High-monounsaturated fat, olive oil-rich diet has effects similar to a high-carbohydrate diet on fasting and postprandial state and metabolic profiles of patients with type 2 diabetes.
Whether metabolic control in type 2 diabetes mellitus (DM) is best achieved with the traditional high-carbohydrate (CHO), low-fat diet or a low-CHO, high-fat diet is still controversial. In a randomized crossover study, we compared the effects of a low-fat (30% of daily energy) diet and a high-fat (40% of daily energy), high-monounsaturated-fat diet for 6 weeks each on fasting and postprandial glucose, insulin, and lipoprotein concentrations in 12 patients with well-controlled type 2 DM (fasting blood glucose, 176 +/- 54 mg/dL; hemoglobin A1c, 6.4% +/- 0.7%) and no overt dyslipidemia (serum total cholesterol, 235 +/- 43 mg/dL; triglycerides, 180 +/- 63 mg/dL). Home-prepared foods were used and olive oil was the main edible fat, accounting for 8% and 25% of daily energy requirements in the low-fat and high-fat diets, respectively. For postprandial studies, the same mixed meal containing 36% fat was used in both dietary periods. Body weight and fasting and 6-hour postprandial blood glucose, insulin, and lipoprotein levels were similar after the two diets. The mean incremental area under the curve of serum triglycerides 0 to 6 hours after the challenge meal, adjusted for baseline levels, did not change significantly after the high-fat diet compared with the low-fat diet (1,484 +/- 546 v 1,714 +/- 709 mg x 6 h/dL, respectively, P = .099). Mean postprandial triglyceride levels at 6 hours were increased about 2 times over fasting levels and were still greater than 300 mg/dL after either diet. A diet high in total and monounsaturated fat at the expense of olive oil is a good alternative diet to the traditional low-fat diet for patients with type 2 DM. However, ongoing postprandial hypertriglyceridemia with either diet points to the need for other therapies to decrease triglyceride-rich lipoproteins (TRL) and the inherent atherogenic risk in type 2 diabetics.
Rodríguez-Villar
C
C
Lipid Clinic, Nutrition and Dietetics Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic i Provincial, Barcelona, Spain.
Manzanares
J M
JM
Casals
E
E
Pérez-Heras
A
A
Zambón
D
D
Gomis
R
R
Ros
E
E
D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage* / Q000494:pharmacology; D005215:Fasting / Q000378:metabolism*; D006801:Humans; D000069463:Olive Oil; D010938:Plant Oils / Q000008:administration & dosage* / Q000494:pharmacology; D019518:Postprandial Period / Q000502:physiology*; D014280:Triglycerides / Q000097:blood
D004040:Dietary Carbohydrates; D004042:Dietary Fats, Unsaturated; D000069463:Olive Oil; D010938:Plant Oils; D014280:Triglycerides