Replacing Red Meat With Chicken Helpful in Type 2 Diabetes With Macroalbuminuria

The withdrawal of red meat from the diet, either by replacing it with chicken or by following a lactovegetarian LPD [low-protein diet], promotes a beneficial effect on renovascular and cardiovascular risk factors associated with DN [diabetic nephropathy] in patients with type 2 diabetes and macroalbuminuria

Replacing red meat with chicken reduces urinary albumin excretion rate (UAER) in type 2 diabetes with macroalbuminuria, according to the results of a crossover design controlled trial.

"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," write Vanessa DF de Mello, MD, from the Universidade Federal do Rio Grande do Sul in Porto Alegre, Brazil, and colleagues. "The effects of withdrawing red meat are unknown in the more advanced stages of diabetic nephropathy."

The investigators evaluated the effects of replacing red meat in the usual diet with chicken and of consuming a lactovegetarian low-protein diet on renal function, fatty acid, and lipid profile in 17 type 2 diabetes patients with macroalbuminuria (24-hour UAER, >/= 200 µg/minute). Each patient followed the usual diet, chicken, and lactovegetarian low-protein diet in a random order for 4 weeks, with measurement of glomerular filtration rate, UAER, serum fatty acid, lipid profile, glycemic control, anthropometric indexes, and blood pressure after each diet.

UAER and non–high-density lipoprotein (HDL) cholesterol were lower after chicken and lactovegetarian low-protein diet than after usual diet. Median UAER was 269.4 µg/minute after chicken (range, 111 – 1128); 229.3 µg/minute after lactovegetarian low-protein diet (76.6 – 999.3); and 312.8 µg/minute after usual diet (223.7 – 1223.7; P < .01). Mean non-HDL cholesterol after chicken was 3.92 ± 0.99 mmol/L; after lactovegetarian low-protein diet, 3.92 ± 0.93 mmol/L; and after usual diet, 4.23 ± 1.06 mmol/L; P = .042. Compared with the usual diet, there was also an increase in serum total polyunsaturated fatty acids (chicken, 39.8% ± 2.6%; lactovegetarian low-protein diet, 39.7% ± 4.4%; and usual diet, 37.3% ± 3.1%; P = .029).

"In macroalbuminuric patients with type 2 diabetes, withdrawing red meat from the diet reduces the UAER," the authors write. "The observed increase in the proportion of serum PUFAs [polyunsaturated fatty acids] and UAER reduction after the withdrawal of red meat reinforces the suggestion that a high proportion of PUFA intake at the expense of a lower proportion of SFA [saturated fatty acid] intake may have a favorable effect on the endothelial function and probably on albuminuria…. The favorable effect of the withdrawal of red meat on renal function may also be related to the different amino acid composition of the diets."

"These results indicate that the withdrawal of red meat from the diet, either by replacing it with chicken or by following a lactovegetarian LPD [low-protein diet], promotes a beneficial effect on renovascular and cardiovascular risk factors associated with DN [diabetic nephropathy] in patients with type 2 diabetes and macroalbuminuria," the authors conclude. "This benefit may be related to the concomitant reduction in albuminuria concentrations and the rise in serum PUFAs."

Am J Clin Nutr. 2006;83:1032-1038

Practice Notes: Achieving the best glycemic control, treating hypertension, using drugs that block the renin-angiotensin-aldosterone system, and treating dyslipidemia are effective strategies in delaying the progression of advanced stages of nephropathy in patients with diabetes.

In macroalbuminuric patients with type 2 diabetes, withdrawing red meat from the diet reduces the UAER and increases serum total polyunsaturated fatty acids.

===============================

FACT: 14 Million Americans are visually impaired: A National Eye Institute (NEI) study has found that although 94 percent of Americans aged 12 and older have good vision, the remaining six percent, or 14 million, are visually impaired. Of these, more than 11 million have uncorrected visual impairment, such as nearsightedness. They need eyeglasses or contact lenses to improve their vision. Teenagers, people with diabetes, Hispanics, and people who are economically disadvantaged have higher rates of visual impairment and can most benefit from corrective lenses. This study is published in the May 10, 2006 issue of the Journal of the American Medical Association.