title: Realistic changes in monounsaturated fatty acids and soluble fibers are able to improve glucose metabolism.
abstract: OBJECTIVE
  Cardioprotective effects of Mediterranean-style diet have been shown. Instead of excluding foods, replacement or addition may facilitate compliance with impact on glucose metabolism of individuals at cardiometabolic risk. This study investigated the effect of changing selected nutrients intake on glucose metabolism during a lifestyle intervention tailored to living conditions of prediabetic Brazilians.
  
  
  METHODS
  183 prediabetic adults treated under the Brazilian public health system underwent an 18-month intervention on diet and physical activity. Dietary counseling focused on reducing saturated fat replaced by unsaturated fatty acids. Data were collected at baseline and after follow-up. ANOVA and multiple linear regression were used to test association of changes in nutrients intake with changes in plasma glucose.
  
  
  RESULTS
  Changes in fasting and 2-h plasma glucose but not in weight, HOMA-IR or C-reactive protein decreased after intervention across tertiles of MUFA changes (p-trend 0.017 and 0.024, respectively). Regression models showed that increase in MUFA intake was independently associated with reduction in fasting (β -1.475, p = 0.008) and 2-h plasma glucose (β -3.321, p = 0.007). Moreover, increase in soluble fibers intake was associated with decrease in fasting plasma glucose (β -1.579, p = 0.038). Adjustment for anthropometric measurements did not change the results but did after including change in insulin in the models.
  
  
  CONCLUSIONS
  Increases of MUFA and soluble fibers intakes promote benefits on glucose metabolism, independently of adiposity, during a realistic lifestyle intervention in at-risk individuals. Mechanisms mediating these processes may include mainly insulin sensitivity improvement.
authors.affiliation: Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
authors.forename: Camila Risso
authors.initials: CR
authors.lastname: de Barros
authors.affiliation: Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Cezaretto
authors.affiliation: Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
authors.forename: Maíra Ladeia Rodrigues
authors.initials: ML
authors.lastname: Curti
authors.affiliation: Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
authors.forename: Milena Monfort
authors.initials: MM
authors.lastname: Pires
authors.affiliation: Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
authors.forename: Luciana Dias
authors.initials: LD
authors.lastname: Folchetti
authors.affiliation: Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
authors.forename: Antonela
authors.initials: A
authors.lastname: Siqueira-Catania
authors.affiliation: Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
authors.forename: Sandra Roberta Gouvea
authors.initials: SR
authors.lastname: Ferreira
keywords: Fiber intake; Glucose metabolism; Lifestyle intervention; Monounsaturated fatty acids