Diabetes, Vol 45, Issue 5 569-575, Copyright © 1996 by American Diabetes Association

ARTICLES

Potentiation of effects of weight loss by monounsaturated fatty acids in obese NIDDM patients

CC Low, EB Grossman and B Gumbiner
Department of Medicine, University of Rochester, NY 14620, USA.

Although moderate weight loss improves glycemic control in obese NIDDM patients, quite often it is not normalized. To determine whether the response to weight loss can be improved by altering the macronutrient composition of hypocaloric diets, 17 obese NIDDM patients were studied at I) baseline, 2) after dieting for 6 weeks on a formula diet enriched in either monounsaturated fatty acids (MUFAs, n = 9) or carbohydrates (CHOs, n = 8) at a 50% caloric deficit, and 3) after 4 weeks of postdiet refeeding on the respective formulas with caloric intake titrated to achieve weight maintenance. Fasting, 24-h, and oral glucose tolerance test (OGTT) blood glucose, plasma insulin, and C-peptide levels were measured. All prediet parameters were similar between groups. After dieting, although weight loss was similar between groups, the fasting glucose level decreased significantly more in the MUFA group (-4.6 +/- 0.7 mmol/l) than in the CHO group (-2.4 +/- 1.0 mmol/l; P < 0.05). Twenty-four-hour glycemia decreased in both groups after dieting, but the MUFA group had a greater decrease than the CHO group (P < 0.05, analysis of variance [ANOVA]). Although decreases in fasting glycemia were maintained in both groups after refeeding, postprandial glycemia deteriorated after refeeding with the CHO- but not the MUFA-enriched formula (P < 0.05). After dieting and refeeding, fasting C-peptide increased 204 +/- 47 pmol/l in the MUFA group, but the CHO group remained at prediet levels (P < 0.05). Twenty-four-hour C-peptide levels were similar between groups after dieting and refeeding, despite the lower glycemia and CHO content of the MUFA formula. However, when equal amounts of CHO were consumed during the OGTT, the MUFA group had significantly higher C-peptide levels after both dieting and refeeding (P < 0.05). Fasting, 24-h, and OGTT insulin levels were similar between groups throughout the study. These results indicate that macronutrient composition is an important determinant of the glycemic response to weight-loss therapy in obese NIDDM patients. Based on the C-peptide response during the OGTT, increased CHO-induced insulin secretion is one possible mechanism by which this occurs.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				T. Coll, E. Eyre, R. Rodriguez-Calvo, X. Palomer, R. M. Sanchez, M. Merlos, J. C. Laguna, and M. Vazquez-Carrera Oleate Reverses Palmitate-induced Insulin Resistance and Inflammation in Skeletal Muscle Cells J. Biol. Chem., April 25, 2008; 283(17): 11107 - 11116. [Abstract] [Full Text] [PDF]

				J. W Krieger, H. S Sitren, M. J Daniels, and B. Langkamp-Henken Effects of variation in protein and carbohydrate intake on body mass and composition during energy restriction: a meta-regression 1 Am. J. Clinical Nutrition, February 1, 2006; 83(2): 260 - 274. [Abstract] [Full Text] [PDF]

				N. P. Hays, R. D. Starling, X. Liu, D. H. Sullivan, T. A. Trappe, J. D. Fluckey, and W. J. Evans Effects of an Ad Libitum Low-Fat, High-Carbohydrate Diet on Body Weight, Body Composition, and Fat Distribution in Older Men and Women: A Randomized Controlled Trial Arch Intern Med, January 26, 2004; 164(2): 210 - 217. [Abstract] [Full Text] [PDF]

				D. M. Bravata, L. Sanders, J. Huang, H. M. Krumholz, I. Olkin, C. D. Gardner, and D. M. Bravata Efficacy and Safety of Low-Carbohydrate Diets: A Systematic Review JAMA, April 9, 2003; 289(14): 1837 - 1850. [Abstract] [Full Text] [PDF]

				L. K. Heilbronn, M. Noakes, and P. M. Clifton The Effect of High- and Low-Glycemic Index Energy Restricted Diets on Plasma Lipid and Glucose Profiles in Type 2 Diabetic Subjects with Varying Glycemic Control J. Am. Coll. Nutr., April 1, 2002; 21(2): 120 - 127. [Abstract] [Full Text] [PDF]

				A. S. Rocca, J. LaGreca, J. Kalitsky, and P. L. Brubaker Monounsaturated Fatty Acid Diets Improve Glycemic Tolerance through Increased Secretion of Glucagon-Like Peptide-1 Endocrinology, March 1, 2001; 142(3): 1148 - 1155. [Abstract] [Full Text] [PDF]

				M. Ryan, D. McInerney, D. Owens, P. Collins, A. Johnson, and G.H. Tomkin Diabetes and the Mediterranean diet: a beneficial effect of oleic acid on insulin sensitivity, adipocyte glucose transport and endothelium-dependent vasoreactivity QJM, February 1, 2000; 93(2): 85 - 91. [Abstract] [Full Text] [PDF]

				J. J. Wilkes, A. Bonen, and R. C. Bell A modified high-fat diet induces insulin resistance in rat skeletal muscle but not adipocytes Am J Physiol Endocrinol Metab, October 1, 1998; 275(4): E679 - E686. [Abstract] [Full Text] [PDF]