Limits...
A randomized cross-over trial of the postprandial effects of three different diets in patients with type 2 diabetes.

Fernemark H, Jaredsson C, Bunjaku B, Rosenqvist U, Nystrom FH, Guldbrand H - PLoS ONE (2013)

Bottom Line: The test meals were consumed at a diabetes ward under supervision.Twenty-one participants were recruited and 19 completed the studies.The large Mediterranean-style lunch-meal induced similar postprandial glucose-elevations as the low-fat meal despite almost double amount of calories due to a pronounced insulin-increase.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical and Health Sciences, Faculty of Health Science, Linköping University, Linköping, Sweden.

ABSTRACT

Background: In the clinic setting both fasting levels of glucose and the area under the curve (AUC) of glucose, by determination of HbA1c levels, are used for risk assessments, in type 2 diabetes (NIDDM). However little is known about postprandial levels, and hence AUC, regarding other traditional risk factors such as insulin and blood-lipids and how this is affected by different diets.

Objective: To study postprandial effects of three diets, during a single day, in NIDDM.

Methods: A low-fat diet (45-56 energy-% from carbohydrates), and a low-carbohydrate diet (16-24 energy-% from carbohydrates) was compared with a Mediterranean-style diet (black coffee for breakfast and the same total-caloric intake as the other two diets for lunch with red wine, 32-35 energy-% from carbohydrates) in a randomized cross-over design. Total-caloric intake/test-day at the clinic from food was 1025-1080 kCal in men and 905-984 kCal in women. The test meals were consumed at a diabetes ward under supervision.

Results: Twenty-one participants were recruited and 19 completed the studies. The low-carbohydrate diet induced lower insulin and glucose excursions compared with the low-fat diet (p<0.0005 for both AUC). The insulin-response following the single Mediterranean-style lunch-meal was more pronounced than during the low-fat diet lunch (insulin increase-ratio of the low-fat diet: 4.35 ± 2.2, of Mediterranean-style diet: 8.12 ± 5.2, p = 0.001) while postprandial glucose levels were similar. The increase-ratio of insulin correlated with the elevation of the incretin glucose-dependent insulinotropic-polypeptide following the Mediterranean-style diet lunch (Spearman, r = 0.64, p = 0.003).

Conclusions: The large Mediterranean-style lunch-meal induced similar postprandial glucose-elevations as the low-fat meal despite almost double amount of calories due to a pronounced insulin-increase. This suggests that accumulation of caloric intake from breakfast and lunch to a single large Mediterranean style lunch-meal in NIDDM might be advantageous from a metabolic perspective.

Trial registration: ClinicalTrials.gov NCT01522157 NCT01522157.

Show MeSH

Related in: MedlinePlus

CONSORT Flow Diagram.Abbreviations: LF, low-fat diet; LC, low-carbohydrate diet; M, Mediterranean diet.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3842308&req=5

pone-0079324-g001: CONSORT Flow Diagram.Abbreviations: LF, low-fat diet; LC, low-carbohydrate diet; M, Mediterranean diet.

Mentions: Twenty-one patients with diabetes were recruited for the study initially, by local advertising and by direct contact from the study organizers with potentially suitable patients. The study was conducted from February 6 2012 to April 2 2012. In two of the participants it was very difficult to obtain repeated venous blood samples during the first or the second experimental day, and further participation was judged to be impossible. Hence, these participants were excluded from further participation. The remaining 19 participants completed all three experimental days and the baseline characteristics of these patients are shown in Table 2. Figure 1 shows a flowchart of the study. The elapsed time period between each meal varied from 44 hours to 31 days with a mean value of 12±7 days.


A randomized cross-over trial of the postprandial effects of three different diets in patients with type 2 diabetes.

Fernemark H, Jaredsson C, Bunjaku B, Rosenqvist U, Nystrom FH, Guldbrand H - PLoS ONE (2013)

CONSORT Flow Diagram.Abbreviations: LF, low-fat diet; LC, low-carbohydrate diet; M, Mediterranean diet.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3842308&req=5

pone-0079324-g001: CONSORT Flow Diagram.Abbreviations: LF, low-fat diet; LC, low-carbohydrate diet; M, Mediterranean diet.
Mentions: Twenty-one patients with diabetes were recruited for the study initially, by local advertising and by direct contact from the study organizers with potentially suitable patients. The study was conducted from February 6 2012 to April 2 2012. In two of the participants it was very difficult to obtain repeated venous blood samples during the first or the second experimental day, and further participation was judged to be impossible. Hence, these participants were excluded from further participation. The remaining 19 participants completed all three experimental days and the baseline characteristics of these patients are shown in Table 2. Figure 1 shows a flowchart of the study. The elapsed time period between each meal varied from 44 hours to 31 days with a mean value of 12±7 days.

Bottom Line: The test meals were consumed at a diabetes ward under supervision.Twenty-one participants were recruited and 19 completed the studies.The large Mediterranean-style lunch-meal induced similar postprandial glucose-elevations as the low-fat meal despite almost double amount of calories due to a pronounced insulin-increase.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical and Health Sciences, Faculty of Health Science, Linköping University, Linköping, Sweden.

ABSTRACT

Background: In the clinic setting both fasting levels of glucose and the area under the curve (AUC) of glucose, by determination of HbA1c levels, are used for risk assessments, in type 2 diabetes (NIDDM). However little is known about postprandial levels, and hence AUC, regarding other traditional risk factors such as insulin and blood-lipids and how this is affected by different diets.

Objective: To study postprandial effects of three diets, during a single day, in NIDDM.

Methods: A low-fat diet (45-56 energy-% from carbohydrates), and a low-carbohydrate diet (16-24 energy-% from carbohydrates) was compared with a Mediterranean-style diet (black coffee for breakfast and the same total-caloric intake as the other two diets for lunch with red wine, 32-35 energy-% from carbohydrates) in a randomized cross-over design. Total-caloric intake/test-day at the clinic from food was 1025-1080 kCal in men and 905-984 kCal in women. The test meals were consumed at a diabetes ward under supervision.

Results: Twenty-one participants were recruited and 19 completed the studies. The low-carbohydrate diet induced lower insulin and glucose excursions compared with the low-fat diet (p<0.0005 for both AUC). The insulin-response following the single Mediterranean-style lunch-meal was more pronounced than during the low-fat diet lunch (insulin increase-ratio of the low-fat diet: 4.35 ± 2.2, of Mediterranean-style diet: 8.12 ± 5.2, p = 0.001) while postprandial glucose levels were similar. The increase-ratio of insulin correlated with the elevation of the incretin glucose-dependent insulinotropic-polypeptide following the Mediterranean-style diet lunch (Spearman, r = 0.64, p = 0.003).

Conclusions: The large Mediterranean-style lunch-meal induced similar postprandial glucose-elevations as the low-fat meal despite almost double amount of calories due to a pronounced insulin-increase. This suggests that accumulation of caloric intake from breakfast and lunch to a single large Mediterranean style lunch-meal in NIDDM might be advantageous from a metabolic perspective.

Trial registration: ClinicalTrials.gov NCT01522157 NCT01522157.

Show MeSH
Related in: MedlinePlus