFQ, food frequency questionnaire; SFA, saturated fatty acids; CHO, carbohydrate; NSP, non-starch polysaccharide Introduction There is a progressive increase in the world-wide preva- lence of Type 2 (non-insulin-dependent) diabetes mellitus [1]. This increase is primarily the result of lifestyle changes, Correspondence to: Ashley J. Adamson, Human Nutrition Research Centre, Wellcome Research Laboratories, Royal Victoria In®rmary, Newcastle upon Tyne NE1 4LP, UK. E-mail: A.J.Adamson@ncl.ac.uk Human Nutrition Research Centre and *School of Clinical Medical Sciences, University of Newcastle, Newcastle, UK Accepted 21 April 2001 984 ã 2001 Diabetes UK. Diabetic Medicine, 18, 984±990