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Withdrawal of red meat from the usual diet reduces albuminuria and improves serum fatty acid profile in type 2 diabetes patients with macroalbuminuria1,2,3
Vanessa DF de Mello, Themis Zelmanovitz, Magda S Perassolo, Mirela J Azevedo and Jorge L Gross
1 From the Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

Background: Replacement of red meat in the diet with chicken has reduced the urinary albumin excretion rate (UAER) and serum cholesterol in microalbuminuric type 2 diabetes patients. The effects of withdrawing red meat are unknown in the more advanced stages of diabetic nephropathy.

Objective: Our objective was to assess the effects of replacing red meat in the usual diet (UD) with chicken (CD) and of consuming a lactovegetarian low-protein diet (LPD) on renal function, fatty acid, and lipid profile in macroalbuminuric type 2 diabetes patients.

Design: A crossover controlled trial was conducted in 17 type 2 diabetes patients with macroalbuminuria (24-h UAER  200 µg/min). Each patient followed the UD, CD, and LPD in a random order for 4 wk. After each diet, glomerular filtration rate, UAER, serum fatty acid, lipid profile, glycemic control, anthropometric indexes, and blood pressure were measured.

Results: UAER [median CD: 269.4 (range: 111–1128) µg/min; LPD: 229.3 (76.6–999.3) µg/min; UD: 312.8 (223.7–1223.7) µg/min; P < 0.01] and mean (±SD) non-HDL cholesterol (CD: 3.92 ± 0.99 mmol/L; LPD: 3.92 ± 0.93 mmol/L; UD: 4.23 ± 1.06 mmol/L; P = 0.042) were lower after CD and LPD than after UD. Compared with the UD, an increase in serum total polyunsaturated fatty acids was also observed (CD: 39.8 ± 2.6%; LPD: 39.7 ± 4.4%; UD: 37.3 ± 3.1%; P = 0.029).

Conclusion: In macroalbuminuric patients with type 2 diabetes, withdrawing red meat from the diet reduces the UAER.

Key Words: Type 2 diabetes mellitus • albuminuria • diabetic nephropathy • red meat • chicken-based diet • low-protein diet • lipids • fatty acids