Diabetes Care, Vol 21, Issue 1 9-15, Copyright © 1998 by American Diabetes Association

ARTICLES

Effects of a monounsaturated fatty acid-enriched hypocaloric diet on cardiovascular risk factors in obese patients with type 2 diabetes

B Gumbiner, CC Low and PD Reaven
Indiana University Center for Weight Management, National Institute for Fitness and Sport, Indianapolis 46202, USA. bgumbine@mdep.iupui.edu

OBJECTIVE: To determine whether the lipoprotein response to weight loss in obese patients with type 2 diabetes can be improved by modifying the macronutrient composition of the commonly prescribed low-fat, high-carbohydrate (CHO) hypocaloric diet. RESEARCH DESIGN AND METHODS: Nine obese patients with type 2 diabetes were treated with a monounsaturated fatty acid (MUFA)-enriched weight-reducing formula diet and compared with eight obese patients with type 2 diabetes treated with a low-fat, high-CHO weight-reducing formula diet. Weight loss ensued for 6 weeks, followed by 4 weeks of refeeding using isocaloric formulas enriched with MUFA or CHO, respectively. Fasting blood samples were obtained to measure plasma lipoproteins and LDL susceptibility to oxidation (measured as lag time: time required to induce in vitro formation of conjugated dienes). RESULTS: At baseline, there were no differences between the groups in plasma lipids, lipoproteins, or LDL susceptibility to oxidation. Weight loss was similar between the groups. Dieting resulted in decreases in total plasma cholesterol, LDL, HDL, triglycerides, and apolipoproteins A and B (P < 0.05), but the MUFA group manifested a greater decrease in total cholesterol, triglycerides, and apolipoprotein B and a smaller decrease in HDL and apolipoprotein A than the CHO group (P < 0.05). Improvements in these parameters were sustained during refeeding. After dieting, lag time was prolonged in the MUFA group (208 +/- 10 min) compared with the CHO group (146 +/- 11 min; P < 0.05). Lag time was prolonged further during refeeding in the MUFA group (221 +/- 13 min, P = 0.10), while the CHO group remained unchanged (152 +/- 9 min, P < 0.05). Lag time correlated strongly with the oleic acid content of LDL after dieting and refeeding (r = 0.74 and r = 0.93, respectively; both P < 0.001). CONCLUSIONS: Macronutrient content is an important determinant of the lipoprotein response to weight loss in obese patients with type 2 diabetes. MUFA-enriched hypocaloric diets potentiate the beneficial effects of weight loss to ameliorate cardiovascular risk factors in obese patients with type 2 diabetes.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				P. M. Clifton, M. Noakes, and J. B. Keogh Very Low-Fat (12%) and High Monounsaturated Fat (35%) Diets Do Not Differentially Affect Abdominal Fat Loss in Overweight, Nondiabetic Women J. Nutr., July 1, 2004; 134(7): 1741 - 1745. [Abstract] [Full Text]

				C. L Pelkman, V. K Fishell, D. H Maddox, T. A Pearson, D. T Mauger, and P. M Kris-Etherton Effects of moderate-fat (from monounsaturated fat) and low-fat weight-loss diets on the serum lipid profile in overweight and obese men and women Am. J. Clinical Nutrition, February 1, 2004; 79(2): 204 - 212. [Abstract] [Full Text] [PDF]

				E. Ros Dietary cis-monounsaturated fatty acids and metabolic control in type 2 diabetes Am. J. Clinical Nutrition, September 1, 2003; 78(3): 617S - 625. [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]

				R. M. Cowett The Infant of the Diabetic Mother NeoReviews, September 1, 2002; 3(9): e173 - 189. [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]

				C. Day The rising tide of type 2 diabetes The British Journal of Diabetes & Vascular Disease, August 1, 2001; 1(1): 37 - 43. [Abstract] [PDF]

				S. Tsimikas, A. Philis-Tsimikas, S. Alexopoulos, F. Sigari, C. Lee, and P. D. Reaven LDL Isolated From Greek Subjects on a Typical Diet or From American Subjects on an Oleate-Supplemented Diet Induces Less Monocyte Chemotaxis and Adhesion When Exposed to Oxidative Stress Arterioscler. Thromb. Vasc. Biol., January 1, 1999; 19(1): 122 - 130. [Abstract] [Full Text] [PDF]