title: Improvement of insulin sensitivity by isoenergy high carbohydrate traditional Asian diet: a randomized controlled pilot feasibility study.
abstract: The prevalence of diabetes is rising dramatically among Asians, with increased consumption of the typical Western diet as one possible cause. We explored the metabolic responses in East Asian Americans (AA) and Caucasian Americans (CA) when transitioning from a traditional Asian diet (TAD) to a typical Western diet (TWD), which has not been reported before. This 16-week randomized control pilot feasibility study, included 28AA and 22CA who were at risk of developing type 2 diabetes. Eight weeks of TAD were provided to all participants, followed by 8 weeks of isoenergy TWD (intervention) or TAD (control). Anthropometric measures, lipid profile, insulin resistance and inflammatory markers were assessed. While on TAD, both AA and CA improved in insulin AUC (-960.2 µU/mL × h, P = 0.001) and reduced in weight (-1.6 kg; P<0.001), body fat (-1.7%, P<0.001) and trunk fat (-2.2%, P<0.001). Comparing changes from TAD to TWD, AA had a smaller weight gain (-1.8 to 0.3 kg, P<0.001) than CA (-1.4 to 0.9 kg, P = 0.001), but a greater increase in insulin AUC (AA: -1402.4 to 606.2 µU/mL × h, P = 0.015 vs CA: -466.0 to 223.5 µU/mL × h, P = 0.034) and homeostatic static model assessment-insulin resistance (HOMA-IR) (AA: -0.3 to 0.2, P = 0.042 vs CA: -0.1 to 0.0, P = 0.221). Despite efforts to maintain isoenergy state and consumption of similar energy, TAD induced weight loss and improved insulin sensitivity in both groups, while TWD worsened the metabolic profile.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00379548.
authors.affiliation: Asian American Diabetes Initiative, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: William C
authors.initials: WC
authors.lastname: Hsu
authors.affiliation: Asian American Diabetes Initiative, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Ka Hei Karen
authors.initials: KH
authors.lastname: Lau
authors.affiliation: R&D Department, Sunstar Inc., Osaka, Japan.
authors.forename: Motonobu
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Asian American Diabetes Initiative, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Dalia
authors.initials: D
authors.lastname: Moghazy
authors.affiliation: Dianne Nunnally Hoppes Laboratory for Diabetes Complications, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Hillary
authors.initials: H
authors.lastname: Keenan
authors.affiliation: Asian American Diabetes Initiative, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, United States of America; Dianne Nunnally Hoppes Laboratory for Diabetes Complications, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: George L
authors.initials: GL
authors.lastname: King
mesh_terms: D000328:Adult; D001213:Asian; D050260:Carbohydrate Metabolism; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D004032:Diet; D004040:Dietary Carbohydrates; D005240:Feasibility Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D010865:Pilot Projects; D012307:Risk Factors; D044465:White People
chemical_list: D004040:Dietary Carbohydrates