Proceedings of the Nutrition Society

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Proceedings of the Nutrition Society (2010), 69:61-69 Cambridge University Press
Copyright © The Authors 2009

Research Article

Session 4: CVD, diabetes and cancer Diet, insulin resistance and diabetes: the right (pro)portions

Symposium on ‘Dietary management of disease’

on 17–19 June 2009, A Meeting of the Nutrition Society, was held at Queen's University Belfast, hosted by the Irish Section.

Michelle Spencea1, Michelle C. McKinleya2 and Steven J. Huntera3 c1

a1 School of Nursing and Midwifery, Queen's University Belfast BT9 5BN, UK
a2 Nutriton and Metabolism Group, Queen's University Belfast BT12 6BJ, UK
a3 Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast BT12 6BA, UK
Article author query
spence m [PubMed]  [Google Scholar]
mckinley mc [PubMed]  [Google Scholar]
hunter sj [PubMed]  [Google Scholar]


Excess energy intake and positive energy balance are associated with the development of obesity and insulin resistance, which is a key feature underlying the pathophysiology of type 2 diabetes. It is possible that dietary macronutrient intake may also be important, in particular increased levels of sugar and fat. High-fat energy-dense diets contribute to energy excess and obesity. Fat type is also a factor, with evidence suggesting that saturated fat intake is linked to insulin resistance. However, controversy exists about the role of carbohydrate in the development of diabetes. Epidemiological studies suggest that the risk of diabetes is unrelated to the total amount of carbohydrate, but that fibre intake and glycaemic load are important. Common dietary advice for the prevention of diabetes often advocates complex carbohydrates and restriction of simple carbohydrates; however, sugars may not be the main contributor to glycaemic load. Evidence continues to emerge in relation to the influence of dietary sugars intake on insulin resistance. In broader dietary terms fruit and vegetable intake may influence insulin resistance, possibly related to increased intake of fibre and micronutrients or displacement of other food types. There is also considerable debate about the most effective diet and appropriate macronutrient composition to facilitate weight loss. Recent evidence suggests comparable effects of diets with varying macronutrient profiles on weight loss, which is predominantly related to energy restriction. However, based on the results of diabetes prevention trials focusing on lifestyle measures, evidence favours low-fat diets as the preferred approach for weight loss and diabetes prevention.

(Online publication December 08 2009)

Key Words:Macronutrient intake; Carbohydrate; Insulin resistance; Diabetes prevention


c1 Corresponding author: Dr Steven J. Hunter, fax +44 28 9031 0111, email