Comparison of the effects on insulin resistance and glucose tolerance of 6-mo high-monounsaturated-fat, low-fat, and control diets. Comparison of high- and low-glycemic-index breakfast cereals with monounsaturated fat in the long-term dietary management of type 2 diabetes. Comparison of 3 ad libitum diets for weight-loss maintenance, risk of cardiovascular disease, and diabetes: a 6-mo randomized, controlled trial. Effects of High-monounsaturated Fatty Acid Enteral Formula versus High-carbohydrate Enteral Formula on Plasma Glucose Concentration and Insulin Secretion in Healthy Individuals and Diabetic Patients Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance. The effect of a high-egg diet on cardiovascular risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) study-a 3-mo randomized controlled trial. One-Year Comparison of a High–Monounsaturated Fat Diet With a High-Carbohydrate Diet in Type 2 Diabetes Effects of a Monounsaturated Fatty Acid–Enriched Hypocaloric Diet on Cardiovascular Risk Factors in Obese Patients With Type 2 Diabetes High-carbohydrate-low-glycaemic index dietary advice improves glucose disposition index in subjects with impaired glucose tolerance. Dietary Monounsaturated Fatty Acids but not Saturated Fatty Acids Preserve the Insulin Signaling Pathway via IRS-1/PI3K in Rat Skeletal Muscle Adverse effects on insulin secretion of replacing saturated fat with refined carbohydrate but not with monounsaturated fat: A randomized controlled trial in centrally obese subjects.
BACKGROUND The effect of dietary fat and carbohydrate on glucose metabolism has been debated for decades . OBJECTIVE The objective was to compare the effect of 3 ad libitum diets , different in type and amount of fat and carbohydrate , on insulin resistance and glucose tolerance subsequent to weight loss . DESIGN Forty-six nondiabetic , obese [ mean ( + /-SEM ) body mass index ( in kg/m(2 ) ) : 31.2 + /- 0.3 ] men ( n = 20 ) and premenopausal women ( n = 26 ) aged 28.0 + /- 0.7 y were r and omly assigned to 1 of 3 diets after > or = 8 % weight loss : 1 ) MUFA diet ( n = 16 ) : moderate in fat ( 35 - 45 % of energy ) and high in monounsaturated fatty acids ( > 20 % of energy ) ; 2 ) LF diet ( n = 18 ) : low-fat diet ( 20 - 30 % of energy ) , and 3 ) control diet ( n = 12 ) : 35 % of energy as fat ( > 15 % of energy as saturated fatty acids ) . Protein accounted for 15 % of energy in all 3 diets . A 2-h oral-glucose-tolerance test ( OGTT ) was performed before and after the 6-mo dietary intervention . All foods were provided by a purpose -built supermarket . RESULTS After 6 mo , the MUFA diet reduced fasting glucose ( -3.0 % ) , insulin ( -9.4 % ) , and the homeostasis model assessment of insulin resistance score ( -12.1 % ) . Compared with the MUFA diet , the control diet increased these variables [ 1.4 % ( P = 0.014 ) , 21.2 % ( P = 0.030 ) , and 22.8 % ( P = 0.015 ) , respectively ] , as did the LF diet [ 1.4 % ( P = 0.090 ) , 13.1 % ( P = 0.078 ) , and 15.5 % ( P = 0.095 ) , respectively ] . No significant group differences were detected in glucose or insulin concentrations during the OGTT , in the Matsudas index , in body weight , or in body composition . CONCLUSION A diet high in monounsaturated fat has a more favorable effect on glucose homeostasis than does the typical Western diet in the short term and may also be more beneficial than the official recommended low-fat diet during a period of weight regain subsequent to weight loss BACKGROUND Results of 6-wk studies suggest that high-carbohydrate diets are deleterious for people with type 2 diabetes . OBJECTIVE Our objective was to see whether long-term replacement of dietary monounsaturated fatty acids ( MUFAs ) with carbohydrate from breakfast cereals with either a high or a low glycemic index ( GI ) affected blood glucose and lipids in subjects with type 2 diabetes . DESIGN Subjects with type 2 diabetes ( n = 91 ) were r and omly assigned to receive approximately 10 % of energy from a low-GI breakfast cereal , a high-GI cereal , or oil or margarine containing MUFA for 6 mo . Eating breakfast cereal was prohibited for subjects in the MUFA group . RESULTS Seventy-two subjects completed the trial . The subjects who received cereals consumed approximately 10 % more energy from carbohydrate than did the subjects in the MUFA group . Changes in glycated hemoglobin , body weight , and fasting cholesterol and triacylglycerol did not differ significantly among groups . HDL cholesterol increased by approximately 10 % in the MUFA group compared with subjects who consumed either high- or low-GI cereals ( P = 0.002 ) . The ratio of total to HDL cholesterol was higher in the subjects who consumed the high-GI cereal than in the MUFA group at 3 mo but not at 6 mo ( diet x time interaction , P = 0.041 ) . During 8-h metabolic profiles , mean plasma insulin was higher and mean free fatty acids were lower in the 2 cereal groups than in the MUFA group ( P < 0.05 ) . CONCLUSIONS A 10 % increase in carbohydrate intake associated with breakfast cereal consumption had no deleterious effects on glycemic control or blood lipids over 6 mo in subjects with type 2 diabetes . The increase in plasma insulin and the reduction in free fatty acids associated with higher carbohydrate intake may reduce the rate of progression of diabetes BACKGROUND The optimal dietary content and type of fat and carbohydrate for weight management has been debated for decades . OBJECTIVE The objective was to compare the effects of 3 ad libitum diets on the maintenance of an initial weight loss of > or=8 % and risk factors for CVD and diabetes during a 6-mo controlled dietary intervention . DESIGN Nondiabetic overweight or obese [ mean + /- SD body mass index ( in kg/m(2 ) ) : 31.5 + /- 2.6 ] men ( n = 55 ) and women ( n = 76 ) aged 28.2 + /- 4.8 y were r and omly assigned to a diet providing a moderate amount of fat ( 35 - 45 % of energy ) and > 20 % of fat as monounsaturated fatty acids ( MUFA diet ; n = 54 ) , to a low-fat ( 20 - 30 % of energy ) diet ( LF diet ; n = 51 ) , or to a control diet ( 35 % of energy as fat ; n = 26 ) . Protein constituted 10 - 20 % of energy in all 3 diets . All foods were provided free of charge from a purpose -built supermarket . RESULTS More subjects dropped out of the MUFA ( 28 % ) group than out of the LF group ( 16 % ) and control group ( 8 % ) ( MUFA compared with control : P < 0.05 ) . All groups regained weight ( MUFA : 2.5 + /- 0.7 kg ; LF : 2.2 + /- 0.7 kg ; and control : 3.8 + /- 0.8 kg ; NS ) . Body fat regain was lower in the LF ( 0.6 + /- 0.6 % ) and MUFA ( 1.6 + /- 0.6 % ) groups than in the control group ( 2.6 + /- 0.5 % ) ( P < 0.05 ) . In the MUFA group , fasting insulin decreased by 2.6 + /- 3.5 pmol/L , the homeostasis model assessment of insulin resistance by 0.17 + /- 0.13 , and the ratio of LDL to HDL by 0.33 + /- 0.13 ; in the LF group , these variables increased by 4.3 + /- 3.0 pmol/L ( P < 0.08 ) and 0.17 + /- 0.10 ( P < 0.05 ) and decreased by 0.02 + /- 0.09 ( P = 0.005 ) , respectively ; and in the control group , increased by 14.0 + /- 4.3 pmol/L ( P < 0.001 ) , 0.57 + /- 0.17 ( P < 0.001 ) , and 0.05 + /- 0.14 ( P = 0.036 ) , respectively . Dietary adherence was high on the basis of fatty acid changes in adipose tissue . CONCLUSIONS Diet composition had no major effect on preventing weight regain . However , both the LF and MUFA diets produced less body fat regain than did the control diet , and the dropout rate was lowest in the LF diet group , whereas fasting insulin decreased and the homeostasis model assessment of insulin resistance and ratio of LDL to HDL improved with the MUFA diet . This trial was registered at clinical trials.gov as NCT00274729 We investigated the effects of high-monounsaturated fatty acid ( MUFA ) versus high-carbohydrate enteral formula on post-pr and ial plasma glucose concentration and insulin response in Japanese patients with type 2 diabetes mellitus and healthy Japanese volunteers . Ten healthy volunteers aged 20.8 ± 1.2 years and 12 diabetic patients with good glycaemic control ( glycosylated haemoglobulin < 7 % ) aged 58.6 ± 7.7 years were r and omly assigned to take high-MUFA or high-carbohydrate formula after a 12-h overnight fast . The patients switched to the other formula after 7 days . Post-pr and ial plasma glucose and insulin response were significantly lower in all subjects after taking high-MUFA formula compared with high-carbohydrate formula . No differences were observed in free fatty acids , triglycerides and plasma glucagon between the two diet groups . In conclusion , a high-MUFA enteral formula  suppresses post-pr and ial hyperglycaemia without exaggerated insulin secretion compared with a high-carbohydrate enteral diet in patients with type 2 diabetes and healthy subjects BACKGROUND Reducing the glycemic load ( GL ) is considered beneficial for managing insulin resistance . The GL can be reduced either by reducing carbohydrate intake or by reducing the glycemic index ( GI ) . OBJECTIVE We studied whether these 2 dietary maneuvers have the same long-term effects on postpr and ial plasma glucose , insulin , triacylglycerol , and free fatty acid ( FFA ) concentrations in subjects with impaired glucose tolerance ( IGT ) . DESIGN Thirty-four subjects with IGT were r and omly assigned to high-carbohydrate , high-GI ( high-GI ) ; high-carbohydrate , low-GI ( low-GI ) ; and low-carbohydrate , high-monounsaturated fatty acid ( MUFA ) diets for 4 mo . Plasma glucose , insulin , and FFAs were measured from 0800 to 1600 at baseline in response to high-GI meals ( 60 % carbohydrate , GI = 61 , GL = 63 ) and after 4 mo in response to meals representative of the study diet . RESULTS Carbohydrate intake ( % of energy ) , GI , and GL in the high-GI , low-GI , and MUFA groups ( breakfast and lunch meals combined ) , respectively , were 60 % , 61 , and 63 ; 60 % , 53 , and 55 ; and 49 % , 61 , and 52 . Compared with the change after 4 mo of the high-GI diet , both the low-GI and MUFA diets reduced 0 - 8-h mean plasma glucose concentrations by 0.35 mmol/L ( P < 0.05 ) . Mean plasma insulin was approximately 20 % higher ( P < 0.05 ) and FFAs approximately 12 % lower ( P < 0.05 ) after the low-GI diet than after the high-GI diet , with no significant effect of MUFA . Changes in 0 - 8-h mean plasma triacylglycerols in the 3 treatment groups differed significantly : -0.14 , 0.04 , and 0.18 mmol/L , respectively , with the high-GI , MUFA , and low-GI diets . CONCLUSIONS In subjects with IGT , reducing the GI of the diet for 4 mo reduced postpr and ial plasma glucose by the same amount as did reducing carbohydrate intake . The 2 dietary maneuvers had different effects on postpr and ial plasma insulin , triacylglycerols , and FFAs BACKGROUND Previously published research that examined the effects of high egg consumption in people with type 2 diabetes ( T2D ) produced conflicting results leading to recommendations to limit egg intake . However , people with T2D may benefit from egg consumption because eggs are a nutritious and convenient way of improving protein and micronutrient contents of the diet , which have importance for satiety and weight management . OBJECTIVE In this r and omized controlled study , we aim ed to determine whether a high-egg diet ( 2 eggs/d for 6 d/wk ) compared with a low-egg diet ( < 2 eggs/wk ) affected circulating lipid profiles , in particular high-density lipoprotein ( HDL ) cholesterol , in overweight or obese people with prediabetes or T2D . DESIGN A total of 140 participants were r and omly assigned to one of the 2 diets as part of a 3-mo weight maintenance study . Participants attended the clinic monthly and were instructed on the specific types of foods and quantities to be consumed . RESULTS There was no significant difference in the change in HDL cholesterol from screening to 3 mo between groups ; the mean difference ( 95 % CI ) between high- and low-egg groups was + 0.02 mmol/L ( -0.03 , 0.08 mmol/L ; P = 0.38 ) . No between-group differences were shown for total cholesterol , low-density lipoprotein cholesterol , triglycerides , or glycemic control . Both groups were matched for protein intake , but the high-egg group reported less hunger and greater satiety postbreakfast . Polyunsaturated fatty acid ( PUFA ) and monounsaturated fatty acid ( MUFA ) intakes significantly increased from baseline in both groups . CONCLUSIONS High egg consumption did not have an adverse effect on the lipid profile of people with T2D in the context of increased MUFA and PUFA consumption . This study suggests that a high-egg diet can be included safely as part of the dietary management of T2D , and it may provide greater satiety . This trial was registered at the Australia New Zeal and Clinical Trials Registry ( http://www.anzctr.org.au/ ) as ACTRN12612001266853 OBJECTIVE —The purpose of this study was to compare the effects of high – monounsaturated fatty acid ( MUFA ) and high-carbohydrate ( CHO ) diets on body weight and glycemic control in men and women with type 2 diabetes . RESEARCH DESIGN AND METHODS —Overweight/obese participants with type 2 diabetes ( n = 124 , age = 56.5 ± 0.8 years , BMI = 35.9 ± 0.3 kg/m2 , and A1C = 7.3 ± 0.1 % ) were r and omly assigned to 1 year of a high-MUFA or high-CHO diet . Anthropometric and metabolic parameters were assessed at baseline and after 4 , 8 , and 12 months of dieting . RESULTS —Baseline characteristics were similar between the treatment groups . The overall retention rate for 1 year was 77 % ( 69 % for the high-MUFA group and 84 % for the high-CHO group ; P = 0.06 ) . Based on food records , both groups had similar energy intake but a significant difference in MUFA intake . Both groups had similar weight loss over 1 year ( −4.0 ± 0.8 vs. −3.8 ± 0.6 kg ) and comparable improvement in body fat , waist circumference , diastolic blood pressure , HDL cholesterol , A1C , and fasting glucose and insulin . There were no differences in these parameters between the groups . A follow-up assessment of a subset of participants ( n = 36 ) was conducted 18 months after completion of the 52-week diet . These participants maintained their weight loss and A1C during the follow-up period . CONCLUSIONS —In individuals with type 2 diabetes  , high-MUFA diets are an alternative to conventional lower-fat , high-CHO diets with comparable beneficial effects on body weight , body composition , cardiovascular risk factors , and glycemic control 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 sample s 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 result ed 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 Controversy exists about the optimal amount and source of dietary carbohydrate for managing insulin resistance . Therefore , we compared the effects on insulin sensitivity ( SI ) , pancreatic responsivity ( AIRglu ) and glucose disposition index of dietary advice aim ed at reducing the amount or altering the source of dietary carbohydrate in subjects with impaired glucose tolerance ( IGT ) . Subjects were r and omized to high-carbohydrate-high-glycaemic index ( GI ) ( high-GI , n 11 ) , high-carbohydrate-low-GI ( low-GI , n 13 ) , or low-carbohydrate-high-monounsaturated fat ( MUFA , n 11 ) dietary advice , with SI , AIRglu and DI measured using a frequently sample d , intravenous glucose tolerance test before and after 4 months treatment . Carbohydrate and fat intakes and diet GI , respectively , were : high-GI , 53 % , 28 % , 83 ; low-GI , 55 % , 25 % , 76 ; MUFA , 47 % , 35 % , 82 . Weight changes on each diet differed significantly from each other : high-GI , -0.49 ( sem 0.29 ) kg ; low-GI , -0.19 ( sem 0.40 ) kg ; MUFA + 0.27 ( sem 0.45 ) kg . Blood lipids did not change , but glycated haemoglobin increased significantly on MUFA , 0.02 ( sem 0.11 ) % , relative to low-GI , -0.19 ( sem 0.08 ) % , and high-GI , -0.13 ( sem 0.14 ) % . Diastolic blood pressure fell by 8 mmHg on low-GI relative to MUFA ( P=0.038 ) . Although SI and AIRglu did not change significantly , DI , a measure of the ability of beta-cells to overcome insulin resistance by increasing insulin secretion , increased on low-GI by > 50 % ( P=0.02 ) . After adjusting for baseline values , the increase in DI on low-GI , 0.17 ( sem 0.07 ) , was significantly greater than those on MUFA , -0.09 ( sem 0.08 ) and high-GI , -0.03 ( sem 0.02 ) ( P=0.019 ) . Thus , the long-term effects of altering the source of dietary carbohydrate differ from those of altering the amount . High-carbohydrate-low-GI dietary advice improved beta-cell function in subjects with IGT , and may , therefore , be useful in the management of IGT Saturated fatty acids ( SFA ) and monounsaturated fatty acids ( MUFA ) show different effects on the development of insulin resistance . In this study , we compared the effect of dietary SFA and MUFA on the insulin signaling pathway in the skeletal muscle of a type 2 diabetic animal model . Twenty-nine-week-old male Otsuka Long-Evans Tokushima fatty ( OLETF ) rats were r and omly divided into three groups and fed one of the following diets for 3 weeks ; a normal chow diet , an SFA ( lard oil ) enriched or a MUFA ( olive oil ) enriched high-fat diet . The vastus lateralis muscle was used for analyses . Insulin tolerance test showed improved insulin sensitivity in rats fed the MUFA diet , as compared to those fed the SFA diet ( p < 0.001 ) . The SFA diet reduced IRS-1 expression and phosphorylated PI3 K levels in skeletal muscle , as compared with a chow diet ( p < 0.001 , respectively ) . On the contrary , muscle IRS-2 expression and phosphorylated ERK1/2 was significantly increased in rats fed the SFA diet ( p < 0.001 , respectively ) . Membrane translocation of glucose transporter type 4 decreased in the skeletal muscle of rats fed the SFA diet , as compared to those fed a chow diet ( p < 0.001 ) . These changes in insulin signaling pathway in skeletal muscle were not observed in rats fed the MUFA diet . In conclusion , the beneficial effect of dietary MUFA on insulin sensitivity is associated with a conserved IRS-1/PI3 K insulin signaling pathway which was altered by dietary SFA BACKGROUND Current dietary guidelines recommend the replacement of saturated fatty acids ( SAFAs ) with carbohydrates or monounsaturated fatty acids ( MUFAs ) based on evidence on lipid profile alone , the chronic effects of the mentioned replacements on insulin secretion and insulin sensitivity are however unclear . OBJECTIVE To assess the chronic effects of the substitution of refined carbohydrate or MUFA for SAFA on insulin secretion and insulin sensitivity in central ly obese subjects . METHODS Using a crossover design , r and omized controlled trial in abdominally overweight men and women , we compared the effects of substitution of 7 % energy as carbohydrate or MUFA for SAFA for a period of 6 weeks each . Fasting and postpr and ial blood sample s in response to corresponding SAFA , carbohydrate , or MUFA-enriched meal-challenges were collected after 6 weeks on each diet treatment for the assessment of outcomes . RESULTS As expected , postpr and ial nonesterified fatty acid suppression and elevation of C-peptide , insulin and glucose secretion were the greatest with high-carbohydrate ( CARB ) meal . Interestingly , CARB meal attenuated postpr and ial insulin secretion corrected for glucose response ; however , the insulin sensitivity and disposition index were not affected . SAFA and MUFA had similar effects on all markers except for fasting glucose-dependent insulinotropic peptide concentrations , which increased after MUFA but not SAFA when compared with CARB . CONCLUSION In conclusion , a 6-week lower-fat/higher-carbohydrate ( increased by 7 % refined carbohydrate ) diet may have greater adverse effect on insulin secretion corrected for glucose compared with isocaloric higher-fat diets . In contrast , exchanging MUFA for SAFA at 7 % energy had no appreciable adverse impact on insulin secretion
In contrast , fasting plasma glucose , fasting plasma insulin as well as the homeostasis model assessment of insulin resistance were not affected by the amounts of MUFA in the dietary protocol s. Conclusions : In summary , this systematic review found that high MUFA diets appear to be effective in reducing HbA1c , and therefore , should be recommended in the dietary regimes of T2D
Background / Aims : In 2008 , the American Diabetes Association recommended low-carbohydrate or low-fat diets for weight management in patients with established type 2 diabetes ( T2D ) , while the amount of monounsaturated fatty acids ( MUFA ) was not specified .
This systematic review focused on the effects of diets high in MUFA versus diets low in MUFA on important risk factors of T2D ( i.e. plasma glucose , insulin , homeostasis model assessment of insulin resistance and glycosylated haemoglobin , HbA1c ) .