Hostname: page-component-7c8c6479df-995ml Total loading time: 0 Render date: 2024-03-29T00:29:48.742Z Has data issue: false hasContentIssue false

A randomised four-intervention crossover study investigating the effect of carbohydrates on daytime profiles of insulin, glucose, non-esterified fatty acids and triacylglycerols in middle-aged men

Published online by Cambridge University Press:  09 March 2007

Audrey E. Brynes
Affiliation:
Nutrition and Dietetic Research Group, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
C. Mark Edwards
Affiliation:
Endocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 OHS, UK
Mohammed A. Ghatei
Affiliation:
Endocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 OHS, UK
Anne Dornhorst
Affiliation:
Endocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 OHS, UK
Linda M. Morgan
Affiliation:
School of Biomedical and Life Sciences, University of Surrey, Guildford GU2 7XH, UK
Stephen R. Bloom
Affiliation:
Endocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 OHS, UK
Gary S. Frost*
Affiliation:
Nutrition and Dietetic Research Group, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
*
*Corresponding author: Dr Gary Frost, fax +44 20 8383 3379, email g.frost@ic.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Postprandial concentrations of glucose, insulin and triacylglycerols (TG) correlate to risk for CHD. Carbohydrates affect many metabolites that could have a potential effect on cardiovascular risk factors. The objective of the present study was to examine, using a randomised prospective study, the acute (day 1) and ad libitum medium-term (day 24) effects of four diets: a high-fat diet (HIGH-FAT; 50 % fat, >34 % monounsaturated fatty acids); a low-glycaemic index (GI) diet (LOW-GI; high-carbohydrate, low-GI); a high-sucrose diet (SUCROSE; high carbohydrate increase of 90 g sucrose/d); a high-GI diet (HIGH-GI; high-carbohydrate, high-GI). Daytime profiles (8 h) (breakfast, lunch and tea) of lipid and carbohydrate metabolism were completed during day 1 and day 24. Seventeen middle-aged men with one or more cardiac risk factors completed the study. There was no change from day 1 or between diets in fasting glucose, lipids or homeostatic assessment model (HOMA) on day 24. The HIGH-FAT compared with the three high-carbohydrate diets was associated with lower postprandial insulin and glucose but higher postprandial TG and non-esterified fatty acids (NEFA). There was a significant increase in the 6 h (15.00 hours) TG concentration (day 1, 2·6 (SEM 0·3) MMOL/L v. DAY 24, 3·3 (sem 0·3) mmol/l; P<0·01) on the SUCROSE diet. Postprandial HOMA (i.e. incremental area under the curve (IAUC) glucose (mmol/l per min)×IAUC insulin/22·5 (mU/l per min)) median changes from day 1 to day 24 were −61, −43, −20 and +31 % for the HIGH-FAT, LOW-GI, SUCROSE and HIGH-GI diets respectively. The HIGH-GI percentage change was significantly different from the other three diets (P<0·001). Despite being advised to maintain an identical energy intake there was a significant weight change (−0·27 (sem 0·3) kg; P<0·02) on the LOW-GI diet compared with the SUCROSE diet (+0·84 (sem 0·3) kg). In conclusion the HIGH-FAT diet had a beneficial effect on postprandial glucose and insulin over time but it was associated with higher postprandial concentrations of TG and NEFA. Conversely the HIGH-GI diet appeared to increase postprandial insulin resistance over the study period.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2003

References

Albano, JD, Ekins, RP, Maritz, G & Turner, RC (1972) A sensitive, precise radioimmunoassay of serum insulin relying on charcoal separation of bound and free hormone moieties. Acta Endocrinol (Copenhagen) 70, 487509.Google ScholarPubMed
Brynes, AE, Edwards, CMB, Ghatei, MA, Bloom, SR & Frost, GS (2002) Men at increased risk of coronary heart disease are not different to age and weight matched healthy controls in their postprandial triacylglyceride, non-esterified fatty acid or incretin response to sucrose. Metabolism 51, 195200.CrossRefGoogle ScholarPubMed
Coulston, AM, Hollenbeck, CB, Swislocki, AL, Chen, YD & Reaven, GM (1987) Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus. American Journal of Medicine 82, 213220.CrossRefGoogle ScholarPubMed
Coulston, AM, Hollenbeck, CB, Swislocki, AL & Reaven, GM (1989) Persistence of hypertriglyceridemic effect of low-fat high-carbohydrate diets in NIDDM patients. Diabetes Care 12, 94101.CrossRefGoogle ScholarPubMed
Department of Health (1994) Committee on Medical Aspects of Food Policy. Nutrition Aspects of Cardiovascular Disease. London: HMSO.Google Scholar
Despres, J-P, Lamarche, P, Mauriege, P, Cantin, B, Dagenais, GR, Sital, M & Lupien, P-J (1996) Hyperinsulinemia as an independent risk factor for ischemic heart disease. New England Journal of Medicine 334, 952957.CrossRefGoogle ScholarPubMed
FAO/WHO (1998) Carbohydrates in human health. Paper 66. Report of a joint FAO/WHO report Rome 14–18 April 1997. FAO Food and Nutrition.Google Scholar
Fontbonne, A, Charles, MA, Thibult, N, Richard, JL, Claude, JR, Warnet, JM, Rosselin, GE & Eschwege, E (1991) Hyperinsulinaemia as a predictor of coronary heart disease mortality in a healthy population: the Paris Prospective Study, 15-year follow-up. Diabetologia 34, 356361.CrossRefGoogle Scholar
Foster-Powell, K & Miller, JB (1995) International tables of glycaemic index. American Journal of Clinical Nutrition 62, 871S893S.CrossRefGoogle Scholar
Frayn, KN & Kingman, SM (1995) Dietary sugar and lipid metabolism in humans. American Journal of Clinical Nutrition 62, 250s263s.CrossRefGoogle ScholarPubMed
Frost, G, Leeds, AA, Dore, CJ, Madeiros, S, Brading, S & Dornhorst, A (1999) Glycaemic index as a determinant of serum HDL-cholesterol concentration. Lancet 27, 10451048.CrossRefGoogle Scholar
Frost, G, Wilding, J & Beecham, J (1994) Dietary advice based on the glycaemic index improves dietary profile and metabolic control in type 2 diabetic patients. Diabetic Medicine 11, 397401.CrossRefGoogle ScholarPubMed
Garg, A (1994) High-monounsaturated fat diet for diabetic patients. Is it time to change the current dietary recommendations? Diabetes Care 17, 242246.CrossRefGoogle ScholarPubMed
Garg, A, Bantle, JP, Henry, RR, Coulston, AM, Griver, KA, Raatz, SK, Brinkley, L, Chen, YD, Grundy, SM & Huet, BA et al. , (1994) Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus. Journal of the American Medical Association 271, 14211428.CrossRefGoogle ScholarPubMed
Gillum, RF (1994) Trends in acute myocardial infarction and coronary heart disease death in the United States. Journal of the American College of Cardiology 23, 12731277.CrossRefGoogle ScholarPubMed
Hokanson, JE & Austin, MA (1996) Plasma triglyceride level is a risk factor for cardiovascular disease independent of HDL cholesterol level: a meta-analysis of population based prospective studies. Journal of Cardiovascular Risk 3, 213219.CrossRefGoogle Scholar
Hu, F, Stampfer, MJ, Manson, JE, Grodstein, F, Colditz, GA, Speizer, FE & Willett, WC (2000) Trends in the incidence of coronary heart disease and changes in diet and lifestyle in women. New England Journal of Medicine 383, 530537.CrossRefGoogle Scholar
Jarvi, AE, Karstrom, BE, Granfeldt, Y, Bjorck, I, Asp, NG & Vessby, B (1999) Improved glycemic control and lipid profile and normalized fibrinolytic activity on a low-glycaemic index diet in type 2 diabetes. Diabetes Care 22, 1018.CrossRefGoogle Scholar
Jenkins, DJ, Wolever, TM, Taylor, RH, Barker, H, Fielden, H, Baldwin, JM, Bowling, AC, Newman, HC, Jenkins, AL & Goff, DV (1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. American Journal of Clinical Nutrition 34, 362366.CrossRefGoogle Scholar
Levy, J, Matthews, DR & Hermans, MP (1998) Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care 21, 21912192.CrossRefGoogle ScholarPubMed
Liu, S, Willett, WC, Stampfer, MJ, Hu, FB, Franz, M, Sampson, L, Hennekens, CH & Manson, JE (2000) A prospective study of dietary glycaemic load, carbohydrate intake, and risk of coronary heart disease in US women. American Journal of Clinical Nutrition 71, 14551461.CrossRefGoogle ScholarPubMed
Ludwig, DS (2000) Dietary glycaemic index and obesity. Journal of Nutrition 130, 280S283S.CrossRefGoogle ScholarPubMed
Ludwig, DS (2002) The glycaemic index: Physiological mechanisms relating to diabetes and cardiovascular disease. Journal of the American Medical Association 287, 24142423.CrossRefGoogle ScholarPubMed
McKeigue, PM, Ferrie, JE, Pierpoint, T & Marmot, MG (1993) Association of early-onset coronary heart disease in South Asian men with glucose intolerance and hyperinsulinemia. Circulation 87, 152161.CrossRefGoogle ScholarPubMed
Mensink, RP & Katan, MB (1990) Effect of dietary trans fatty acids on high-density and low-density lipoprotein cholesterol levels in healthy subjects. New England Journal of Medicine 323, 439445.CrossRefGoogle ScholarPubMed
Murray, CJL & Lopez, AD (1997) Mortality by cause for eight regions of the world: Global Burden of Disease. Lancet 349, 12691276.CrossRefGoogle ScholarPubMed
Parks, EJ & Hellerstein, MK (2001) Carbohydrate-induced hyper-triacylglycerolemia: historical perspective and review of biological mechanisms. American Journal of Clinical Nutrition 71, 412433.CrossRefGoogle Scholar
Raben, A, Holst, J, Madsen, J & Astrup, A (2001) Diurnal metabolic profiles after 14 d of an ad libitum high starch, high sucrose or high fat diet in normal-weight never obese and postobese women. American Journal of Clinical Nutrition 73, 177189.CrossRefGoogle ScholarPubMed
Reaven, GM (1995) The fourth musketeer – from Alexandre Dumas to Claude Bernard. Diabetologia 38, 313.CrossRefGoogle Scholar
Reaven, GM (1997) Do high carbohydrate diets prevent the development or attenuate the manifestations (or both) of syndrome X? A viewpoint strongly against. Current Opinion in Lipidology 8, 2327.CrossRefGoogle ScholarPubMed
Sciarrone, SE, Strahan, MT, Beilin, LJ, Burke, V, Rogers, P & Rouse, IR (1993) Ambulatory blood pressure and heart rate responses to vegetarian meals. Journal of Hypertension 11, 277285.CrossRefGoogle ScholarPubMed
Turner, RC, Holman, RR, Matthews, DR, Hockaday, TD & Peto, J (1979) Insulin deficiency and insulin resistance interaction in diabetes: estimation of their relative contribution by feedback analysis from basal plasma insulin and glucose concentrations. Metabolism 28, 10861096.CrossRefGoogle ScholarPubMed
Williams, CM (1997) Postprandial lipid metabolism: effects of dietary fatty acids. Proceedings of the Nutrition Society 56, 679692.CrossRefGoogle ScholarPubMed
Wood, D, Durrington, P, Poulter, N, McInnes, G, Rees, A & Wray, R (1998) Joint British recommendations on prevention of coronary heart disease in clinical practice. Heart 80, s1s26.Google Scholar